Diabetes
Average American has very high risk of diabetes
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Body mass index (BMI), the ratio of body weight to height, is tightly linked to lifetime risk of diabetes mellitus, researchers reported at the Scientific Sessions of the American Diabetes Association. “On average, every American has a very high risk of diabetes,” CDC investigators told conference participants.
Using the National Health and Nutrition Examination Survey (NHANES) data, Dr. K. M. Venkat Narayan and associates at the Centers for Disease Control and Prevention in Atlanta, calculated the lifetime risk of diabetes according to BMI for subjects between 18 and 84 years old.
A BMI between 20 and 25 is considered normal, whereas values above or below this range represent being under- and overweight, respectively. Obesity is typically defined as a BMI of 30 or greater.
Elevation of fat-derived molecule foretells early insulin resistance
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A study in the June 15 issue of The New England Journal of Medicine (NEJM) reveals that elevated levels of a molecule called RBP4 (retinol binding protein 4) can foretell early stages in the development of insulin resistance, a major cause of type 2 diabetes as well as cardiovascular disease.
The new findings, led by researchers at Beth Israel Deaconess Medical Center (BIDMC), offer a potential new target for the development of anti-diabetic therapies to lower serum RBP4 levels as well as an early means of identifying individuals who are at risk of developing diabetes - before the onset of overt disease.
“Type 2 diabetes is a rapidly increasing epidemic in the Western world,” explains senior author Barbara Kahn, MD, Chief of the Division of Diabetes, Endocrinology and Metabolism at BIDMC and Professor of Medicine at Harvard Medical School. “Since it is now occurring even in childhood, predictions indicate that it could shorten lifespan in the U.S. for the first time in more than a century.”
Researchers Say Low-Carb Diet Benefits Diabetics
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With a continuing epidemic of type 2 diabetes and dwindling resources to combat it, new approaches are clearly needed. Because it is disease of insulin and blood sugar regulation, low-carbohydrate diets have been an obvious choice for diabetic patients but have been resisted by some professionals and agencies in favor of pharmacologic approaches.
Now, medical researchers in Sweden have reported a follow-up study of patients on a low-carbohydrate diet up to 22 months and report stable improvement and reduced need for medication.
The Swedish group, led by Dr. Jorgen Vesti Nielsen, had previously reported on16 obese patients on a 20-percent carbohydrate diet over 6 months. After 22 months, patients continued to show improvement in hemoglobin A1C, a marker for long-term blood-sugar levels in diabetes.
Costs pose hurdle for diabetes monitoring devices
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Monitoring systems that can help diabetics better control fluctuations in their blood sugar levels will take time to catch on because they are expensive and insurers are not yet providing coverage for the devices, physicians and analysts said.
Continuous glucose monitors are an important step forward in diabetes care because they provide more frequent readings on blood sugar levels than current finger-stick tests, allowing patients to better manage the condition through diet adjustments and insulin injections, physicians said.
The systems, however, are expensive, due to the cost of their disposable wire-like sensors, which are inserted just under the skin and must be replaced every few days. The sensors measure glucose levels and transmit the data wirelessly to a pager-size receiver.
Diabetes figures all set to blow out by 2050
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Researchers who carried out a study of diabetes are predicting that by the year 2050 there will be 39 million with the disease in the United States.
They have based their estimate on the figures for prevalence and incident in the period between 2000 and 2004 which show a steady rise in the national incidence of diagnosed diabetes.
This projection represents 9.3 million more people with diagnosed diabetes than previously thought.
U.N. launches “Unite for Diabetes” campaign
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The International Diabetes Federation (IDF) launched its “Unite for Diabetes” campaign this week here at the Scientific Sessions of the American Diabetes Association, urging global support of the United Nations Resolution on diabetes.
The U.N.‘s resolution aims to raise awareness of the global burden of diabetes, and officials are calling for worldwide governmental support of this effort.
New figures announced by the International Diabetes Federation show that diabetes affects 230 million people, approximately 6 percent of the world’s adult population. Seven of the ten countries with the highest prevalence are in the developing world.
When it comes to diabetes doctors failing to follow ‘doctors orders’
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According to the latest reports when it comes to diabetes and following doctors orders, doctors are failing their patients.
The results of four completely independent studies presented at the American Diabetes Association’s Annual Scientific meeting, indicate that doctors are failing to prescribe higher dose therapy in people with type 2 diabetes and high blood glucose levels or high blood pressure.
The findings imply that a lack of action on the part of doctors may be an important barrier to effective diabetes management.
Gene therapy stops diabetic nerve damage, in rats
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One of the serious complications of diabetes is nerve damage that, because of lack of sensation, can lead to foot injuries, infection and even amputation. Now, researchers raise the hope that gene therapy might prevent this happening.
They have shown in experiments with rats that transferring a gene for a protein that promotes expression of a growth factor, VEGF-A, protects against diabetic neuropathy, as the condition is called.
