Researchers at the Medical University of Vienna have found that the breast of one in two women with lobular breast cancer can be preserved through chemotherapy prior to a breast operation.
“Up until now it had been the view that neoadjuvant chemotherapy hardly had any benefits in cases of lobular breast cancer due to the poor response rate of the cancer, however no one had yet examined the question of the breast preservation rate,” says study leader Prof. Dr. Florian Fitzal from the University Department of Surgery, who also works at MedUni Vienna’s interdisciplinary Breast Centre.
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Atypical antipsychotic medications have been suggested to contribute to the risk of type 2 diabetes in patients with serious mental illness, possibly by directly interfering with glucose metabolism. New research suggests that olanzapine and risperidone treatment leads to a small but significant decrease in insulin sensitivity in patients with schizophrenia and shizoaffective disorder. The study examined insulin sensitivity and whole body adiposity in 41 olanzapine-treated patients and 33 risperidone-treated patients. Mean change from baseline in insulin sensitivity normalized to fat free mass declined 9% and 13.2% during the clamp procedure’s low insulin phase and 10.4% and 2.1% during the high insulin phase, in olanzapine and risperidone-treated patients, respectively.
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The link between cognitive impairment and diabetes may be insulin-mediated and studies have shown that intranasal insulin can actually benefit patients with impaired memories and cognitive deficits. Studies have also shown that the effect of insulin on the CNS may be gender-dependent, with women being more sensitive to its benefits than men. The effect of sex on the treatment response to intranasal insulin was investigated in a group of memory-impaired subjects. A total of 104 patients with Alzheimer’s disease or amnestic mild cognitive impairment were randomized to either placebo or intranasal insulin . Cognitive evaluations including delayed story recall and computerized Stroop test were conducted at baseline, at 2 and 4 months treatment and then at 2 months postcessation.
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Impaired insulin sensitivity hinders glucose metabolism and increases neuritic plaques in the brain and adversely affects memory. Thus, insulin resistance, a symptom of diabetes, is a risk factor for Alzheimer’s disease . A previous study localized the occurrence of insulin resistance in the hippocampal formation of AD cases accompanied by increased concentrations of suppressed insulin receptor substrate-1 . Some antidiabetic agents such as glucagon-like peptide 1 analogues can cross the blood-brain barrier and enhance IR sensitivity. The efficacy of the GLP-1 analogue liraglutide in counteracting insulin resistance in the brain was investigated in an ex vivo case control study.
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A nationwide audit of the extent, safety, efficacy and tolerability of reported off-license exenatide use has found that the addition of exenatide to obese insulin-treated patients can improve glycemia and weight. The anonymous online audit was carried out by the Association of British Clinical Diabetologists and assessed real clinical practice by 315 contributors from 126 U.K. centers. HbA1c and weight changes, exenatide discontinuation, adverse events and treatment satisfaction were compared among 4,857 patients with mean baseline HbA1c of 9.45% and BMI of 40 kg/m2, 39.6% of whom used exenatide with insulin. A comparison of patients using exenatide with insulin versus non-insulin-treated patients revealed mean latest HbA1c of 0.51% vs.
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Blood glucose monitoring is essential in glycemic control and the reliability of glucose monitoring devices has a major impact on clinical outcomes. A study investigated the accuracy and precision of the most commonly used blood glucose meters in a hospital setting. The following BGMs were evaluated in 200 type 1 and 400 type 2 diabetes patients admitted to a Greek clinic: Accu-Check Aviva, Precision-Xceed and Glucocard X-sensor. Using these three BGMs, capillary glucose values were tested and compared to simultaneously analyzed plasma glucose using the oxidase method of the World Health Organization . Using the WHO method values as control, differences between and some degree of unreliability among the three BGMs were observed.
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