Diabetes
Arsenic Exposure May Be Associated With Type 2 Diabetes
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In a study involving a representative sample of U.S. adults, higher levels of arsenic in the urine appear to be associated with increased prevalence of type 2 diabetes, according to a report in the August 20 issue of JAMA.
Arsenic from inorganic sources is highly toxic and causes cancer in humans, according to background information in the article. Millions of individuals worldwide are exposed to drinking water contaminated with inorganic arsenic, including 13 million Americans whose public water supply contains more than the U.S. Environmental Protection Agency standard of 10 micrograms per liter. Exposure to high concentrations of the element in drinking water and in the workplace has been shown to be associated with diabetes, but little is known about the effect of lower levels on diabetes risk. In contrast, arsenobetaine—an organic arsenic compound derived eating seafood—is considered non-toxic.
Ana Navas-Acien, M.D., Ph.D., of the Johns Hopkins Bloomberg School of Public Health, Baltimore, and colleagues studied 788 adults age 20 and older who had their urine tested for arsenic levels as part of the government-conducted 2003-2004 National Health and Nutrition Examination Survey (NHANES).
Gum disease tied to diabetes risk
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People with moderate to severe gum disease may have an elevated risk of developing type 2 diabetes, the results of a new study suggests.
Researchers found that among nearly 9,300 U.S. adults who were followed for 17 years, those who began the study with gum disease were more likely to develop diabetes later on. Men and women with moderate gum disease had twice the risk of diabetes as those with healthy gums, while substantial tooth loss was linked to a 70 percent higher risk.
The findings, published in the journal Diabetes Care, do not prove that gum disease causes diabetes in some people. But the study is the first to show such a temporal association between the two conditions; the relationship between diabetes and gum disease is well-known, but it has traditionally been assumed that gum disease is solely a consequence of diabetes.
Cultural sensitivity may improve diabetes outcomes
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Culturally tailored diabetes education may help ethnic minorities with type 2 diabetes better control their blood sugar.
“There is some evidence suggesting culturally tailored health education can improve some clinical outcomes in the short-term,” co-author Dr. Yolanda Robles of Cardiff University the UK told Reuters Health. However, “further research is needed to assess long-term effects,” Robles said.
Language and cultural barriers may hinder the delivery of quality diabetes health education to ethnic minorities, yet education is a vital aspect of diabetes care, Robles and colleagues report in the Cochrane Database of Systematic Reviews from The Cochrane Collaboration.
Diabetic foot ulcers often have poor outcomes
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Although the majority of patients hospitalized because of diabetic foot ulcers initially do reasonably well, in the long-term the outcome is often poor, French researchers report in the journal Diabetes Care.
“Despite a satisfactory rate of healing,” investigator Dr. Antoine Avignon told Reuters Health, “the overall prognosis of patients with diabetic foot ulcers is not satisfactory.”
Avignon of Universite Montpellier 1 and colleagues came to this conclusion after following 89 patients with diabetic foot ulcers for an average of more than 6 years.
Men may need to work harder to cut diabetes risk
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Losing weight through diet and exercise lowers diabetes risk in men and women, but men may have to work harder for the same benefit, new research suggests.
In a study of more than 1,100 adults at risk of type 2 diabetes, researchers found that those who went on an “intensive” regimen of calorie-cutting and exercise lowered their risk of developing diabetes over the next year.
However, despite the fact that men lost more weight and exercised more than women did, that did not translate into a greater reduction in diabetes risk, the researchers report in the journal Diabetes Care.
Diabetes makes people more vulnerable to TB: study
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Diabetes makes a person about three times as likely to develop tuberculosis, and it may be to blame for more than 10 percent of TB cases in India and China, researchers said on Monday.
To clarify the link between the diseases, researchers at the Harvard School of Public Health in Boston examined data on 1.7 million people from 13 studies done in Canada, Mexico, the United States, Britain, Russia, Taiwan, India and South Korea.
Having diabetes raised a person’s chances of getting active TB disease regardless of geographic region, the researchers found, with the risk rising roughly three-fold compared to people without diabetes, the researchers wrote in the Public Library of Science journal PLoS Medicine.
Many Hispanics with diabetes unaware of potential eye disease, do not receive eye exams
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Hispanic patients with diabetes appear to have less frequent eye examinations than the national average for Hispanic individuals, and many are not aware of the potential ocular complications of diabetes, according to a report in the July issue of Archives of Ophthalmology, one of the JAMA/Archives journals.
One in five Hispanic individuals older than 40 years currently has diabetes, and almost half have diabetic retinopathy, a related eye disease, according to background information in the article. “The limited use of health care services in minority groups may make them more susceptible to the complications of uncontrolled diabetes,” the authors write. “In addition, a substantial proportion of those with diabetes are unaware of their condition, although already presenting signs of moderate to severe diabetic retinopathy. The importance of appropriate and timely care for diabetic retinopathy or macular edema [swelling in the retina] is paramount, as it is the leading cause of visual loss among working-age Hispanic individuals.”
Beatriz Muñoz, M.Sc., of the Wilmer Eye Institute, Johns Hopkins University, Baltimore, and colleagues interviewed 349 randomly selected Hispanic individuals without diabetes and a group of 204 Hispanic individuals with diabetes. Participants answered questions about demographic information, health care habits and knowledge of diabetes and diabetic retinopathy.
Heart disease and diabetes: Which statins have been well-investigated?
