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May 21, 2009, 6:04 AM CT

More than a bad night's sleep

More than a bad night's sleep
Sleep apnea has long been known to be linked to obesity. But a newly released study reported in the recent issue of Diabetes Care finds that the disorder is widely undiagnosed among obese individuals with type 2 diabetes nearly 87 percent of participants reported symptoms, but were never diagnosed.

For those with untreated sleep apnea, it doesn't just mean their sleep is disrupted; existing research shows that it can also mean an increased risk of heart disease and stroke.

"The high prevalence of undiagnosed, and therefore, untreated sleep apnea among obese patients with diabetes constitutes a serious public health problem," said Gary Foster, PhD, main author and director of the Center for Obesity Research and Education at Temple University.

The newly released study, called Sleep AHEAD, looked at 306 obese patients with type 2 diabetes already enrolled in the Look AHEAD trial, a 16-site study investigating the long-term health impact of an intensive lifestyle intervention in 5, 145 overweight or obese adults with type 2 diabetes.

Each participant had a sleep study (polysomnogram) that measures various breathing and brain activity during sleep. Participants also filled out a series of questions about symptoms correlation to sleep (snoring, sleepiness during the day), and had their weight, height, waist and neck circumferences measured.........

Posted by: JoAnn      Read more         Source


May 20, 2009, 6:54 PM CT

Risk of Gestational diabetes

Risk of Gestational diabetes
Gestational diabetes happens in more than three per cent of pregnancies in Ontario. Commonly the condition resolves itself after delivery, but a number of studies have shown that these women are at a very high risk for developing "regular" type 2 diabetes during the later part of life. New research out of the Institute for Clinical Evaluative Sciences (ICES) has observed that even women with mild abnormalities in their blood sugar during pregnancy, previously thought not to have any clinical significance, are 2.5 times more likely to develop type 2 diabetes in comparison to those who had completely normal glucose testing.
  • To test for gestational diabetes, women receive a glucose challenge test (GCT) in the late second trimester of pregnancy. If the result of this test is abnormal, they go on to have a diagnostic test, called the oral glucose tolerance test (OGTT). If this test does not show gestational diabetes, women are reassured their glucose levels are normal and that no further testing is needed.
  • However, recent studies have suggested that women who have even mild abnormalities on either the GCT or the OGTT do actually have subtle differences in their metabolism after pregnancy.
  • The study examined 15,000 pregnant women aged 20-49 in Ontario who had a mild abnormality on their GCT but did not ultimately get diagnosed with gestational diabetes. They were in comparison to about 60,000 pregnant women who did not have abnormalities on their GCT. The women were followed for 6.4 years after delivery, and those who had had an abnormal GCT were 2.5 times more likely to develop type 2 diabetes in comparison to those who had not had an abnormal GCT.
........

Posted by: Emily      Read more         Source


April 22, 2009, 5:26 AM CT

Sleep pattern and risk of diabetes

Sleep pattern and risk of diabetes
Scientists at Universit Laval's Faculty of Medicine have observed that people who sleep too much or not enough are at greater risk of developing type 2 diabetes or impaired glucose tolerance. The risk is 2 times higher for people who sleep less than 7 hours or more than 8 hours a night. The findings were published recently on the website of the journal Sleep Medicine

The scientists arrived at this conclusion after analyzing the life habits of 276 subjects over a 6-year period. They determined that over this timespan, approximately 20% of those with long and short sleep duration developed type 2 diabetes or impaired glucose tolerance versus only 7% among subjects who were average duration sleepers. Even after taking into account the effect attributable to differences in body mass among the subjects, the risk of diabetes and insulin resistance was still twice as high among those with longer and shorter sleep duration than average sleepers.

The scientists also point out that diabetes is not the only risk linked to sleep duration. A growing number of studies have shed light on a similar relationship between sleep and obesity, cardiovascular disease, and overall mortality. The authors observe that among adults, between 7 and 8 hours of nighttime sleep may be the optimum duration to protect against common diseases and premature death.........

Posted by: JoAnn      Read more         Source


April 17, 2009, 5:03 AM CT

Laughter Coupled With Standard Diabetic Treatment

Laughter Coupled With Standard Diabetic Treatment
The correlation between the body, mind and spirit has been the subject of conventional scientific inquiry for some 20 years. The notion that psychosocial and societal considerations have a role in maintaining health and preventing disease became crystallized as a result of the experiences of a layman, Norman Cousins. In the 1970s, Cousins, then a writer and magazine editor of the popular Saturday Review, was diagnosed with an autoimmune disease. He theorized that if stress could worsen his condition, as some evidence suggested at the time, then positive emotions could improve his health. As a result, he prescribed himself, with the approval of his doctor, a regimen of humorous videos and shows like Candid Camera©. Ultimately, the disease went into remission and Cousins wrote a paper that was reported in the New England Journal (NEJM) and a book about his experience, Anatomy of an Illness: A Patient's Perspective, which was published in 1979. The book became a best seller and led to the investigation of a new field, known then as whole-person care or integrative medicine and now, lifestyle medicine.

