COMMON DIABETES DRUG CAN REDUCE BAD CHOLESTEROL

A common diabetes drug Metformin can also help lower “bad” cholesterol that is known for promoting cardiovascular diseases by hardening the arteries, significant research has found.

“The findings suggest that Metformin might indeed have an additional beneficial effect with regards to cardiovascular diseases among the diabetes patients”, said study first author Dr Tao Xu from Helmholtz Zentrum Minchen, the German research centre for environment health in Neuherberg.

Along with the team from the German Diabetes Centre (DDZ) in Dusseldorf, Dr Tu and colleagues analysed more than 1,800 blood samples of participants.

Using a comprehensive approach, the scientists investigated metabolic products (metabolites) as well as genetics of these participants.

They found that the administration of Metformin in patients suffering from Type 2 Diabetes led to a change in metabolite levels.

According to the authors, this was associated with a significantly decreased level of LDL or “bad” cholesterol.

The researchers speculate that Metformin intake affects the levels of LDL cholesterol, leading to a down-regulation of specific genes.

“This is also supported by the fact that three lipid metabolites are decreased after taking the diabetes drug. Presumably, this is the mechanism how the production of ‘LDL’ cholesterol is repressed by Metformin,” explained

Dr Rui Wang-Sattler from the institute of epidemiology II of the Helmholtz Zentrum Minchen.

“Until now the exact mechanism is unclear. Thus, we want to continue our contribution to its decryption”, added co-study author Dr Stefan Brandmaier in a paper published in the journal Diabetes Care.

Metformin is the oldest and most frequently used oral anti-diabetes drug.

It affects blood fat levels via AMPK signalling pathway. The AMP activated protein kinase (AMPK) is an enzyme that determines the energy status of the cell.

In case, the energy status is low, AMPK stops energy consuming processes like the synthesis of cholesterol or fatty acids.

You think youve got it bad

Sometimes it's easy to get sucked into the, 'I'm the only one in the world feeling like this' syndrome; after all, we have HIV and neuropathy, can't get much worse than that...can it? It's quite long and neuropathy plays a small role but it's more than worth a few minutes of your time, so read on guys...it's good to get perspective every now and then.

The article is from the Daily Mail online(see link below)

Even at my lowest, I can still see the funny side of cancer
By Meredith Norton
Last updated at 11:15 AM on 12th August 2008

Meredith Norton was newly married with a baby when she was diagnosed with a rare form of breast cancer four years ago.

Warned her chances of survival were slim, Meredith, then 34, decided to write down her experiences as a way of coping. The result is a witty yet deeply poignant account of a woman facing her own mortality. . .

Life was wonderful. I had an 11-month-old son, Lucas, was about to celebrate my second wedding anniversary with my French husband, Thibault, a business consultant, and had also just landed a great job teaching English as a foreign language.

The only minor niggle was my comically lopsided breasts. All breast-feeding mums know the bizarre effects. One minute your breasts are huge, the next minute deflated. Rock hard, then lumpy. One of mine was huge, throbbing, covered with a red rash, and radiating enough heat to defrost a frozen lamb shank in ten minutes.

Doctors had prescribed antibiotics and told me not to worry. So I didn't - until, visiting my parents, I showed my mother. She demanded I see a doctor again immediately.
By 2pm the next day, I had seen a surgeon, had an ultrasound and mammogram, and been scheduled for a biopsy. Everyone said my lopsided breasts were almost certainly the result of mastitis, a blocked milk duct, but they wanted to be sure.

And so I enjoyed the last worry-free week of my life. Four days later, the surgeon told me I had inflammatory breast cancer. She wrote that on a notepad and underneath printed 'chemotherapy', with an arrow pointing to 'double mastectomy'.

I went from numb shock to heaving sobs in seconds. I had only a 40 per cent chance of being alive in five years. Worst of all was the image I could hardly bear to think about: my son would never know his mother.

Lucas's first birthday party, just a few days later, was a strange event. We were determined to celebrate - statistics said it might be our last chance - so we braved it out without telling friends my news.

Just one week after my diagnosis, I started chemotherapy. I was convinced that my hair wouldn't fall out. After all, for 15 years I'd been colouring, blow-drying and hot-combing with no ill effects.

And it certainly put up a good fight. At my second chemo, two weeks later, the nurses were amazed that the shedding hadn't started. But then, standing in the shower, I noticed vast quantities of hair on my bar of soap, my shoulders and between my toes.
For the next two days, I carefully gelled down what remained to hide the mangy bald spots.

Then, at the supermarket with my friend Rebecca, I reached to scratch over my ear and all the hair peeled off - like a piece of Velcro. We stood holding the patches and laughed until our cheeks ached.

I spent the rest of the evening trying to look seductive and batting my eyelashes at poor Thibault. He tried not to cry.

I had honestly never looked so bad - not even when I slept with my forehead sticking out of my sleeping bag at Girl Scout camp and it got attacked by mosquitoes. I was officially the least desirable woman alive.

Thank God for Lucas. Cancer was no excuse for not playing with him. The fact that his first trip to the beach might be my last was irrelevant.

