New diabetes guidelines see three major changes

By jeremyc | March 26, 2015

The American Diabetes Association (ADA) has recently published new guidelines for diabetes treatment, and they include three major changes.

These changes were highlighted in a recent commentary by Giulio R. Romeo, MD, and Martin J. Abrahamson, MD, of the Joslin Diabetes Center and Beth Israel Deaconess Medical Center in Boston.

The authors wrote, “The common motif of the 2015 Standards is the continued emphasis of individualizing therapeutic decisions based on factors that include ethnicity, overall risk for [heart disease], life expectancy, [other] conditions, the patient’s preferences and goals, and his or her ability to adhere to treatment regimens. Once more, the patient takes the center stage.”

The first major change is a new body mass index (BMI) cutoff for Asian-Americans. Traditionally, a person with a BMI over 25 has a risk of diabetes and those with a BMI over 30 is obese. However, since Asian-Americans often have higher visceral fat levels than other groups, they typically have a lower BMI. Therefore, Romeo and Abrahamson wrote that the cutoff for this population should be lowered to 23 from 25.

The second change in the guidelines is that blood glucose levels should not be universal, and should be personalized for each patient, taking into account several factors. These factors include age, life expectancy, presence of other conditions and the patient’s preferences and motivation.

Romeo and Abrahamson also suggested that statins should be recommended for diabetes patients over 40 years of age. Precautionary statins are often recommended even in cases where cholesterol levels appear normal.New diabetes guidelines see three major changes

The American Diabetes Association (ADA) has recently published new guidelines for diabetes treatment, and they include three major changes.

These changes were highlighted in a recent commentary by Giulio R. Romeo, MD, and Martin J. Abrahamson, MD, of the Joslin Diabetes Center and Beth Israel Deaconess Medical Center in Boston.

The authors wrote, “The common motif of the 2015 Standards is the continued emphasis of individualizing therapeutic decisions based on factors that include ethnicity, overall risk for [heart disease], life expectancy, [other] conditions, the patient’s preferences and goals, and his or her ability to adhere to treatment regimens. Once more, the patient takes the center stage.”

The first major change is a new body mass index (BMI) cutoff for Asian-Americans. Traditionally, a person with a BMI over 25 has a risk of diabetes and those with a BMI over 30 is obese. However, since Asian-Americans often have higher visceral fat levels than other groups, they typically have a lower BMI. Therefore, Romeo and Abrahamson wrote that the cutoff for this population should be lowered to 23 from 25.

The second change in the guidelines is that blood glucose levels should not be universal, and should be personalized for each patient, taking into account several factors. These factors include age, life expectancy, presence of other conditions and the patient’s preferences and motivation.

Romeo and Abrahamson also suggested that statins should be recommended for diabetes patients over 40 years of age. Precautionary statins are often recommended even in cases where cholesterol levels appear normal.

Topics: Diabetes | No Comments »

Regular exercise reduces erectile dysfunction

By jeremyc | March 25, 2015

According to a recent study, erectile dysfunction (ED) was reported less in older men who exercised regularly. Past studies have also found that exercise could improve sexual health.

The study was led by Adriana C. Vidal, PhD, of the Samuel Oschin Comprehensive Cancer Institute in Los Angeles, who said, “This study is the first to link the benefits of exercise in relation to improved erectile and sexual function in a racially diverse group of patients.”

The researchers noted that ED affects 60 percent of men over the age of 65 years. They said, “Oesity, diabetes, sedentary lifestyle, smoking, coronary artery disease, and lower socioeconomic status have also been highly associated with the presence and progression of ED.”

The study looked at close to 300 men in the age group of 58-65 years, of which 32 percent were black.

On analysis, the researchers found that the men who exercised over 18 metabolic equivalent hours in a week had higher sexual function, regardless of race. To reach this count, a person could do 2.5 hours of intense exercise, 4.5 hours of moderate exercise or six hours of light exercise.

Men who exercised less than the threshold of 18 metabolic equivalent hours per week did not have a significant boost in sexual function.