Background

The unscientific foundation that was laid down by Cousins was taken up by a number of medical scientists including the academic medical researcher Dr. Lee Berk in the l980s. In earlier work, Berk and colleagues discovered that the anticipation of "mirthful laughter" had surprising and significant effects. Two hormones - beta-endorphins (the family of chemicals that elevates mood state) and human growth hormone (HGH; which helps with optimizing immunity) - increased by 27% and 87 % respectively in study subjects who anticipated watching a humorous video. There was no such increase among the control group who did not anticipate watching the humorous film. In another study, they observed that the same anticipation of mirthful laughter reduced the levels of three detrimental stress hormones. Cortisol (termed "the steroid stress hormone"), epinephrine (also known as adrenaline) and dopac, (the major catabolite of dopamine), were reduced 39, 70 and 38%, respectively (statistically significant in comparison to the control group). Chronically released high levels of these stress hormones can be detremential to the immune system.........

Posted by: JoAnn      Read more         Source


March 31, 2009, 5:21 AM CT

Link Between Schizophrenia And Diabetes

Link Between Schizophrenia And Diabetes
People with schizophrenia are at increased risk for type 2 diabetes, Medical College of Georgia scientists have found.

In a study of 50 people newly-diagnosed with schizophrenia or a related psychotic disorder with no other known risk factors, 16 percent had either diabetes or an abnormal rate of glucose metabolism, says Dr. Brian Kirkpatrick, vice chair of the MCG Department of Psychiatry and Health Behavior. In a similar size control group of people without schizophrenia, none had signs of or had developed the disease.

People with diabetes cannot produce or properly use insulin, a hormone that converts glucose, starches and other food into energy.

"These findings point toward there being some shared environmental factors or genetic factors between the development of schizophrenia and diabetes," he says.

Dr. Kirkpatrick presented his findings at the International Congress on Schizophrenia Research in San Diego March 28-April 1.

Scientists have long suspected that schizophrenia led to an increased risk of diabetes, Dr. Kirkpatrick says.

To find out whether there was a link, he and his colleagues at the University of Barcelona in Spain and the University of Maryland administered a two-hour oral glucose test to patients who had still not been placed on anti-psychotic medication. Catching them before prescriptive therapy was important because scientists already knew that some of the most effective schizophrenia drugs also cause rapid weight gain - a risk factor for type 2 diabetes.........

Posted by: JoAnn      Read more         Source


March 24, 2009, 6:18 AM CT

Intensive insulin therapy has its own risks

Intensive insulin therapy has its own risks
Intensive insulin treatment increases significantly the risk of hypoglycemia in critically ill patients, found a newly released study in CMAJ (http://www.cmaj.ca/press/cmaj.090206.pdf).

Intensive insulin treatment is used in a number of intensive care units around the world as a means to tightly regulate blood sugar. Eventhough labour intensive, it has been recommended as a standard of care for critically ill patients by a number of organizations including the American Diabetes Association and the American Association of Clinical Endocrinologists.

A randomized trial in 2001 reported that intensive insulin treatment significantly reduced hospital mortality, eventhough subsequent trials have reported inconsistent effects on mortality and higher rates of severe hypoglycemia.

The CMAJ study includes data from 26 trials, including the NICE-SUGAR Study on intensive insulin treatment, an international, multicentre randomized trial that is the largest intensive insulin treatment trial to date. The NICE-SUGAR study is published online in the New England Journal (NEJM) March 24, 2009 and March 26 for the print edition.

"By including the largest trial on intensive insulin treatment published to date, we provide the most current and precise estimate of the effect of intensive insulin treatment on vital status and hypoglycemia in the ICU setting," write Dr. Donald Griesdale, anesthesiologist and critical care doctor at Vancouver General Hospital and clinical instructor at the University of British Columbia, and coauthors.........

Posted by: JoAnn      Read more         Source


March 3, 2009, 6:04 AM CT

Can we cure type 2 diabetes with bariatric surgery?

Can we cure type 2 diabetes with bariatric surgery?
As the occurence rate of obesity-induced type 2 diabetes mellitus continues to increase worldwide, medical research indicates that surgery to reduce obesity can completely eliminate all manifestations of diabetes. As per a research findings reported in the March 2009 issue of The American Journal of Medicine, researchers analyzed 621 studies from 1990 to April of 2006, which showed that 78.1% of diabetic patients had complete resolution and diabetes was improved or resolved in 86.6% of patients as the result of bariatric surgery. The primary risk factor for type 2 diabetes is obesity, and 90% of all patients with type 2 diabetes are overweight or obese.

The dataset included 135,246 patients where 3188 patients reported resolution of the clinical and laboratory manifestations of type 2 diabetes. Nineteen studies with 11,175 patients reported both weight loss and diabetes resolution outcomes separately for the 4070 diabetic patients in those studies. Clinical findings were substantiated by the laboratory parameters of serum insulin, HbA1c, and glucose.

