A ‘paradigm shift’ in the diagnosis of diabetes: study

Updated 02 March 2018
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A ‘paradigm shift’ in the diagnosis of diabetes: study

PARIS: Scientists on Friday unveiled a revised classification for diabetes, one they said could lead to better treatments and help doctors more accurately predict life-threatening complications from the disease.
There are five distinct types of diabetes that can occur in adulthood, rather than the two currently recognized, they reported in The Lancet Diabetes & Endocrinology, a leading medical journal.
The findings are consistent with the growing trend toward “precision medicine,” which takes into account differences between individuals in managing disease.
In the same way that a patient requiring a transfusion must receive the right blood type, diabetes sub-types need different treatments, the study suggested.
Similarly, scientists have also identified distinct kinds of microbiome — the bacterial ecosystem in our digestive tract — that can react differently to the same medication, rendering it more or less effective.
“This is the first step toward personalized treatment of diabetes,” said senior author Leif Groop, an endocrinologist at Lund University in Sweden, adding that the new classification is a “paradigm shift” in how the disease is viewed.
People with diabetes have excessively high blood glucose, or blood sugar, which comes from food.
Some 420 million people around the world today suffer from diabetes, with the number expected to rise to 629 million by 2045, according to the International Diabetes Federation.
Currently, the disease is divided into two sub-types.
With type-1 — generally diagnosed in childhood and accounting for about 10 percent of cases — the body simply doesn’t make insulin, a hormone that helps regulate blood sugar levels.
For type-2, the body makes some insulin but not enough, which means glucose stays in the blood.
This form of the disease correlates highly with obesity and can, over time, lead to blindness, kidney damage, and heart disease or stroke. Acute cases may also require limb amputations.
It has long been known that type-2 diabetes is highly variable, but classification has remained unchanged for decades.
For the study, researchers monitored 13,270 newly diagnosed diabetes patients ranging in age from 18 to 97.
By isolating measurements of insulin resistence, insulin secretion, blood sugar levels, age, and the onset of illness, they distinguished five distinct clusters of the disease — three serious and two milder forms.
Among the severe types, a group of patients with insulin resistence — in which cells are unable to use insulin effectively — was at far higher risk of kidney disease.
“This group has the most to gain from the new diagnostics as they are the ones who are currently most incorrectly treated,” Groop said.
Another group facing serious complications was composed of relatively young, insulin-deficient patients.
The third “severe” group were people with auto-immune diabetes corresponding to the original “type-1” diagnosis.
The two other groups have milder types of the disease including one, which includes about 40 percent of the patients, beset with a form of diabetes related to advanced age.
“This will enable earlier treatment to prevent complications in patients who are most at risk of being affected,” said lead author Emma Ahlqvist, an associate professor at Lund University.
The results were checked against three other studies from Sweden and Finland.
“The outcome exceeded our expectations,” said Groop.
The researchers plan to launch similar studies in China and India.
 


Johnson & Johnson shares plunge after report on asbestos in baby powder

In this file photo taken on July 13, 2018, In this photo illustration, a container of Johnson's baby powder made by Johnson and Johnson sits on a table on in San Francisco, California. (AFP)
Updated 15 December 2018
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Johnson & Johnson shares plunge after report on asbestos in baby powder

  • The controversy has long dogged the company, which has been facing a wave of several thousand court cases claiming the baby powder is causing cancer

NEW YORK: US pharmaceutical and cosmetics group Johnson & Johnson saw its shares plunge Friday after a media report alleged the group had deliberately concealed for decades that its baby powder sometimes contained asbestos.
A lengthy investigation by the Reuters news agency, which reviewed thousands of company documents, showed the company marketed talc-based products that, at least between 1971 and the beginning in the 2000s, sometimes contained asbestos.
The company’s executives, researchers, doctors and lawyers were aware but deliberately chose not to disclose this information and not to refer it to the authorities, according to the report.
Johnson & Johnson strenuously rejected the claims made in the article, calling it “one-sided, false and inflammatory.”
“Simply put, the Reuters story is an absurd conspiracy theory,” the company said in a statement. “Johnson & Johnson’s baby powder is safe and asbestos-free.”
J&J stock closed down more than 10 percent at $133 on the New York Stock Exchange, its worst one-day fall in 16 years.
The controversy has long dogged the company, which has been facing a wave of several thousand court cases claiming the baby powder is causing cancer.
In July, Johnson & Johnson was ordered to pay $4.7 billion in damages to a group of 22 women claiming to have developed ovarian cancer following the use of the powder.
The company said Friday there were rigorous tests showing the talc did not contain the cancer-causing mineral.
In addition, “J&J has cooperated fully and openly with the US FDA and other global regulators, providing them with all the information they requested over decades.”
According to Reuters, the company also tried, unsuccessfully, to block regulations that lower the maximum level of asbestos allowed in talc-based cosmetics.