Diabetes
Tai chi shows promise for managing diabetes
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The ancient art of tai chi may help in controlling or lowering the risk of type 2 diabetes, two small studies suggest.
In one study, Taiwanese researchers found that tai chi helped lower long-term blood sugar levels in 30 middle-aged adults with type 2 diabetes. In the second, an Australian team found that a combination of tai chi and qigong benefited 11 adults at risk of type 2 diabetes.
Both tai chi and qigong (pronounced “chee-kung”) are ancient Chinese practices designed to promote good health. Qigong combines gentle movements, meditation and breathing techniques; tai chi involves slow, fluid movements combined with mental imagery and deep breathing.
EHR-based Program Improves Diabetes Care
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Using the Electronic Health Record to actively engage diabetes patients in their own care results in improved blood sugar and cholesterol levels, better vaccination compliance and increased tobacco cessation rates, according to a new Geisinger study.
Geisinger Health System launched an Electronic Health Record-driven care program for its 20,000 diabetes patients in 2005. A study published in April’s Journal of General Internal Medicine showed improvements for most of those diabetic patients:
• the percentage of patients receiving pneumonia vaccinations increased from 56 to 80%;
• the percentage of patients receiving microalbumin test for possible kidney complications increased from 57 to 87%;
• the percentage of patients with an optimal cholesterol level increased from 54 to 57%;
• the percentage of documented non-smokers increased from 77 to 82%.
Fitness, body weight impact type 2 diabetes risk
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Lower cardiorespiratory fitness and higher body weight are independently associated with the development of type 2 diabetes in women, new research suggests.
“These findings underscore the critical importance of promoting regular physical activity and maintaining normal weight for diabetes prevention,” Dr. Xuemei Sui, of the University of South Carolina, Columbia, said in an interview with Reuters Health.
Sui and associates followed 6,249 women between the ages of 20 and 79 years for 17 years. The women were free of heart disease, cancer, and diabetes at the outset.
Increased risk of myocardial infarction and diabetes in East Germany
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More people suffer from overweight, high blood pressure and metabolic disturbances in East Germany than in West Germany. This is the result of a study with almost 36 000 patients, published in the current edition of the Deutsches Ärzteblatt International (Dtsch Arztebl Int 2008; 105[12]: 207-13).
Potential association of type 2 diabetes genes with prostate cancer
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-Scientists have identified six new genes which play a role in the development of type 2 diabetes, and among the group is the second gene known to also play a role in prostate cancer.
The new findings bring the total number of genes or genomic regions implicated in diabetes to 16, said Laura Scott, assistant research scientist in the Department of Biostatistics. Researchers from the University of Michigan were one of three teams of scientists in Europe and North America that led the multi-group collaboration. The findings, which were published today in the journal Nature Genetics, provide new insights into the mechanisms which are usually responsible for the control of glucose, or sugar, levels in the blood, and to the derangements that can result in type 2 diabetes, which impacts more than 170 million people worldwide.
One of the newly discovered genes, which goes by the name of JAZF1, contains a separate variant that has recently been shown to play a role in prostate cancer, and is the second gene that appears to play a role in both conditions.
Metformin may delay diabetes onset in those at risk
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In people who are at risk of developing diabetes, treatment with metformin leads to modest improvements in weight, lipid (fat) profiles and fasting blood sugar. In addition, substantial reductions in insulin resistance, a condition that usually precedes diabetes, are seen, as well as the actual development of diabetes, according to a large review of published studies on this topic.
Dr. Shelley R. Salpeter from Stanford University School of Medicine, California and colleagues combined data from 31 trials that compared metformin with placebo or no treatment in a total of 4570 adults at risk for diabetes. Metformin comes in a long-acting tablet form and is sold under several trade names, such as Glucophage and Fortamet.
Metformin, compared with the other two groups, reduced body mass index by 5.3 percent, fasting blood sugar by 4.5 percent, fasting insulin by 14.4 percent, and calculated insulin resistance by 22.6 percent, according to the report in the American Journal of Medicine.
Heart patients with diabetes need extra care
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People hospitalized because of acute heart failure face an increased risk of dying in the hospital and in the longer term if they have diabetes or pre-diabetes, researchers report.
The finding “could help target some patients for more intensive therapy,” write Dr. John J. V. McMurray from the University of Glasgow, UK, and colleagues in the medical journal Heart.
The team studied 454 consecutive patients admitted to one university hospital for heart failure; 110 of them (24 percent) had diabetes, 60 (13 percent) had pre-diabetes indicated by high blood levels of glucose, and 284 had normal blood glucose.
Being underweight may raise diabetes risk
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Being underweight may place men and women over age 60 at increased risk for developing diabetes, Japanese researchers report.
“Older people who are underweight may need to take care of their poor nutrition status,” Dr. Toshimi Sairenchi noted in comments to Reuters Health.
To examine the association between underweight and diabetes risk, Sairenchi and colleagues collected information in 1993 from 39,201 men and 88,012 women who were between 40 and 79 years old and who did not have diabetes. They followed the men and women for an average of 5.3 years.
