AMAZING ADVANCE FOR DIABETICS

Diabetics using stem-cell therapy have been able to stop taking insulin injections for the first time, after their bodies started to produce the hormone naturally again. In a breakthrough trial, 15 young patients with newly diagnosed type 1 diabetes were given drugs to suppress their immune systems followed by transfusions of stem cells drawn from their own blood. The results show that insulin-dependent diabetics can be freed from reliance on needles by an injection of their own stem cells. The therapy could signal a revolution in the treatment of the condition, which affects more than 300,000 Britons. People with type 1 diabetes have to give themselves regular injections to control blood-sugar levels, as their ability to create the hormone naturally is destroyed by an immune disorder.

All but two of the volunteers in the trial, details of which are published today in the Journal of the American Medical Association (JAMA), do not need daily insulin injections up to three years after stopping their treatment regimes. The findings were released to reporters yesterday as the future of US stem-cell research was being debated in Washington.

Stem cells are immature, unprogrammed cells that have the ability to grow into different kinds of tissue and can be sourced from people of all ages. Previous studies have suggested that stem-cell therapies offer huge potential to treat a variety of diseases such as Alzheimer's, Parkinson's and motor neuron disease. A study by British scientists in November also reported that stem-cell injections could repair organ damage in heart attack victims. But research using the most versatile kind of stem cells - those acquired from human embryos - is currently opposed by powerful critics, including President Bush.

The JAMA study provides the first clinical evidence for the efficacy of stem cells in type 1 diabetes. Sufferers of the chronic condition, which normally emerges in childhood or early adulthood, have to inject themselves at least four times a day. Type 2 diabetes, which tends to affect people later in life, is linked to lifestyle factors such as obesity. There are almost two million type 2 diabetics in Briton, most of whom control their blood-sugar levels with pills or through diet.

The new study, by a joint team of Brazilian and American scientists, found that one of the first patients to undergo the procedure has not used any supplemental synthetic insulin for three years. "Very encouraging results were obtained in a small number of patients with early-onset disease," the authors, led by Julio Voltarelli, from the University of Sao Paulo in Ribeirao Preto, Brazil. write. "Ninety-three per cent of patients achieved different periods of insulin independence and treatment-related toxicity was low, with no mortality."

Type 1 diabetes occurs when the body's own immune system malfunctions and destroys the insulin-producing beta cells of the pancreas, causing a shortage in the hormone. By the time most patients receive a clinical diagnosis, 60 to 80 per cent of their beta cells have been wiped out. The disease progresses from this point very quickly, and can result in serious long-term complications including blindness, kidney failure, heart disease and stroke.

Dr Voltarelli's team hoped that if they intervened early enough they could wipe out and then rebuild the body's immune system by using stem cells, preverving a reservoir of beta cells and allowing them to to regenerate. They enrolled Brazilian diabetics aged between 14 and 31 who had been diagnosed within the previous six weeks. After stem cells had been harvested from their blood, they then underwent a mild form of chemotherapy to eliminate the white blood cells causing damage to the pancreas. They were then given transfusions of their own stem cells to help rebuild their immune systems.

Richard Burt, a co-author of the study from Northwestern University's Feinberg School of Medicine in Chicago, said that 14 of the 15 patients were insulin-free for some time following the treatment. Eleven of those were able to dispense with supplemental insulin immediately following the infusion of stem cells and have not had recourse to synthetic insulin since then, he said. "Two other patients needed some supplemental insulin for 12 and 20 months after the procedure, but eventually both were able to wean themselves from taking daily shots," he added. One patient went 12 months without shots, but relapsed a year after treatment after suffering a viral infection, and resumed daily insulin injections. Another volunteer was eliminated from the study because of complications. The therapy, known as autologous hematopoietic stem cell transplantation, has already shown benefits to individuals with a range of auto-immune diseases such as rheumatoid arthritis, Crohn's disease and lupus.

There are still question marks about exactly how the treatment works, and further studies will be required to fully evaluate it's safety and efficacy. "As a research scientist I am always hesitant to speak of a cure, but the initial results have been good and show the importance of conducting more trials," Dr Burt said. Given the right funding opportunities, university hospitals in London could be conducting research into the therapy within the next 12 months, he added. "It will probably be five to eight years before we see a treatment being widely available," he said. In an accompanying editorial in JAMA, Dr Jay Skyler, of the Diabetes Research Institute at the University of Miami, wrote: "Research in this field is likely to explode in the next few years and should include randomised controlled trials, as well as mechanistic studies."

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Smokers have daughters?

If true it is odd that it has not been picked up before

COUPLES who smoke when they conceive a child are almost twice as likely to have a girl, according to new research that suggests tobacco "kills" male foetuses. An Australian fertility expert has voiced concern that the startling results could encourage prospective parents to take up smoking to determine their baby's gender.

In an analysis of 9000 pregnancies between 1998 and 2003, researchers at the Liverpool School of Tropical Medicine in Britain found that mothers who smoked during pregnancy were a third less likely to have a boy than non-smokers. When the father also smoked, the chance of having a boy was almost halved. The researchers believe that chemicals in cigarettes, like nicotine, inhibit sperm carrying male, or Y, chromosomes from fertilising eggs. The study's leader, Professor Bernard Brabin, said the results raised serious questions about the impact of smoking on population balance. "The message is clear: if you want an increased chance of a male baby, don't smoke during pregnancy," Professor Brabin said.

