Diabetes
22 Sep Pre-Diabetes Associated With Increased All-Cause and Cardiovascular Mortality
MedicalResearch.com Interview with: Yuli Huang and Yunzhao Hu Department of Cardiology, the First People's Hospital of Shunde, Shunde District, Foshan, PR China. Medical Research: What are the main findings of the study? Response: “Prediabetes” is a general term that refers to an intermediate stage between normoglycaemia and overt type 2 diabetes mellitus (T2DM). It includes 2 groups of individuals, those with impaired glucose tolerance (IGT) and those with impaired fasting glucose (IFG). In 2003, the American Diabetes Association (ADA) redefined the fasting plasma glucose (FPG) concentration range for diagnosing IFG from 110 to 125 mg/dl to 100 to 125 mg/dl in order to better identify individuals at future type 2 diabetes mellitus risk. However, this change has been contentious and was not adopted by the World Health Organization (WHO) Expert Group or other international guidelines. In this meta-analysis, we included data from 26 prospective cohort studies with for 280,185 participants and found that, after controlling for multiple cardiovascular risk factors, the presence of prediabetes at baseline, defined as defined as IFG of 110 to 125 mg/dL(IFG 110), IGT or combined IFG 110 and/or IGT, was associated with increased risk of all-cause and cardiovascular mortality. Specifically, IFG 110 was associated with 12% and 19% increase of all-cause and cardiovascular mortality, IGT was associated with 33% and 23% increase of all-cause and cardiovascular mortality, combination of IFG110 and/or IGT was associated with 21% and 21% increase of all-cause and cardiovascular mortality, respectively. Although IFG 100 was not associated with all-cause or cardiovascular mortality in the overall analysis, the risk was greater in young and middle age males according to subgroup analyses.17 Sep Neuropathy Predisposes Diabetics To Falls on Stairs
Posted at 16:00h
in Diabetes
MedicalResearch.com Interview with:
Steven Brown
School of Healthcare Science
Faculty of Engineering
Manchester Metropolitan University UK
Medical Research: What are the main findings of the study?
Answer: Our main findings were increased extremes of sideways sway in patients with diabetes and severe peripheral neuropathy during stair negotiation. Measured by an increase in the amount of lateral separation between the centre-of-mass and centre-of-pressure. Our results showed a 3cm increase in maximum sway in patients with diabetic peripheral neuropathy during both stair descent and stair ascent.
17 Sep Study Confirms Increased Risk, Earlier Onset of Diabetes in South East Asians
MedicalResearch.com Interview with: Dr. Adam Tabak MD Clinical Research Associate Epidemiology & Public Health Institute of Epidemiology & Health Faculty of Population Health Sciences University College London, UK Medical Research: What are the main findings of the study? Dr. Tabak: Some of the major findings are confirmatory, such as the almost 3 times increased risk and an earlier onset of type 2 diabetes among south Asians, and a decreased insulin sensitivity in this ethnic group. The major novel finding is related to the fact that we could model events before diabetes diagnosis. We found a faster increase in fasting glucose before the diagnosis is south Asians compared to whites and that although insulin secretion increased in both ethnicities until 7 years before diagnosis, this increase was faster among whites.13 Sep Inflammation May Explain Why Glycemic Control Alone May Not Prevent Diabetic Heart Disease
MedicalResearch.com Interview with:
Carlos F. Sánchez-Ferrer, M.D., Ph.D.
Professor of Pharmacology
Universidad Autónoma de Madrid, Spain.
Medical Research: What are the main findings of the study?
Dr. Sánchez-Ferrer: We were studying the possible ways of interaction between high glucose levels, which are found in diabetes mellitus, with vascular damage,
which is the most common and devastating consequence of this disease.
An intriguing fact is that a very strict control of blood sugar in
diabetic patients is not sufficient to avoid the development of such
diabetes-induced cardiovascular diseases. We think our results can
explain why this is happening.
Using cultured smooth muscle cells from the main human artery (aorta)
in the presence of high concentrations of extracellular glucose, we
observed:
1. In the absence of inflammation, excess glucose in the culture fluid
didn’t enter the cells.
2. When extra glucose was forced into the cells, no harm was done in
the absence of inflammation.
