For Diabetics, Health Risks Fall Sharply

By SABRINA TAVERNISE and DENISE GRADYAPRIL 

Federal researchers on Wednesday reported the first broad national picture of progress against some of the most devastating complications of diabetes, which affects millions of Americans, finding that rates of heart attacks, strokes, kidney failure and amputations fell sharply over the past two decades.

The biggest declines were in the rates of heart attacks and deaths from high blood sugar, which dropped by more than 60 percent from 1990 to 2010, the period studied. While researchers had had patchy indications that outcomes were improving for diabetic patients in recent years, the study, published in The New England Journal of Medicine, documents startling gains.

“This is the first really credible, reliable data that demonstrates that all of the efforts at reducing risk have paid off,” said Dr. David M. Nathan, director of the Diabetes Center at Massachusetts General Hospital, who was not involved in the study. “Given that diabetes is the chronic epidemic of this millennium, this is a very important finding.”

The number of Americans with diabetes more than tripled over the period of the study and is now nearly 26 million. Nearly all the increase came from Type 2 diabetes, which is often related to obesity and is the more common form of the disease. An additional 79 million Americans have pre-diabetes, which means they are at high risk of developing the disease.
Researchers from the Centers for Disease Control and Prevention, who wrote the study, estimate that diabetes and its complications account for about $176 billion in medical costs every year. The study measured outcomes for both Type 1 and Type 2.

Researchers said the declines were the fruit of years of efforts to improve the health of patients with Type 2 diabetes. Doctors are much better now at controlling the risk factors that can lead to complications — for example, using medications to control blood sugar, cholesterol and blood pressure — health experts said. What is more, a widespread push to educate patients has improved how they look after themselves. And a major effort among health care providers to track the progress of diabetes patients and help steer the ones who are getting off track has started to have an effect. 

“These results are very impressive,” said Dr. K. M. Venkat Narayan, professor of medicine and epidemiology at Emory University, who specializes in diabetes and was not involved in the study. “There is strong evidence that we’re implementing better care for patients with diabetes. Awareness has increased tremendously, and there’s been a great deal of emphasis on coordinated care in health care settings.”

Edward W. Gregg, a senior epidemiologist at the Centers for Disease Control and Prevention and the lead author of the study, said researchers used four federal data sets — the National Health Interview Survey, the National Hospital Discharge Survey, the United States Renal Data System, and Vital Statistics — over a 20-year period to give a comprehensive picture of diabetes outcomes.

Dr. Gregg said the study relied on large sample sizes, including hundreds of thousands of diabetics who had heart attacks, and thousands who died from high blood sugar.
“This is the first time we’ve put the full spectrum together over a long period of time,” Dr. Gregg said. He pointed out that heart attacks, which used to be the most common complication by far, had dropped down to the level of stroke, which also fell.
“We were a bit surprised by the magnitude of the decrease in heart attack and stroke,” he said.
Beyond the declines in the rates of heart attacks and deaths from high blood sugar, the study found that the rates of strokes and lower extremity amputations — including upper and lower legs, ankles, feet, and toes — fell by about half. Rates for end-stage kidney failure dropped by about 30 percent. The study did not measure blindness, another critical diabetes complication.

Dr. Gregg cautioned, however, that the number of Americans with diabetes continued to rise. “We have to find a way to replicate these successes, to transfer that knowledge into preventing the disease to begin with,” he said.

The declines in rates of complications began around 1995 and continued gradually, but steadily, over time, the data show. What drove the outcomes varied by the complication, Dr. Gregg said. Improved blood sugar control has made a difference, especially in reducing the rate of amputations and end-stage kidney disease. Declines in smoking and the rising use of statins to lower cholesterol and of other medications to control blood pressure contributed to the declines in heart attacks and strokes.

Six factors that can help cure diabetes



Sunday, April 06, 2014 by: Sandeep Godiyal
Tags: diabetes, natural cures, beta cells