Diabetes linked to endometrial cancer risk
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Type 2 diabetes is associated with cancer of the lining of the uterus (endometrial cancer), regardless of the presence of most other risk factors, study findings suggest.
“A positive association has been observed in nearly all studies of type 2 diabetes in relation to the incidence of endometrial cancer,” Dr. Babette S. Saltzman, of the Fred Hutchinson Cancer Research Center, Seattle, Washington, and colleagues note in the American Journal of Epidemiology.
“Given the adverse effect of obesity on the incidence of both diabetes and endometrial cancer, investigators have adjusted for obesity in a number of these studies,” they note. “To varying degrees, all found that diabetes was independently associated with endometrial cancer.”
Workouts boost function of insulin-making cells
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Sedentary older people at risk of developing diabetes showed significant improvement in the function of their insulin-making beta cells after just one week of exercise, University of Michigan researchers found.
Beta cell function is known to decline with age, although it is not clear why, Drs. Cathie J. Bloem and Annette M. Chang explain in the Journal of Clinical Endocrinology and Metabolism.
As people age, they may also become less sensitive to the blood sugar-regulating effects of insulin and develop impaired insulin secretion, the researchers add. And while short-term exercise boosts insulin sensitivity, it has not been clear how it might affect beta cell function.
Expensive sugar pills work better than cheap ones
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Want a sugar pill to work really well? Charge more for it.
A study published on Tuesday shows the well-known “placebo effect” works even better if the dummy pill costs more.
Dan Ariely, a behavioral economist at Duke University in North Carolina, and colleagues at the Massachusetts Institute of Technology tested 82 volunteers.
Diabetes type affects joint replacement outcomes
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People with type 1 diabetes who undergo total hip or knee replacement generally fare worse than people with type 2 diabetes, who in turn do worse than non-diabetic patients, according to study findings presented this week at the meeting of the American Academy of Orthopaedic Surgeons in San Francisco.
“The biggest finding was that diabetes predicted higher complication rates, and this is obviously not a huge surprise,” researcher Dr. Michael P. Bolognesi, from Duke University Medical Center in Durham, North Carolina, told Reuters Health.
While type 1 diabetic patients overall did worse than type 2 diabetics, he added, the very worst outcomes were actually seen in a subgroup of type 2 diabetics with uncontrolled disease.
Test helps diabetics detect nerve trouble
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The indicator plaster neuropad, or IPN, is a new test that can help diabetic patients identify nerve damage brought on by diabetes, clinicians report in the journal Diabetes Care.
“The IPN can be performed by the patient at home in 10 minutes, and the result can be offered to the doctor in the next visit,” Dr. Nicholas Tentolouris from Athens University Medical School in Greece told Reuters Health.
“The test offers the opportunity to the patients to participate actively in the prevention of the devastating complications related to diabetic foot problems,” he added.
Joslin study finds restricting insulin doses increases mortality risk
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A new study led by researchers at the Joslin Diabetes Center has found that women with type 1 diabetes who reported taking less insulin than prescribed had a three-fold increased risk of death and higher rates of disease complications than those who did not skip needed insulin shots. The new research appears in the March issue of Diabetes Care.
The study highlights the dangers of insulin restriction and concludes that mortality associated with the behavior appears to occur in the context of eating disorder symptoms often exhibited in women with diabetes – sometimes referred to as “diabulimia” in the media.
This 11-year follow-up study of 234 women is one of the first to show an increased risk of mortality as well as higher rates of kidney and foot problems in those who restricted their insulin intake. In addition, the average age of death was younger for those involved in insulin restriction: 45 years of age as compared to 58 years for those who did not restrict.
Stress hormone impacts memory, learning in diabetic rodents
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Diabetes is known to impair the cognitive health of people, but now scientists have identified one potential mechanism underlying these learning and memory problems. A new National Institutes of Health (NIH) study in diabetic rodents finds that increased levels of a stress hormone produced by the adrenal gland disrupt the healthy functioning of the hippocampus, the region of the brain responsible for learning and short-term memory. Moreover, when levels of the adrenal glucocorticoid hormone corticosterone (also known as cortisol in humans) are returned to normal, the hippocampus recovers its ability to build new cells and regains the “plasticity” needed to compensate for injury and disease and adjust to change.
The study appears in the Feb. 17, 2008, issue of Nature Neuroscience and was conducted by the National Institute on Aging (NIA), part of the NIH. NIA’s Mark Mattson, Ph.D., and colleagues in the Institute’s Intramural Research Program performed the study with Alexis M. Stranahan, a graduate student at Princeton University in New Jersey.
“This research in animal models is intriguing, suggesting the possibility of novel approaches in preventing and treating cognitive impairment by maintaining normal levels of glucocorticoid,” said Richard J. Hodes, M.D., NIA director. “Further study will provide a better understanding of the often complex interplay between the nervous system, hormones and cognitive health.”
