USC Westside Center for Diabetes | April Updates

INSIDE THIS ISSUE


		USC Comes to the Westside: Event at the Regency Club

		Drugs: A potential new way to improve glucose control has some slithery beginnings.

		Welcome: Meet the center's newest endocrinologist.

Points of Interest


		New support group

		April Diabetes Updates

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	April Diabetes Updates Cholesterol Lowering in the News Most of us in America are going to die from heart disease. But when you have diabetes this risk is doubled or even quadrupled. The good news is that we can do something to lower your risk of heart disease; the bad new is that most people in America are not getting appropriate treatment. An important message from me, and from all of us at the Westside Center, is that you can and should be getting optimal treatment to lower your risk of having a heart attack. So how do we do this? In addition to a healthy diet and exercising, drugs known as "statins" are very effective at lowering cholesterol levels and reducing the risk for a heart attack. What they do is to lower the body's own production of cholesterol. The statins are: Mevacor (or lovastatin), Pravachol (or pravastatin), Lescol (or fluvastatin), Zocor (or simvastatin), Lipitor (or atorvastatin), and Crestor (or rosuvastatin). Lescol is the weakest statin; Crestor the strongest and the newest. The statin that has been in the news recently is Lipitor. Findings from two research studies, REVERSAL and PROVE-IT, have looked at the effect of high doses of Lipitor (80 mg-most people take 10 or 20 mg). These drugs were given to people at very high risk for having a heart attack (those who have had a recent heart attack or who have diabetes). Lipitor was compared to Pravachol, which didn't lower the cholesterol level as much. Current guidelines say that the bad (LDL) cholesterol level should be less than 100 mg/dl. These two studies showed that lowering the LDL cholesterol level to 70 mg/dl is probably a good idea, especially if you have diabetes and a prior heart attack. And probably everyone with type 2 diabetes and prediabetes should be on a cholesterol lowering drug of some sort. What these studies do not say is that Lipitor is better than any other cholesterol lowering drug or that there is magic to giving 80 mg of Lipitor. They also don't answer the question of how low is too low. At very low levels of cholesterol the risk for dying may increase. So we need to study this low end of cholesterol levels, as well. Remember to have your lipid panel checked at least every 6 months. Keep your LDL cholesterol level is as low as possible-around 70 mg/dl is ideal. Discuss this with us if you have any questions or concerns. It is exciting that we have made so much progress at preventing heart attacks recently, and I want to be sure that each of you benefits from the new knowledge we have. Nutrition Tip: Understanding the Risk of Getting Too Much Mercury From Fish The mercury content in fish has been reported to be higher than we previously realized. This may mean we should limit fish intake, particularly for women of reproductive age. However, since an increase in mercury levels may not be good for any of us, it is good to be aware of the risk. On the plus side, fish has many healthy qualities and is still an important part of the diet. You still should have fish or shellfish, but since many fish contain mercury you may need to limit the amount and frequency if you are at risk. The FDA and EPA have made the following recommendations for women becoming pregnant, already pregnant women, nursing mothers and young children: 1. Avoid eating high mercury fish like shark, swordfish, albacore, king mackerel and tilefish (larger fish that live longer have more mercury). 2. You can have low mercury fish such as shrimp, canned light tuna (but not albacore or "white" tuna), salmon, perch, trout, catfish, pollock and sardines. We can measure the mercury level in your blood, to be sure you are okay. For more information about mercury in fish or shellfish call 1-888-SAFEFOOD or visit the FDA website: www.cfsan.fda.gov. FDA Hearing to be Held About the Future of Diabetes Research The FDA and the NIH are holding a joint symposium and public hearing on May 13 and 14 in Washington DC. The purpose of this symposium is to address the current realities in diabetes care and develop strategies for future research. The reason why this is important is that the FDA hasn't had much input on diabetes treatment from those of us who do it everyday. Mostly scientists who are removed from the practicalities of care make the decisions. This is a chance for the rest of us to be heard. One of the issues under consideration is how decisions about new monitoring devices and medications are made. In the past new treatments were judged solely on their ability to lower blood sugar levels. But as we know, it is not just lowering blood sugar that matters-it is preventing low blood sugar reactions, keeping blood sugar levels more stable, helping with weight loss and lowering the risk for heart disease, as well. It is very important for all of us to write to the FDA to let them know the importance of devices such as reliable continuous glucose sensors or medications which can stabilize blood sugar readings and help with weight loss. You can write to: James Cross, Center for Drug Evaluation and Research, FDA (HFD-020), 5515 Security Lane, Rockville, MD 20852, FAX: 301-480-8329, e-mail: james.cross@fda.hhs.gov, or Sanford Garfield, NIDDK, NIH, 6707 Democracy Blvd., rm. 685, Bethesda, MD 20892-5460, e-mail: garfields@ep.niddk.nih.gov. Center Updates We now have expanded nutrition services as well as internal medicine coverage. Our nurse practitioner, Donna Miller, also will be increasing her hours to provide more accessibility and ease of appointments. Please be sure to use our practitioners if they can be of help to you. We will soon have a state-of-the-art machine for measuring the percentage body fat and other weight and fitness related parameters, so you can ask for this at your next appointment. We hope this measurement can help you on your path to enhanced fitness and encourage your weight loss and exercise. Our studies on inhaled insulin are on going. We hope to start working on a study with Exenatide soon (the drug made from the saliva of the Gila Monster). Dr. Peters is a member of the national advisory board for the drug, which will hold its first meeting this month in Chicago. Unfortunately, pramlinitide, the drug from Amylin that is injected with insulin and can help with weight loss as well as improve diabetic control, is being held up by the FDA. The newest (and most effective) sensor for continuous measurement of blood sugar levels (by Therasense, which has recently been purchased by Abbott) has been submitted to the FDA for approval. Once approved I think it will be a great tool for helping people with diabetes. Center Development As you know, insurance doesn't pay for preventive health care. So our center depends on your donations to exist and to underwrite our yearly deficit. For the center to remain open for the next two years we need to raise $700,000. We have already raised nearly $300,000; please help us reach our short-term goal. Our longer term goals include funding an endowed chair for Dr. Anne Peters. This would allow her to continue to her work to help prevent and treat diabetes. An endowed chair would cost $2 million and would be a gift that would continue giving forever. This could be named to honor a special person whom Dr. Peters has helped. Another long term goal is to name the center. This would ensure the existence of the center for perpetuity. To help us support the center call David Eshaghpour at (323) 442-1700 or contact Dr. Peters.
	Photos By Mark Harmel ©2001/2002 USC. All Rights Reserved

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