Topics: Erectile Dysfunction | No Comments »

Air pollution may increase anxiety, stroke risk

By jeremyc | March 24, 2015

According to a new research review, air pollution may be linked to a greater risk of stroke and high blood pressure, while another study found a possible link between air pollution and anxiety in women.

The studies, however, were observational with no clear cause-effect relationship between air pollution and the above-mentioned conditions. However, an editorial on these studies suggested that lower air pollution could improve these people’s health.

The editorial was written by Michael Brauer, a professor at the School of Population and Public Health at the University of British Columbia in Vancouver. He wrote, “The findings of these two studies support a sharper focus on air pollution as a leading global health concern. They also suggest opportunities for reducing the prevalence of two debilitating and common diseases. One of the unique features of air pollution as a risk factor for disease is that exposure to air pollution is almost universal. While this is a primary reason for the large disease burden attributable to outdoor air pollution, it also follows that even modest reductions in pollution could have widespread benefits throughout populations.”

The first study was led by Anoop S. V. Shah, is a clinical lecturer in cardiology at the University Centre for Cardiovascular Science at the University of Edinburgh in Scotland.” The researchers performed a meta-analysis of data from 103 studies in 28 countries.

The researchers found that hospital admissions for stroke and death risk from stroke increased as the carbon monoxide in air and other substances in the air increased. Also, the first day of exposure to air pollution had the closest link to an increased stroke risk.

Middle- and lower-income countries likely had more polluted air than high-income countries. The researchers called for changes in policy to reduce air pollution exposure.

The second study was led by Melinda C. Power, a postdoctoral fellow in the Department of Epidemiology at the Harvard School of Public Health in Boston. It used data on over 71,000 women with an average age of 70 years from the US Nurses’ Health Study.

Around 15 percent of the women reported high anxiety levels, and those who were exposed to air pollution had a greater risk of anxiety. The effects seemed stronger in the first month after exposure.

Topics: Stroke | No Comments »

Autistic patients may have more gastrointestinal symptoms

By jeremyc | March 23, 2015

According to a new study, the mothers of children who had autism reported more gastrointestinal symptoms in the first three years of their children’s lives, as compared to mothers of non-autistic children.

However, the researchers noted that their study did not indicate a cause-effect relationship between gastrointestinal symptoms and autism.

Crystal Beadle, PhD, a licensed neuropsychologist not associated with this study, agreed with this above statement. Beadles said, “There is no definitive scientific link between food intolerance or other GI symptoms and autism at this time. However, there is overwhelming evidence of significantly increased comorbidity between food intolerance, GI symptoms, picky eating, and autism. Several studies have shown reported behavioral improvement when children with autism spectrum disorder (ASD) are placed on either a gluten free, casein free, yeast free, or other ‘limited’ diet.”

Beadle added, “However, there are just as many “negative studies” showing no improvement for children with [autism spectrum disorders] when treated with dietary modifications or restrictions. This has been interpreted to show there is no link between autism and food intolerance or GI symptoms. So, no, there is no agreed-upon scientific link between autism and food intolerance or gut symptoms at this time.”

The study was led by Michaeline Bresnahan, PhD, of Columbia University in New York City. The researchers said, “Even though GI symptoms are common in early childhood, physicians should be mindful that children with autism may be experiencing more GI difficulties in the first 3 years of life than children with typical development and developmental delays. Furthermore, the GI symptoms may be more persistent in children with autism. The potential for underrecognition and undertreatment of GI dysfunction in the context of a complicated developmental picture is real. Treatments that address GI symptoms may significantly contribute to the well-being of children with autism and may be useful in reducing difficult behaviors.”

Topics: General Health News | No Comments »

FDA approves new diabetic retinopathy medication

By jeremyc | March 22, 2015

The US Food and Drug Administration (FDA) has recently approved a new drug called aflibercept (brand name Eylea) by Regeneron for treating diabetic retinopathy in patients with diabetic macular edema.

Edward Cox, director of the Office of Antimicrobial Products, Center for Drug Evaluation and Research at the FDA, said, “Diabetes is a serious public health crisis, affecting more patients every year. Today’s approval gives patients with diabetic retinopathy and diabetic macular edema another therapy to treat this vision-impairing complication.”

