Diabetes, Weight Loss Surgery Works Better Than Medicine

Two studies have found that weight-loss operations worked much better than the standard therapies for Type 2 diabetes in obese and overweight people whose blood sugar was out of control. 

Those who had surgery, which stapled the stomach and rerouted the small intestine, were much more likely to have a complete remission of diabetes, or to need less medicine, than people who were given the typical regimen of drugs, diet and exercise.

The surgery also helped many to lower their blood pressure and cholesterol.

The new studies, published on Monday by The New England Journal of Medicine, are the first to rigorously compare medical treatment with these particular stomach and intestinal operations as ways to control diabetes. 

Doctors had been noticing for years that weight-loss operations, also called bariatric surgery, could sometimes get rid of Type 2 diabetes. But they had no hard data.

Experts say better treatments are desperately needed for the disease.

“Type 2 diabetes is one of the fastest growing epidemics in human history,” according to an editorial published with the two studies.

The question is whether major surgery, with its risks and complications, should be more widely used. 

Some surgeons and obesity experts are pushing to establish a role for the surgeries in treating diabetes, not just obesity, while other experts say more research is needed.

The president for medicine and science for the American Diabetes Association, Dr. Vivian Fonseca, said the two studies were “not game changers” because they were relatively small.

The disease, which causes high blood sugar, is linked to obesity and often becomes harder to manage as it progresses. It can bring devastating complications like heart disease, strokes, blindness, amputations and kidney failure.

In the United States, the number of diabetes cases has tripled in the past 30 years to more than 20 million, according to the Centers for Disease Control and Prevention. Most of the cases are Type 2. Type 1, far less common, is not linked to obesity.

Researchers said the operations used in the studies help control diabetes not just because they make people lose weight — a known treatment for the disease — but because the changes in anatomy alter the levels of gut hormones that affect the metabolism of sugars and fats.

UCLA researchers eliminate major roadblock in regenerative medicine

In regenerative medicine, large supplies of safe and reliable human embryonic stem (hES) cells are needed for implantation into patients, but the field has faced challenges in developing cultures that can consistently grow and maintain clinical-grade stem cells.

Standard culture systems use mouse “feeder” cells and media containing bovine sera to cultivate and maintain hES cells, but such animal product — based media can contaminate the cells. And because of difficulties in precise quality control, each batch of the medium can introduce new and unwanted variations.

Now, a team of stem cell biologists and engineers from UCLA has identified an optimal combination and concentration of small-molecule inhibitors to support the long-term quality and maintenance of hES cells in feeder-free and serum-free conditions. The researchers used a feedback system control (FSC) scheme to innovatively and efficiently select the small-molecule inhibitors from a very large pool of possibilities.

The research findings, published today in the journal Nature Communications, represent a major advance in the quest to broadly transition regenerative medicine from the benchtop to the clinic.

“What is significant about this work is that we’ve been able to very rapidly develop a chemically defined culture medium to replace serum and feeders for cultivating clinical-grade hES cells, thereby removing a major roadblock in the area of regenerative medicine,” said Chih-Ming Ho, the Ben Rich — Lockheed Martin Professor at the UCLA Henry Samueli School of Engineering and Applied Science and a member of the National Academy of Engineering.

Unlike current animal product — based media, the new medium is a “defined” culture medium — one in which every component is known and traceable. This is important for clinical applications and as drugs or cells enter the world of regulatory affairs, including good manufacturing practice compliance and Food and Drug Administration supervision.

Genetic discovery by British scientists raises hopes for malaria treatments

Genetic discovery by British scientists raises hopes for malaria treatments - Times Online

The genetic code of the plant that provides the most effective treatment for malaria has been cracked by scientists, raising the prospect of cheaper and more plentiful drugs against a disease that kills about a million people each year.

The achievement by British researchers will assist the development of higher-yielding varieties of the sweet wormwood plant Artemisia annua that addresses a global shortage of the drug artemisinin and reduces its cost. New seeds could be produced using insights from the study and be available to farmers in as little as two to three years.

Artemisinin combination therapies (ACTs), in which the drug is given in combination with older anti-malarial treatments, are recommended by the World Health Organisation as the best way to fight malaria.

Artemisinin can be made only by using an acid extracted from sweet wormwood, a herb used in traditional Chinese medicine. As most of the varieties under cultivation are wild plants with low yields, demand for ACTs outstrips supply and the drugs are much more expensive than older, less-effective treatments.