Diabetes
06 May Pediatric Diabetes Incidence Rises Dramatically in Last Decade
MedicalResearch.com Interview with:
Dana Dabelea, MD, PhD
Professor and Associate Dean, Faculty Affairs
Colorado School of Public Health
University of Colorado Denver
Aurora, CO 80045
MedicalResearch.com: What are the main findings of the study?
Dr. Dabelea: We found that the proportion of US youth living with Type 1 Diabetes has increased by at least 21% over a period of only 8 years. This increase was seen in both boys and girls, most age-groups and race/ethnic groups. While we do not completely understand the reasons for this increase, since the causes of Type 1 Diabetes are still unclear, it is likely that something has changed in our environment- both in the US and elsewhere in the world- causing more youth to develop the disease, maybe at increasingly younger ages.
04 May Coffee Consumption and Risk of Type 2 Diabetes
MedicalResearch.com Interview with:
Dr. Frank B. Hu MD MPH PhD
Professor of Nutrition and Epidemiology
From the Departments of Nutrition and Epidemiology
Harvard School of Public Health, Boston, MA
MedicalResearch.com: What are the main findings of the study?
Dr. Hu: We found that people who increased the amount of coffee they drank each day by more than one cup over a four-year period had a 11% lower risk for type 2 diabetes than those who made no changes to their coffee consumption, but those who decreased their coffee consumption by more than a cup per day increased their type 2 diabetes risk by 17%.
02 May Psychological Distress Increases Risk of Diabetes in Pre-Diabetics
MedicalResearch.com Interview with:
Marianna Virtanen PhD
Finnish Institute of Occupational Health
Helsinki, Finland
MedicalResearch: What are the main findings of the study?
Dr. Virtanen: We examined whether psychological distress predicts incident type 2 diabetes and if the association differs between populations at higher or lower risk of type 2 diabetes. We used a clinical type 2 diabetes risk score to assess future diabetes risk and in addition, participants’ prediabetes status. We found that psychological distress did not predict future type 2 diabetes among participants who were normoglycemic and among those with prediabetes combined with a low diabetes risk score. However, psychological distress doubled the risk of type 2 diabetes among participants with prediabetes and a high diabetes risk score.
30 Apr Diabetes Remission After Lap-Band Surgery
MedicalResearch.com Interview with:
Prof. Paul E O'Brien
Centre for Obesity Research and Education
Monash University
Melbourne, Australia
MedicalResearch.com: What are the main findings of the study?
Prof. O'Brien: Using a randomised trial format we compared the diabetes status at two years after a program of multidisciplinary diabetes care (MDC) alone or with the addition of a Lap-Band procedure in 50 people who were overweight (BMI 25-30) and with diabetes. 52% of the Lap-Band group had remission of their diabetes as measured by glucose tolerance testing compared to 8% in the multidisciplinary diabetes care group. The Lap-Band procedures were performed as outpatients with a 2-3 hr length of stay. There were no perioperative adverse events. The surgical group had lost a mean of 11.5kg in weight. The incremental cost effectiveness ratio (ICER) for remission of diabetes was AUD $20,700.
28 Apr Type 2 Diabetes: Telephone-Based Peer Support Improved Risk Factors
MedicalResearch.com Interview with:
Juliana C. N. Chan, MBChB MD FHKAM FRCP
Professor Juliana Chan is Professor of Medicine and Therapeutics, Director, Hong Kong Institute of Diabetes and Obesity and International Diabetes Federation Centre of Education at the Chinese University of Hong Kong, Prince of Wales Hospital and Chief Executive Officer of Asia Diabetes Foundation Hong Kong.
MedicalResearch.com: What are the main findings of the study?
Dr. Chan: In this 1-year randomized study, we asked the question whether type 2 diabetic patients receiving team-based integrated care augmented by information technology would further improve in their glycemic control if given additional peer support through the telephone. All patients underwent comprehensive risk assessment guided by the web-based JADE portal which generated personalized risk report with attained treatment targets and decision support. After 1 year, all patients improved significantly in all risk factors including A1c with improved treatment adherence, self efficacy and psychological wellbeing. Although the peer support group did not further improve in A1c, short-stay hospitalization rates were substantially reduced by 50% , especially amongst those with emotional distress. These patients accounted for 20% of the intervention group, in whom peer support further reduced psychological distress and treatment non-adherence.
