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Routine self-monitoring of blood glucose levels by people with type 2 diabetes who are not taking insulin is an ineffective use of health resources as the modest benefits are outweighed by the significant cost of test strips, suggest 2 studies http://www.cmaj.ca/embargo/cmaj091017.pdf and http://www.cmaj.ca/embargo/cmaj090765.pdf in CMAJ (Canadian Medical Association Journal) www.cmaj.ca . In Ontario, blood glucose test strips are the third largest cost for the Ontario Public Drug Programs in 2007/08, accounting for $100 million or 3.3% of drug expenditures. Usage of test strips increased by almost 250% from 76,320 people in 1997 to 263,513 people in 2008. Almost 53% of...

Dec. 14, 2009 -- Every cup of coffee a person drinks per day may lower the risk of diabetes by 7%. A new review of research on the link between lifestyle factors, like coffee and tea consumption, and diabetes risk suggests that drinking regular or decaffeinated coffee and tea all lower the risk of type 2 diabetes. Researchers say the number of people with type 2 diabetes is expected to increase by 65% by 2025, reaching an estimated 380 million people worldwide. “Despite considerable research attention, the role of specific dietary and lifestyle factors remains uncertain, although obesity and physical...

COLLEGE STATION – A gene commonly studied by cancer researchers has been linked to the metabolic inflammation that leads to diabetes. Understanding how the gene works means scientists may be closer to finding ways to prevent or cure diabetes, according to a study by Texas AgriLife Research appearing in the Journal of Biological Chemistry. "Because we understand the mechanism, or how the gene works, we believe a focus on nutrition will find the way to both prevent and reverse diabetes," said Dr. Chaodong Wu, AgriLife Research nutrition and food scientist who authored the paper with the University of Minnesota's Dr....

A natural glue that sticks mussels to rocks and boat hulls has inspired US scientists to develop a new type of medical adhesive for use in pancreatic islet transplantation, an experimental medical procedure for treating patients with type 1 diabetes. The glue, developed by Phillip Messersmith's team at Northwestern University in Evanston, consists of a branched poly(ethylene glycol) core with catechol-derived end groups. Speaking at the Materials Research Society's meeting in Boston last week, Messersmith explained that the catechol functional group plays a key role in the solidification and adhesive capabilities of the marine blue mussel Mytilus edulis' adhesive proteins. 'Catechol in the presence of an...

Reviewed by Louise Chang, MDThere is more evidence that breastfeeding benefits moms as well as their babies.Breastfeeding was shown to significantly lower a woman's risk for developing metabolic syndrome in a study reported today by researchers with Kaiser Permanente.The longer the women in the study breastfed, the more protection they seemed to derive. Is Your Type 2 Diabetes Under Control? Get Your Health Score Insulin Resistance, Belly Fat Metabolic syndrome is a cluster of risk factors linked to both diabetes and heart disease, including elevated blood pressure, insulin resistance, and belly fat.The new study is one of the most rigorously...

A $200 million genetic research facility planned for Fairfax County could bring with it thousands of jobs over the next decade and spur spinoff businesses that would focus on the fast-growing field of personalized medicine, Virginia officials and researchers said Monday as they announced the move. Enticed by millions of dollars in tax breaks and a location close to universities and federal agencies, officials with the Ignite Institute for Individualized Health, a nonprofit organization specializing in DNA research, announced that the center's facility would be in a 300,000-square-foot campus in the Northern Virginia suburb. A location has not been selected....

Many are conflicted - to get the H1N1 (Swine Flu) shot or not. Regardless of what you decide for you and your family members, everyone would be wise to work at preventing the flu. Your best defense against the virus or any other infection is to strengthen your immune system. My naturopathic recommendation is to work on a strong, healthy body, and worry less about the outside bugs. Fear is not a good defense or offense, but just one more stress that we place on ourselves that will not only not protect us from getting the virus - but will...

Myriad of Compounds Intended to Stop the Progression of Metabolic Diseases Moves Through the PipelineThe competition to develop new therapeutics targeting metabolic disease is heating up. Here’s why: the latest estimates from the American Diabetes Association state that there are nearly 24 million Americans with diabetes. In addition, approximately 32% of American adults are medically obese. Many companies have honed in on this large and growing market, and several of them presented their latest findings at IQPC’s “Groundbreaking Advances and Key Opinions in Metabolic Diseases Drug Discovery and Development� held recently in San Francisco. “When we founded the company, we...

