Study suggests method to predict diabetes

Two recent UCLA studies published this Wednesday and last Wednesday presented new findings on diabetes, a metabolic disorder characterized by high blood sugar levels, which suggest the possibility of early detection and the importance of lifestyle changes while still healthy.

One report indicates an increase in the prevalence of diabetes diagnoses in California from 2001 to 2005, while the other UCLA study has identified three early markers that may predict in healthy individuals the possibility of diabetes in the future, indicating an alternative and more effective method of detection.

The study focuses on type 2 diabetes, which results from increased resistance to insulin, a hormone that decreases blood sugar levels. This inability to process insulin stems from inflammation in the body, which in turn is caused by the fat cells’ secretion of chemical signaling compounds called cytokines.

Three of these compounds, named tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP), are the key molecules confirmed to lead to diabetes.

The study is unique in that it looks at the connection between two different systems of the body, said Simin Liu, the lead author of the study and a professor of epidemiology and medicine at UCLA.

“It is interesting that metabolism and immunology are linked,” he said.

The study was conducted by looking at women at two time points six years apart.

“It’s different from other studies because he’s looking at people both before and after they become diabetic,” said Cathy Lee, an assistant professor in internal medicine at UCLA.

Baseline measurements of the level of inflammatory cytokines were taken in a group of healthy women without diabetes. Six years later, they compared 1,584 of the women who had developed type 2 diabetes with 2,198 women who were still healthy.

Conclusions were drawn having taken into account other risk factors such as diet, sedentary lifestyle, smoking and family history.

“Comparing the blood measurements (taken six years before) of the diabetic women with the healthy women allowed us to confirm that these pro-inflammatory cytokines play an important role in the pathogenesis of type 2 diabetes,” Liu said.

In fact, the presence of these cytokine markers corresponded to a double or triple increase in the risk of the development of type 2 diabetes.

Diabetes, which also consists of the insulin-deficient type 1 diabetes, can lead to kidney failure, heart disease, blindness and nerve damage.

Diabetes diagnoses are rising in California, according to the UCLA report released this Wednesday that shows an increase in rates from 6.2 in 2001 to seven percent in 2005. This corresponds to 1.8 million people, as compared to 1.5 million four years before.

“The American lifestyle, being sedentary, eating fat foods, not exercising, (result in) the propensity to become obese, which in turn leads to higher risk for diabetes,” she said.

With type 2 diabetes making up 83 percent of diabetes cases and type 1 diabetes making up the other 17 percent, the identification of the cytokine markers for type 2 diabetes can play a significant role in early detection and prevention.

“If these cytokines are detected at high levels in still healthy individuals, they can reduce the risk of diabetes by making changes to their lifestyle or diet,” Liu said. “Maybe aspirin or other anti-inflammatory drugs can be utilized.”

Currently, the method of diabetes detection is through a blood glucose level test, but by the time the levels are in the diabetic range, it is already too late, Liu said.

While there are no certain predictors of the disease, the identification of these markers can indicate how great the risk is, and that is a tremendous step forward in the field, Lee said.

“It is something that can be so easily detected in the blood,” she said. “If you have high cytokine formation while you’re still healthy, you can do something about it to either lower the cytokine or reduce inflammation.”