24 Apr Diabetes: Nocturnal Hypoglycemia and Risk of Cardiac Arrhythmias
MedicalResearch.com Interview with:
Prof. Simon R. Heller
Professor of Clinical Diabetes
Department of Human Metabolism
University of Sheffield, Sheffield, U.K.
MedicalResearch.com: What are the main findings of the study?
Prof. Heller: We explored the potential to hypoglycaemia to cause cardiac arrhythmias since we have previously shown that a low glucose can alter the electrocardiogram. We had a hypothesis that alterations in heart rhythm or ectopic beats might contribute to cardiac mortality and in part explain the association between intensive diabetic therapy and increased mortality. We therefore undertook continuous glucose monitoring and 12 lead EKG monitoring for a period of 5 days in individuals with Type 2 diabetes at increased CV risk. We found that hypoglycaemia was fairly common and that nocturnal episodes in particular, were generally marked by a pattern whereby glucose levels dropped to low levels for some hours during which patients slept. These periods of hypoglycemia were associated with a high risk of marked slow heart rates (bradycardia) accompanied by ectopic beats. Our data suggest that this was due to overactivity of the vagus nerve. We have therefore identified a mechanism which might contribute to increased mortality in individuals with Type 2 diabetes and high CV risk during intensive insulin therapy.
08 Apr Diabetes: Patients Still Face High Out of Pocket Expenses
MedicalResearch.com Interview with: Dr. Rui Li Division of Diabetes Translation Centers for Disease Control and Prevention Atlanta, GA MedicalResearch.com: What are the main findings of the study? Answer: The proportion of people with diabetes facing high out-of-pocket (OOP) burden declined between 2001 and 2011. Although insurance and income related disparities have declined, almost one-fourth of all people with diabetes still face a high out-of-pocket burden.06 Apr Diabetes: How Long from Onset to Retinopathy?
MedicalResearch.com Interview with:
Massimo Porta, MD PhD
Professor of Medicine Head, Unit of Internal Medicine 1
Department of Medical Sciences University of Turin
MedicalResearch.com: What are the main findings of the study?
Dr. Porta: Type 2 diabetes has a slow, insidious onset and may remain undiagnosed for several years, during which complications may arise and progress. As a result, many patients already have retinopathy at the time a clinical diagnosis is finally made. Previous attempts at estimating the duration of this period of "hidden" diabetes relied upon extrapolations of a linear correlation between known duration of diabetes and prevalence of retinopathy.
This led to overestimates, because:
a) the best fitting correlation may not be linear,
b) series included insulin treated patients, who might have late-onset type 1 diabetes,
c) patients with any mild retinopathy were included whereas we now know that up to 10% of non diabetic individuals may have minimal retinal signs.
By taking these variables into account, ie including only patients not on insulin and with moderate or more severe retinopathy and applying different mathematical models, we ended up with an estimated duration preceding diagnosis of type 2 diabetes of 4-6 years, against longer than 13 years using "standard" criteria.
04 Apr Lifestyle Interventions Reduced Risk of Diabetes, Cardiac Mortality
MedicalResearch.com Interview with:
Prof Guangwei Li MD
Department of Endocrinology
China-Japan Friendship Hospital
Center of Endocrinology and Cardiovascular Disease, National Center of Cardiology & Fuwai Hospital, Beijing, China
MedicalResearch.com: What are the main findings of the study?
Answer: Our study first shows that a six-year period of lifestyle intervention in Chinese people with IGT reduced the incidence of diabetes over a protracted time period and was ultimately associated with a significant reduction in total and cardio-vascular disease mortality. This reduction in mortality appears to be mediated in part by the delay in onset of diabetes resulting from the lifestyle interventions.