About 50 percent of people with diabetes develop this complication within 25 years after being diagnosed, the researchers note in the research journal Diabetes, but there is currently no effective treatment for diabetic neuropathy.
Mixing insulin analogs for Type 1 kids is safe, say researchers
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We’re usually told it’s a big health and safety no-no to mix ‘n’ match medications, right? Well, here’s an exception that affects diabetics. Apparently, youngsters with Type 1 diabetes and their parents/caregivers can safely mix rapid-acting and long-acting insulin analogs in the same syringe. The results of a new study published in the Journal of Pediatrics (April 2006) show that doing so does not compromise blood sugar stability in the long-term.
Examples of rapid-acting insulin analogues are Apridra and NovoRapid. Lantus is an examples of a long-acting insulin glargine. For some kids, mixing the two together could potentially reduce the number of insulin shots required daily. This is always good news for children and their parents.
Higher-dose statin may benefit some diabetics
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Treating diabetics who have signs of heart disease with a high dose of the cholesterol-lowering drug Lipitor (80 mg daily), rather than the normal dose of 10 mg daily, can lower the rate of major cardiovascular events by 25 percent, according to a new report.
In the main analysis of data from the study, increasing the dose of Lipitor (also called atorvastatin) was shown to provide significant clinical benefits for patients with heart disease.
In a subanalysis, Dr. James Shepherd of the University of Glasgow and colleagues set out to determin if this benefit applied to patients with heart disease and diabetes as well.
Breast-feeding curbs obesity in at-risk kids
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Women who develop diabetes during pregnancy are liable to have large babies, which in turn can lead to obesity in childhood—but that chain of events may be interrupted if the mother breast-feeds, researchers report.
Diabetes that develops during pregnancy is termed gestational diabetes mellitus or GDM. “In a recent study of infants of mothers who had GDM, we demonstrated that parental obesity and excessive intrauterine growth resulting in neonatal overweight independently contribute to early childhood obesity,” Dr. Ute M. Schaefer-Graf and colleagues explain in the medical journal Diabetes Care.
For their current study, the researchers from Vivantes Medical Center and Charite University Medical Center in Berlin, Germany, examined the association between breast-feeding and being overweight in early childhood in the same group of 324 children.
Antidepressants extend time to relapse in diabetics
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Maintenance treatment with the antidepressant sertraline (Zoloft) after a first episode of depression has resolved extends the time to relapse in patients with diabetes, study results suggest. And sustained remission of depression is associated with improved control of blood sugar.
Depression is highly prevalent among patients with diabetes, Dr. Patrick J. Lustman, from Washington University School of Medicine in St. Louis, and colleagues note, and recurrence after initial successful treatment is common. Depression, in turn, is linked to increased morbidity and mortality among diabetics, they point out in the Archives of General Psychiatry for May.
Previous studies have been limited to no more than 16 weeks of treatment, the authors report. The goal of the current study was to see if continued antidepressant treatment beyond the first remission would be effective in prolonging depression-free periods and improving glycemic (blood sugar) control.
Study shows results of tight glucose control
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Here’s what we know about controlling blood glucose (blood sugar) in people with diabetes: It’s not easy, but it can be done. It requires vigilance and resolve. And it can save your life.
A recent study by the National Institutes of Health (NIH) has answered one of the most important questions about diabetes: Can glucose control lower the risk of heart attacks and strokes? The answer is yes - intensive glucose control can reduce the risk by more than half. From 1983 to 1989, the NIH-sponsored Diabetes Control and Complications Trial (DCCT) randomly assigned a large number of people with diabetes to an intensive or conventional treatment group. Those in the intensive group were held to a stricter level of glucose control and were required to self-monitor their own glucose levels throughout the day. The DCCT ended in 1993 after conclusively demonstrating that intensive control better protected against damage to the eyes (retinopathy), kidneys (nephropathy), and nerves (neuropathy).
Fiber from whole grains may lower diabetes risk
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The type of fiber found in whole grains and many vegetables—called insoluble fiber—may help prevent diabetes by improving the body’s use of the blood-sugar-regulating hormone insulin, a small study suggests. The findings, published in Diabetes Care, add to evidence linking cereal fiber to a lower diabetes risk.
Since a decline in insulin sensitivity precedes type 2 diabetes, people may help lower their diabetes risk by getting more insoluble fiber, Dr. Martin Weickert, a researcher at the German Institute of Human Nutrition in Nuthetal who led the study told Reuters Health.
Many diabetics can’t define “healthy” weight
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Although weight loss is a cornerstone of managing diabetes, many people who have the disease don’t know what their ideal weight range should be, a study suggests.
About half of the time, researchers at the University of Pittsburgh found, overweight diabetics defined their “healthiest” weight with a number that was still too heavy for their height.
Some even considered a weight in the obese range to be their optimal number, according to findings published in the journal Diabetes Care.