Diabetic retinopathy is a common eye disease among diabetes patients, and can lead to blindness. Eylea treats this condition with a recommended injection dosage of once a month, into the eye.

The safety and efficacy of this medication was assessed by two clinical studies, which found that Eylea could reduce diabetic retinopathy severity as compared to a laser-based treatment.

The medication is also linked to certain side effects, such as eye pain, cataracts, floaters, increased eye pressure and bleeding of the tissues surround the eyes. Severe side effects include retinal.detachment and eye infections. Before this approval, Eylea was recommended for treating age-related macular degeneration.

Topics: Diabetes | No Comments »

Lower back pain risk linked to alcohol, nicotine use and depression, obesity

By jeremyc | March 21, 2015

A recent study has found that alcohol abuse, nicotine dependence, depression and obesity could increase lower back pain risk.

The study looked at how the above-mentioned conditions were linked to back pain. The researchers suggested that addressing these factors could prevent or treat back pain. The study was led by Scott T. Shemory, MD, of the Crystal Clinic Orthopedic Center in Akron, Ohio.

Shemory said, “The findings will allow physicians to better counsel and more closely follow their high-risk patients.”

For this study, the researchers looked at data from the medical records of 26 million patients, out of whom 1.2 million were diagnosed with lower back pain.

On analysis, the researchers found that people with nicotine dependence had a four times greater risk than non-smokers to develop lower back pain. The risk was 3.3 times higher among alcohol abusers and six-fold among the obese. Patients diagnosed with depression were 5.5 times more likely to be diagnosed with lower back pain than non-depressed people.

The researchers suggested, “Physicians should counsel their patients of the risk of [low back pain] in order to diminish the disability and cost associated with progression to chronic symptoms.”

Topics: General Health News | No Comments »

Better fitness linked to lower lung, colon cancer risk in middle-aged men

By jeremyc | March 20, 2015

According to a new study, a higher level of fitness and cardiorespiratory activity was linked to a lower lung and colon cancer risk in middle-aged men. Also, older men with cancer may be able to lower their risk of death by maintaining a high fitness level.

Past studies have also indicated that exercise could lower the risk of lung, prostate, uterus, breast and colon cancer, said the National Cancer Institute.

This particular study was led by Susan G. Lakoski, MD, of the Vermont Cancer Center at the University of Vermont in Burlington.

Lakoski said, “There is an inverse association between midlife cardiorespiratory fitness [CRF] and incident lung and colorectal cancer but not prostate. High midlife CRF is associated with lower risk of [death] in those diagnosed as having cancer at Medicare age [65 or older].”

For this study, the researchers looked at data on around 14,000 men with an average age of 49 years at the start of the study. Over an average follow-up period of 6.5 years, 1,310 of the patients were found to have developed prostate cancer, while 181 had colorectal cancer and 200 had lung cancer.

On analysis, the researchers found than men with high fitness levels had a 55 percent lower chance of developing lung cancer and a 44 percent lower colorectal cancer risk, as compared to men with lower fitness levels. Exercise was not found to have affected prostate cancer risk.

Among the men who developed cancer at 65 years of age or older, the high fitness group had a 32 percent lower risk of cancer-related death than the low-fitness group.

The researchers said, “Future studies are required to determine the absolute level of CRF necessary to prevent site-specific cancer as well as evaluating the long-term effect of cancer diagnosis and mortality in women.”

Topics: Cancer | No Comments »

Heart disease risk drops with vegetables, whole grains, fish and fruits

By jeremyc | March 19, 2015

According to a recent study, men and women can cut their heart disease risk by following healthy diet guidelines.

The study was led by Thomas A. B. Sanders, PhD, of King’s College London and compared two groups of participants. One group followed a traditional UK diet and the other group ate more fish, whole grains, vegetables and fruits.

After a 12-week period, the group following the healthy diet had reduced their weight, blood pressure and cholesterol levels.