3. When the inflammation-stimulating protein interleukin-1 (IL-1) was
introduced, more glucose entered the cells.
4. With IL-1, the glucose entering the cells was metabolized via
chemical pathways that spur escalating inflammation, overwhelming the
cells’ ability to counteract it.
5. In the presence of the anti-inflammatory drug anakinra, which blocks
the activity of IL-1, the deleterious changes didn’t occur.
12 Sep Diabetes: Incretin-Based Drugs Not Linked To Congestive Heart Failure
MedicalResearch.com Interview with:
Kristian Filion, PhD FAHA
Assistant Professor of Medicine
Division of Clinical Epidemiology
Jewish General Hospital/McGill University
Montreal, Quebec H3T 1E2 Canada
Medical Research: What are the main findings of the study?
Dr. Filion: Previous studies have raised concerns that the use of incretin-based drugs, a type of medication used to treat diabetes, may increase the risk of congestive heart failure. We therefore examined this potential drug safety issue using a large, population-based database, which allowed us to study the safety of these medications in a real world setting. In doing so, we found that the use of incretin-based drugs was not associated with an increased risk of congestive heart failure among patients with type 2 diabetes. Similar results were obtained among both classes of incretin-based drugs (glucagon like peptide-1 [GLP-1] analogs and dipeptidyl peptidase-4 [DPP-4] inhibitors), and no duration-response relationship was observed.
12 Sep Diabetes: Vascular Complications Vary By Duration of Disease
MedicalResearch.com Interview with:
Dr. Sophia Zoungas:
Faculty of Medicine, Nursing & Health Sciences
Monash University, Clayton
Medical Research: What are the main findings of the study
Dr. Zoungas: Our study shows that age (or age at diagnosis) and duration of diabetes disease are linked to the risk of death and marcovascular complications (those in larger blood vessels) whereas only diabetes duration is linked to the risk of microvascular complications (in smaller blood vessels such as those in the kidney and eyes)
12 Sep Sleep Apnea Predisposes To Impaired Brain Blood Flow With Physical Activity
MedicalResearch.com Interview with:
Paul M. Macey, Ph.D.
Assistant Professor in Residence
Associate Dean for Information Technology and Innovations,
Chief Innovation Officer UCLA School of Nursing and Brain Research Institute
Medical Research: What are the main findings of the study?
Dr. Macey: People with sleep apnea are less able to control the blood flowing to their brain, in particular when they grip tightly, or have their foot put in cold water. We measured changes in blood flowing through the brain using an MRI scanner while people gripped hard, had their foot placed in cold water, and breathed out hard into a tube with a very small hole in it. These activities all lead to more blood flowing to the brain in healthy people, which probably helps protect the cells from being starved of blood and oxygen. However, people with sleep apnea send less blood that the healthy participants during the gripped and cold foot activities.
A further important finding is that women with sleep apnea are worse off than men. The female patients showed much weaker blood flow than the males, even accounting for normal differences between men and women.
11 Sep Diabetes: Patients Demonstrate Negative and Positive Coping Mechanisms
MedicalResearch.com: Interview with:
Dr. Heather Stuckey D.Ed
Department of Medicine
Pennsylvania State University College of Medicine, Hershey, PA
MedicalResearch: What are the main findings of this study?
Dr. Stuckey: The main findings were that people with diabetes had both negative psychosocial and positive (adaptive) ways of coping with diabetes.
Negative themes included: 1) Anxiety/fear, worry about hypoglycemia and complications of diabetes, depression and negative moods/hopelessness and 2) Discrimination at work and public misunderstanding about diabetes.
Two psychosocial themes demonstrated adaptive ways of coping with diabetes: 1) Having a positive outlook and sense of resilience in the midst of having diabetes and 2) Receiving psychosocial support through caring and compassionate family, friends, healthcare professionals and other people with diabetes.
Most diabetes social sciences research focuses on only the negative aspects of having diabetes. Although this paper discussed negative aspects, it also focused on the adaptive, or positive, ways in which people with diabetes viewed their disease. "We found that although these negative experiences with diabetes exist, people also held on to the positive aspects. Some said diabetes made their lives a little richer because they ate healthier foods, or they were able to connect with their family more to overcome challenges. It gave them a better appreciation of what they have. The discrimination at work and from society was a finding that was unexpected, but was evident throughout both the quantitative and qualitative data.
