Type 2 diabetes is very common and the number of people affected is increasing. The disease is linked to obesity, with 80% of individuals who develop the disease being obese. Therefore as the incidence of obesity rises around the world, so too does the incidence of type 2 diabetes. The World Health Organization (WHO) estimates that more than 180 million people worldwide have diabetes. It claims that this number is likely to more than double by 2030.*

When a team of Cochrane Researchers set out to see if dietary advice alone could help a person with type 2 diabetes, they were only able to identify two trials that together involved just 358 people.

"Considering the importance of this disorder, we were disappointed to find such a small amount of relevant data," says lead researcher Lucie Nield, who works in Centre for Food, Physical Activity & Obesity, University of Teesside, Middlesbrough.

The two studies did, however, indicate that dietary advice alone could play an important role. One study randomly assigned people to either a control group or a dietary advice group. After six years 67.7% of people in the control group had diabetes, compared with only 43.8% in the advice group. This was a 33% reduction. In another study 12 months of dietary advice led to significant reductions in many diabetes related factors, such as insulin resistance, fasting C-peptide, fasting proinsulin, fasting blood glucose, fasting triglycerides, and fasting cholesterol and PAI-1.

"These two studies give grounds for believing that dietary advice alone could play an important role in reducing type 2 diabetes, but we do need more well-designed, long-term studies before we can work out the best advice to give," says Nield.

*who.int/mediacentre/factsheets/fs312/en/

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p75NTR acts by depressing the cell's normal signalling mechanisms that are necessary to stimulate the growth of new blood vessels. In its absence, this process proceeds normally.

Dr Emanueli said: "Our findings demonstrate the importance of understanding the individual factors responsible for such diabetes-induced complications. The data reveal that by suppressing the action of one particular gene, we can improve recovery of tissues following inadequate blood flow, and this opens up new avenues for its use to combat diabetes-induced vascular disease."

Paper:

Neurotrophin p75 Receptor (p75NTR) Promotes Endothelial Cell Apoptosis and Inhibits Angiogenesis: Implications for Diabetes-Induced Impaired Neovascularization in Ischemic Limb Muscles by *Andrea Caporali, *Elisabetta Pani, Anton J.G. Horrevoets, Nicolle Kraenkel, Atsuhiko Oikawa, Graciela B. Sala-Newby, Marco Meloni, Brunella Cristofaro, Gallia Graiani, Aurelie S. Leroyer, Chantal M. Boulanger, Gaia Spinetti, Sung Ok Yoon, Paolo Madeddu, Costanza Emanueli, Circulation Research Volume 103, published online before print July 17, 2008.

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