Diabetes a metabolic disorder which afflicts millions and takes a heavy toll is a controllable chronic disease maintained with help of medications. In past decade lot of research has been done to evaluate the role of surgery in diabetes. Yes, bariatric surgery or gastric bypass surgery helps diabetics and can potentially turn out to be more effective then medications in some subset of patients.
"Gastric bypass uniquely restores pancreatic β-cell function and reduces truncal fat, thus reversing the core defects in diabetes. "
http://vitals.nbcnews.com/_news/2013/02/26/17104943-amazing-results-for-diabetes-patients-after-weight-loss-surgery?lite
http://care.diabetesjournals.org/content/early/2013/02/14/dc12-1596.abstract?sid=79afa429-64fe-480c-a1b2-b29ec7f58797
Godspeed!
Thursday, February 28, 2013
Friday, February 22, 2013
Poor Quality Drugs!!
Lancet has published today an editorial highlighting the risk and cost of poor quality drugs.
Few numbers;
1. 120 people died and hundreds more suffered adverse reactions after taking a contaminated heart medicine in Pakistan.
2. Contaminated injectible steroid in US has caused outbreak of fungal meningitis resulting in 704 people getting sick and 46 killed.
3. The contamination of heparin by Chinese counterfeiters in 2007 and 2008, killed 149 patients in the USA.
4. In 2009, the European Union seized 34 million fake tablets in just 2 months, including antibiotics, cancer treatments, and sildenafil citrate (Viagra).
The numbers are much higher but we are not made aware of them because of various reasons.
There is a need for more research and robust data gathering to estimate the burden of poor quality drugs. This has been hampered on many accounts.
In fact Royal Pharmaceutical Society's 1989 statement reads like this, "no great publicity (about fake drugs) should be sought because it could damage public confidence in medicines" (Cockburn et al : 2005; SCRIP, 1989).
With innovative technologies (like RFID), advanced data assimilators and analytics (Watson), advanced pharmacovigilance, collective involvement, responsibility, and responses of all interested parties: health professionals, drug regulatory authorities, judicial entities, and drug companies at both national and international levels.-Can and will make a difference.
References:
1.Strenghtening Global Action Against Poor Quality Drugs
2. Countering the Problem of Falsified and Substandard Drugs
3. Counterfeit drugs: a growing global threat
Few numbers;
1. 120 people died and hundreds more suffered adverse reactions after taking a contaminated heart medicine in Pakistan.
2. Contaminated injectible steroid in US has caused outbreak of fungal meningitis resulting in 704 people getting sick and 46 killed.
3. The contamination of heparin by Chinese counterfeiters in 2007 and 2008, killed 149 patients in the USA.
4. In 2009, the European Union seized 34 million fake tablets in just 2 months, including antibiotics, cancer treatments, and sildenafil citrate (Viagra).
The numbers are much higher but we are not made aware of them because of various reasons.
There is a need for more research and robust data gathering to estimate the burden of poor quality drugs. This has been hampered on many accounts.
In fact Royal Pharmaceutical Society's 1989 statement reads like this, "no great publicity (about fake drugs) should be sought because it could damage public confidence in medicines" (Cockburn et al : 2005; SCRIP, 1989).
With innovative technologies (like RFID), advanced data assimilators and analytics (Watson), advanced pharmacovigilance, collective involvement, responsibility, and responses of all interested parties: health professionals, drug regulatory authorities, judicial entities, and drug companies at both national and international levels.-Can and will make a difference.
References:
1.Strenghtening Global Action Against Poor Quality Drugs
2. Countering the Problem of Falsified and Substandard Drugs
3. Counterfeit drugs: a growing global threat
Saturday, February 09, 2013
Diabetes and Cancer
Chronic diseases are the scourge of the new age. All over the world people living with diabetes are expected to increase, especially in India.
Epidemiological studies indicate an increased risk of cancer for diabetic people. There is increased risk of hepatocellular cancer, pancreatic cancer, breast cancer, endometrial cancer, colorectal cancer, stomach cancer and bladder cancer. Prostate is the odd guy out as the risk for it is decreased if you have diabetes (possibly because of low testosterone levels).
The causal relationship between diabetes and cancer is not well established. There may be confounding bias, observational bias as the evidence is epidemiological. There are few biological hypothesis. Hyperinsulinemia drives growth and diabetics have hyperinsulinemia. Also cancer cells express IGF-1 (Insulin like growth factor receptors) receptors. Inflammation is more common in diabetics and chronic inflammation is a risk for cancer.
Summary and Actions To Be Taken:
1. Epidemiological evidence is there to say that diabetics are at increased risk for cancer.
2. Causal relationship and biological mechanism still needs further elucidation.
3. Diabetes and cancer share several risk factors, like obesity and physical inactivity. An effort to prevent and control diabetes will have a positive effect on cancer incidence. One need not have to wait for conclusive evidence to implement healthy habits and preventive measures.
4. Researchers and clinicians need to be more aware and collect prospective data. Also design studies to benefit patients.
5. The cancer risk conferred by diabetes may be moderate but considering that 366 million people have diabetes worldwide and it is expected to reach 552 million by 2030 calls for awareness and action.
Reference: Diabetes mellitus and cancer risk: Review of the epidemiological evidence
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