(NaturalNews) Type I diabetes, though similar to Type II diabetes, is also very different in a crucial way. While Type II diabetes involves the body's inability to utilize its own insulin properly, Type I diabetes occurs when the body cannot make enough natural insulin on its own. This happens when the beta cells that lie within the pancreas are not able to produce a sufficient amount of insulin.
A few of the known triggers for Type I diabetes include chemical exposure, incompatible choice in foods, bacterial infections, autoimmune issues and viral infections, to name just a few of the factors that could cause the diseases. Over the years, there have been a number of studies whose results have appeared in reputable medical journals that point to the effectiveness of certain elements when it comes to providing a cure for Type I diabetes. These foods and compounds all share one exciting characteristic: their potential to provide beta cell regeneration. A few of the compounds that have been shown to help cure Type I diabetes follows:
Corn Silk
A study in 2009 found that the vitamins, proteins, carbohydrates, flavanoids and other compounds that make up corn silk stimulated the regeneration of beta cells while also reducing blood sugar in rats with Type I diabetes.
Avocado
Avocado seed extract is responsible for the reduction of blood sugar in diabetic rats. This result was noted in a study performed in 2007 in which the pancreatic islet cells showed a protective and restorative improvements.
Honey
A human study has shown its positive effects of honey on curing Type I diabetes. A study conducted in 2010 gives promise to the effects of long-term consumption of honey when it comes to the regeneration of beta cells as indicated by the levels of fasting C-peptide.
Stevia
A substance whose properties compared favorably with glibenclamide, a popular medication often prescribed to people with Type I diabetes, stevia has been shown to provide revitalization to beta cells that have been damaged. This, and other findings, were recorded in a 2011 study on humans.
Nigella Sativa
Also widely known as black seed, this plant can lead to a partial regeneration of beta cells, according to an animal study completed in 2003. During a human study, undertaken in 2010, diabetics who consumed 1 gram of black seed for a period of up to 12 weeks showed a wide range of benefits. This includes an increase in the function of beta cells.
Chard
During a 2000 study, when diabetic rats were fed chard extract, their injured beta cells began to recover.

The above list is just the beginning of the many natural elements and compounds that show great promise in relieving Type I diabetes. This can lead to a better quality of life for those people who have the disease.




Diabetes costliest among non-specialty Rx



A snapshot of 2013 prescriptions by the PBM Express Scripts shows that diabetes medications trounce all others in terms of annual patient spend on traditional medications, followed by drugs for high cholesterol, hypertension and heart disease.
Further, diabetes was among the top-10 most expensive traditional medications whose use went up between 2012 and 2013, rising 14%, whereas spend per patient for cholesterol and blood pressure/heart disease fell.
Express Scripts research indicates that diabetes medication expenses are only going to increase, and predicts the spend will continue to grow between 10% and 13% every year through 2016.
The PBM found that use of traditional medications, such as diabetes therapies, rose 0.5% between 2012 and 2013. Use and cost, however, are two different metrics, and although use of traditional medication inched up a half-percentage point, higher prices pushed spending up almost 5%. This is not a surprise for investors: drug companies noted throughout the year that higher prices supported their balance sheets, even when volumes fell.
Use of specialty medications—which includes drugs like the lauded, or condemned, hepatitis C medication Sovaldi —rose 2.5% between 2012 and 2013, and the spend jumped 14%, while accounting for almost 28% of total drug outlay. Express Scripts said brands had a significant impact in overall drug costs in both the traditional and specialty drug categories.
Despite Sovaldi's reknown, it was not a leading specialty class based on spend. Instead, the top three most expensive specialty medication classes were for inflammatory conditions, multiple sclerosis and cancer.
While specialty may sound like an off-to-the-side category, Express Scripts notes that specialty drugs comprised the majority of the FDA's 2013 approvals for the third year in a row, vs. 33% of FDA approvals in 2008. Among last year's big names: Roche's Kadcyla, Roche's Gazyva and Pharmacyclics/Janssen's Imbruvica.




