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Health Headlines - June 7

Posted Oct 23 2008 2:24pm
Female Hormone May Prevent Type 1 Diabetes

New animal research suggests that a naturally produced estrogen hormone known as estradiol might help protect against diabetes by preventing the death of pancreatic cells critical to the production of insulin.

The findings are based on work with mice and have not yet been tried in a human trial.

"This is the first study that shows that the female hormone estrodial is important to ensuring pancreatic beta-cell survival in both females and males," said study co-author Dr. Franck Mauvais-Jarvis. He is an assistant professor with the department of molecular and cellular biology and the department of medicine in the division of diabetes, endocrinology & metabolism at Baylor College of Medicine in Houston.

Almost 21 million Americans are currently living with diabetes, according to the American Diabetes Association.

Most people with diabetes have what's known as the type 2 form of the disease, which results from the body's inability to properly use the naturally produced hormone insulin to regulate blood sugar levels by processing sugars into energy.

However, between 5 percent and 10 percent of diabetics have a version of the disease known as type 1 diabetes, in which the body doesn't produce any insulin.

Focusing on type 1 diabetes, Mauvais-Jarvis and his colleagues noted that the body's inability to produce insulin is driven by the death of insulin-producing pancreatic beta-cells.

In an attempt to isolate estradiol's potential impact on pancreatic beta-cell destruction, the researchers worked with both male and female mice that were either unable to produce estradiol, lacked an estrogen receptor needed for normal estradiol functioning, or were given a compound that prevented the estrogen receptors from working.

Reporting in this week's issue of the Proceedings of the National Academy of Sciences, the researchers said that both genders of mice experienced severe beta-cell death while demonstrating dramatically lower-than-normal levels of insulin production -- leading to the onset of type 1 diabetes.

However, Mauvais-Jarvis and his team found that after administering targeted doses of estradiol, the pancreatic beta-cells were "rescued" from death, insulin production resumed, and diabetes was averted.

The researchers concluded that -- at least in mice -- estradiol appears to offer protection against the chain of events that lead to type 1 diabetes.

Mauvais-Jarvis was cautiously optimistic that the work with mice might one day translate into a benefit for humans at risk for diabetes.

"One has to be cautious, because this study has been performed in mice, and although the mouse is the best available model to study human diseases, mice are not humans," he said.

Still, Mauvais-Jarvis said the study indicates that estradiol may offer a new clinical route for the prevention of diabetes in women and men.

"That's a novel paradigm," he said. "Thirty years ago, it was believed that sex hormones were involved only in reproduction and sexual behavior. But in the last 10 years, there has been a kind of challenge to this concept, and we have discovered novel functions regarding estrodial -- such as the prevention of beta-cell death -- that have been revealed to be true for both sexes."

Mauvais-Jarvis stressed, however, that offering patients estrogen-replacement therapy wasn't an option, given recent findings that such treatment appears to elevate the risk of breast cancer in women.

Rather, he suggested that "the future is try to dissect the good and the bad uses of estrodial," in an effort to develop medicines that could prevent beta-cell deaths and diabetes without harmful side effects.

Dr. Robert Rizza, a professor of medicine at the Mayo Clinic, and president of the American Diabetes Association, called the new findings "intriguing."

"There have been various studies that have shown that estrogen may lower the risk for developing diabetes, and this study shows why this might be the case," he sad. "This could be a mechanism."

"It may or may not be true for humans," Rizza added. "But it will teach us more about how estrogen works. And if it turns out to be the case, this could be used for other novel therapies to prevent diabetes."

Biggest Specialty Drug Spending Increase Found With Anti-Inflammatories

Americans spent 33.9 percent more in 2005 on anti-inflammatories -- the biggest percentage increase in any specialty drug category, a new U.S. report finds.

Drugs used to treat anti-inflammatory diseases -- such as rheumatoid arthritis -- include the injectable brands Enbrel, Humira, Kineret and Remicade. These drugs have an average cost of $1,417 per prescription and comprise more than 19 percent of the yearly total that most patients are allowed to spend on a specialty drug in a drug benefit plan.

