QUARTESIAN NEWS LETTER

Aims to provide interesting articles and news on current areas of research

Issue 03 to scientific fellow members of the industry

Vol 01
th EDITORIAL
10 Oct, 2010
Issues surrounding Diabetes…
Quartesian Conveys Greetings for this Festival Season!!!

We received more than 50 feedbacks for our second issue (first issue received around
15 feedbacks). This shows more than 300% increase in the participation of the readers
in comparison to first issue.

We are happy to make a mention of Ms. Renuka from Fortis Clinical research, who
volunteered and contributed to this news letter. In this way one more new step has
been taken to entertain external contributors. We are very much encouraged with the
readers’ response and we thank for their best wishes, suggestions and contribution…

We are very glad to present third issue of QNL. In this issue the main focus is on
Diabetes research and five important study findings in this area have been briefed.
Chief Editor
We have tried to explore the relationship of Type 2 Diabetes with breastfeeding, short
Dr. Shiva Murthy N sleep, hyper-triglyceridemic waist, and childhood obesity.

Scientific Contributors Breastfeeding again proved to be protective to women’s health against diabetes.
Chromosomal link can act as the biomarker for diagnosing expected diabetes in
Mrs. Manjula Devanur childhood itself. After reading the articles presented in this issue you will agree with
Dr. Shiva Murthy N my next three comments:
Ms. Renuka Gahlawat A) Being lean is always better to keep diabetes away.
B) Sleep well and be happy without diabetes.
Review Board
C) Nature can be the best source of medicines. Guava leaves tea can slow down
Mr. Soumitra Chowdhury glucose uptake in GIT…
Mr. Benjamin Jackson
Dr. Vladimir Mats Playing with words is always interesting and writing meaningful sentences aimed at
Mr. John Packianathan protecting ones health, gives us immense pleasure…
Mr. Prakash Velappan
Mr. Prasanna Sondur We look forward to bring many more issues… thanks again for your continued
Mrs. Ramya Krishna support…. QNL editorial board
Dr. Rhuta Khaparde

Send your queries to

shiva.murthy@quartesian.com
Breastfeeding and Type 2 Diabetes
Breastfeeding and its relation with various diseases is constantly on debate.
“Breastfeeding protects women from getting breast cancer” - is a well established fact.
1
New issue raised by RRISK study on relationship between breastfeeding and type 2 diabetes is presented below .
o RRISK (Reproductive Risk factors for Incontinence Study at Kaiser) recently reported that mothers who did not breastfeed their
children had significantly higher rates of type 2 diabetes later in life than moms who breastfed.
o Study involved a well-characterized, population-representative cohort of 2233 women, aged 40-78 years in California between 2003
and 2008.
o Fifty six percent had breastfed an infant for ≥1 month. In fully adjusted models, the risk of type 2 diabetes among women who
consistently breastfed all of their children for ≥1 month remained similar to that of women who had never given birth (Odds Ratio
1.01; 95% CI, 0.56-1.81).
o In contrast, mothers who had never breastfed an infant were more likely to have developed type 2 diabetes than nulliparous women
(Odds Ratio 1.92; 95% CI, 1.14-3.27).
o Mothers who never exclusively breastfed were more likely to have developed type 2 diabetes than mothers who exclusively
breastfed for 1-3 months (OR 1.52; 95% CI, 1.11-2.10).
o Results showed that risk of type 2 diabetes increases when term pregnancy is followed by <1 month of lactation, independent of
physical activity and BMI in later life.
Based on these findings, researchers opined that mothers should be encouraged to exclusively breastfeed all of their infants for at least 1 month.

SUPPORT AND FEEDBACK ON SECOND

ISSUE OF QNL
We are glad to share that we received lot of support and positive feedback from the prominent personnel
in the industry and the list below is a sample one. We thank each and everyone and request for continued
support….