11 Sep Diabetes in Pregnancy: Lower HbA1c Threshold Improves Detection
MedicalResearch.com Interview With: Ruth C. E. Hughes Department of Obstetrics and Gynecology University of Otago, Christchurch Women’s Hospital Christchurch, New Zealand Medical Research: What are the main findings of the study? Dr. Hughes: The increasing prevalence of undiagnosed type 2 diabetes in women of childbearing age was the main driver behind our study. In clinical practice, we were finding that women with probable undiagnosed diabetes (and pre-diabetes) had already started developing pregnancy complications at the time they were diagnosed with gestational diabetes diagnosis in the late second trimester. It seemed logical to try to identify them in early pregnancy, with the idea that they might benefit from earlier intervention. We thus explored the usefulness of first trimester HbA1c measurements to identify women with unrecognised pre-existing diabetes. In our study, an HbA1c of 5.9% (41mmol/mol) was the optimal screening threshold for diabetes in early pregnancy. We found that a threshold of 6.5% (48mmol/mol), which is endorsed by the World Health Organization and American Diabetes Association for diagnosing diabetes in pregnancy, would miss almost 50% of women with probable pre-existing diabetes. Of great relevance, women with an early HbA1c of 5.9%-6.4% (41-46mmol/mol) had poorer pregnancy outcomes than those with an HbA1c <5.9% (<41mmol/mol), with a 2.5-3 fold higher relative risk of major congenital anomaly, preeclampsia, shoulder dystocia, and perinatal death. These women were also more likely to deliver before 37 weeks gestation.09 Sep Prediabetes Associated With Increased Cancer Risk
MedicalResearch.com Interview with:
Professor Yuli Huang
The First People's Hospital of Shunde, Daliang Town, China, and colleagues
Medical Research: What are the main findings of the study?
Professor Huang: In this meta-analysis of 16 prospective cohort studies comprising more than 890,000 individuals, we found that the presence of prediabetes at baseline associated with a 15% increased risk of cancer overall. The results were consistent across cancer endpoint, age, duration of follow-up and ethnicity. There was no significant difference for the risk of cancer with different definitions of prediabetes (impaired fasting glucose [IFG] and/or impaired glucose tolerance [IGT]).
04 Sep Surprising Gender Differences in Diabetes Prevalence Over 25 Year Period
MedicalResearch.com Interview with
Andy Menke PhD
Department of Epidemiology, Tulane University School of Medicine
New Orleans, Louisiana
Medical Research: What are the main findings of the study?
Dr. Menke: The prevalence of diabetes increased more in men than women between 1976 and 2010 in the US, from 4.7% to 11.2% in men and from 5.7% to 8.7% in women. Changes over time in the distribution of age, race/ethnicity, and obesity in the population explained all of the increase in women and only half of the increase in men.
03 Sep Elevated Calcium Linked To Increased Diabetes Risk
MedicalResearch.com Interview with:
Jordi Salas-Salvadó MD PhD
Physiopathology of Obesity and Nutrition
Institute of Health Carlos III, Madrid, Spain
Medical Research: What are the main findings of the study?
Dr. Salas-Salvadó: The main finding of our study is that an increase in albumin-adjusted serum calcium increases the risk of type 2 diabetes in Mediterranean individuals at high cardiovascular risk. This association remained significant even after taking classic risk factors into account. To the best of our knowledge this is the first study assessing the association between changes in serum calcium levels and the risk of type 2 diabetes development.
31 Aug Type 1 Diabetes: New Model Predicts Major Outcomes
MedicalResearch.com Interview with: Dr. Sabita Soedamah-Muthu Division of Human Nutrition,Wageningen University Wageningen, the Netherlands and Prof Trevor Orchard Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA Medical Research: What are the main findings of the study? Answer: We present a new prognostic model combining information on age, glycated haemoglobin, waist-hip ratio, albumin/creatinine ratio and HDL (good) cholesterol to assess the 3, 5 and 7 year risk of developing major outcomes in patients with type 1 diabetes.27 Aug Sulfonylurea For Diabetes Linked To Increased Heart Disease Risk
MedicalResearch.com Interview with:
Dr. Frank B. Hu
Department of Nutrition
Harvard School of Public Health
Boston, MA
Medical Research: What are the main findings of the study?