Scientists observed a progressive relationship of diabetes resolution and weight loss as a function of the operation performed: laparoscopic adjustable gastric banding, gastroplasty, gastric bypass, and biliopancreatic diversion/duodenal switch (BPD/DS). Gastric banding yielded 56.7% resolution, gastroplasty 79.7%, gastric bypass 80.3% and BPD/DS 95.1%. After more than 2 year post-operative, the corresponding resolutions were 58.3%, 77.5%, 70.9%, and 95.9%. In addition, the percent excess weight loss was 46.2%, 55.5%, 59.7% and 63.6%, for the type of surgery performed, respectively.........

Posted by: JoAnn      Read more         Source


February 27, 2009, 6:22 AM CT

Taking care of muscles in type 2 diabetes

Taking care of muscles in type 2 diabetes
Research by kinesiology investigator Dustin Hittel, PhD, has proven that muscle in extremely obese individuals produces large amounts of a protein called myostatin, which normally inhibits muscle growth suggesting that for Type 2 diabetics, and the very obese, the task of getting healthy appears to be more difficult than initially thought.

It has been known for some years that naturally occurring mutations in the gene which controls myostatin results in doublemuscling in cattle, dogs and even humans. A number of in the body building community think that blocking myostatin is a shortcut to the Arnold Schwarzenegger body.

The flipside is that producing too much myostatin has been linked with muscle wasting conditions such as HIV-AIDS, starvation and now, Type 2 diabetes.

Hittel believes this appears to be due to a pre-diabetic condition known as insulin resistance that "tricks" the muscles into thinking the body is starving despite the fact that blood sugar levels are skyrocketing.

"When that happens, the body reverses muscle production using myostatin," says Hittel. "This is especially worrisome because losing muscle mass further erodes your ability to control your blood sugar with exercise".

One of the tell-tale signs of the transition between insulin resistance and full-blown Type 2 diabetes is a loss of muscle mass.........

Posted by: JoAnn      Read more         Source


February 25, 2009, 6:19 AM CT

Diabetes can lead to postpartum depression

Diabetes can lead to  postpartum depression
BOSTON, Mass. (Feb 23, 2009) Postpartum depression is a seriousand often undiagnosedcondition affecting about 10 to 12 percent of new mothers. Some of the causes might include personal history of depression, stressful life events, and lack of social, financial or emotional support. Left untreated, it can have lasting negative effects not only on the mother but on her child's development.

In the first study of its kind, researchers at Harvard Medical School and the University of Minnesota School of Public Health report that low-income women with diabetes have a more than 50% increased risk of experiencing this serious illness.

"While prior studies have linked diabetes and depression in the general population, this is the first time, to our knowledge, that the relationship has been studied specifically in pregnant women and new mothers," says Katy Backes Kozhimannil, research fellow in the Department of Ambulatory Care and Prevention at Harvard Medical School and Harvard Pilgrim Health Care. "We believe these findings may help clinicians better identify and treat depression in new mothers".

These findings are published in the February 25 edition of JAMA, the Journal of the American Medical Association

For over 25 years, clinicians have been aware that new mothers are at risk for postpartum depression. However, the condition is difficult to identify. A number of symptoms are attributed to the every-day struggles of being a new mother. Others, such as irrational thoughts about harming the baby or, on the other hand, obsessing over the baby's health, are simply difficult for new mothers to admit.........

Posted by: JoAnn      Read more         Source


February 12, 2009, 5:36 AM CT

Elevated blood sugar level leads to decreased brain funciton

Elevated blood sugar level leads to decreased brain funciton
Results of a recent study conducted by scientists at Wake Forest University Baptist Medical Center and his colleagues show that cognitive functioning abilities drop as average blood sugar levels rise in people with type 2 diabetes.

The study appears in this month's issue of Diabetes Care

The ongoing Memory in Diabetes (MIND) study, a sub-study of the Action to Control Cardiovascular Risk in Diabetes Trial (ACCORD), found a statistically significant inverse relationship between A1C levels (average blood glucose levels over a period of two to three months) and subjects' scores on four cognitive tests. No association, however, was found between daily blood glucose levels (measured by the fasting plasma glucose test) and test scores.

For the study, scientists at 52 of the 77 ACCORD sites throughout the United States and Canada administered a 30-minute battery of cognitive tests to nearly 3,000 individuals ages 55 years and older.

"The tests used in the study measured several aspects of memory function," said Jeff Williamson, M.D., M.H.S., principal investigator for the study at the Wake Forest clinical site. "For example, we tested one's ability to switch back and forth between memory tasks or to 'multitask,' an important skill for people needing to manage their diabetes".........

Posted by: JoAnn      Read more         Source



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Did you know?
Eventhough having diabetes can sometimes feel isolating to individuals, participation in an Internet-based discussion group offers hope, inspiration and encouragement as well as bolsters people's perceived ability to cope with diabetes, according to a new study from Joslin Diabetes Center. The study, which appears in the November/recent issue of The Diabetes Educator, examined the impact of Joslin's Online Discussion Boards - forums in which people with diabetes can find information and share thoughts and experiences on specific diabetes issues.

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