Archive for the ‘Diabetes & Endocrinology’ Category

A new study in this month’s issue of the journal Obstetrics & Gynecology demonstrates that excessive weight gain during pregnancy, especially in the first trimester, can increase a woman’s risk of developing gestational diabetes mellitus (GDM). Although it’s known that too much weight gain can lead to GDM (which is one of the reasons why doctors carefully follow a pregnant woman’s weight), results from the current study shows that women who gained more weight during pregnancy than recommended by the US Institute of Medicine were 50% more likely to develop the disorder. GDM can lead to early delivery, increased risk of c-sections, type 2 diabetes in the mother post-partum, and even increases the likelihood that the child will develop diabetes and obesity later in life. [HealthDay via Yahoo! News]

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This past week new data suggested that some people taking the anti-obesity drug Meridia (sibutramine) are at greater risk of heart attacks and strokes than people taking a placebo. It also raised blood pressure and heart rate among users. What is interesting is how two large regulatory agencies responded to this data. The European Medicines Agency (EMEA) has already advised physicians and pharmacists to stop prescribing and dispensing the medication, while the U.S. FDA has urged pharmaceutical company Abbott Laboratories, the maker of Meridia, to place a stronger warning on the drug. The warning is to caution against the use of the drug by people who are already at increased risk of cardiovascular disease. Was the EMEA too hasty in its decision or is the FDA not forceful enough? Proponents of the drug agree that it shouldn’t be given to those with cardiovascular disease or diabetes, while critics are in favor of an overall ban. In the drug’s twelve years on the market it has been linked to more than 80 deaths, including 30 people under age 50. [via New York Times]

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The American Diabetes Association (ADA) is now urging physicians to consider using hemoglobin A1C levels to screen for diabetes. Hemoglobin A1C is a type of hemoglobin created when blood levels of sugar are too high. By measuring hemoglobin A1C, doctors can gauge a patient’s average blood sugar level over the past 2 to 3 months. As such, it’s historically been used to gauge a diabetic’s level of sugar control. However, because this test has become highly standardized from lab to lab, the ADA states it can now be a useful tool for detecting diabetes and pre-diabetes without the need to be fasting, which will make it easier and more convenient for more people to be screened. Generally, people without diabetes have an A1C level of less than 5%. The new guidelines call for the diagnosis of type 2 diabetes at A1C levels above 6.5%, and prediabetes if the A1C levels are between 5.7 and 6.4%. [via Health.com]

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University of Chicago researchers estimate that over the next 25 years the number of Americans with diagnosed and undiagnosed diabetes will soar from 23.7 million to 44.1 million. Not only that, medical spending related to diabetes care and management will climb from $113 billion to $336 billion annually. Diabetes is a chronic illness which often requires daily medication, insulin, glucose monitoring supplies, lab tests and frequent visits to the doctor. It is also a disease which could be potentially prevented, which is why primary preventative care is so important (and sorely lacking) in the U.S. As the researchers state, “Without significant changes in public or private strategies, this population and cost growth are expected to add a significant strain to an overburdened health care system.” With these new figures, the study will hopefully influence policymakers during this time of uncertainty in the future of U.S. healthcare. [via Medical News Today]

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The Drug and Therapeutics Bulletin, a monthly review of pharmacotherapeutics in medicine published by the British Medical Journal, is recommending that physicians take a second look before prescribing daily low-dose aspirin to patients. A recent review of European data questions whether there is any benefit at all for those without a history of cardiovascular disease to be taking a daily aspirin, especially since long-term low-dose aspirin therapy almost doubles the likelihood of gastrointestinal bleeding (a potentially serious side effect). The journal authors support continued use of aspirin in those with known cardiovascular disease, such as diabetes, high blood pressure and heart attacks. But, in light of current evidence, is not recommending daily low-dose aspirin for prevention of cardiovascular disease. [via Drug and Therapeutics Bulletin]

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The FDA is working with pharmaceutical company Eli Lily to update label information on a common drug used to treat type 2 diabetes. The drug, called Byetta, is an injectable medicine that helps to control blood sugar levels. However, over a three-year period, the FDA received 78 reports of kidney problems, including kidney failure, among patients taking Byetta. Thus, new Byetta drug information will carry the warning that the medication may contribute to kidney malfunction. Signs of kidney problems can include change in the frequency of urination, urine color and amount of urine produced. Also, hand and feet swelling, low back aches, fatigue and changes in appetite can also be signs of kidney damage. Patients taking Byetta should notify their physicians if they experience any of these symptoms because kidney failure can cause serious problems due to the build up of metabolic waste products in the body. [HealthDay via Businessweek]

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Jeff Kapche, a 15-year law enforcement veteran who is currently a detective with the Fort Bend County, Texas Sheriff’s Department has just won a case for all diabetics. The United States District Court for the District of Columbia found that the Federal Bureau of Investigation (FBI) discriminated against Mr. Kapche when it refused to hire him as a special agent because of how he manages his type I diabetes. People with type I diabetes require frequent administrations of insulin, which Mr. Kapche injects. However, the FBI’s policy requires special agents to manage their diabetes with insulin pumps, rather than injections, due to the unpredictable nature of the job. However, given Mr. Kapche’s impeccable record of diabetes management throughout his long tenure of public service the court has found the FBI’s policy to be discriminatory. ”I am thrilled the jury understood that the FBI’s decision was discriminatory and that I could be a good Special Agent,” said Kapche. “I don’t want anyone else to go through what I have experienced and I hope this jury verdict sends the message that employers should look at each person as an individual, not simply someone with a disease.” Read more.

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Researchers from University of Michigan and Wayne State University are publishing the results of their study on the effects of triglycerides on diabetic neuropathy, a condition whereby nerves are damaged due to the progression of diabetes, often resulting in numbness, tingling, and pain in the feet, hands, legs and arms. Triglycerides are a type of fat that’s produced by the body. It’s a standard component to the “cholesterol test” which almost every person has had done. Elevated triglycerides can play a role in cardiovascular disease, and now this new study is suggesting that patients with high levels of triglycerides are more likely to experience worsening of their neuropathy. This is important because until now doctors couldn’t necessarily predict which patients will have a decline in their neuropathy. Now we may be able to target those patients with elevated triglycerides in hopes of slowing disease progression.

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The Proceedings of the National Academy of Sciences report today that vitamin C and vitamin E supplements may counteract the beneficial affects of exercise on diabetes and glucose metabolism. The University of Jena and Harvard University study shows that exercise induces bursts of free radicals that cause our body to activate and metabolize carbohydrates more efficiently, which can prevent type 2 diabetes and other conditions that may lead to stroke, coronary artery disease and kidney failure. Mitigating these free radicals with antioxidant vitamins could, therefore, block the health effects conferred by exercise.

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The EndoBarrier is a new technology that may be an alternative to gastric surgery for people who are dangerously obese. It’s an impermeable sleeve that can be deployed in the stomach to line the first 60 centimeters of the small intestine. The barrier is designed to remain in place for a few months and prevents the intestine from absorbing calories.  In animal experiments and preliminary human trials, it reduces weight and rapidly brings type 2 diabetes under control. Weight gain (especially around the waist) is associated with type 2 diabetes.

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