Amin (Ana Design)
Aleksandra Pesic (PSR Group)
Rashi Gandhi (Triest Life Sciences)
Ashok Shenoy K (Kasturba Medical
College)
Ajay (Clintec)
Ashok Srivastava (Pharmalynx)
Karnvir (Atharva Life Sciences)
Rajiv Mahajan (Company Not known)
M E Clark (Duanemorris)
Raminder S. Sachdeva (DBMS)
Sahil Verma (DBMS)
Shilpi Jain (Panacea Biotec)
Kamal Shahani (Cliniminds)
Vyjayanthi.G (Apotex)
Dhanpat Ram Agarwal (ITAG)
Chintamani Joshi (FRLHT)
Mithun Garai (Lamda Therapeutics)
Rajiv Ramanathan (Quintiles)
Jebasingh B (Company Not known)
Rehaman (Aroma Consulting)
Renuka Gahlawat (Fortis Clinical Karthik Anantharaman (Integrated Disease
Research) Management)
Ofelia R. Nievas (Clinipace) Suman R Menon (Director, IICRM)
Joy Ganguly (Fortis Health Care) Wasif Khan (Company Not Known)
Rashmi Jain (e-Chikitsa Informatics Aayam Gupta (Yoga Teacher, Suva
Pvt.Ltd) Republic Of Fiji Islands)
P. Kamalakannan, (Priyadarshini Dental VSK (Journalist)
College) Geetanjali Rao (Company Not known)
Pierre T. Soumenkoff (US Biomedical Kushal Sarda (Bharati Vidyapeeth Pune)
Systems) Prason Kumar (Lailapharma)
S.Manivannan (Parama Health Care) Sheetal (Dr. Reddys)
K. Venkateshwarlu., M.D (Ayu) (Natural Sharon Bingert (Creative Technical Writer
Remedies) and Trainer in both Telecommunications
Swaroop.Sarangan (RIL) and Pharma Industries)
Praveen (BIOCON) Shyam (PeopleSearch Consultants)
Param Hans Mishra (Indian Spinal Injury Richee Moon (Super Religare Laboratories)
Center) Rajesh Agarwal (IFGL Bio Ceramics)
Jaison Jose (Novartis) Ramanjot Kaur (Company Not Known)
James Fan (ICON) Jadhav Rahul (Company Not Known)
Chandrashekar (ICON) Bharat Reddy (Deloitte)

Please send your feedback and support to our initiative by emailing to

shiva.murthy@quartesian.com 2
 Guava Leaf Extract – a folk remedy for Diabetes2

World Health Organization has estimated approximately 366 million people (4.4 %) with Diabetes Mellitus (DM) in
the global population by 2030.

Type II DM is expected to become more serious both in the developing as well as developed nations because of
lifestyle changes, a shift to “Western-Style” diet.

The common guava fruit (Psidium guajava) is used as a folk medicine for diabetes in Japan, Africa and East Asia.

Some alpha- glucosidase enzymes such as maltase, sucrase, and alpha-amylase digest carbohydrates to glucose in
the digestive tract. Inhibiting their activity would prevent digestion of carbohydrates and provide glycemic
control.

Research (Deguchi et al) demonstrated that aqueous guava leaf extract (GvEx) inhibits the in-vitro activities of
these alpha-glucosidase enzymes in a dose dependent manner with 50% inhibitory concentration as 0.6 mg/mL,
2.1 mg/mL and 3.6 mg/mL for alpha amylase, maltase and sucrase, respectively.

Research also elucidates the active component of the GvEx as some phenols, such as peduncladgin, casuarinin and
isostrictinin.

Further research revealed that the single ingestion of GvEx reduces postprandial glucose elevation via the
inhibition of alpha-glucosidase.

Consecutive ingestion of guava leaf tea with every meal also improves diabetic symptoms, such as hyperglycemia,
hyperinsulinemia, insulin resistance as well as hyperlipidemia in pre-diabetic and mild- diabetic patients.

With its alimentotherapy, guava leaf tea and GvEx induce neither toxicity, mutagenicity, nor abnormal
interaction with anti-diabetic and anti-hyperlipidemia drugs. Thus, a safe food material.