Supplements of the sunshine vitamin may improve insulin resistance and sensitivity, both of which are risk factors for diabetes, says a new study from New Zealand. Insulin resistance, whereby insufficient insulin is released to produce a normal glucose response from fat, muscle and liver cells, was significantly lower in women following high-dose vitamin D supplementation, according to results of a randomised, controlled, double-blind trial published in the British Journal of Nutrition. The optimal effects were observed when blood vitamin D levels were in the range 80 to 119 nanomoles per litre, said the researchers, “providing further evidence for an increase...

I received some news from my doctor this week that, on the surface, is discouraging: I have been diagnosed with diabetes... No sympathy is requested. I got exactly what I deserved. Mea culpa. “So what does that have to do with saving the country?” you ask.

Barcelona — Four widely prescribed oral sulfonylurea drugs are associated with significantly increased risk of all-cause mortality compared with metformin in type 2 diabetic patients having a history of MI, according to a comprehensive Danish national cohort study. The study included all Danish adults with a prior MI who started on oral glucose-lowering monotherapy during 1997-2006. The conclusion: Glimepiride, glyburide, glipizide, and tolbutamide were associated with 33%-43% higher mortality risk than was metformin, Dr. Tina Ken Schramm said at the annual congress of the European Society of Cardiology. In contrast, single-agent gliclazide and repaglinide had all-cause mortality risks similar to...

Metformin Kills Breast Cancer Stem Cells, May Fight Many Cancers Reviewed by Louise Chang, MD The next breakthrough breast cancer treatment may be a diabetes drug already on the shelves of nearly every pharmacy. The drug is metformin, available generically and under brand names such as Glucophage and Fortamet. A growing body of evidence suggests that diabetes patients taking metformin are less likely to get cancer, and have better outcomes if they do get cancer, than those not taking the drug. Now Harvard researcher Kevin Struhl, PhD, and colleagues find that metformin can kill breast cancer stem cells, thought to...

Study: Women With Diabetes May Be 26% More Likely Than Other Women to Develop Atrial Fibrillation Reviewed By Laura J. Martin, MDWomen with diabetes may be 26% more likely than other women to develop a heart rhythm problem called atrial fibrillation.Researchers report that news in the October edition of Diabetes Care.Data came from more than 34,000 adults who got their health care through Kaiser Permanente Northwest. The group included 17,000 diabetes patients.When the study started, atrial fibrillation was more common in diabetes patients than in people without diabetes, affecting 3.6% of the diabetes patients, compared to 2.5% of those without...

Poor bone fracture healing could be next on the list of conditions linked to diabetes, U.S. researchers say. The report, published in the American Journal of Pathology, suggests those with diabetes may have increased production of an inflammatory molecule known as TNF that causes bone fractures to heal more slowly and less satisfactorily. Dr. Dana Graves and colleagues of the University of Medicine and Dentistry of New Jersey in Newark and the Boston University School of Medicine looked at bone repair in a mouse model of diabetes. The researchers find increased levels of inflammatory molecules, particularly TNF-alpha and a mediator...

Two popular treatments lower blood sugar but may not prevent heart disease Tightly controlling blood sugar in people with diabetes doesn’t relieve inflammation that can lead to heart disease, a new study shows. A study of 500 people newly diagnosed with type 2 diabetes shows that a drug called metformin and a once-daily injection of insulin are both effective in controlling blood sugar levels. But the drugs, either alone or in combination, don’t lower levels of three markers of inflammation any more than a placebo does, Aruna Pradhan, a cardiologist at Brigham and Women’s Hospital in Boston, and colleagues report...

It would be entirely fitting for Congress to rekindle the "war on cancer" in response to the death of Sen. Edward Kennedy (D-Mass.), but another disease worthy of a war is diabetes. Cancer kills more people each year - 560,000, according to the Centers for Disease Control and Prevention, compared with 233,600 for diabetes and its complications. But the CDC estimates that the diabetes figures are hugely underreported and that the actual numbers may be 65 percent higher, or 386,000. Kennedy's death from glioblastoma, an aggressive brain cancer, is one reason for a renewed attack on cancer. But, as Gina...

