Mystery of why certain diabetes drugs work well for some and not others solved

According to the American Diabetes Association, 23.6 million children and adults in the United States, or 7.8% of the population, have diabetes, the majority of whom have Type-2 diabetes. And in Australia, more than one million are affected by the disease. As a consequence of diabetes, most patients also suffer from heart disease. What's more, mortality rates for adults with diabetes is two to four times higher than the general population, with heart disease and stroke accounting for approximately 65 percent of deaths in people with diabetes.

Most people must take anti-diabetic drugs to protect their kidneys from damage in order to slow the disease's progression. Researchers have long been unclear why some anti-diabetic drugs work well for some, but not others. Now, scientists from Austin Hospital of Melbourne, Australia had discovered why. In a paper recently published in the journal Diabetes Care, they report that a diet high in salt can reduce the effectiveness of the medications. "It's a wakeup call for people with diabetes who eat too much processed food," says Lead Researcher Dr. Elif Ekinci, an endocrinologist at the Austin Hospital. "We showed that the drugs work best in a low-salt environment. It really highlights that salt is having an effect on 'protein leakage' in diabetes, the No. 1 cause of kidney disease."

While most people with diabetes understand that they must avoid salt due to its link to heart disease and high blood pressure, the findings stress the importance of diabetics with normal blood pressure levels to limit salt intake. This is easier said than done. One patient, Bob Gunning of Lower Plenty, Australia, described switching to a low-salt diet as "murder at first." But he says, it's been worth it. "Before, I was sluggish and pale, I had a bit of a gut. I've lost that gut, I'm sleeping better and people are complimenting me on how well I look." Mr. Gunning also notes that food now actually tastes better. "I can actually taste food now," he says. "I never knew it was so blunted by salt and salty sauces." Unfortunately, however, as Dr. Ekinci points out, salt is widely used to preserve and flavor food, making it difficult for most people to cut salt from their diets.

News Release: Salt can stymie diabetes drugs  www.theage.com.au  June 1, 2009