Please get your doctor’s advice before you start to use the same. Research in this area is in progress and your
doctor is the best judge. (Authors are not responsible for any AEs or complications if you decide to use on your
own)

Clinical Data Management and SAS programming Industry Training Courses

An innovative Industry-Academia collaboration has been established between Quartesian and CliniMinds to
offer 6 months diploma courses. For course details please contact/write to shiva.murthy@quartesian.com
3
 Short sleep –
Increases risk for Impaired
Impaired Fasting Glucose3
The Western New York Health Study reported that short sleep duration is associated with an elevated risk of a pre-diabetic state,
known as incident-impaired fasting glycaemia (IFG). IFG means where our body is not able to regulate glucose as efficiently as it
should be doing it and people with IFG have a greater risk of developing type 2 diabetes and is at an increased risk of heart
disease and stroke.

The researchers followed 1455 participants who were free of type 2 diabetes and known cardiovascular disease at baseline (1996–
2001) and were reexamined in the period 2003–2004 in a nested case-control study.

The Fasting Plasma Glucose (FPG) was <100 mg/dL at baseline and 100 to 125 mg/dL at follow-up for the cases and controls (n =
272) had FPG <100 mg/dL at both exams. Cases (n = 91) were individually matched to three controls (n = 272) on sex, race, and
year of study enrollment.

Average sleep duration was categorized as short (<6 hours), mid-range (6 to 8 hours), and long (>8 hours).

In multivariate conditional logistic regression after adjustment for several diabetes risk factors, the odds ratio of IFG among short
sleepers was 3.0 (95% CL: 1.05, 8.59) compared to mid-range sleepers.

On the contrary, there was no association between long sleep and IFG: Odds Ratio 1.6 (95% CL: 0.45, 5.42).

Adjustment for insulin resistance attenuated the association only among short sleepers: Odds Ratio 2.5 (95% CL: 0.83, 7.46).

Based on these findings, researchers concluded that short sleep duration was associated with an elevated risk of IFG and opined
that insulin resistance appears to mediate this association. As per this study, people who sleep less than six hours a night may be
three times more likely to IFG.

A
Academic Participation

CTA 2010 – Organized by Virtue Insight

Dr. Shiva Murthy, Director, Clinical Research and

Business Development of Quartesian,
participated in CTA 2010, Bangalore. He
participated in panel discussion on “Overcoming
regulatory challenges in Asian clinical trials”.

Picture A: (Right to Left) Dr. Radhika Bobba, Dr.

Shiva Murthy N, Mr. Lakshmanan Sathappan,
B Prof. Thuppil Venkatesh, and Dr. Milind Antani.

Picture B: Active participation from Quartesian’s

representative. Dr. Murthy commented and
raised queries on “Setting up a medical writing
unit in India” and “Patient Safety and
Pharmacovigilance” topics.

Thanks for supplying the

photos and giving this opportunity.

4
 Medical Consultants Required For
RNTCP* - Technical Assistance Project

*Revised National Tuberculosis Control Programme

Eligibility: MBBS with at least 2 years of

experience in implementing public health
programmes with hands on experience in
supervision and training.

Remuneration: Rs. 60,000/- pm plus travel

allowance and benefits.

Work in Brief: Work as 3rd party service provider

and will interact with WHO as consultants. Provide
technical assistance to the RNTCP. Work closely
with Govt. staff, partner states, district and sub-
district level.

Application procedure: Apply before 20th October,

2010, visit www.sams.co.in for more information.
You can also email your details to
rtap@sams.co.in.

This information is obtained from Times of India,

Bangalore, October 06, 2010, Ascent, Page 2.

This information is presented with the intention of

supporting this important national programme.

Hypertriglyceridemic Waist –
Prone for Gestational Diabetes4

Diane Brisson and group worked on this concept.

The aim of the study was to study the association between the hypertriglyceridemic-waist phenotype
(i.e., abdominal obesity in combination with hypertriglyceridemia) in early pregnancy and glucose
intolerance in later pregnancy.

They included 144 white pregnant women in whom the plasma triglycerides and waist girth were
measured at 11–14 weeks of gestation and glycemia was measured following a 75 g oral glucose
tolerance test performed at 24–28 weeks of gestation.

