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Evan D. Rosen Articles

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One of the most frustrating things about diabetes is the myriad of ways it can hurt you. Regular readers of this Viewpoint know that patients with diabetes are more prone to heart attacks, stroke, and peripheral vascular disease, as well as damage to the eyes, nerves, and kidney. As if this wasn’t enough, there is another common complication of diabetes that gets less attention, yet which affects thousands of patients every year.
Traditionally, medications come from any of several classes of small molecules, like amino acids, steroids, or small lipids. Such agents are relatively easy to put into tablets, and generally they are not destroyed by acid in the stomach before they can be absorbed. Proteins, on the other hand, present a difficult challenge for pharmacologists
Low levels of vitamin D have long been known to predispose to osteoporosis and rickets in children. It's for this reason that mothers used to spoon feed cod liver oil, a rich source of vitamin D, to their unwilling children. Nowadays we supplement milk products with extra vitamin D, sparing legions of kids from the horrors of cod liver oil, which tastes about as bad as it sounds. Now, evidence is emerging that vitamin D may help prevent the onset of type 1 diabetes as well.
Maintaining glucose levels as close to normal as possible is a good thing. Regular readers of this Viewpoint know that I am a strong advocate of tight blood sugar control because this approach leads to fewer diabetic complications.
Some people just can't catch a break. For years now, physicians have been telling patients that normal blood pressure is anything below 140/90, and if you fell below this number you were A-OK in the blood pressure department. Well, some of these folks probably got a rude surprise if they read about a study published in the New England Journal of Medicine. This study looked at people with "high-normal" blood pressure (systolic BP 130-139, diastolic BP 85-89), people that were previously felt to be out of danger from the perils of hypertension. What the study found was that these folks were actually still two to three times as likely to have heart attacks or strokes than were people with lower normal values.
In the past several months I’ve written a few pieces about immunomodulation of type 1 diabetes, or attempts to suppress the immune attack on insulin-producing beta cells. These studies have involved compounds that rein in the immune system in a more or less specific way, and all have been tested on mice with a tendency to develop type 1 diabetes. Now, a new study published in the journal Lancet raises the bar just a bit further, because the tests were performed in human beings with type 1 diabetes and not rodents.
Regular readers of this column in Diabetes In Control know that I'm pretty much a one-trick pony when it comes to diabetes. "Control is King" is my motto, and helping you to get there quickly and safely is what this is all about. Several studies performed in both type 1 and type 2 diabetes have shown that tight glucose control is the best way to avoid serious complications of diabetes like blindness and irreversible damage to kidneys and nerves.
ACE inhibitors, are used to reduce blood pressure in patients with hypertension. ACE inhibitors are also known to reduce the likelihood of developing diabetic kidney disease, and it is for this reason that many physicians (myself included) use ACE inhibitors liberally in people with both diabetes and high blood pressure.
A cynical oncologist once told me that his goal was to help patients to live long enough to die of a heart attack. A cardiologist who was there retorted that he was aiming to let his patients live long enough to get hit by a bus
Resistance is Futile
During pregnancy, a variety of important changes occur in a woman’s body that allow it to accommodate and nurture a developing fetus. Among these changes are alterations in how sugar is handled; early in pregnancy fasting sugar levels fall, while postprandial (after a meal) levels rise. By the end of the second trimester, most women experience a 50% reduction in the body’s ability to respond to insulin, equal to what many people with type 2 diabetes experience.
Consider a hamburger. When most of us eat a burger, we stop thinking about it the moment the hunger pangs disappear. You may think about it for an extra few minutes if it was especially greasy and it gives you a stomachache, but that’s it. In fact, the really interesting stuff doesn’t even start until after the burger’s been broken down to its chemical building blocks and absorbed.
A hot question in biology these days is "How many genes do we have?" Perhaps a more important question is "How many proteins are encoded by our genes?", because proteins actually do the work inside cells. The reason for the distinction is that some genes can give rise to many different proteins. Some hormone genes, for example, yield a single large protein that is then diced and sliced into several smaller proteins, each with its own specialized function.
Evan David Rosen, M.D., Ph.D. Assistant Professor of Medicine, Harvard Medical School has taken a thorough look at the newest immunosuppressives and how they work for diabetes patients. His article Nipping Things in the Bud brings to light some of the uses for these medications and why research is ongoing.
NF-kB is an inflammation activation protein that seems to work in the liver. What does this have to with diabetes? Everything according to Evan David Rosen, M.D., Ph.D. Assistant Professor of Medicine, Harvard Medical School. You can find out why, by reading Some Further Inflammatory Remarks.
Evan David Rosen, M.D., Ph.D. weighs in with his opinion as to how the obestiy numbers got to where they are in his new article Obesity: How big a problem is it?
Although we have a lot of information from ADA Evan David Rosen, M.D., Ph.D. Assistant Professor of Medicine, Harvard Medical School, brings us more research he uncovered about a new protein like drug from Lilly. FGF-21 is unique because as an anti-diabetic drug it appears to increase glucose uptake in an insulin-independent fashion. Learn more at A New Face In The Crowd: FGF-21
Something old, Something new? A new function for a molecule that is already known.

Visfatin, a newly discovered hormone for obesity or old hormone with a new story? Find out by reading what Evan David Rosen, M.D., Ph.D. Assistant Professor of Medicine, Harvard Medical School, has to say in his feature Something Old, Something New.
Evan David Rosen, M.D., Ph.D. Assistant Professor of Medicine, Harvard Medical School
Few areas of medical research are as contentious as the study of stem cells. Most folks are aware of the ethical and political debate surrounding the use of embryonic stem cells, with the promise of medical advances balanced against objections to the use of fetal tissue.

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