Juice extracted from North American lowbush blueberries, biotransformed with bacteria from the skin of the fruit, holds great promise as an anti-obesity and anti-diabetic agent. The study, published in the International Journal of Obesity, was conducted by researchers from the Université de Montréal, the Institut Armand-Frappier and the Université de Moncton who tested the effects of biotransformed juices compared to regular blueberry drinks on mice. "Results of this study clearly show that biotransformed blueberry juice has strong anti-obesity and anti-diabetic potential," says senior author Pierre S. Haddad, a pharmacology professor at the Université de Montréal's Faculty of Medicine. "Biotransformed blueberry...

Two cans of fizzy drink a day could cause long term liver damage, resulting in the need for a transplant, according to new research. Researchers are now urging parents to cut back on their children’s consumption of fizzy drinks as well as reducing fresh fruit juices substituting them for water. Liver damage is normally associated with alcohol abuse but the new study has found that non-alcoholic drinks with a high sugar content can cause a condition called fatty liver disease. Related Articles Artificial sweeteners 'do nothing to help weight loss' Scientists from Israel found that people who drank a litre...

A gene that controls the way the body responds to the hormone insulin has been identified, marking a breakthrough in the fight against diabetes. Scientists believe a variation in the gene's DNA promotes insulin resistance, the primary cause of type 2 diabetes. The disease is the most common form of diabetes, affecting around two million people in the UK. The discovery could lead to new drug treatments that target the genetic fault and prevent the body failing to respond to insulin. The hormone controls the way cells absorb glucose from the blood and use it to generate energy. In type...

Researchers are inching ever closer to bringing the latest stem-cell technologies from bench to bedside — and are, in the process, learning more about some diseases that long have remained medical black boxes. This week, scientists at the Harvard Stem Cell Institute (HSCI) reported the first success in generating new populations of insulin-producing cells using skin cells of Type 1 diabetes patients. The achievement involved the newer embryo-free technique for generating stem cells, and marked the first step toward building a treatment that could one day replace a patient's faulty insulin-making cells with healthy, functioning ones. (See the top 10...

A deficiency of the sunshine vitamin may worsen plaque accumulation in vessels of diabetes patients Vitamin D deficiency may exacerbate the excess heart disease risk that people with type 2 diabetes face, a new study in the Aug. 25 Circulation suggests. In lab tests, researchers demonstrate that immune cells with very low vitamin D levels turn into soggy, cholesterol-filled baggage that can become building blocks of arterial plaques. Carlos Bernal-Mizrachi, an endocrinologist at Washington University School of Medicine in St. Louis, and his colleagues found that people with diabetes seem more susceptible than nondiabetics to the negative cardiovascular effects attributable...

Researchers searching for a cure for obesity said on Thursday they have developed a drug that not only makes mice lose weight, but reverses diabetes and lowers their cholesterol, too. The drug, which they have dubbed fatostatin, stops the body from making fat, instead releasing the energy from food. They hope it may lead to a pill that would fight obesity, diabetes and cholesterol, all at once. Writing in the journal Chemistry and Biology, Salih Wakil of Baylor College of Medicine in Texas, Motonari Uesugi of Kyoto University in Japan and colleagues said the drug interferes with a suite of...

As the palette of artificial sweeteners has grown and manufacturers have honed the skill with which they blend them to mimic sugar taste, debate has swirled around whether these sensory stand-ins really help people consume fewer calories and avoid weight gain. New research adds another dimension to the uncertainty: It suggests that even when artificial sweeteners fool the taste buds, they still don't fool the ultimate arbiter of our appetites -- our subconscious brains. The latest evidence for this comes from a brain scanning study performed in the Netherlands. Paul Smeets, a neuroscientist at University Medical Center Utrecht, used a...

A small molecule earlier found to have both anti-fat and anti-cancer abilities works as a literal turnoff for fat-making genes, according to a new report in the August 28th issue of the journal Chemistry and Biology, a Cell Press journal. The chemical blocks a well known master controller of fat synthesis, a transcription factor known as SREBP. That action in mice that are genetically prone to obesity causes the animals to become leaner. It also lowers the amount of fat in their livers, along with their blood sugar and cholesterol levels. "We are frankly very excited about it," said Salih...

