RedScrubs
The Resource for Medical Professionals

Bitter melon is a fruit used in cooking around the world. It has been used historically as a treatment modality for diabetes and as a stimulant for digestion, dyspepsia, constipation, demulcent and as an inflammation modulator. It has been theorized to contain bioactive compounds effective for treating HIV infection. These compounds have been identified as glycoprotein lectins.

Diabetes is a disease that comes with complications. These complications can include heart disease, stroke, eye damage, chronic kidney disease, foot amputations – complications that can cost a person with type 2 diabetes about $10,000 per year. In a one of a kind report issued last year, we were able to take a look at how many complications occur in an individual with type 2 diabetes.

A study recently published in JAMA express highlighted the comparison between two diabetic treatments on progression of coronary atherosclerosis in patients with type 2 diabetes. Up until this point, no study has shown an antidiabetic regimen to reduce the progression of atherosclerosis.

Commonly used glucose lowering agents include the sulfonyureas (ie. Glimerpiride), which are insulin secretagogues and thiazolidinediones, which are insulin sensitizers.

A recent article published in the British Medical Journal (BMJ) is disputing the NICE guidelines established by the National Institute for Health and Clinical Excellence for women who are hyperglycemic during preconception to the postnatal period. NICE essentially states that screening for gestational diabetes should be by risk factor alone. The article acknowledges that NICE is aware that this approach has poor sensitivity and specificity compared with universal administration of the oral glucose tolerance test. However, in the guidelines that NICE expresses, this method misses nearly half of the women with gestational diabetes, particularly those with mild gestational diabetes.

The American Heart Association (AHA) released a scientific position paper in the Journal Circulation, in March, 2008 on the role of high blood sugars and Acute Coronary Syndrome (ACS). Hyperglycemia, although frequently documented in ACS patients, remains largely unappreciated as a risk factor and is undertreated in both the acute care and outpatient care settings. The researchers believe this is due largely in part to a lack of evidence-based research.

Sirtis, a biopharmaceutical company, announced on March 21, 2008, the first patent covering a broad class of compounds that activate the enzyme SIRT1, a new class of chemical compounds that lower glucose and improve insulin sensitivity. The patent covers the first new chemical entities (NCEs) that Sirtis plans to take to human trials the first half of 2008.

Research highlighting the high cost of diabetes is likely to be helpful in terms of policy debates and decision making in addressing health care and prevention issues associated with diabetes. A 2008 update on the costs of diabetes care revealed that we have spent an estimated $174 billion dollars in 2007 including $116 billion dollars in excess medical expenditures and $58 billion dollars in reduced productivity.

The leaves of the Banaba plant have been consumed traditionally in the Phillipines for the treatment of diabetes for years. Scientists, curious about this activity, decided to strike out and find the active components in this plant and to see if it really did have an effect on diabetes.

The American Diabetes Association has revised its medical nutrition therapy guidelines from those published in 2002 and 2004. The entire set of revised guidelines may be found in the January issue of Diabetes Care, 2008.