Diabetes and the PancreasThe New Epidemic

William J. Hennen, PhDChief Scientific Officer

Brent Vaughan, MS RDR&D Scientist

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Diabetes Mellitus

Singapore

Year % population with diabetes

1975 1.5

1984 4.7

1992 8.6

1998 9.6

The New Epidemic

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Diabetes Mellitus

MalaysiaYear % population with diabetes1960 0.61982 2.11995 7.71996 8.32004 9.0

The New Epidemic

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Diabetes Mellitus

• Number of people with diabetes is on the rise.

The New Epidemic

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Ethic differences

In Malaysia and Singapore, diabetes is most common in Indians ( 16 % ), followed by Malays ( 4.7 % ) and then Chinese ( limited data ).

Latest update!!

• World Health Organization survey on worldwide Diabetic population in 1997 is 135 million and estimated that by 2025 to be 300 million.

Latest update!!

• Population of diabetics in Singapore is 300,000.

Latest update!!

• 1 in 3 people in their 60’s will get diabetes.

• Accounts for 1 in 10 deaths in Singapore.

Cost $$$$• Costs depends on how serious the

disease is.• A diabetic person spends $ 1,600/yr on

unsubsidized specialist outpatient care in public hospital.

• He spends $ 650/yr for subsidized outpatient care at a polyclinic.

• If his kidney fails, he will have to pay $ 12,400 / year for dialysis and diabetic treatment.

Latest update!!

• Surveys have shown that for every two known diabetics, there is at least one who never knew of having the disease

• Type 2 diabetes is no longer seen as a disease of the middle age or old age. Children as young as 10 years suffering from ( Type1 & Type 2 ) are uncommon now

Diabetes Mellitus

• Far reaching effects–Non-traumatic amputations (60% or

56,000)–Blindness ( 53 %)–Kidney disease (40% of all new

cases)–200%-400% increased risk of

cardiovascular disease

The New Epidemic

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Blood Glucose

• Stress

• General health

• Activity

• Consumption of food

Factors

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Diabetes Mellitus

• Children and adolescents (age <40)

• Frequent drinking, eating, urination

• Autoimmune• Requires insulin

Type I (5-10%)

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Diabetes Mellitus

• Late onset, usually age >40

• Insulin resistance and/or decreased insulin production

• Requires insulin in late stages

• Possible genetic link

• Immune component

Type II (90-95%)

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Diabetes Mellitus

• Vision (cataracts and glaucoma)

• Kidneys (loss of kidney function)

• Nerves (loss of sensation in hands and feet)

• Heart/Circulation (increased risk of heart attack and stroke, poor circulation)– Leading cause of death among diabetics.

Secondary Conditions

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Diabetes and Supplements

• Transfer Factor

• Fenugreek

• Bitter melon

• Gymnema

• Indian kino

• Korean ginseng

• Alpha Lipoic Acid

• Chromium

• Vanadium

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Diabetes and Supplements

• Reduced blood sugar in mice. (Biotherapy. 1996;9(1-3):149-57)

• Type I diabetes has a dominant autoimmune component. (J Clin Invest. 2004 Feb;113(3):451-63.)

– May be initiated through viral infections. (J Immunol. 2004 Mar 1;172(5):3173-80.)

• Increased immune activation and low-grade inflammation in type II diabetes.

(Diabetes Care. 2004 Mar;27(3):813-23.)

– Autoimmune mechanism possible. (Minerva Endocrinol. 2003 Dec;28(4):297-312.)

Transfer Factor - Immunity

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Diabetes and Supplements

• Stimulates ß-cell activity.

(Am J Physiol 1999 Oct;277(4 pt 1):E617-23.;Diabetes 1998 Feb;47(2):206-10.)

• Synergistic effect with vanadium: lowering dose and improving safety.

(Indian J Exp Biol 1999 Feb;37(2):193-5.;Indian J Exp Biol 1999 Feb;37(2):196-9.)

• Lowers plasma glucose.

(East Mediterr Health J 2000 Jan;6(1):83-8.;Eur J Clin Nutr 1988 Jan;42(1):51-4.)