And then the hot flushes started. Calmly, the doctor explained that chemo drugs were suppressing my hormones. The full impact dawned. Aged just 34, I'd been hurled prematurely and possibly irreversibly into the menopause. I was devastated.

The doctor was apologetic because she'd forgotten to mention freezing my eggs. Thibault tried to be positive. The menopause meant no periods, no birth control, no monthly mood swings.

'No more crazy wife who growls! It is the greatest gift for our family,' he declared. I wasn't sure whether to hug him or throttle him. There was no longer any reason to keep my situation secret.

Plague of the pitiers

The three worst groups of people to tell were the ones who had heard and didn't know what to say, the cancer survivors who expected me to feel some sort of camaraderie, and the pitiers.

The pitiers would approach with long faces. 'How. Are. You. Doing?' they'd whisper. When I said that I was fine, they'd demand the truth. Well, the truth was that I was doing great - until I saw their funereal faces.
Acquaintances I hadn't spoken to in years rang, armed with extraordinarily intimate details, saying things like: 'I heard you had breast cancer with a concentration of disease around the right nipple.'

Eight weeks into chemotherapy, a friend insisted I saw a therapist. It was a chance to offload - not about cancer but about Lance Armstrong, the world champion cyclist who overcame cancer and has gone on to win even more accolades.

Ever since my diagnosis, well-meaning friends had been giving me copies of his autobiography.

Intended to inspire, the only thing I learnt was that Lance and I are polar opposites - physically and mentally. If surviving this form of breast cancer required any of the Lance-like traits of heroic physical overexertion, then I was as good as dead.

I needed to stay positive and use humour to help me through the darkest moments.

The therapist said I seemed very much in touch with my feelings. He suspected that my friends and family simply confused my coping well with being in denial.

Then he said the worst thing imaginable. Children orphaned before eight years old can't remember their parents. He suggested I make videos for Lucas to remember me by.

I appreciated his frankness. But by the next day, I was obsessed with the vision of myself rotting in the earth while Lucas watched a tape of me teaching him how to tie his shoes or parallel park - things he'd probably never need in the Velcro-and-electric-car future.

Uncontrollable rage

Also there was no way I could do myself justice during tapings. This was due to a drug called G-CSF, an immunobooster that increased production of blood cells to counteract the suppression caused by the chemotherapy. One of the side-effects is intense rage.

I dreaded the injections of G-CSF. So did Thibault. Some nights I kicked him simply because he was sleeping soundly. I threw plates and slammed doors.

Three months later, I learnt the cancer had not spread and only my right breast would be removed. The operation was smooth and painless.

But then came the moment of truth. The doctor unswaddled the bandages around my rib cage. Finally, there it was. On the left side sat my flat, deflated boob, and on the right side nothing - just a thin line of Steri-Strip tape over the incision. Flat as a wall.

There were no black stitches, no gruesome scar. It was just gone.

I pulled Thibault in front of the mirror. We were both expecting a horror show. But this was so tidy that it was hard to believe a breast had ever been there.

The week I started radiation, Thibault returned to work. We'd been living for six months off our meagre savings and friends' outrageous generosity. I accepted this, knowing I would eventually reciprocate or die.

Now, it was just me and Lucas and two daily radiation appointments for the next six weeks.

Although my days were organised around treatment, I felt normal. I had a small child who wanted salami and string cheese now.

The party before the storm

Six weeks later, my hair was growing back and treatment was finished. My friends threw a party to celebrate. They got a chocolate cake that said 'Meredith Kills Cancer Dead' in big, pink letters.

I hadn't exactly survived cancer yet - it was much too soon to claim that - but I had survived 16 weeks of accelerated, dose-dense chemotherapy, a mastectomy, and 54 radiation appointments.

My shot veins and scarred and burned chest were battle wounds; the stubble on my head made me look like GI Jane. I felt like a war hero, but something about this didn't feel like a victory party.

The following week brought bad news. Doctors said the risk of recurrence was a staggering 80 per cent. I needed chemo every day for two weeks, then a week off before an infusion of Herceptin for an entire year - 17 cycles.

The doctor reassured me that these 1,500 pills - over 11/2lb of poison - weren't a big deal and that the chemo would be ' supereasy.' But it was actually a daily dose of six huge, chalky horse pills with four huge side-effects.

One, they made me sleep so heavily that I once napped through Lucas falling out of his bed. Two, the pills caused freakish skin discolouration. My tongue, gums and palms grew darker and more dead-looking with every pill.

Three, my skin became so thin and dry that the edges of my calculator sliced through it like a samurai sword.

The fourth, most debilitating side-effect was peripheral neuropathy. I lived permanently with that feeling you have when you try to make a fist but your hands are asleep: that stinging, burning cramp that dissolves as your circulation recovers.

My hands and feet were hypersensitive, as though the ground was either on fire or a bed of nails.

And then, finally, it was over. Twenty months after being diagnosed, I had my last infusion.

And so, gradually, life has got back to normal. Aside from my three-month check-ups and the lingering effects of colds due to my weakened immune system, I feel healthy.