Diabetes Tied to Higher Risk of Pancreatic Cancer in Study




FRIDAY, April 4, 2014 (HealthDay News) -- People with diabetes have double the risk of pancreatic cancer compared to people who don't have diabetes, according to a new analysis of 88 previous studies.
Diabetes has been considered a risk factor for pancreatic cancer, but what's not clear is which condition comes first. This new analysis suggests that at least for some people, pancreatic cancer might be responsible for diabetes.
Experts note, however, that the overall risk for pancreatic cancer remains low among people with diabetes.
"Our study demonstrated that there is an overall two-fold increased risk of pancreatic cancer in patients with diabetes mellitus," said Dr. Mehrdad Nikfarjam, a senior lecturer and transplant surgeon at the University of Melbourne, in Australia.
Diabetes mellitus includes type 1 and type 2 diabetes.
"The study also demonstrates that diabetes mellitus itself may be an early indicator of the development of pancreatic cancer in certain cases," Nikfarjam said. "Patients with diabetes mellitus that were analyzed had a seven-fold increased risk of being diagnosed with pancreatic cancer within the first year of being diagnosed with diabetes."
"Studies have demonstrated that pancreatic cancer can produce certain substances that influence the way the body handles insulin and blood sugar, resulting in diabetes," he said. "In some patients with pancreatic cancer and diabetes, the diabetes actually improves once the cancer is removed."
But Nikfarjam also said there is a plausible biological connection for diabetes to influence the growth of pancreatic cancer, too.
"It is thought that the chemical changes that occur in the body with type 2 diabetes can promote the growth of pancreas cells and also result in damage that leads to the development of pancreatic cancer," he said. "Type 1 diabetes is similarly thought to be a risk factor, but to a lesser extent."
Although the review found an association between diabetes and risk of pancreatic cancer, it did not prove that either disease causes the other.
A U.S. expert said the review results are not unexpected.
"The conclusions from this meta-analysis are very consistent with those drawn at a [U.S. National Institutes of Health] workshop on the subject," said Dr. Robert Ratner, chief scientific and medical officer at the American Diabetes Association.
"Clearly, there is a relationship between diabetes and pancreatic carcinoma, and it could go in either direction," he said. "Pancreatic cancer might cause diabetes or diabetes might cause pancreatic cancer."
Ratner added that the overall risk of pancreatic cancer is quite low, so this isn't something that should worry most people with diabetes.
Nikfarjam agreed. "The risk of developing pancreatic cancer overall remains very low, even in long-standing diabetic patients," he said. "These patients should not be alarmed. It is even possible that good blood sugar control may lessen the risks."
A major problem with pancreatic cancer, however, is that it's often diagnosed at a very late stage. Overall five-year survival rates are less than 1 percent, and many patients diagnosed with late-stage pancreatic cancer don't survive more than four to six months after the diagnosis, according to background information included in the study.
Although the current review of past studies found an overall two-fold increased risk of pancreatic cancer in people with diabetes, that risk was highest soon after diagnosis. Within the first year after diagnosis, the risk of pancreatic cancer was nearly seven times higher than for someone without diabetes.
Although the risk stays elevated for a long time, after 10 years the risk of pancreatic cancer for someone with diabetes is just 36 percent higher than for someone without diabetes.
This suggests a window of opportunity for diagnosing pancreatic cancer earlier than it is currently. Detection methods for pancreatic cancer may include CT scans, PET scans and endoscopy, according to the American Cancer Society. Testing for pancreatic cancer is often expensive.
"It would not be feasible to screen all people with diabetes," Nikfarjam said. "Patients over the age of 55 without significant risk factors for diabetes who develop diabetes out of the blue appear to be a potentially good initial screening target."
Ratner agreed that it wouldn't make sense to screen everyone newly diagnosed with diabetes for pancreatic cancer because so few would have it.
"There are circumstances where it might make sense. Someone with a family history of pancreatic cancer or a history of chronic pancreatitis or someone who smokes already has an increased risk of pancreatic cancer," Ratner said.
"If the onset of diabetes is associated with a loss of appetite and weight loss, that's not the typical onset of type 2 diabetes," he said. "Type 2 usually causes hunger and isn't associated with a loss of weight. If someone's risk is higher and the onset of diabetes isn't typical, that's someone who may warrant more substantive investigation."
Results of the study were published online recently in the journal Annals of Surgical Oncology.



High diabetes rate linked to ethnic backgrounds, poor walkability



The diabetes rates in the suburban GTA region of Peel are among the highest in Ontario due to ethnic background of its residents and lack of walkability, researchers at Toronto’s St. Michael’s Hospital say.
The region, which is comprised of Caledon, Brampton and Mississauga, is “characterized by wide streets and high-traffic intersections – neither of which are conducive to walking,” the researchers found.
Using data from the Institute for Clinical Evaluative Sciences and Statistics Canada, Peel Public Health also found that the region has a large population of residents from South Asia and the Caribbean, who are more genetically susceptible to developing diabetes than people of European descent.
•          
“We found that diabetes rates were highest in neighbourhoods that discourage walking and in neighbourhoods where more of the residents come from world regions that have high levels of diabetes,” Dr. Gillian Booth, an endocrinologist and researcher St. Michael’s Hospital, said in a statement on Monday.
One in 10 adults in Peel has diabetes and researchers predict that by 2025, one in six will have the disease.
Overall, the number of people in Ontario living with diabetes has been increasing over the years, with 1.2 million people diagnosed with the chronic disease in 2010.
To determine where diabetes is most common, Peel Public Health partnered with researchers at St. Michael’s Centre for Research on Inner City Health and developed an “atlas” of region, mapping rates of the disease across the community.
“Peel certainly lights up on a map of Ontario diabetes rates,” said Dr. Rick Glazier, researcher at St. Michael’s Hospital. “When we looked at the region in more detail, we found that some neighbourhoods, particularly those in Brampton, had noticeably higher rates.”
The 233-page diabetes atlas contains maps and data comparing the rates of diabetes against certain risk factors including:
•           Obesity
•           Income level
•           Ethnic background
•           Physical inactivity
•           Unhealthy diet
Peel Public Health and the region’s planning department are now collaborating to “influence built environment policies and processes.”
“The diabetes atlas is a useful reference to help us grow in a way that is healthy, economically viable and sustainable,” said Arvin Prasad, director of integrated planning at the Region of Peel.