Fenugreek (Trigonella foenum-graecum)

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Diabetes and Supplements

• Improved glucose utilization in humans; lowering fasting and meal-time levels.

(J Ethnopharmacol 1986 Sep;17(3):277-82.;Bangladesh Med Res Counc Bull 1999 Apr;25(1):11-3.)

• May have insulin-like or insulin-stimulating action. (Int J Biochem 1989;21(2):149-55.;J Ethnopharmacol 1985 Jul;13(3):313-21.)

• May help repair damaged ß cells. (J Ethnopharmacol 2000 Nov;73(1-2):71-9.; Diabetes Res Clin Pract 1998 Jun;40(3):145-51.)

• Lowers synthesis of glucose. (Biochem J 1993 May 15;292(pt1):267-70.)

Bitter Melon (Momordica charantia)

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Diabetes and Supplements

• Lowered plasma glucose in both type I and type II diabetics.

(J Ethnopharmacol 1990 Oct;30(3):295-300.; J Ethnopharmacol 1990 Oct;30(3):281-94.)

• Increased insulin release. (J Endocrinol 1999 Nov;163(2):207-12.)

• Decreased glucose absorption. (J Vet Med Sci 1997 Apr;59(4):245-51.)

Gymnema (Gymnema sylvestre)

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Diabetes and Supplements

• Insulin-like properties (Acta Diabetol Lat 1989 Oct-Dec;26(4):291-300.)

• Lowers plasma glucose. (J Ethnopharmacol 2002 Jan;79(1):95-100.; J Nat Prod 1983 Mar-Apr;46(2):232-4.)

• Able to reverse experimentally-induced diabetes in animals.

(J Nat Prod 1983 Mar-Apr;46(2):232-4.)

Indian Kino (Pterocarpus marsupium)

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Diabetes and Supplements

• Benefits in both short-term and long-term plasma glucose control in humans. (Diabetes Care 1995 Oct;18(10):1373-1375)

– Possibly due to increased insulin sensitivity and/or secretion.

– Other research suggests effects on glucose receptors and enzymes.

(J Pharmacobiodyn 1981 Jun;4(6):410-417; Biol Pharm Bull 1996 Sep;19(9):1238-1240)

Korean Ginseng (Panax ginseng)

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Diabetes and Supplements

• May increase insulin sensitivity. (Diabetes Care 1999 Feb;22(2):280-7.)

• May prevent or reduce the symptoms of nerve damage.

(Diabetes Care 2003 Mar;26(3):770-6.;Bull Exp Biol Med 2000 Oct;130(10):986-90.)

–Improves peripheral nerve conduction

–Antioxidant properties.

Alpha Lipoic Acid

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Diabetes and Supplements

• Improves diabetic glucose levels w/o affecting individuals with normal or low blood sugar.– Increases insulin receptor numbers and

insulin binding at the receptor. (J Am Coll Nutr. 1999 Feb;18(1):6-12.;J Am Coll Nutr. 1998 Dec;17(6):548-55.)

– 1-2 months of dosing may be necessary

• Lowers serum insulin and

glycosylated hemoglobin levels. (J Fam Pract. 1998 Jan;46(1):83-6.)

Chromium

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Diabetes and Supplements

• Inhibits the glucose from leaving cells. (Mol Cell Biochem 2002 Feb;231(1-2):23-35.;Metabolism 2000 Mar;49(3):400-10.)

• Targets muscle cells. (Physiol Behav 1993 Aug;54(2):407-9.;Mol Cell Biochem 1992 Feb 12;109(2):157-62.)

• May also lower insulin requirements in type I diabetics, based on rodent research.

(Mol Cell Biochem. 2000 Mar;206(1-2):177-82.)

Vanadium

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Diabetes and Supplements

• Diabetes is one of the fastest growing diseases.– A major contributor to illness and death

worldwide.

• Many supplements can aid the diabetic condition.– Increasing insulin secretion and/or sensitivity– Modifying the absorption of sugar– Altering the cellular movement of glucose.

Key Points

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