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As NPR points out, social media and online communities have the potential to provide a broad-based support network to the increasing number of Americans suffering from diabetes.
The diabetes online community (DOC) consists of millions of Americans nationwide who blog and share testimonials on every aspect of living with the disease, from insulin testing to dating advice, through social media services. A few years ago, drug companies started paying attention to these video testimonials and to bloggers talking about their products. Emerging internet technology is already encouraging a growing number of people to use online resources to track their medical information or even to crowdsource their medical bills. But officials from the Food and Drug Administration are careful to note that while pharmaceuticals’ online outreach might be the wave of the future, there must be greater transparency in identifying which bloggers and online resources are funded or sponsored by the drug industry so as not to dupe customers in what is largely a profit-motivated enterprise. Dipeptidyl peptidase-4 inhibitors commonly used to control blood sugar levels in people with type 2 diabetes may also reduce the risk of autoimmune diseases in these patients, according to research presented this week at the American College of Rheumatology Annual Meeting in San Diego. Dipeptidyl peptidase-4 inhibitors (commonly called DPP-4 inhibitors) such as linagliptin (Tradjenta), saxagliptin (Onglza), and sitagliptin (Januvia) are approved by the United States Food and Drug Administration for the treatment of type 2 diabetes. Patients taking insulin, or with pre-existing systemic autoimmune diseases, HIV or cancer were excluded. Rheumatoid arthritis and other autoimmune diseases were defined with two or more diagnosis codes that were seven or more days apart and one or more prescriptions for disease-specific immunosuppressive drugs or steroids. Scientists at an Academy of Finland Centre of Excellence have discovered a new mechanism regulating the immune response that can leave a person susceptible to autoimmune diseases. Females can mount more powerful immune responses than males, but the flip side of this enhanced protection against infections is a greater risk for autoimmune disorders.
A research team at the Krembil Research Institute has discovered a pair of tissue biomarkers that directly contribute to the harmful joint degeneration associated with spine osteoarthritis. New research by University of Manchester scientists has for the first time shown that our spinal discs have 24-hour body clocks which when they malfunction, can contribute to lower back pain. UCLA researchers have designed a portable imaging system that can diagnose gout, a condition that affects more than 8 million adults in the U.S.
The very first bony fish on Earth was susceptible to arthritis, according to a USC-led discovery that may fast-track therapeutic research in preventing or easing the nation's most common cause of disability. Acanthosis nigricans is probably the most readily recognized skin manifestation of diabetes.
In addition to the direct effects of hyperinsulinemia on keratinocytes, insulin also appears to augment androgen levels in women. Clinically, acanthosis nigricans presents as brown to gray-black papillomatous cutaneous thickening in the flexural areas, including the posterolateral neck, axillae, groin, and abdominal folds.
The histopathology of clinical lesions demonstrates papillomatosis and hyperkeratosis but minimal acanthosis. Bigfoot was founded by Jeffrey Brewer, former CEO of JDRF International, and Bryan Mazlish, the mysterious “Bigfoot” in Dan Hurley’s piece for Wired Magazine, in November 2014, with the sole purpose of revolutionizing the treatment of Type 1 diabetes. Bigfoot recently received approval by the FDA of its Investigational Device Exemption (IDE) submission for a first clinical study of the smartloop automated insulin delivery system. The Diabetes Media Foundation is a 501(c)(3) tax-exempt nonprofit media organization devoted to informing, educating, and generating community around living a healthy life with diabetes.