Diabetes expenses have decreased, but are still high


BY KATHRYN DOYLE

 (Reuters Health) - Out-of-pocket expenses for diabetes treatment have gone down for many U.S. patients over the past decade, according to a new study. But nearly a quarter of people with diabetes still face high expenses.
In particular, "(out-of-pocket) expenses declined in the people with public insurance and in people with low income between 2001 and 2011," mostly because prescription drug costs went down, Rui Li told Reuters Health by email.
Li led the study at the Division of Diabetes Translation, part of the National Center for Chronic Disease Prevention and Health Promotion at the Centers for Disease Control and Prevention in Atlanta, Georgia.
The researchers examined data from ten years of a nationwide medical expenditure study. They defined people with high out-of-pocket expenses as those spending more than 10 percent of their family income on health care.
In 2001 and 2002, 28 percent of adults under age 65 with diabetes faced a high expense burden, which decreased to 23 percent by 2011, according to results published in Diabetes Care.
The dip was biggest for people with public insurance like Medicare or Medicaid: 43 percent of them had burdensome out-of-pocket expenses in 2001 and 2002, compared to 21 percent in 2011.
For people with private insurance, the proportion under high expense burden increased slightly over the course of the study.
The average person with diabetes accounted for more than half of the total out-of-pocket medical expenses of his or her family.
On the whole, expenses went down mostly because prescription drug spending went down, the authors write.
Over the last decade, Medicaid has made cheaper generic drugs more attractive to patients and prescribers, partly by limiting the amount of brand-name drugs that can be prescribed at one time.
"Any move to lowering expenses is great, but as the authors point out, there are some changes in the way the data was reported just around the time they show the major changes, so there still needs to be some caution with interpretation," said Dr. Robert J. Rushakoff, a diabetes researcher at the University of California, San Francisco.
Rushakoff was not involved with the study.
It's also possible that out-of-pocket expenses have gone down because people stopped being able to afford them at all, he told Reuters Health in an email.
High out-of-pocket costs for diabetes patients are a problem outside the U.S. as well, Li said.
"A study of 35 low and middle income countries found that persons with diabetes experienced differentially higher out-of-pocket medical spending, particularly among individuals with high levels of spending, and a greater chance of incurring catastrophic medical spending compared with otherwise similar individuals without diabetes," Li said.
Although older medications are now inexpensive, lab tests, medical follow-up and supplies remain costly, Rushakoff said.
Generic prescription medications can be filled for as little as $4 per month at Walmart or similar stores, he said. Test strips are a bigger expense, but people who are not on insulin don't need to use as many, and insurance generally covers them.
The Affordable Care Act may help continue to bring expenses down, in that more people will have insurance, Rushakoff said.

For patients, the best way to keep expenses down is to use generic medications or look into discount cards which are available for many newer medications and reduce the co-pay, he said. They can also make sure the test strips they select are covered by their insurance plan

Diabetes Mellitus Due to Food Additives and Pollution?