Nothing else has happened, but it will. As my father says: 'None of us gets out of here alive.'

But life really is too short to worry. Against all the odds, I am here to celebrate Lucas's fourth birthday on the third anniversary of my cancer diagnosis. For now, that's enough.

• Adapted from Lopsided: How Having Breast Cancer Can Be Really Distracting by Meredith Norton, published by Virago, £11.99. To order a copy (p&p free), call 0845 155 0720.

Read more: http://www.dailymail.co.uk/health/article-1043682/Even-lowest-I-funny-cancer.html#ixzz1UnfzZIJ5

Statins Bad News For Neuropathy Patients Or Not

Today's post from neuropathy.org (see link below), is the first of two, looking at statins and their potential role in neuropathy development. Statins are one of the fastest growing drug groups around at the moment and have been proved to be very successful in reducing 'bad' cholesterol levels. Cholesterol problems are unfortunately a feature of the modern age as our diets become more and more fats-based but neuropathy patients have long been advised not to take them for fear of worsening their symptoms. Similarly, there are thousands of cases where statins have been given the blame for actually causing neuropathy in the first place. What's the truth? This article suggests that statins may not be as harmful to the nervous system as first thought. Tomorrow's post suggests the opposite. The best advice has to be to discuss the issue very carefully with your doctor and don't leave until your satisfied that these drugs are not going to bring your nerve problems. In the end you may need to trust your doctor's opinions but be aware of possible beginning or worsening of symptoms.

“Ask the Doctor” Column: Influence of Statins on Neuropathy

This is a column in which leading clinicians answer your questions about neuropathy – usually one question per issue, and more when we are able. Please send your questions to “Ask the Doctor” c/o Neuropathy News, The Neuropathy Association, 60 East 42nd Street, Suite 942, New York, NY 10165.

Dear Doctor: I have just read the part of Dr. Weimer's article (on www.neuropathy.org website) dealing with the influence of statins on neuropathy--most helpful. But a recent article (2007) I found on Google suggests that for people with controlled type 2 diabetes the use of statins may actually retard the progression of neuropathy. Do you have a comment on this please? Thank you. - Michael S.

Dr. Louis H. Weimer Answers: In clinical medicine, an occasional dilemma occurs when two well designed and well-conducted large trials produce seemingly contradictory results. This situation arose in June regarding the correlation between statins and neuropathy as reported in an earlier study conducted in Denmark and a recently announced Australian study.

The Danish study concluded that patients taking statin-class cholesterol-lowering drugs were more likely to have neuropathy, especially if they took the drugs for a longer time period or had definite evidence of neuropathy. One criticism of the Danish study was that no assurance was given that some of the patients taking statins did not have mild and unrecognized forms of diabetes or simple glucose intolerance, now recognized to be risk factors for neuropathy. In addition, the lipid disorders prompting the statin use in the first place are under scrutiny as a neuropathy risk factor as part of the metabolic syndrome—the study's authors acknowledged this limitation. This one study was the primary basis for the widely publicized concerns of statins and toxic neuropathy. Beyond this study, there have been a small but recognized number of individual patients who appear to develop neuropathy soon after starting a statin and then improve after stopping the drug.

The more recent Australian study found that diabetes patients were less likely to have neuropathy if they received a statin or fibrate. For statins, the reduction in neuropathy rates was found to be about 35%. Fibrates, a separate class of lipid-lowering drugs, had a similar effect, suggesting that improved lipids and cholesterol could be more important than an independent effect of the drugs. However, exactly why these drugs are beneficial or harmful to nerves is poorly understood. The Australian study tracked almost 1,300 diabetic patients over eight years. Its findings also reported significantly higher rates of neuropathy in untreated patients. The study's findings have not yet been published in a medical journal, but they were announced and discussed at this year's American Diabetes Association annual medical meeting.

It is too early to know if these protective effects are valid and can be duplicated by other studies. Also unknown is if these effects will be applicable to patients without diabetes. It is well accepted that any toxic nerve effects of statins are quite rare: some of these patients may have developed neuropathy for the reasons mentioned above despite the statin treatment while others may have a rare sensitivity to the drugs. In addition to the findings from these two studies, there is also experimental animal study evidence that appears to support both contentions of toxicity and protection—adding to the uncertaintybut there is better evidence for neuroprotection than toxicity.

The critical decision for neuropathy patients is whether statins are more beneficial to their overall health than whether they are potentially harmful. There is well-established and convincing evidence for the benefits of these agents and now possibly added nerve protection for patients with diabetes. The evidence for nerve toxicity remains less clear. Patients with existing neuropathy and a lipid or cardiac condition known to benefit from statins probably should not avoid these agents simply for the rare neuropathy risk. The situation is more complex for the rare patients who worsen soon after starting new treatment or patients who develop neuropathy while taking statins for an extended period. Further studies will be needed to address all of the outstanding questions.

Dr. Louis H. Weimer is associate clinical professor of Neurology at Columbia University. He is also co-director of the Peripheral Neuropathy Center of Excellence at Columbia.

http://www.neuropathy.org/site/News2?id=7161