They also have a Twitter account, a Facebook page, and a diabetes dictionary, and they’re looking into Pinterest and Instagram. And internet tools do present a promising opportunity for a pharmaceutical model that puts drug manufacturers in direct contact with the people they are servicing, creating better market information and bearing potential benefits for both patients and drug makers.
Drugs for pre-diabetic or borderline patients can run Americans with private insurance up to $100 per prescription.
Researchers recently studied how often people with type 2 diabetes taking a DPP-4 inhibitor developed autoimmune diseases—such as rheumatoid arthritis, lupus, inflammatory bowel disease, psoriasis and multiple sclerosis—when compared to those not taking one.
Kim's team compared two mutually exclusive groups: 58,275 patients with type 2 diabetes starting DPP4i combination therapy with patients with type 2 diabetes starting non-DPP4i combination therapy. Potential confounders such as age, sex, co-existing conditions, diabetes-related factors, medications, and health care utilization were controlled for in the analysis. Kim's team found that patients with type 2 diabetes who were starting a DPP-4 inhibitor appear to be at a lower risk of developing RA or other autoimmune diseases compared to those starting non-DPP4i drugs. Thyroid diseases, type 1 diabetes, rheumatoid arthritis, psoriasis and inflammatory bowel disease are some examples. Acanthosis nigricans is common in the general population, and most cases are linked to obesity and insulin resistance.
High insulin levels stimulate the production of ovarian androgens and ovarian hypertrophy with cystic changes.21 Although associated with elevated androgen levels, the acanthosis nigricans in women with polycystic ovarian syndrome (PCOS) does not respond reliably to antiandrogen therapy, implicating the relative importance of hyperinsulinemia over hyperandrogenism in acanthosis nigricans. In the majority of cases, the most important factor in diagnosing acanthosis nigricans is recognizing the usually associated hyperinsulinemia, which is a known risk factor for type 2 diabetes. Hyperpigmentation of the basal layer has been variably demonstrated and the brown color of the lesions is attributed to the hyperkeratosis by most. Topical treatment with calcipotriol,salicylic acid, urea, systemic and topical retinoids have all been used with anecdotal success.
Their  mission is expressed in a system of care to transform the lives of people who depend upon the daily administration of insulin, a life-giving but also dangerous drug.
The trial is slated to take place at three sites, each of which is a global leader in closed-loop insulin delivery research. Especially because diabetes cases have soared by 50 percent in the last 15 years, and are likely to continue affecting more and more Americans across the country, this could be an important way forward.
Although the overall incidence rate of RA or other autoimmune diseases was low (approximately one in 1,000), patients taking DPP4i combination therapy appeared to be 34 percent less likely to develop RA and 27 percent less likely to develop the other autoimmune diseases.
Several drugs have also been reported to cause acanthosis nigricans, including systemic glucocorticoids, nicotinic acid, and estrogens such as diethylstilbestrol. Moving with unprecedented speed in medical device development, over the past 20 months they’ve assembled a team of 40 people and are driving toward commercialization of a cutting edge approach to improving the lives of people with T1D. So, in addition to tweeting about new products, pharmaceuticals are sponsoring bloggers like Sparling. Subgroup analysis comparing DPP4i to sulfonylurea showed similarly protective effect of DPP4i on autoimmune diseases, but not comparing DPP4i versus thiazolidinediones. Drug-related and idiopathic acanthosis nigricans or familial acanthosis nigricans have been reported.


IGF-1 receptors are expressed on basal keratinocytes and are upregulated in proliferative conditions.
In some cases, oral, esophageal, pharyngeal, laryngeal, conjunctival, and anogenital mucosal surfaces may be involved.
In general, though, acanthosis nigricans should be considered a prognostic indicator for developing type 2 diabetes. Studies show that high concentrations of insulin stimulate fibroblast proliferation through IGF-1 receptors in vitro. In general, however, the back of the neck is the most consistently and severely affected area. In a large, population-based study from Galveston, Texas, acanthosis nigricans was present in 7 percent of school-age children. Other members of the tyrosine kinase receptor family, including the epidermal growth factor receptor and the fibroblast growth factor receptor, have been implicated in acanthosis nigricans. This percentage increased to 66 percent of children who weighed 200 percent of their ideal body weight. Several genetic syndromes [Crouzon and SADDAN (severe achondroplasia with developmental delay and acanthosis nigricans)] with mutations in fibroblast growth factor receptor 3 result in acanthosis nigricans in the absence of hyperinsulinemia or obesity. In particularly florid cases, involvement on the back of the hands over the knuckles and even on the palms can be seen. In patients with acanthosis nigricans in association with malignancy, there is usually improvement following treatment of the underlying malignancy. In this study, fasting insulin levels correlated with the presence and severity of skin findings.
When it is associated with malignancy, a tumor of intra-abdominal origin, usually gastric, is seen in the majority of cases. In the Galveston study, despite similar obesity rates, the prevalence was lower in whites (0.5 percent) and Hispanics (5 percent) than in African American children (13 percent). It has been repeatedly described that patients' skin improves with chemotherapy and remits with recurrences.
This finding suggests a possible genetic predisposition or increased sensitivity of the skin to hyperinsulinemia among certain populations.
Although historical data have emphasized the relationship between acanthosis nigricans and malignancy, a true association is rare. Only when the onset is particularly rapid, the clinical findings are florid, or in the non-obese or non-diabetic adult with acanthosis nigricans is an evaluation for malignancy beyond routine age appropriate screening warranted . In one author's experience with seeing more than 12,000 patients with cancer, only two developed acanthosis nigricans.



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