Added by Lara Stielow

The most commonly noted causes for the rise in diabetes mellitus are obesity and overeating but could food additives and pollution contribute? Type 2 diabetes accounts for 90-95% of all diabetes cases. In 2000, 171 million people worldwide had diabetes and that is expected to increase to 366 million by 2030. This epidemic has received a lot of attention but the fact remains that there is zero evidence that diabetes mellitus results from overeating and a sedentary lifestyle.
The problem with this disease, and many others, is that the mechanisms involved are so complex that approaches to managing the rise are more treatment-based than prevention-based.  The current model explaining type 2 diabetes assumes, without true evidence, that insulin resistance precedes elevated insulin levels. Hyperinsulinemia is thought to be the body’s compensatory response to insulin resistance but there is no understood mechanism by which such resistance triggers secretion.
In 2012, a meta-analysis published by the American Diabetes Association proposed that food additives may trigger type 2 diabetes. The study takes a critical view of the current disease model and the commonly blamed culprits: obesity, overeating, and an inactive lifestyle. Though the authors are of the opinion that hypersecretion of insulin is the catalyst of insulin resistance they conclude that there are likely many factors which could contribute.
One realistic environmental trigger for diabetes cited in the ADA analysis is BPA (bisphenol A).  BPA has been found to impair β-cell function, which is the pancreatic cell responsible for producing, storing, and releasing insulin. BPA has been shown in animal studies to have this effect in fetal, neonatal, and perinatal periods as well as adulthood.
A Lancet study, done in 1981, examined one inconsistency in an annual trend of initial diabetes diagnosis. The results suggest that the ingestion of a nitrogenous preservative while pregnant can contribute to diabetes in the offspring. This study specifically examined ketosis-prone diabetes, a particularly severe and more deadly form of diabetes. Although this was observed in type 1 diabetes an impairment of  β-cell function is common to both forms of diabetes suggesting that the potential involvement of food additives and pollution is worthy of further investigation.
Multiple epidemiological studies suggest that pollution might play a causative role in the development of type 2 diabetes. These studies have found consistent correlations between exposures to pollutants and diabetes mellitus. Living in a county in which a toxic waste dump is located increases the risk of developing diabetes, as does contact with certain organic pollutants and specific factories.

While most medical professionals and researchers believe that obesity, a sedentary lifestyle, and genetic risk factors are the main culprits of diabetes mellitus, those factors themselves have not been scientifically proven to cause type 2 diabetes. Increasing research is examining the possibility that an interplay of traditionally accepted “causes” of diabetes with environmental factors, such as chemical exposure, are at the root of diabetes mellitus. When the mechanism of disease onset is fully understood the doors will open to finding an effective (non-exacerbating) treatment and possibly even a cure.

The Key To Fighting Obesity Might Be Found In...Chocolate?

 JUSTIN SEDOR

The good news about chocolate just keeps pouring in. It's no secret that dark chocolate is full of antioxidants and other compounds that help boost brain function and mood as well as contribute to heart health. Scientists are even exploring ways to get the beneficial molecules found naturally in the cacao plant into a more concentrated form that can be taken orally, via a pill.

As scientists learn more about this magical substance, though, the headlines are getting even more exciting. New research on specific antioxidant compounds in chocolate suggest that your favorite dessert could be used to fight obesity and diabetes.

In a recent lab study, scientists fed mice a variety of different diets with different levels of fat and sugar. They tested the effects of several combinations of cocoa flavanols on the rodents and found that one set of compounds, called oligomeric procyanidins (or PCs), had a significant weight-control effect when given to mice on a high-fat diet. The PCs were also shown to help the mice regulate their blood glucose levels, indicating that they might be useful as a treatment for diabetes. Of course, further research is needed to get an idea of the effects of the compound on humans.


Although it's not quite an "eat chocolate to lose weight" situation, we kind of love that one of our favorite "indulgences" might provide a key weapon for fighting obesity and diabetes. Pretty sweet, no?

Why Tequila Probably Doesn't Have Obesity, Diabetes Fighting Properties



By Heather Hoch
Despite several news organizations reporting that a new study might show that tequila could actually help prevent diabetes and obesity, the leap from the agavins, the sugary compound in the agave plant, to tequila, which is distilled from agave, is actually too formidable to draw that conclusion. We know, we wanted it to be true too, but the facts are that the very preliminary study released by the American Chemical Society just doesn't show that the liquor is in any way good for you.
As Fox News reported, the study tested diet-induced obesity and diabetes on a group of mice who were also given agavins, the sugary chemical compound found in agave. Other mice in the study were given agave syrup, aspartame, glucose, fructose, and sucrose. Of the sugars, agavins helped control blood sugar levels and reduce weight in the mice better than the other options.
Agavins help combat diabetes and obesity due to the way that they are metabolized. The natural sugar acts as a dietary fiber in the bloodstream and do not raise blood sugar levels, leading some scientists to believe that it is a healthier alternative sweetener.
However, according to local nutrition expert Sharon Salomon, not only is the agavin content in agave distillates like tequila and mezcal nearly non-existent, the study itself is not yet conclusive to correlate to human diets.
"Agavin may some day be made into a sweetener or added to other products but this is not the type of research that should be reported because there's really nothing there yet," she says. "Unless you're a fat mouse being fed straight agavin!"
We'll hold out for the day when a study actually proves liquor is good for us -- other than maybe anecdotally in an emotional way.