Dr Anne Clark, of the Fertility Society of Australia, said it was already known that male embryos were less robust and more likely to miscarry than females. "More male are conceived than girls but about the same number are born, once this weakness is accounted for," Dr Clark said, "but we didn't know about this smoking connection." She said she was concerned they could motivate parents wanting a girl child to smoke. "If people think that smoking might get them what they want, they're wrong," Dr Clark said. "The mother is going to be three times more likely to have a fertility problem and twice as likely to have a miscarriage if she takes up [smoking] around . conception. The message is, don't smoke at all if you want a child."

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Fat kids not schools' fault

Australian writer Anita Quigley has some sharp words for the "obesity" whiners

OF all the middle-class, neurosis-inducing, guilt-ridden topics, the subject of children's eating habits takes the cake - low-fat of course. But it really is very simple: If you are the parent of a fat child and think his or her school canteen is to blame, then you are kidding yourself. Your child is pudgy, plump or obese - thanks to you.

And yesterday's uproar by parents over schools that aren't doing enough to stop students eating junk food - either in the canteen or by ordering in-- is ridiculous. The fact pupils are being delivered pizzas and sell bootlegged Coke at school just shows the ingenuity of today's mobile phone-equipped, pepperoni-craving children. More importantly it also shows that the war on childhood obesity won't be won in the classroom.

Parents are well within their rights to demand more influence over what their children eat at school. However, they also need to be reasonable and meet their end of the bargain. It is impossible to instil a habit of healthy eating if your children go home to soft drinks and takeout for dinner five nights a week. Equally, you may argue that schools providing foods high in fat and sugar undo all the good work done at home. However, School Canteens Association of NSW's Jo Gardner says of school kids aged five to 15, less than 3 per cent of their food consumption comes from the canteen.

Meanwhile, Duncan Irvine, head of Duncan's Catering, which operates canteens in 37 government high schools, says 75 per cent of all food consumed at school is brought in from home. Based on those figures, you cannot blame the school tuckshop for your child's weight problems. But what you can blame it on is what you pack into your children's lunchboxes. You can also blame the parents for the amount of money they give their kids to buy lunch.

Part of being a parent means making school lunches, and nourishing ones at that. Not a peanut butter sandwich every day with a bag of chips thrown in. However, like most parenting issues these days, "time-poor" mums and dads are outsourcing their responsibilities to schools. They demand schools be chiefly responsible for the exercise their children get, all the sex education their children need to know, and the discipline their children aren't getting at home. Now they are demanding that healthy eating be the school's obligation too.

Of course, most are only echoing our political leaders. For every time there is an issue in the community about the failings of young people, politicians want a remedy included in the curriculum. It was therefore refreshing to yesterday hear new Education Minister John Della Bosca say forcing students to eat healthy food is not the responsibility of schools. The pressure on schools today to turn out model citizens is absurd. When is there time anymore for teachers to do the basic teaching of core subjects?

Government and private schools began phasing in healthy food regimens at canteens nearly four years ago, amid rising evidence of a childhood obesity epidemic. This year all sugary soft drinks were banned. But as you can see students are taking alternative measures to acquire fast food.

In Britain, where government-supplied school lunches have just been turned upside-down by super cook Jamie Oliver to be more healthy, parents have been caught throwing junk food over school fences to their children. A friend, Emma, who does canteen duty at her children's primary school on the North Shore, says it is not unusual for pupils to produce $50 and $20 notes to buy their lunch - clearly with no budget attached. "In some cases, it's not even a matter of what they're eating, it's how much," she says. "You will see the same child twice at morning recess and at lunchtime they come back three times."

I appreciate that the older your kids get, when you kiss them goodbye at the school gate you also kiss goodbye to the ability to control their diets. However, it's parents who have a lesson to learn - stop passing the buck.

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Just some problems with the "Obesity" war:

1). It tries to impose behavior change on everybody -- when most of those targeted are not obese and hence have no reason to change their behaviour. It is a form of punishing the innocent and the guilty alike. (It is also typical of Leftist thinking: Scorning the individual and capable of dealing with large groups only).

2). The longevity research all leads to the conclusion that it is people of MIDDLING weight who live longest -- not slim people. So the "epidemic" of obesity is in fact largely an "epidemic" of living longer.

3). It is total calorie intake that makes you fat -- not where you get your calories. Policies that attack only the source of the calories (e.g. "junk food") without addressing total calorie intake are hence pissing into the wind. People involuntarily deprived of their preferred calorie intake from one source are highly likely to seek and find their calories elsewhere.

4). So-called junk food is perfectly nutritious. A big Mac meal comprises meat, bread, salad and potatoes -- which is a mainstream Western diet. If that is bad then we are all in big trouble.

5). Food warriors demonize salt and fat. But we need a daily salt intake to counter salt-loss through perspiration and the research shows that people on salt-restricted diets die SOONER. And Eskimos eat huge amounts of fat with no apparent ill-effects. And the average home-cooked roast dinner has LOTS of fat. Will we ban roast dinners?

6). The foods restricted are often no more calorific than those permitted -- such as milk and fruit-juice drinks.

7). Tendency to weight is mostly genetic and is therefore not readily susceptible to voluntary behaviour change.

8). And when are we going to ban cheese? Cheese is a concentrated calorie bomb and has lots of that wicked animal fat in it too. Wouldn't we all be better off without it? And what about butter and margarine? They are just about pure fat. Surely they should be treated as contraband in kids' lunchboxes! [/sarcasm].

Trans fats:

For one summary of the weak science behind the "trans-fat" hysteria, see here. Trans fats have only a temporary effect on blood chemistry and the evidence of lasting harm from them is dubious. By taking extreme groups in trans fats intake, some weak association with coronary heart disease has at times been shown in some sub-populations but extreme group studies are inherently at risk of confounding with other factors and are intrinsically of little interest to the average person.

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