The biggest reason for this dramatic increase in spending for these drugs? According to the 2006 Express Scripts Specialty Drug Trend Report, treatments for inflammatory diseases such as rheumatoid arthritis are beginning earlier in a patient's life and lasting longer. Additional uses for medications -- such as Enbrel being used to treat psoriasis -- are also causing more patients to use these drugs.

Costs seem to be somewhat controlled with a reported increase in specialty pharmacy usage -- up 77 percent in 2005. Home prescription deliveries decreased by 30 percent, while local pharmacy pickups decreased by 2 percent.

"Enhanced patient-care models and management programs offered by specialty pharmacies encourage therapy adherence, helping to improve outcomes while reducing overall treatment costs," Dr. Steve Miller, chief medical officer of Express Script's CuraScript, said in a prepared statement.

Other statistics noted in the report:

After anti-inflammatories, the class of drugs used to treat multiple sclerosis experienced the next largest increase, at 11.7 percent per prescription.
Inflation pushed anti-cancer drugs to an average of almost $1,600 per prescription, and drugs for treating anemia saw a 6 percent increase in spending.
Technology advancements in tests and screenings drove the use of growth hormone replacement drugs to increase by 10 percent.
Anticoagulant usage increased 21.4 percent -- but future generic alternatives to some expensive brands in this category could help curtail these costs.
Reduced utilization caused a decrease in spending for infertility drugs by 3.9 percent, and specialty antiviral drugs saw a decrease of 6.7 percent.

Health Tip: Be Careful About Herbal Supplements

The makers of herbal supplements say they can treat or prevent a host of conditions and symptoms, including arthritis, headaches and colds. But you should do your homework when selecting herbal supplements for what ails you, the American Academy of Family Physicians warns.

Although herbal supplements may contain natural ingredients, the AAFP says some of these products also contain potential allergens and chemicals that can make you sick -- and they aren't necessarily listed on the product's label.

Certain people should be especially careful about taking herbal supplements, including those with diabetes, high blood pressure, epilepsy, blood clotting problems, Parkinson's, heart disease, liver or thyroid problems. People with psychiatric conditions or conditions of the immune system also should be particularly cautious, the academy warns.

Health Tip: Bad Breath Isn't Always a Harmless Problem

Although halitosis (bad breath) usually is nothing more than a harmless reflection of what you've eaten, sometimes it's a sign of a serious dental or medical condition, the American Dental Association says.

Halitosis could indicate chronic bronchitis or sinusitis, postnasal drip, gastrointestinal illness, and liver or kidney disease, the ADA warns.

If watching the foods you eat and brushing and flossing regularly do not control halitosis, the ADA recommends talking to your dentist about any other conditions that may be responsible, including periodontal disease. If your dentist doesn't find a cause, you should talk with your doctor.

Health Tip: Scleroderma Characterized by Hardening of the Skin

Scleroderma, an autoimmune disorder whose primary symptom is hardening of the skin, affects up to four times as many women than men. It also tends to strike people between ages 25 and 55, although it can occur at any age.

The cause of scleroderma is unknown, says the Scleroderma Foundation. The severity of the disease depends on which body parts are affected, and how early and appropriately the condition is treated.

Treatments often are directed at individual symptoms, including gastrointestinal problems, joint pain and high blood pressure.

Scleroderma, affecting about 300,000 people in the United States, isn't infectious, contagious or cancerous, the foundation says.

Health Tip: What to Expect After LASIK

If you're considering LASIK eye surgery, you may be wondering how quickly you'll see the results.

The Eye Surgery Education Council says that although many patients see improved vision immediately or the day after surgery, the full improvement may not be seen for up to a few months.

Side effects -- including dry eyes, blurry vision and reduced night vision -- are not uncommon and are usually temporary after LASIK surgery. Most of these symptoms clear up on their own. If they don't, the eye council recommends talking to your doctor.
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