Sarah Samaan, MD, physician partner with the Baylor Heart Hospital in Plano, Texas, said, “Ideally, a heart smart diet will include at least 8 servings of fruits and veggies daily, with a serving being 1/2 to one cup. A good green salad at dinner and a few pieces of fruit for snack times should fit the bill. Incorporating whole grains is as easy as a bowl of oatmeal for breakfast and a sandwich on whole grain bread for lunch.”

She added, “And while fish might not be on everyone’s weekly menu, there are so many different varieties and ways of cooking seafood that it shouldn’t be hard to come up with something that will suit your taste. Just be sure to avoid fried fish, which is often more caloric and higher in saturated fats than a cheeseburger.”

The authors of the study said, “[These health improvements] would be expected to reduce the risk of [heart disease] by one-third in healthy middle-aged and older men and women.”

A total of 162 non-smoking, healthy adults were recruited for this study. The traditional diet involved potatoes, red meat, white bread and refined cereals. The healthy diet group lost an average of 1.3kg and the control group gained 0.6kg. Moreover, the healthy group saw their cholesterol levels fall 8 percent and fatal heart disease risk fall 15 percent. Their non-fatal heart disease risk fell 30 percent.

Sanders said, “Our findings apply to middle-aged and older people without existing health problems. This is important because most heart attacks and strokes occur in those not identified as being at high risk.”

Topics: Heart | No Comments »

US DEA calls Fentanyl a public health threat

By jeremyc | March 18, 2015

The US Drug Enforcement Agency (DEA) has issued a warning against fentanyl, saying that it is often used to increase the potency of heroin.

Fentanyl is an opioid drug that is generally prescribed to relieve pain for patients who are terminally ill. Steve Leuck, founder of AudibleRx, said. “Fentanyl is an incredibly potent narcotic pain medication that is available, by prescription, in a patch, lozenge or nasal spray dosage form. The fentanyl patch is restricted to opioid tolerant patients who require continuous around the clock opioid treatment which has not managed by alternative pain treatment options and the lozenge or nasal spray are used for acute uncontrolled breakthrough pain in cancer patients. Fentanyl is not only highly addictive, it is very closely monitored when prescribed for a patient due to its potential for causing death due to respiratory depression. Even one dose in a patients who is naive to opiates, especially children, may decrease respiration enough to cause death.”

The DEA’s records indicate that people have been producing fentanyl illegally. The DEA reported 942 fentanyl-related seizures in 2013, and this number rose dramatically to 3,344 in 2014. DEA Administrator Michele M. Leonhart said, “Often laced in heroin, fentanyl and fentanyl analogues produced in illicit clandestine labs are up to 100 times more powerful than morphine and 30-50 times more powerful than heroin. Fentanyl is extremely dangerous to law enforcement and anyone else who may come into contact with it.”

Topics: General Prescription Drugs News | No Comments »

HRT with statins may reduce death rates in menopausal women

By jeremyc | March 17, 2015

According to a new Swedish study, hormone replacement therapy (HRT) along with statins may reduce the risk of heart disease and death in women having menopause.

The study found that women who were undergoing HRT and taking statins had a lower risk of death. This is in contrast to past studies that have linked HRTs to an increased risk of heart disease.

The researchers noted that Swedish women undergo a certain type of HRT that could be different from what is followed in the US. Ingegard Anveden Berglind, MD, PhD, of the Center for Pharmacoepidemiology at the Karolinska Institutet in Stockholm led the study.

Statins such as Crestor, Lipitor, Pravachol and Zocor are used for lowering cholesterol. HRT is used to treat the unpleasant symptoms associated with menopause.

For this study, the researchers looked at data on over 78,000 women in the 40-74 years age group from the Swedish National Patient Register and the Swedish Prescribed Drug Register. Around 70 percent of them used statins.

Over a follow-up period of four years, the number of non-statin users who died was two times the number of statin-uses. The number of deaths due to heart disease was three times higher. All the women associated with the study used 17-A estradiol HRT, which is the only type of HRT currently available in Sweden.

Topics: Women's Health | No Comments »

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