Diabetes May Cause Memory Loss Among Middle-Agers


by Nick Ng 

Diabetes not only elevates blood sugar and blood pressure, it can also increase the likelihood of memory loss in middle-age adults. This is due to the damage in the memory storage  unit in the brain — called the hippocampus — that shrinks in size over a long period of time, according to a recent Mayo Clinic study.
Dr. Rosebud Roberts, M.B., who is one of the researchers of the study , stated that people who had diabetes earlier in life are more likely to have brain damage than those who have the disease later in life. This degenerate process happens over a long period of time.
Memory loss and poor cognitive thinking have been associated with the effects of diabetes for many years in science and medicine. However, this new  study provides solid evidence that explains why and how it happens over time.
A recent study that Roberts and her colleagues conducted was published in Neurology. It consisted of 1,437 participants with an average age of 80. After they were diagnosed as being cognitively normal, having mild cognitive impairment (MCI), or having dementia, the participants undergo a MRI scan to check for brain damage that could be signs of dementia. Afterwards, the participants’ medical records were reviewed to see if anybody was diagnosed with diabetes or high blood press when they were middle-agers, which ran between ages 40 to 64.
Researchers found that middle-agers who had diabetes had an average of 2.9 percent decrease in their brain size than those who didn’t have diabetes. Diabetics also had a smaller hippocampus — an average of 4 percent decrease in size than non-diabetics. Therefore, diabetics tend to lose their long-term memory and recall recent events , according to Roberts.
A previous German research in 2013, however, provided strong evidence that people don’t have to be diabetic to have memory loss.  The study, which was conducted at the Department of Neurology and Center for Stroke Research Berlin, showed that middle-age folks and the elderly with chronic high blood glucose also exhibit similar memory loss and decrease in brain size as those with diabetes. They concluded that high glucose concentration could damage the structure of the brain cells.
Dr. Anges Flöel, M.D., who is part of the research team, stated that the hippocampus is vulnerable and sensitive to the imbalances of its metabolic supply — including glucose. High blood sugar levels may damage the brain cells’ outer membrane, which decreases the amount of communication levels between the cells and disrupt the communication process. Therefore, the process in which the hippocampus encode, store, and retrieve memory and process information  would be endangered. High blood sugar can also damage the blood vessels of the brain, which decreases the amount of nutrients, blood, and oxygen flow to the brain cells, added Flöel.
Even though the Mayo Clinic study showed a relationship between diabetes and high blood press with memory loss and cognitive thinking among middle-agers, it doesn’t necessarily prove that there is a direct causation and correlation relationship.
Keith Fargo, Ph.D., the director of Scientific Programs & Outreach at Alzheimer’s Association in Chicago, Illinois, stated that anyone can be at risk dementia as long as they have a brain. Dementia can creep up and target anyone who doesn’t take care of themselves. Middle age is a time when taking care of the brain’s health is just as important as physical health.
Middle-agers with diabetes may not always be at high risk for memory loss. Adopting a more active and social lifestyle can help diabetics lower their risk of dementia so that they can continue to enjoy conversations with their friends and family without worrying if they will forget their names and faces tomorrow.


Diabetes and high blood pressure in middle age could lead to brain cell loss later in life


People who develop diabetes and high blood pressure in middle age are more likely to have brain cell loss and other damage to the brain, as well as problems with memory and thinking skills, than people who never have diabetes or high blood pressure or who develop it in old age, a new study suggests.
Middle age was defined as age 40 to 64 and old age as age 65 and older.
"Potentially, if we can prevent or control diabetes and high blood pressure in middle age, we can prevent or delay the brain damage that occurs decades later and leads to memory and thinking problems and dementia," study author and Mayo Clinic epidemiologist Rosebud Roberts M.B., Ch.B said.
For the study, the thinking and memory skills of 1,437 people with an average age of 80 were evaluated. The participants had either no thinking or memory problems or mild memory and thinking problems called mild cognitive impairment. They then had brain scans to look for markers of brain damage that can be a precursor to dementia.
Participants' medical records were reviewed to determine whether they had been diagnosed with diabetes or high blood pressure in middle age or later.
For diabetes, 72 people developed it in middle age, 142 in old age and 1,192 did not have diabetes. For high blood pressure, 449 people developed it in middle age, 448 in old age and 369 did not have it.
Compared to people who did not have diabetes, people who developed diabetes in middle age had a total brain volume average of 2.9 percent smaller. In the hippocampus area of the brain, the volume was 4 percent smaller. They also were twice as likely to have thinking and memory problems.
Compared to people who did not have high blood pressure, people who developed high blood pressure in middle age were twice as likely to have areas of brain damage.
The study is published online in the journal Neurology.