Genetically engineered gut bacteria trigger insulin production in mice. Friendly gut microbes that have been engineered to make a specific protein can help regulate blood sugar in diabetic mice, according to preliminary research presented last week at the American Chemical Society conference in Washington, D.C. While the research is still in the very early stages, the microbes, which could be grown in yogurt, might one day provide an alternative treatment for people with diabetes. The research represents a new take on probiotics: age-old supplements composed of nonharmful bacteria, such as those found in yogurt, that are ingested to promote health....

Aug. 21, 2009 -- Low levels of vitamin D are known to nearly double the risk of cardiovascular disease in patients with diabetes, and researchers at Washington University School of Medicine in St. Louis now think they know why. They have found that diabetics deficient in vitamin D can't process cholesterol normally, so it builds up in their blood vessels, increasing the risk of heart attack and stroke. The new research has identified a mechanism linking low vitamin D levels to heart disease risk and may lead to ways to fix the problem, simply by increasing levels of vitamin D....

U.S. life expectancy has risen to a new high, now standing at nearly 78 years, the government reported Wednesday. The increase is due mainly to falling death rates in almost all the leading causes of death. The average life expectancy for babies born in 2007 is nearly three months greater than for children born in 2006. The new U.S. data is a preliminary report based on about 90 percent of the death certificates collected in 2007. It comes from the National Center for Health Statistics, part of the Centers for Disease Control and Prevention. Life expectancy is the period a...

It sounds like a simple idea for improving health care: draw up guidelines on how best to treat a particular illness and then pay doctors to follow them. That strategy, which some insurers and health plans already employ, has been embraced during the health care debate by some lawmakers in Congress who want to extend it more broadly. The goal is to improve treatment and, at the same time, save money. But setting guidelines that are good for every patient, it turns out, can get messy, with some experts warning that a big national plan of this sort poses risks....

Obama in his Town Hall cited doctor's opting to amputate diabetics rather than counsel weight lose and diet because they pay very little for counseling whereas amputation pays $30,000-$40,000. AMA has issued a statement saying Medicare pays $541-$708. American College of Surgeons echoed the AMA numbers. Charles Krauthammer pointed out that people are losing confidence in the health care proposals when Obama is wrong by a factor of thirty.

Adi Mor, a student at Tel Aviv University's Department of Neuro-biochemistry, has developed what could be the first tablet-based treatment for children and adults with Type 1 diabetes. Early results show that the compound is effective in restoring insulin production in animal models — which could spell an end to the daily needle injections endured by diabetics.

WASHINGTON (CNN) - Former presidential candidate Mike Huckabee compares his past weight problem to President Obama's economic policies in a pitch Wednesday for a financial newsletter. Huckabee, a former Arkansas governor who failed to win the 2008 Republican presidential nomination, charges that the president "is devouring the entire free-enterprise system" and lists Obama's decision to bail out the auto and banking industries as mistakes. The pitch for "Successful Investing" was sent out to readers of the conservative publication Human Events.

Increasing blood levels of vitamin D are linked to a lower prevalence of the metabolic syndrome, as well as improved 'good' cholesterol levels, says a new study. According to findings published in the Journal of Clinical Lipidology, the lowest levels of the sunshine vitamin were associated with a 31 per cent prevalence of metabolic syndrome, compared to only 10 per cent for people wit the highest average levels. The researchers noted that the results do not prove that low vitamin D levels contributes or causes metabolic syndrome, and called for more studies to "assess whether increasing vitamin D intake...

A study from the University of Bristol in England shows that men with short legs are at increased risk for heart attacks. Men with short legs have higher blood levels of triglycerides, lower blood levels of the good HDL cholesterol that prevents heart attacks and are more likely to store fat in their bellies, signs of not responding adequately to insulin, that causes late-onset diabetes. The authors feel that something that happened before a man was born caused both his short legs and his insulin resistance. Women who do not get enough to eat during the first three months of...

Animal study shows over-the-counter medications lower weight and treat type 2 diabetes Over-the-counter allergy medications turn obese, diabetic mice into healthy, normal-weight mice, researchers report. The new research focuses on mast cells, immune system players critical to the inflammatory response involved in allergies. The study appears along with three other independent studies in the July 26 online Nature Medicine that show a connection between type 2 diabetes and the immune system. “Certainly the study is very exciting,” says George King of Harvard University’s Joslin Diabetes Center in Boston, who was not involved in the research. “It’s the first type to...