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All of the five different statins that are licensed for use in Germany can lower the cholesterol level in the blood. But the deciding factor for patients is how well the medicine can prevent heart attacks and other coronary artery problems. From this point of view, simvastatin (marketed under various brand names) is the best tested. It has been shown to lengthen life expectancy of people with diabetes and particular heart diseases.
The statins are medicines that might be able to lower the risk of another heart attack among people who have already had one. These five types of statins are licensed for use in Germany: atorvastatin, fluvastatin, lovastatin, pravastatin and simvastatin. Statins are known as cholesterol-lowering or fat-lowering medicines. This is because they can reduce the levels of cholesterol in the blood.
Many doctors are convinced that this cholesterol-lowering effect is also responsible for lowering the risk of a heart attack. However, it is not known exactly how this might work. Statins have an impact on the blood vessels, and there could also be other, yet unknown effects. Which of these might be responsible for the effectiveness of statins is still unclear.
Type 2 diabetes epidemic seen looming
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The current pattern of type 2 diabetes in young adults and trends in childhood obesity rates point to a dramatic impact on the future health of adults in the United States, concludes the writer of a report published Monday.
The bulging of kids’ waistlines, Dr. Joyce Lee warns, is apt to lead to a large number of younger adults with type 2 diabetes, the serious complications related to the disease, and ultimately, shorter life spans.
“The full impact of the childhood obesity epidemic,” Lee warns in the Archives of Pediatrics and Adolescent Medicine, “has yet to be seen because it can take up to 10 years or longer for obese individuals to develop type 2 diabetes.”
Heart failure outcomes worse in diabetics: study
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A new study shows that having diabetes independently raises the risk of illness and death in people with heart failure, which occurs when the heart loses its ability to pump blood efficiently.
A “novel finding,” according to the research team, was that having diabetes conferred a greater increased risk of heart-related death or need for hospital admission in individuals whose heart’s showed fairly well preserved blood-pumping power compared with individuals whose heart’s showed poorer blood-pumping power.
These are the findings of Dr. John J. V. McMurray of the University of Glasgow, UK, and colleagues who analyzed outcomes for nearly 7,600 patients with chronic heart failure.
New US estimates show diabetes affects 24 million
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New government estimates show that nearly 24 million people in the United States have diabetes, an increase of more than 3 million in two years.
This means that nearly 8 percent of the U.S. population has diabetes, mostly the type-2 diabetes linked with obesity, poor diet and a lack of exercise, the U.S. Centers for Disease Control and Prevention said on Tuesday.
The estimates, based on 2007 data, also show that 57 million people have pre-diabetes, a condition that puts people at increased risk for diabetes. And up to 25 percent of people with diabetes do not know they have it, the CDC said—down from 30 percent two years ago.
New Spanish-language Consumer Guide Compares Oral Diabetes Medications
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Pastillas para la diabetes tipo 2, a new consumer guide for Hispanic adults who have type 2 diabetes and need information to help them compare various oral medications for their illness, has been released by the Agency for Healthcare Research and Quality.
Diabetes is one of the most serious health issues facing Hispanics in the United States. AHRQ data show that nearly one in eight Hispanics take a prescription drug for diabetes.
“This guide offers critically important information to help Hispanics who have diabetes control their disease and avoid side effects,” said AHRQ Director Carolyn M. Clancy, M.D. She added that providing information in Spanish will help efforts to get Hispanic patients more involved in their own health care and to eliminate racial and ethnic disparities in health care.
Many diabetic Latinas lack nutrition knowledge
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One-third of Latin American women with type 2 diabetes living in Connecticut have not seen a registered dietitian or diabetes educator for help with healthy eating, new research indicates.
Even among the women who had gotten professional help, nutrition knowledge was limited, Dr. Nargul Fitzgerald of Rutgers, The State University of New Jersey, in New Brunswick and her colleagues found.
The research “highlights a really dire need,” Fitzgerald told Reuters Health, pointing out that poorly managed diabetes can have severe health consequences including heart attacks and strokes. “We don’t have enough services, we don’t have enough certified diabetes educators or nutritionists who can speak the language or who are culturally competent enough to work with Latinos.”
Testosterone gel benefits some men with diabetes
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Men with type 2 diabetes or the metabolic syndrome, or both, are prone to have low testosterone levels. If so, testosterone replacement therapy with a gel applied to the skin may improve their response to insulin and their sexual function, according to the results of a new clinical trial.
Testosterone levels fall if testicular function is subnormal, a condition termed hypogonadism. “Consideration should be given to screening type 2 diabetic and metabolic syndrome patients for hypogonadism,” Dr. T. Hugh Jones told the Endocrine Society’s annual meeting in San Francisco this week.
Jones, of Barnsley Hospital and the University of Sheffield in the UK, and colleagues tested the effect of a testosterone gel (Tostran) on insulin resistance and symptoms of hypogonadism in 221 men with low testosterone levels.
Diabetes linked to depression risk and vice versa
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People being treated for type 2 diabetes are at increased risk for depression, according to a new report, and individuals with depression have a moderately increased risk of developing type 2 diabetes.
To explore the relationship between diabetes and depression, Dr. Sherita Hill Golden at Johns Hopkins University School of Medicine in Baltimore and colleagues analyzed data on 6814 subjects who underwent three examinations between 2000 and 2005.
Among 4847 participants without depression at the start of the study, the researchers report, rates of occurrence of depression symptoms during follow-up were similar for people without diabetes and those with untreated type 2 diabetes, but about twice as high in people being treated for type 2 diabetes.