Dr. Hu: in this study among approximately 5000 patients with type 2 diabetes followed for up to 10 years, longer duration of sulfonylurea therapy was associated with a higher risk of coronary heart disease. The continuous sulfonylurea therapy for 10 years was associated with almost two times greater risk of coronary heart disease compared with nonusers. However, given the observational nature of the study, we cannot make causal inference from these findings.
24 Aug Non-White Diabetics Have Higher Incidence of Early Kidney Disease
MedicalResearch.com Interview with:
Satyesh K Sinha, PhD
Assistant Professor
Charles R Drew University of Medicine and Science
Los Angeles, CA-90059
Medical Research: What are the main findings of the study?
Dr. Sinha: Our main finding is that compared to Whites, African Americans (AAs) and Hispanics, with diabetes, have a higher prevalence of early chronic kidney disease (CKD) which is significantly associated with urinary albumin excretion (UAE) and/or C-reactive protein (CRP).
22 Aug Diabetic Lifestyle Interventions Reduced Hospitalizations, Medications and Costs
MedicalResearch.com Interview with:
Mark A. Espeland PhD Professor
Department of Biostatistics
Sticht Center on Aging Center for Diabetes Research
WFU Primate Center Center for Integrative Medicine
Translational Science Institute
Wake Forest School of Medicine, Winston-Salem, NC
Medical Research: What are the main findings of the study?
Dr. Espeland : Over 10 years, overweight and obese adults with type 2 diabetes who were provided a lifestyle intervention targeting sustained weight loss and increased physical activity, lowered their rates of hospitalizations and medication use and reduced the costs of their health care by over $5,000.
21 Aug Recurrent Hypoglycemia Raises Stroke Risk in Kidney Disease Patients
MedicalResearch.com Interview with: Prof. Chia-Huang Kao From the Graduate Institute of Clinical Medical Science Department of Radiation Oncology and Nuclear Medicine and PET Center Graduate Institute of Clinical Medical Science China Medical University Hospital, Taichung, Taiwan. Medical Research: What are the main findings of the study? Prof. Kao: Patients with chronic kidney disease (CKD) are at high risk for hypoglycemia; several factors are reported to contribute to hypoglycemia in these patients. However, most previous studies were limited by the relatively small number of patients with CKD included in the study by the exclusion of cases with CKD. In the present study, the incidence rate of hypoglycemia in patients with CKD was 4.5%, which is approximately twice the value noted in previous reports and multivariate analysis revealed a 2.53-fold increase in the risk of death for CKD patients with hypoglycemia after adjusting for related confounding factors including hypertension, hyperlipidemia, diabetes, and antidiabetic drugs.20 Aug Intensive Blood Pressure Treatment Did Not Increase Falls or Fractures
MedicalResearch.com Interview with
Karen Margolis, M.D., M.P.H.
Senior Investigator (Director of Clinical Research)
HealthPartners Institute for Education and Research
Minneapolis, MN, 55440-1524
Medical Research: What are the main findings of the study?
Dr. Margolis: The study compared falls and fractures in patients aged 40-79 with diabetes who were treated for high blood pressure. One group received treatment that aimed at getting systolic blood pressure under 120, while the other group received treatment to achieve systolic blood pressure under 140. The results show that patients who received intensive blood pressure treatment did not fall more than less intensively treated patients, nor did they incur more fractures over an average follow-up of about five years.
19 Aug African Americans Have Highest Rates of Diabetic Macular Edema
MedicalResearch.com Interview with:
Rohit Varma, MD, MPH
Grace and Emery Beardsley Professor and Chair
USC Department of Ophthalmology
Director, USC Eye Institute
Associate Dean for Strategic Planning and Network Development
Keck School of Medicine of USC
Medical Research: What are the main findings of the study?
Dr. Varma: Our research demonstrates African-Americans bear a heavier burden of diabetic macular edema (DME), one of the leading causes of blindness in diabetic patients in the United States, compared to Non-Hispanic whites. The study points to a need for improved screening and greater attention to vision loss by clinicians and patients particularly those who are at high risk of developing diabetic macular edema.