They reported that waist girth >85 cm in combination with a triglyceride level 1.7 mmol/L in the first
trimester was associated with an increased risk of two-hour glucose 7.8 mmol/L following the 75 g oral
glucose tolerance test (Odds Ratio 6.1, p = 0.002).

This risk remained significant even after researchers controlled for maternal age, fasting glucose at first
trimester and previous history of gestational diabetes (Odds Ratio 4.7, p = 0.02).

Based on these data, researchers concluded that measurement of waist girth in combination with
measurement of triglyceride concentrations in the first trimester of pregnancy could improve early
screening for gestational glucose intolerance.

5
 Chromosomal Link –
Type 2 Diabetes in Children and Adolescents5
G. Cai, and Group reported biomarker for early presentation of type 2 diabetes in Children and Adolescents.

Researchers aimed to localize quantitative trait loci influencing fasting serum glucose levels in 1030 Hispanic
children participating in the Viva La Familia Study.

They measured fasting serum glucose levels enzymatically, and genetic linkage analyses using SOLAR
software.

They identified that fasting glucose was heritable, with a heritability of 0.62 ± 0.08 (P < 0.01). Genome-wide
scan mapped fasting serum glucose to markers D13S158–D13S173 on chromosome 13q (LOD score of 4.6).

They reported that insulin receptor substrate 2 gene is the regulator of glucose homeostasis and is the
candidate gene for obesity. This region was also reported previously to be linked to obesity and diabetes-
related phenotypes.

Researchers concluded that a quantitative trait locus on chromosome 13q contributes to the variation in
fasting serum glucose levels in Hispanic children at high risk for obesity.

References
1. Eleanor Bimla Schwarz, Jeanette S. Brown, Jennifer M. Creasman,
REGISTER IMMEDIATELY FOR
5th DIA India Conference
Alison Stuebe, et al. Lactation and Maternal Risk of Type 2 Diabetes:
October 23-26, 2010 A Population-based Study. The American Journal of Medicine, 2010;
Hotel The Lalit Ashok, Bangalore, India 123 (9): 863.
2. Yoriko Deguchi, Kouji Miyazaki. Anti-hyperglycemic and anti-
TUTORIALS No 5: OCTOBER 23, 2010, 2-6 pm hyperlipidemic effects of guava leaf extract. Deguchi and Miyazaki
Nutrition & Metabolism 2010, 7:9
Biosimilars: 3. Lisa Rafalson, Richard P. Donahue, Saverio Stranges, Michael J.
Prospects and Challenges in the Development Lamonte, Jacek Dmochowski, Joan Dorn, Maurizio Trevisan. Short
Licensing and Commercialization Sleep Duration Is Associated with the Development of Impaired
Fasting Glucose: The Western New York Health Study. Annals of
Dr. Shiva Murthy N Epidemiology, 2010.
Quartesian CR P. Ltd. 4. Diane Brisson, Patrice Perron, Simon-Pierre Guay, Daniel Gaudet,
Dr. Srinivas Sidgiddi and Luigi Bouchard. The "hypertriglyceridemic waist" phenotype and
Connexios Life Sciences glucose intolerance in pregnancy. CMAJ, September 2010.
5. G. Cai, S. A. Cole, N. F. Butte, V. S. Voruganti, A. G. Comuzzie. A
Contact immediately
Quantitative Trait Locus on Chromosome 13q Affects Fasting
Glucose Levels in Hispanic Children. Journal of Clinical
Endocrinology & Metabolism, 2007; 92 (12): 4893.

Disclaimer: The contents of the news letter are for internal circulation only and not for sale. To the
best of our knowledge the information was collected from the open sources and the article is re-
synthesized at Quartesian. We do not claim any copyrights and original authors of the research
retains all the claims and copyrights. We have done best to convey messages and conclusions to
reflect original article. We will not be responsible for any misunderstanding and disputes arising
out of this article. If you believe that any work included violates any copyrights you hold or
represent, we will immediately remove it upon notification. Basically this article is prepared and
distributed with the intention to spread the knowledge and enhance the research in the area
described. All queries are welcome to shiva.murthy@quartesian.com 6