01 Apr Diabetes Associated with Brain Pathology, but Not Amyloid Accumulation
Posted at 20:20h
in Alzheimer's - Dementia, Author Interviews, Diabetes, Mental Health Research, NIH, University of Pittsburgh
MedicalResearch.com Interview with:
Rosebud O Roberts, M.B., Ch.B.
Professor of Epidemiology
Professor of Neurology
Mayo Clinic
MedicalResearch.com: What are the main findings of the study?
Dr. Roberts: We found that among persons 70 years and older, people with type 2 diabetes had a reduced glucose uptake (hypometabolism) in brain cells. We also found a similar association for people without type 2 diabetes but who had elevated hemoglobin A1c levels levels at the time of enrollment (HBA1c is a measure of glucose control, and represents the average blood glucose levels over a 3 month period). However, we did not find an association of diabetes with increased brain amyloid accumulation. Our findings were based on an investigation of the association of type 2 diabetes with markers of brain pathology: brain hypometabolism was assessed by 18F-fluorodeoxyglucose positron emission tomography [PET] and amyloid accumulation was assessed by 11-C Pittsburgh Compound B PET imaging.
31 Mar Diabetes: Insulin Resistance May Link Brain Disconnections and Cognitive Dysfunction
MedicalResearch.com Interview with: Gao-Jun Teng, MD Chair and Professor, Dept of Radiology Zhongda Hospital, Southeast University Nanjing 210009, China MedicalResearch.com: What are the main findings of the study? Answer: This current study demonstrates that the aberrant resting-state functional connectivity among default mode network (DMN) regions, especially the posterior cingulated cortex (PCC) to right middle temporal gyrus (MTG), is associated with insulin resistance and cognitive performance, which might be the key to understanding the cognitive impairment in type 2 diabetes (T2DM).30 Mar Diabetic Kidney Disease: Potential New Therapeutic Target Discovered
MedicalResearch.com Interview with:
Dr. Paolo Fiorina, MD PhD
Assistant Professor, Division of Nephrology,
Harvard Medical School
and
Dr. Roberto Bassi
Post-doctoral research fellow
Nephrology Department at Children's Hospital Boston.
MedicalResearch.com: What are the main findings of the study?
Dr. Fiorina: It is common knowledge that type 2 diabetes is a worldwide epidemic and that diabetic nephropathy has become the leading cause of renal failure in the western world. One of the main drivers and worsening factors for the diabetic kidney disease is proteinuria associated with various degrees of tubular damage, and unfortunately, therapies to halt or prevent this complication are not available so far. Our findings show that B7-1 when expressed on podocytes (a specific subset of renal cells) determines alterations in podocytes function and morphology, predisposing individuals with T2D to the loss of proteins into the urine. We also demonstrate that Abatacept, an immunomodulatory drug currently employed for the treatment of a variety of autoimmune diseases, is able to specifically target this malignant pathway, preventing podocytes cellular alterations in vitro and proteinuria development in two murine models of diabetic nephropathy in vivo.
28 Mar Diabetes: High Level of Self Care Improved Glycemic Control and Reduced Mortality
MedicalResearch.com Interview with:
Michael Laxy
Helmholtz Zentrum München
German Research Center for Environmental Health
Institute of Health Economics and Health Care Management
Neuherberg, Germany
MedicalResearch.com: What are the main findings of the study?
Answer: In patients with type 2 diabetes a high level of self-management behavior was associated with a better glycemic control, i.e. a lower HbA1c level, in the cross-sectional perspective and a reduced mortality over a 12-year period. This effect remained robust after controlling for socio-demographic and disease related factors, including medication.
26 Mar Sleep Loss Associated with Obesity and Diabetes
MedicalResearch.com Interview with: Prof. Dr. Bernd Schultes Endocrinology and Diabetes Internal Medicine eSwiss Medical & Surgical Center Brauerstrasse 97 9016 St. Gallen Schweiz MedicalResearch.com: What are the main findings of the study? Professor Schultes: Sleep loss promotes the development of obesity and diabetes by metabolic and behavioral mechanism. MedicalResearch.com: Were any of the findings unexpected? Professor Schultes:...