WAUSAU, Wis. – A central Wisconsin man accused of killing his 11-year-old daughter by praying instead of seeking medical care was found guilty Saturday of second-degree reckless homicide. Dale Neumann, 47, was convicted in the March 23, 2008, death of his daughter, Madeline, from undiagnosed diabetes. Prosecutors contended he should have rushed the girl to a hospital because she couldn't walk, talk, eat or drink. Instead, Madeline died on the floor of the family's rural Weston home as people surrounded her and prayed. Someone called 911 when she stopped breathing. (snip) Neumann, who once studied to be a Pentecostal minister,...

Enlarge ImageGood fat. These engineered brown fat cells were converted from mouse skin connective tissue cells.Credit: Shingo Kajimura Eating grapefruit, climbing stairs, counting carbs--you've tried everything to shed the extra pounds. But still that stubborn paunch persists. Researchers might be one step closer to a solution for this persistent fat. They have found a way to turn ordinary skin cells into a type of fat that burns rather than stores calories. These cells might one day be used to help curb our rapidly expanding waistlines. When most people think of body fat, they picture the whitish goo in love...

(Ivanhoe Newswire) — Crack open the latest medical textbook to the chapter on type 2 diabetes and you'll be hard pressed to find the term "immunology" anywhere. Metabolic conditions and immunologic conditions are, with a few exceptions, thought to be distant cousins. Recent studies, however, two of which are from Harvard Medical School researchers, have linked type 2 diabetes with immunology in a way that might persuade researchers to start viewing them as siblings. Type 1 and type 2 diabetes both involve abnormalities in the insulin-producing beta cells of the pancreas, but their root causes are completely different. Type 1...

Polysaccharides from black tea may blunt the spike in sugar levels after a meal more than similar compounds from green and oolong tea, and offer potential to manage diabetes, says a new study. The black tea polysaccharides also exhibited the greatest activity for scavenging free radicals, which are linked to development of diseases such as cancer and rheumatoid arthritis, according to new findings published in the Journal of Food Science. Interest in tea and its constituents has bloomed in recent years, with the greatest focus on the leaf’s polyphenol content. Green tea contains between 30 and 40 per cent of...

People who get divorced are more likely to suffer health problems including heart disease and cancer, even if they go on to remarry, a study has shown. Divorce and widowhood have a long-term negative effect on physical wellbeing that is only marginally ameliorated if the person finds a new partner. The stress and financial uncertainty of separation can continue to take their toll on our bodies decades after the Decree Absolute comes through, the research indicates. Divorced people have 20 per cent more chronic health conditions such as heart disease, diabetes or cancer than married people, according to the study...

Research led by the German Institute of Human Nutrition (DIfE) has identified a new gene associated with diabetes, together with a mechanism that makes obese mice less susceptible to diabetes. A genomic fragment that occurs naturally in some mouse strains diminishes the activity of the risk gene Zfp69. The researchers also found that the corresponding human gene (ZNF642) is especially active in overweight individuals with diabetes. The results of the study, which also involved scientists from the University of Leipzig and the German Cancer Research Center in Heidelberg, are published July 3 in the open-access journal PLoS Genetics. According to...

Bayer Diabetes Care in the UK and Ireland today unveils "DIDGET(TM), the first and only blood glucose meter for kids with diabetes that connects directly to Nintendo DS(TM) and Nintendo DS(TM) Lite gaming systems. The DIDGET meter is designed to help kids manage this lifelong condition by rewarding them for building consistent blood glucose testing habits and meeting personalised glucose target ranges. "One of the biggest challenges facing parents of children with diabetes is the constant struggle to instil the habit of regular blood glucose testing that is critical for consistent diabetes management," says John Gregory, Professor in Paediatric Endocrinology,...

NYT Reporter Finds Sotomayor's Diabetes Struggle Inspiring-But Gov. Palin Raising a Family Was Troubling New York Times White House reporter Sheryl Gay Stolberg issued another flattering bunch of factoids about Obama's Supreme Court nominee Sonia Sotomayor -- she controls her diabetes: "Court Nominee Manages Diabetes With Discipline." Stolberg suggested that Sotomayor's "no-nonsense" approach to her insulin injections was a sign of how she will tackle Supreme Court cases. Judge Sonia Sotomayor carries a small black travel pouch, not much larger than a wallet. It contains the implements she needs -- a blood sugar testing kit, a needle and insulin --...

