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Diabetes Treatments Offer Cardiovascular Benefits

Diabetes Treatments Offer Cardiovascular Benefits

Tuesday, September 3, 2013. An article published online on August 26, 2013 in the Journal of Clinical Endocrinology & Metabolism reports the finding of Ronald Goldberg, MD of the University of Miami and his associates of a positive effect for the antidiabetic drug metformin or lifestyle interventions in reducing risk factors for cardiovascular disease in adults with impaired glucose tolerance, who are at increased risk of developing type 2 diabetes.

The current study included 1645 participants in the Diabetes Prevention Program who were randomized to receive metformin, a placebo, or an intensive program of lifestyle modification (which had the goal of producing 7% weight loss by combining a low fat diet with increased physical activity). Blood samples collected at the beginning of the study and after one year were analyzed for lipids and other factors.

At the end of the treatment period, participants in the metformin intervention and the lifestyle modification program had lower levels of small and dense low-density lipoprotein (LDL) particles and increases in high-density-lipoproteins (HDL). Those following the lifestyle program also experienced a reduction in triglycerides as well as large and buoyant VLDL particles. These changes could help reduce the risk of atherosclerosis, a common complication of diabetes.

"Cardiovascular disease is the most significant cause of death and disability in people with diabetes," noted Dr Goldberg, who is affiliated with the University of Miami's Miller School of Medicine. "Our findings demonstrate that the same therapies used to slow the onset of diabetes also may help allay the risk of heart disease."

"We show for the first time in a year-long study involving a large, multiethnic high-risk group that intensive lifestyle change and metformin treatments, previously demonstrated to slow diabetes development, also produced widespread and mostly favorable alterations in lipoprotein subfractions, using techniques that yielded corroborative changes in size and density," the authors announce. "The findings offer optimism that these interventions in addition to slowing diabetes development may also slow progression of atherosclerosis.

"Preventing or slowing the development of diabetes with these treatments also improves the cholesterol and triglyceride profile of a person's blood," Dr Goldberg affirmed. "Thanks to the added benefits of existing diabetes interventions, we stand a better chance of lowering the risk of heart disease in this patient population."

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Type 2 diabetes increases, metformin decreases Parkinson's disease risk

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In an article published online on April 10, 2012 in the journal Parkinsonism and Related Disorders, researchers from Taiwan report a benefit for the drug metformin in reducing the risk of Parkinson's disease in diabetic patients, who are at increased risk of developing Parkinson's. Metformin, which is derived from the French lilac known as Galega officinalis, has been used to treat diabetes for a number of years and has recently been associated with other benefits, including the prevention of cardiovascular mortality and some cancers.

Mark Wahlqvist of Taiwan's National Health Research Institutes and his colleagues analyzed data from 800,000 men and women included in the Taiwan National Health Insurance database from 1996 to 2007, which provided information on the presence of diabetes and Parkinson's disease, and the use of oral antihyperglycemic drugs, including sulfonylurea drugs and metformin. Subjects with type 2 diabetes were age- and gender-matched with those who were free of the disease.

The risk of developing Parkinson's disease among diabetics was more than double that of nondiabetics, however, treatment with oral antidiabetic drugs significantly reduced the risk. Nevertheless, when drug treatment was broken down according to the type of drug used, treatment with sulfonylureas was associated with an increase in Parkinson's disease risk and metformin with a decrease, either alone or in combination with sulfonylurea drugs. For those who initiated metformin treatment first without insulin, the risk of Parkinson's disease diminished by 60 percent.

A suggested mechanism for metformin in Parkinson's disease prevention is a resetting of energy metabolism regulation in the cells, similar to what would be expected to result from diet and exercise.

"An exciting aspect of the finding is that metformin seems to be working to protect the brain against neurodegeneration which contributes to Parkinsonism," Dr Walhqvist enthused. "This means it may also be considered a relevant therapy for the prevention of dementia as well."

Life Extension Magazine® September 2013 Issue Now Online!

Life Extension Magazine September, 2013

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