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News Roundup W/E 21st August

We have talked a lot about the psychological impact on those dealing with diabetes and this week shows some research for those of us who do get depressed and live with diabetes rend to have an increased chance of developing diabetic retinopathy. Interesting article that I think shows how much care we should give to not only the things we can see but other issue that might be bothering us.

Article from
Patients with diabetes who also suffer from depression are more likely to develop a serious complication known as diabetic retinopathy, a disease that damages the eye’s retina, a five-year study finds. Diabetic retinopathy occurs when diabetes is not properly managed and is now the leading cause of blindness in patients between 25 and 74 years old, according to the study appearing online in the journal General Hospital Psychiatry.

“Our study controlled for obesity, smoking, sedentary lifestyle and HbA1c levels, and still found that depression was associated with an increased risk of retinopathy,” said co-author Wayne Katon, M.D. HbA1c is a blood test that measures a person’s average blood sugar levels over several months. Katon is the director of health services and psychiatric epidemiology at the University of Washington Medical School, in Seattle. He and his colleagues studied 2,359 patients with diabetes enrolled in the Pathways Epidemiologic Study and assessed their levels of depression using the Patient Health Questionnaire-9 (PHQ-9), a self-reported survey of depression symptoms.

Over the five-year follow-up period, 22.9 percent of the patients who had PHQ-9 scores that ranked as “major depression” developed diabetic retinopathy, compared with 19.7 percent of the patients without depression. With a five-point increase on the PHQ-9 score, patients’ risk of having diabetic retinopathy increased by up to 15 percent. “Our findings suggested that psychobiologic changes associated with depression such as increased cortisol levels and activity of blood-clotting factors may be linked to the development of retinopathy,” Katon said. “There is no question that the burden of depression among patients with diabetes is very high and that depression is a risk factor for worse outcomes in patients with diabetes, as was seen in this study,” said Todd Brown, M.D., an assistant professor of medicine at the division of endocrinology and metabolism at Johns Hopkins University. He added that multiple explanations might account for these findings-some related to biological changes and some due to behavioral social issues, such as decreased physical activity and poorer utilization of health care. “The big question with all of this is whether identifying and treating depression in patients with diabetes will change clinical outcomes,” Brown said. “And currently, there are no universal recommendations for depression screening among patients with diabetes.”

JDRF-funded researchers in Israel have found that stem cells made from beta cells in the pancreas of adults have a ‘memory’ that makes them better able to produce insulin than other types of stem cell.
The team from Tel Aviv University, led by Shimon Efrat, published their discovery in the July issue of the journal Cell Stem Cell.

Stem cells can be taken from either embryos or adults. Both types have the potential to turn into many different types of cell, including insulin-producing beta cells. However this latest study suggests that the source of the stem cells has more influence than previously thought. The genetic ‘memory’ of stem cells derived from the pancreas means the cells find it easier to turn into insulin-producing beta cells, making them a better option for treating for type 1 diabetes.

Scientists hope to be able to use these stem cells to grow new beta cells to replace those destroyed in people with type 1 diabetes. When coupled with therapies to prevent or block the immune system from attacking the newly introduced beta cells, this research offers a possible route to a cure for type 1.

This project forms part of the JDRF research programme aiming to find ways to replace or regenerate insulin-producing beta cells in people with type 1 diabetes. For the full article click here.