20 Mar Diabetes Key Risk Factor for Cognitive Impairment in Late-Life
MedicalResearch.com Interview with:
Rosebud O Roberts, M.B., Ch.B.
Professor of Epidemiology
Professor of Neurology
Mayo Clinic
MedicalResearch.com: What are the main findings of the study?
Dr. Roberts: The onset of type two diabetes in midlife (before age 65 years) is associated with brain pathology (subcortical brain infarctions, reduced hippocampal volume, reduced whole brain volume) in late-life. Early onset of diabetes also increases the risk of developing mild cognitive impairment which is an intermediate stage between normal cognitive aging and dementia. Our findings suggest that loss of brain volumes may be an intermediate stage or a link between diabetes and cognitive impairment.
We also found that diabetes onset in late-life (after age 65 years), is also associated with brain pathology (cortical infarctions, reduced whole brain volume).
Finally, onset of hypertension in midlife, but not late-life, is associated with brain pathology in late- life.
20 Mar FDA Study on Diabetes Medication Use In US Shows Marked Increase in Number of Prescriptions
MedicalResearch.com Interview with:
Christian Hampp PhD
Senior Staff Fellow/Epidemiologist at FDA
Office of Pharmacovigilance and Epidemiology, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD
MedicalResearch.com: What are the main findings of the study?
Dr. Hampp: Our study described U.S. market trends for antidiabetic drugs, focusing on newly approved drugs, concomitant use of antidiabetic drugs, and effects of safety concerns and restrictions on thiazolidinedione use.
We found that since 2003, the number of adult antidiabetic drug users increased by approximately 43% to 18.8 million in 2012. During 2012, 154.5 million prescriptions for antidiabetic drugs were filled in outpatient retail pharmacies. Since 2003, metformin use increased by 97% to 60.4 million prescriptions dispensed in 2012. Among antidiabetic drugs newly approved for marketing between 2003 and 2012, the dipeptidyl-peptidase-4 (DPP-4) inhibitor sitagliptin had the largest share with 10.5 million prescriptions in 2012.
Possibly triggered by safety concerns, the use of pioglitazone declined in 2012 to approximately 52% of its peak in 2008, when 14.2 million prescriptions were dispensed in outpatient retail pharmacies and the use of rosiglitazone use decreased to fewer than 13,000 prescriptions dispensed in retail or mail-order pharmacies in 2012.
18 Mar Gestational Diabetes Increases Risk of Future Heart Disease
MedicalResearch.com Interview with:
Erica P. Gunderson, PhD, MS, MPH
Senior Research Scientist, Cardiovascular and Metabolic Section
Division of Research, Kaiser Permanente Northern California
Oakland, CA 94612-2304
MedicalResearch.com: What are the main findings of the study?
Dr. Gunderson: The study found that:
- Gestational diabetes is a pregnancy complication that reveals a woman’s greater risk of future heart disease.
- Women who experience gestational diabetes face an increased risk of subclinical atherosclerosis (early heart disease) even if they do not develop type 2 diabetes or the metabolic syndrome years after pregnancy.
- Study participants with a history of gestational diabetes who did not develop diabetes or metabolic syndrome showed a greater carotid artery wall thickness (marker of early atherosclerosis) compared to those who never experienced gestational diabetes. The vessel narrowing also could not be attributed to obesity or other risk factors for heart disease that were measured before pregnancy.
- Weight gain and blood pressure elevations in women with gestational diabetes were responsible for these differences in the artery wall thickness.
15 Mar Diabetes: Medication Adherence Improves with Information, Motivation and Skills
MedicalResearch.com Interview with:
Chandra Y. Osborn, PhD, MPH
Assistant Professor of Medicine & Biomedical Informatics
Division of General Internal Medicine & Public Health
Center for Health Services Research
Vanderbilt University Medical Center
Nashville, TN 37232-8300
MedicalResearch.com: What are the main findings of your study?
Dr. Osborn: We found that knowing how to take your diabetes medications (e.g., what to do if a dose is missed), believing medications are good for you, and having the appropriate skills to take them regardless of the situation (e.g., when life is busy, when in public) accounts for 41% of why people successfully take their diabetes medications, which, in turn, explains 9% of their glycemic control.