When the cystic fibrosis gene was found in 1989, therapy seemed around the corner. Two decades on, biologists still have a long way to go, finds Helen Pearson. During the day, Lap-Chee Tsui and Francis Collins were attending a gene-mapping workshop. At night they were scrutinizing the pages churning out of a fax machine they had set up in a dorm room. Their hunt for the cause of cystic fibrosis had reached a gene that looked from its sequence like it might have a role in transporting ions through cell membranes, a process that goes awry in those with the...

The vinegar used to garnish salad dressings, pickles and other foods, may live up to its folk reputation as a fat buster and health promoter. Japanese researchers Tomoo Kondo and colleagues noted that vinegar has also been used as a folk medicine since ancient times, for a range of illnesses. Modern research suggests that acetic acid, the main component of vinegar, may help control blood pressure, blood sugar levels, and fat accumulation. Their new study showed that lab mice fed a high-fat diet and given acetic acid developed significantly less body fat (up to 10 percent less) than other mice,...

COLUMBUS, Ohio – A study comparing how two common dietary oil supplements affect body composition suggests that both oils, by themselves, can lower body fat in obese postmenopausal women with Type 2 diabetes. The two oils compared were safflower oil, a common cooking oil, and conjugated linoleic acid (CLA), a compound naturally found in some meat and dairy products that has been associated with weight loss in previous studies. Both are composed primarily of polyunsaturated fatty acids, which are considered “good fats” that, when consumed in proper quantities, are associated with a variety of health benefits. In the study, 16...

NEW ORLEANS — An international committee of experts has endorsed the use of the hemoglobin A1c assay to diagnose diabetes, at a level of 6.5% or above. The 21-member international committee, chaired by Dr. David M. Nathan, was appointed by the American Diabetes Association (ADA), the European Association for the Study of Diabetes (EASD), and the International Diabetes Federation (IDF). Their consensus report—presented in a symposium at the annual scientific sessions of the American Diabetes Association and published simultaneously online in Diabetes Care—has not yet been officially endorsed by the three organizations. “This is the first major departure from the...

Last week, a team of eight cyclists completed the coast-to-coast bike marathon called the Race Across America in record time. It was quite an achievement under any circumstances, but what made it extraordinary was something all eight of them had in common: Type 1 diabetes. Type 1, sometimes called juvenile diabetes, poses special challenges for athletes. A person with Type 1 can’t produce insulin and must take regular injections to control blood sugar. But exercise can also lead to precipitous, even deadly, drops in blood sugar. (Type 2 diabetes, by far the more common form of the disease, typically develops...

News From The American Chemical Society, May 13, 200919 May 2009    Advance in detecting melamine-adulterated food Researchers in Indiana are reporting an advance toward faster, more sensitive tests for detecting melamine, the substance that killed at least 6 children and sickened 300,000 children in China who drank milk and infant formula adulterated with the substance. The improved tests may ease global concerns about food safety, the researchers say. Their report is scheduled for the May 27 issue of ACS' Journal of Agricultural and Food Chemistry, a bi-weekly publication. In the new study, Lisa Mauer and colleagues note that tests...

WASHINGTON: Harold Hamm Oklahoma Diabetes Center researchers have found a link between taking vitamin C with insulin and stopping blood vessel damage caused by type 1 diabetes. While neither therapy produced desired results when used alone, the combination of insulin to control blood sugar together with the use of Vitamin C, stopped blood vessel damage caused by the disease in patients with poor glucose control, said researchers. The findings appear this week in the Journal of Clinical Endocrinology and Metabolism. "We had tested this theory on research models, but this is the first time anyone has shown the therapy's effectiveness...

How the humble hydrangea shrub could hold the key to curing MS, diabetes and arthritis By FIONA MACRAE 05th June 2009 It's bright and beautiful flowers bring a splash of colour to gardens all over Britain. But it seems the hydrangea is more than just a pretty bloom. A drug made from its roots could be used to treat a raft of common diseases, researchers say. The colourful shrub - a staple of Chinese medicine - has the power to 'revolutionise' the treatment of multiple sclerosis, psoriasis and some forms of diabetes and arthritis, scientists claimed yesterday. Hydrangea: The common...