19 Aug Fenofibrate Improves Cholesterol Profile in Diabetes
MedicalResearch.com Interview with: Prof. Michael d’Emden Endocrine Research Unit Royal Brisbane Hospital, Brisbane, Australia Medical Research: What are the main findings of the study? Prof. d’Emden: Our study is the largest trial of women having type 2 diabetes assessing the role of a fibric acid derivative, in this case fenofibrate, ever conducted. There were 3657 female subjects randomized to placebo or fenofibrate. The study demonstrated greater reductions in women of total cholesterol, triglycerides and LDL-cholesterol and greater increases in HDL-cholesterol. In women, fenofibrate decreased total cardiovascular end-points by 30% compared with only 13% in men, although there was no-treatment-by-sex interaction. The majority of end points assessed revealed a consistent trend to increased benefit being seen in women.07 Aug Interval Training Beats Continuous Exercise For Glucose Control
MedicalResearch.com Interview with:
Kristian Karstoft MD
The Centre of Inflammation and Metabolism and The Centre for Physical Activity ResearchDepartment of Infectious Diseases and CMRC, Rigshospitalet
Faculty of Health Sciences,
University of Copenhagen, Copenhagen, Denmark
Medical Research: What are the main findings of the study?
Dr. Karstoft: Four months of Interval-walking training (IWT; five sessions/week, one hour/session) in individuals with type 2 diabetes mellitus maintained insulin secretion, improved insulin sensitivity index and disposition index in opposition to energy-expenditure and time-duration matched continuous walking training (CWT).
01 Aug Diabetic? Tree Nuts May Help Control Your Blood Sugar
MedicalResearch.com Interview with:
Effie Viguiliouk
M.Sc. Candidate, Department of Nutritional Sciences
University of Toronto
Medical Research: What are the main findings of the study?
Effie Viguiliouk: This systematic review and meta-analysis of the totality of evidence from 12 randomized clinical trials in 450 participants with type 2 diabetes found that eating about 1/2 a cup of tree nuts per day (equivalent to about 60 g or 2 servings) significantly lowered the two key markers of blood sugar, HbA1c and fasting glucose, in comparison to calorically matched control diets without tree nuts.
30 Jul Insulin Sensitivity Predicts Kidney Health in Adolescent Diabetes
MedicalResearch.com Interview with: Petter Bjornstad, M.D. Children's Hospital Colorado University of Colorado Denver Aurora, CO 80045 Medical Research: What are the main findings of the study? Dr. Bjornstad: Type 2 diabetes is the most common cause of end-stage renal disease in the Western world. It is therefore of paramount importance to develop a better understanding of the determinants of diabetic nephropathy risk and progression, to improve outcome in adolescents with type 2 diabetes. We report high rates of microalbuminuria and renal hyperfiltration in adolescents with type 2 diabetes, which forecast early renal morbidity and mortality. In our observational study, insulin sensitivity measured by hyperinsulinemic-euglycemic clamp studies, rather than adiposity, blood pressure, lipid and glycemic control was associated with markers of renal health (albumin-to-creatinine ratio and estimated glomerular filtration rate).30 Jul High Protein Low Carb Diet For Type 2 Diabetes Management
MedicalResearch.com Interview with:
Grant Brinkworth PhD
Associate Professor
Senior Research Scientist
CSIRO Animal, Food and Health Sciences
Adelaide BC, South Australia
Medical Research: What are the main findings of the study?
Dr. Brinkworth: Both a very low carbohydrate, high protein, high unsaturated fat diet and a high carbohydrate, low fat diet achieved similar weight loss, improvements in body composition and health risk markers. However, compared to the high carbohydrate, low fat diet, a very low carbohydrate high protein, high unsaturated fat diet had more favourable effects on blood lipid profile, glycemic control (indicated by greater reductions in glycosylated haemoglobin – primary clinical measure of blood glucose control and the requirements for blood glucose controlling drugs) and for reducing daily blood glucose fluctuations.
The findings from this study suggests that a novel eating pattern that markedly limits carbohydrates, increases protein and unsaturated fat may have more favourable therapeutic potential for optimising the management of type 2 diabetes and reducing cardiovascular disease risk.