14 Mar Diabetes: TNFR1 As Biomarker of Renal Disease and Mortality
MedicalResearch.com Interview with:
Prof Samy Hadjadj:
Université de Poitiers, UFR Médecine Pharmacie, Centre d’Investigation clinique,
CHU de Poitiers, Centre d’Investigation clinique, Poitiers, France
MedicalResearch.com: What are the main findings of the study?
Prof: Hadjadj: The study helps to establish sTNFR1 as a valid biomarker not only for renal outcomes in type 2 diabetes but also for all cause death. Interestingly the addition of sTNFR1 concentration to the UKPDS model outcome equation showed to add some clinical prognostic value to this model for all-cause death.
11 Mar Emergency Room Visits for Insulin-Related Hypoglycemia
MedicalResearch.com Interview with:
Andrew I. Geller, MD
Medical Officer in the Division of Healthcare Quality Promotion at CDC.
MedicalResearch.com: What are the main findings of the study?
Dr. Geller: Using CDC’s national medication safety monitoring system, we estimated that, each year, there were about 100,000 visits made to U.S. emergency departments (EDs) for insulin-related hypoglycemia and errors during 2007-2011, or about half a million ED visits over the 5-year study period. This is important because many of these ED visits for insulin-related hypoglycemia may be preventable.
We also found these ED visits were more common with increasing age: every year, 1 in 49 insulin-treated seniors (aged 65 years or older) visited the ED because of hypoglycemia while on insulin or because of a medication error related to insulin. Among the very elderly (aged 80 years or older), this number was 1 in 8 annually.
05 Mar Genetically Elevated BMI Raises Risks of Hypertension and Diabetes
Posted at 21:44h
in Author Interviews, Blood Pressure - Hypertension, Diabetes, Genetic Research, University of Pennsylvania
MedicalResearch.com Interview with:
Brendan Keating D.Phil
Assistant Professor, Dept of Pediatrics and Surgery, University of Pennsylvania
Lead Clinical Data Analyst, Center for Applied Genomics
Children's Hospital of Philadelphia
Michael V. Holmes, MD, PhD, MSc, BSc, MRCP
Transplant Surgery
Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
MedicalResearch.com: What are the main findings of the study?
Answer: We found that individuals with a genetically-elevated BMI had higher
blood pressure, inflammatory markers, metabolic markers and a higher
risk of type 2 diabetes, although there was little correlation with
coronary heart disease in this study population of over 34,500
European-descent individuals of whom over 6,000 had coronary heart
disease.
27 Feb Diabetes: Greater Stroke Risk in Women than Men
MedicalResearch.com Interview with:
Gang Hu, MD, MPH, PhD, FAHA
Assistant professor & Director
Chronic Disease Epidemiology Lab
Adjunct assistant professor, School of Public Health
LSU Health Sciences Center
Pennington Biomedical Research Center,
Baton Rouge, Louisiana
MedicalResearch.com: What are the main findings of the study?
Dr. Gang Hu: Our study suggests a graded association between HbA1c and the risk of stroke among female patients with type 2 diabetes and poor control of blood sugar has a stronger effect in women older than 55 years.
26 Feb OverEating Saturated Fat May Build More Fat But Less Muscle
MedicalResearch.com Interview with:
Dr. Ulf Risérus
Associate Professor in Clinical Nutrition
Department of Public Health and Caring Sciences
Clinical Nutrition and Metabolism
Faculty of Medicine, Uppsala university
Sweden
MedicalResearch.com: What are the main findings of the study?
Dr. Risérus: It has previously been shown in animal studies that overfeeding polyunsaturated fat causes less fat accumulation than saturated fats, but this study is the first to suggest that this could be true also in humans. Overeating saturated fats caused significantly more accumulation of fat in the liver and intra-abdominally, as compared with overeating polyunsaturated fats from. This study suggests it does matter where the excess calories come from when we gain weight. If a high-caloric diet contains large amounts of saturated fats it seems to switch on some genes that may promote abdominal fat storage and insulin resistance, and thereby result in a more unfavorable fat storage. In contrast, such effects were not seen if the diet was lower in saturated fats but higher in polyunsaturated fats from non-tropical vegetable oils. This study also suggests a novel contributing factor regarding the tendency of some individuals to accumulate fat in the liver and abdomen, i.e. in some people excessive amounts of saturated fat in combination with sugars might induce more fat in their livers and a propensity towards abdominal visceral fat accumulation.