Diabetes and TB: A growing threat


By Dr. Susan Fisher-Hoch,

Editor's note: Dr. Susan Fisher-Hoch is a professor in the Department of Epidemiology at the University of Texas Houston School of Public Health in Brownsville, Texas

(CNN) -- Working in public health for 14 years in Brownsville, Texas, in a border region with poor health conditions, has taught me a lot about how disease threats can get a boost from an unsuspected source.
For tuberculosis, this unsuspected source is now diabetes.
Tuberculosis is common globally but mistakenly thought of as something that does not affect the United States. It is an airborne, bacterial infection, easily spread by coughing, and it can be fatal.
It often lies dormant in the body for many years, and most of the 11 million people in the United States who have the infection are not even aware of it. The only vaccine has limited effectiveness and is not given in the United States.
TB continues to have a serious impact in America, with nearly 9,600 cases in 2013, according to the Centers for Disease Control and Prevention. It is not only an issue on the U.S. border with Mexico; rather, it is found in every state, with a particular impact in Florida, Texas, California and New York. Drug-resistant varieties pose an alarming threat since the required treatment is so lengthy and often toxic.
Today, the biggest risk for tuberculosis is not HIV/AIDS, which led to a surge in cases in the late 1980s, but diabetes. Diabetes impairs the immune system and leaves a person who has been exposed to TB much more likely to develop active disease.
This is precisely what we saw when we started to investigate TB in communities on the border with Mexico. The alarm has spread to California and the Pacific Northwest, where 20% to 30% of TB cases can be traced to diabetes. TB experts in Florida are also concerned about this phenomenon.
Is this on the radar of health providers treating diabetes patients in the United States? Unfortunately, few are aware of the risk of TB or are looking for it.
They are also unaware that the course of TB disease is frequently more severe in patients with diabetes, who do not tolerate TB drugs well. Diabetes patients often have difficulty completing treatment, take longer to be cured and are more likely to relapse, even die, and develop drug-resistant TB.
TB physicians in Texas are acutely aware of the problem. One told me about a woman with severe diabetes in her 30s. When exposed to TB, she quickly developed active disease. Despite the best efforts of the medical staff, she was not able to absorb the TB medication due to nausea and vomiting.
As a result, her TB became drug-resistant, and she had to undergo a rigorous, two-year ordeal of treatment. Five of her children also became infected, and two had to be treated for active disease. She was cured and survived, but this is not always the case.
The dimensions of the problem are truly staggering. Diabetes is an exploding global epidemic, much larger than HIV/AIDS. In India, diabetes has nearly doubled the number of cases of TB.
Today, 26 million of the 382 million people with diabetes live in the United States. By 2035, nearly 600 million people in the world will have diabetes, and by 2050 so will a third of all Americans, according to the International Diabetes Federation and the CDC. Ignoring this new threat could result in a reversal of the decline in TB experienced over recent years.
Diabetes took my teeth but not my life
So what do we need to do?
We must educate health care providers, patients and communities. All TB patients should be screened for diabetes. Diabetes caregivers and their patients need to be aware of the risk of TB, and patients born in or traveling to neighborhoods or countries where TB is common should be screened. If TB is found, these patients need treatment, along with the support they need to get through the many months of daily medication.
We also need strong investment in research and development of TB vaccines, rapid and inexpensive diagnostic methods for both TB and diabetes, and fast-acting, easy-to-take TB medication.
Research largely depends on government funding since the pharmaceutical industry shows little interest in TB. Congress has not made TB a priority despite the increasing risk to the public at large.
We all know someone with diabetes. Diabetes could reverse the achievements of several decades in TB control, but, if we combine good science, adequate funding and above all, political will, we can get ahead of this looming crisis.
We responded slowly to the combined AIDS/TB threat in the 1980s. We need to react faster to the diabetes/TB threat today.
Diabetes continues to spread around the world