29 Jul Diabetes Raises Risk of Oral Cancers
MedicalResearch.com Interview with: Yung-Song Lin MD Chi Mei Medical Center Taipei Medical University Medical Research: What are the main findings of the study? Dr. Lin: The risks of developing oral cavity cancer, oropharyngeal cancer, and nasopharyngeal cancer (NPC) were significantly higher in patients with diabetes.28 Jul Shift Work May Raise Risk of Diabetes
MedicalResearch.com Interview with:
Professor Zuxun Lu
School of Public Health
Tongii Medical College
Huazhong University of Science and Technology
Wuhun, Hubei, China.
Medical Research: What are the main findings of the study?
Prof. Lu: The main finding of this systematic review and meta-analysis was that shift work is associated with an increased risk of diabetes mellitus (DM). The association between shift work and DM appeared to be independent of physical activity, family of history of DM and body mass index. We found that the increased risk of diabetes mellitus was more pronounced in rotating shift group and male shift workers than in other shift group and female shift workers, respectively.
23 Jul Genes Linked To Breast Cancer In East Asian Women Identified
Posted at 21:50h
in Author Interviews, Breast Cancer, Diabetes, Genetic Research, Nature, Vanderbilt
[caption id="attachment_6606" align="alignleft" width="125"]
Dr. Qiuyin Cai, M.D., Ph.D. Courtesy: Vanderbilt University[/caption]
MedicalResearch.com Interview with:
Qiuyin Cai, M.D., Ph.D.
Associate Professor of Medicine
Vanderbilt University
Medical Research: What are the main findings of the study?
Dr. Cai: We conducted a genome-wide association study in East Asians to search for additional genetic changes that are linked to breast cancer development. The study was conducted as part of the Asia Breast Cancer Consortium, which includes 22,780 women with breast cancer and 24,181 control subjects. We found DNA sequence changes in two genes, PRC1 and ZC3H11A, and a change near the ARRDC3 gene were associated with breast cancer risk. These results were also replicated in a large consortium, including 16,003 breast cancer cases and 41,335 control subjects of European ancestry.
14 Jul Chronic Inflammation Associated With Increased Risk of Diabetes and Heart Disease
MedicalResearch.com Interview with: Dr Alex Dregan Lecturer in Translational Epidemiology and Public Health, Division of Primary Care and Public Health Research King's College London, London Medical Research: What are the main findings of the study? Dr. Dregan: Our study showed that chronic inflammation was associated with increased risk of developing cardiovascular disease, specifically type II diabetes and coronary heart disease. The risk of cardiovascular disease increased with the severity of inflammatory disorders. In addition, inflammation also increased the risk of multiple morbidity (two or more cardiovascular diseases).13 Jul Hypoxia Associated With Improved Insulin Sensitivity
MedicalResearch.com Interview with:
Eric Ravussin, Ph.D., Boyd Professor
Director Nutrition Obesity Research Center
Douglas L. Gordon Chair in Diabetes and Metabolism
Associate Executive Director for Clinical Science
Baton Rouge LA
Medical Research: What is the background of this study?
Dr. Ravussin: It has long been postulated that hypoxia is bad for metabolic health.
Hypoxia of adipose tissue has been thought to cause oxidative stress, resulting in the recruitment of macrophages with resultant secretion of cytokines and inflammation. However, repeated bouts of hypoxia induced during vigorous exercise results in increased glucose uptake and vascularization of muscle tissue. In addition, living at high altitude is associated with a lower prevalence of impaired fasting glucose and type 2 diabetes compared with living at low altitude.
Therefore, we asked the question, “What is the balance between the beneficial effects of hypoxia in muscle tissue and ‘bad’ effects in adipose tissue”? We devised a study in eight healthy men of different ethnicities, put into a hypoxic environment for 10 consecutive nights for 10 hours. The subjects slept in a hypoxic tent, using nitrogen dilution.
Medical Research: What are the main findings of the study?
Dr. Ravussin: The main findings of this study included:
- Adipose tissue hypoxia was confirmed;
- Subjects lost an average of 1.2 kg;
- This study reports for the first time a reduced fasting glucose level and improved whole-body (skeletal muscle) and hepatic insulin sensitivity after nightly exposure to moderate hypoxia.