26 Feb Diabetes and Depression: Cognitive Therapy Improved Both
MedicalResearch.com Interview with:
Steven A. Safren, Ph.D., ABPP
Professor of Psychology, Harvard Medical School
Director, Behavioral Medicine, Department of Psychiatry
Massachusetts General Hospital,
Boston, MA 02114
MedicalResearch.com: What are the main findings of the study?
Dr. Safren: The main findings of the study are that, in patients with uncontrolled type 2 diabetes and depression, a type of psychological treatment, cognitive behavioral therapy (CBT) that addressed both self-care and depression, resulted in improvements in both depressed mood, self-care, and glucose control. This was a randomized controlled trial, and this cognitive-behavioral treatment worked better than lifestyle adherence and nutrition counseling alone; and the effects were sustained over 8 months.
26 Feb Disabilities Increase Risk of Diabetes
MedicalResearch.com Interview with:
Barbara H. Bardenheier PHD, MPH, MA
Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention
Atlanta, GA
MedicalResearch.com: What are the main findings of the study?
Dr. Bardenheier: Our main findings were that older adults who become disabled, even mildly, are at increased risk of developing diabetes.
25 Feb Common Measurement of Kidney Function Altered by Poor Glycemic Control
MedicalResearch.com Interview with: Eiji Ishimura, MD, PhD, FASN, FACP Osaka City University Hospital Professor,Department of Nephrology Osaka, JAPAN MedicalResearch.com: What are the main findings of the study? Dr. Ishimura: Poor glycemic control is a major factor in the overestimation of glomerular filtration rate (GFR) in diabetic patients. We found this simple conclusion by directly measuring GFR by use of inulin clearance. We have created new formulae to accurately assess the GFR in diabetic patients, with the correction of hemoglobin A1C (HbA1C) or glycated albumin (GA) as followings; 1) eGFRcr corrected by HbA1c=eGFRcr / (0.428 + 0.085 × HbA1c) 2) eGFRcr corrected by GA=eGFRcr / (0.525 + 0.028 × GA)14 Feb Type 2 Diabetes: Weight Gain Pattern Before Diagnosis
MedicalResearch.com Interview with:
Dorte Vistisen
Senior researcher, MSc PhD
469 - Epidemiology
DK-2820 Gentofte Denmark
MedicalResearch.com: What are the main findings of the study?
Dr. Vistisen: Our study highlights the complexity of type 2 diabetes. We show that in most people the development of type 2 diabetes is preceded by many years of overweight and not by massive weight gain.
14 Feb Oral Health and Diabetes: Effects of Health Coaching
MedicalResearch.com Interview with:
Ayse Basak Cinar, Assistant Professor
The Department of Odontology
The Faculty of Medical and Health Resources
2200 Copenhagen N Denmark
MedicalResearch.com: What are some of the unique or enlightening findings of this study that haven’t been published before?
Answer: To our knowledge, this is the first randomized controlled intervention study comparing the impact of individualized Health Coaching (HC) to formal Health Education (HE); applying HC as a holistic intervention for management of more than one specific type of chronic disease, namely oral health and diabetes management.
The present study has two phases [the Turkish Phase, Turkey (2010-2012) and the Danish Phase, Denmark (2012- ...)]. The unique/enlightening figures from the Turkish phase as follows:
The HC group compared to the HE group had significantly higher improvement at;
HbA1c* (reduction: 0, 8% vs. 0%), and Periodontal Attachment Loss (PAL) (56% vs. 26%), (p≤0.01)
Tooth Brushing Self-Efficacy (TBSE) (increase: 61% vs.25%) and stress (reduction: 16% vs. 1%), (p≤0.01).