Diabetes Prevented by Gene Mutation


Eric Ohm

Diabetes may be prevented by a rare genetic mutation found in the human genome. The mutation reduces the chances of contracting type-2 diabetes by at least 66 percent. The study was based on the genetic testing of 150,000. The mutation effects a gene called SLC30A8 by limiting a protein called ZnT8 that produces insulin. Those who have the mutation seem to produce slightly more insulin and have lower blood glucose levels for their entire lives. The results came as a surprise to the international community because the same mutation the team was studying  in humans had already been studied in mice. The mutation had been observed to actually cause diabetes in certain strains of mice.
The international team began their work two years ago with population samples from Finland and Sweden. 28,000 people were studied and put into groups of high risk and low risk for diabetes, comparing things like age, weight, lifestyle, history of diseases and diabetes. There where 406 people in the high risk group, their age averaged 80 years old and according to Dr. Timothy Rolph, Vice President  of Pfizer a research based pharmaceutical company, they “all had bad habits.” The high risk group smoked, drank, where overweight and had a static lifestyle, but they did not have diabetes.
Two people out of the high risk group were found to have a mutation that limited ZnT8. The find prompted further investigation and the team widened their research base and collected data  from 18,000 people who fit the high risk profile. 31 people from that study showed to have the same mutation as the previous two.
The international team led by Dr. David Altshuler, Deputy Director of the Board Institute of Harvard and M.I.T, met with Chief executive of deCODE genetics Dr. Stefanson in Ireland to search their genetics database for more examples of the mutation they had found. DeCODE is a genetics institute that carries a vast library of genetic samples taken from the Icelandic population. The group found 39 out of 5,440 people had the mutation. Dr. Stefanson said the search took just five minutes to complete. They then submitted their findings to a medical journal but were rejected. The reviewer stated their findings must be wrong because it contradicts what studies  had shown with mice.
The team decided to gather more evidence mapping out the genes of 13,000 more people with similar results. They wrote a second paper and had it published by Nature Genetics. These studies show promising potential for drugs that mimic the mutations effects. The idea is the creation of a drug that allows the patient to produce more insulin and lower the blood glucose levels without having to directly inject insulin to stabilize although Timothy Rolph cautions it could take 10 to 20 years to get the drug to market.
Diabetes has swept the world and is considered a growing epidemic. In the U.S. 25.8 million Americans have diabetes with 1.9 Americans aged 20 or older are newly diagnosed with diabetes every year, according to the American Diabetes Association. If present trends continue it is believed by 2050 1 in 3 Americans will be diagnosed with diabetes. The discovery of this mutation may have come just in time to thwart the rising numbers of diabetes.


Lack Of Sleep Linked With Heart Disease Risk Factors For Obese Adolescents



Obese adolescents who suffer from inadequate levels of sleep may be at an increased risk for heart disease, according to a new study from researchers at the University of Michigan Health System and Baylor University.
For the study, the researchers followed the development of 37 obese teens between the ages of 11 and 17. They specifically reviewed the physical indicators for heart disease including fasting cholesterol, blood sugar, waist circumference, body mass index (BMI) and blood pressure. They also monitored sleep levels using body monitors attached 24 hours a day for one week.
They found that the kids sleeping the least also showed the highest levels of other risk factors associated with heart disease:
"However, the strong association between sleep duration and cardiometabolic risk score independent of the effects of body composition and physical activity suggest a potential influence of sleep duration on cardiometabolic health in obese adolescents."




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Televisions in The Bedroom Linked With Childhood Obesity



Children with televisions in their bedrooms may be statistically more likely to suffer from childhood obesity than those who do not, according to a study from researchers at the Geisel School of Medicine at Dartmouth College in Lebanon, New Hampshire.
For the study the researchers reviewed health records from 6,522 boys and girls between the ages of 10 and 14 over the course of 30 years. At the beginning of the study the researchers found that 59.1 percent of the kids had a television in their bedroom. After two years, those kids with televisions had an average increase of .57 percent BMI and an increase of .75 percent BMI after four years.
"Children viewing bedroom televisions might have more control over the programs viewed and might therefore be more highly exposed to advertisements that target their demographic," the study authors write.

"In contrast to limiting screen time, which may require consistent parental monitoring, removing a child's bedroom television is a structural change in the child's electronic media environment that is potentially long lasting." 

Strawberries Linked To Decreasing Bad Cholesterol


Consuming large amounts of strawberries has been linked with a drop in bad cholesterol, according to a new study from researchers at Italy's Universita Politecnica delle Marche and the Universities of Salamanca, Granada and Seville in Spain.
For the study the researchers examined 23 healthy volunteers and added 500 mg of strawberries to their diet. They tested bad cholesterol levels before and after the study and found an 8.78 percent drop in total cholesterol levels and a 13.72 percent drop in bad cholesterol.

"This is the first time a study has been published that supports the protective role of the bioactive compounds in strawberries in tackling recognized markers and risk factors for cardiovascular diseases," the researchers explained in their study report.