Diabetes News for Jan. 6, 2002

FDA Changes To Prevent Drug Mix-ups

Because there are so many drugs on the market with similarly sounding names, the Food and Drug Administration is now encouraging label-changes to try to prevent mix-ups.

Every year, approximately 1.3 Americans are injured by medication errors, such as receiving the wrong dose or the wrong drug. The FDA recently conducted a study of 400 deaths caused by medication errors and found that 16% were due to name mix-ups. One of the worst of these occurred about a year ago, when a person with diabetes died after getting the tranquilizer chlorpromazine instead of the diabetes medicine chlorpropamide.

In an attempt to prevent these tragic mix-ups, the FDA is now encouraging pharmaceutical companies to use labels with different-colored lettering, a mix of capital and lower-case letters, and italics. The FDA has already sent 142 letters to makers of more than 30 medications, ordering label changes to highlight confusing names.

In addition, FDA workers are starting to test whether or not a new drug name is confusing before it is introduced to the market. The test involves the writing of fake prescriptions for 120 volunteer doctors, nurses, and pharmacists to read to see if a mix-up occurs. So far, confusion has caused about a third of potential brand names to be rejected.

The FDA also encourages consumers to take steps to insure that they are not receiving incorrect medications. Such steps include asking doctors to write the reason for the medication on the prescription to make it easier for pharmacists to determine which medication is being prescribed, talking to pharmacists about new prescriptions, and being aware of what the medications look like so that differences can be reported.

Does Drinking Prevent Heart Disease?

Many studies have attempted to determine the health benefits of moderate consumption of alcohol. One of the most recent of these appears to show that drinking between one-half and two drinks per day can reduce the risk of heart disease.

The study was conducted by researchers at the Harvard School of Public Health in Boston, Massachusetts. Over 2,419 men with Type 2 diabetes participated in the Health Professionals' Follow-up Study. During the follow-up period, 150 men were diagnosed with coronary artery disease, and 69 of these died.

The researchers have published their results in the Journal of the American College of Cardiology (volume 38, pages 1836-1842, December 2001). They found that men who had half a drink or less per day had a 24% reduction in their heart disease risk when compared to nondrinkers. Those who drank one-half to two drinks per day cut their risk by 36%, and those who drank more than two drinks per day decreased their risk of heart disease by 41%. How many drinks more than two is optimal was not clearly reported.

The study authors believe that their results indicate that moderate drinking may have more benefits than risks, as there appears to be a notable decrease in the occurrence of heart disease with light drinking. Whether alcohol itself is responsible for the reduction in risk, or whether people who chose to drink have other personality or lifestyle characteristics that reduce their risk was not made clear in this study.

Heart Disease On The Rise

In a new report, the American Heart Association (AHA) asserts that cardiovascular disease is still the leading cause of death in the United States, and that heart disease and stroke rates are not going down.

The AHA has estimated that 61,800,000 Americans have cardiovascular disease, including high blood pressure, coronary heart disease, stroke, birth defects of the heart, and congestive heart failure. About 50 million Americans have high blood pressure, 12.6 million have coronary heart disease, and 4.6 million have had a stroke.

According to the AHA, levels of heart disease and stroke decreased every year for many years. However, the levels are now remaining the same, and are even increasing in certain groups. This is probably due to the increasing occurrences of obesity and diabetes which can both increase the risk of heart disease, as well as trends to higher fat consumption.

The AHA encourages people to become aware of their risk for heart disease and stroke, and to make lifestyle changes as needed. This includes taking appropriate medication, not smoking, eating well, exercising, and keeping blood pressure and cholesterol at appropriate levels.

High Blood Pressure Poorly Treated In US

Although over two-thirds of adults with diabetes in the US have high blood pressure and are therefore at greater risk for heart attack and death, few are getting treatment for the condition.

Recently, the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia released statistics in the American Journal of Preventive Medicine (volume 21, January 2002) from data that was conducted between 1988 and 1994 on over 1,500 adults. Researchers found that 71% of the participants with diabetes had high blood pressure or were on blood-pressure lowering medication. Risk of high blood pressure increased with age, and 83% of people with diabetes who were over the age of 65 were found to have high blood pressure.

Although many of the participants did have high blood pressure, 29% were unaware that they had this condition, and only a little over 50% were taking hypertensive medications. Of those who were taking medicine to reduce their blood pressure, only 43% had actually done so to an acceptable level.

The poor treatment of blood pressure control could be due to people who don't follow treatment recommendations, or doctors who don't prescribe correct medications. In any case, the CDC hopes these statistics will encourage people to become more aware of their blood pressure levels to maintain better health.

Manage Stress To Control Blood Sugar

Those with Type 2 diabetes who are having a hard time controlling their blood sugar levels may benefit from a stress-management program, according to new research.

The newest issue of Diabetes Care (volume 25, pages 30-34, January 2002) includes a study conducted by doctors at Duke University in Durham, North Carolina. The study included 72 adults over the age of 30 with Type 2 diabetes who used diet, exercise, and oral medication to manage their disease.

Thirty-eight of the participants participated in group stress management therapy, and learned muscle relaxation techniques, deep breathing, and guided imagery to reduce stress. After five sessions, the participants lowered their blood glucose levels by an average of 0.5%. Abouty one-third of the participants who received stress management decreased their glucose levels by 1%, compared to 12% of people with diabetes who did not particpate in the sessions.

The other 34 participants, called the "control group", received basic diabetes education. After one year, those who received stress management had lower glucose levels than when they started the study, and those in the control group had slightly higher glucose levels. None of the participants had significant changes in diet and exercise habits.

These results have prompted the researchers to encourage doctors to include stress management techniques when creating treatment plans for people with Type 2.

Drugs Tested For Prevention Of Type 2

There are many risk factors for developing Type 2 diabetes. One of these is the condition called impaired glucose tolerance (IGT), which occurs when blood glucose levels are elevated, but not to the point at which a person would be diagnosed with diabetes. A new study will attempt to determine whether a particular drug therapy can prevent those with IGT from developing diabetes.

The drug trial is called NAVIGATOR (Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research), and is being conducted by the pharmaceutical company Novartis Pharmaceuticals. Over 7,500 people from 40 countries will participate in the study, which will continue until the year 2007. Participants in the study will be given the drugs nateglinide and valsartan to see whether these drugs can reduce or delay Type 2 diabetes and cardiovascular disease in people with IGT.

Currently, nateglinide, a short-acting drug that stimulates insulin release, is used to correct mealtime glucose highs in people with diabetes. Researchers believe that it may be effective in treating IGT and preventing the progression to diabetes. Valsartan, an angiotensin receptor blocker, is used to treat high blood pressure, and researchers think that it might also improve insulin sensitivity and reduce the risk of developing Type 2 diabetes. Both drugs are made by Novartis.

Currently, IGT is rarely diagnosed, although up to one in seven people over the age of 40 has the condition. About half the people with IGT will develop Type 2 diabetes within ten years.

Researchers hope the NAVIGATOR study will lead to more effective treatment of IGT and the prevention of Type 2.

Vitamins Help Elderly Prevent Infections

For many older adults, immune system deficiencies may lead to an increased risk of infectious diseases. A new study shows that this may be prevented by taking vitamin and mineral supplements.

The study was conducted by researchers at Wake Forest University School of Medicine in Winston-Salem, North Carolina, who have published their results in the journal Clinical Infectious Diseases (volume 33, 1892-1900, December 2001). The researchers examined many studies on nutritional interventions for the elderly.

According to the data that was studied, adults over the age of 65 will have enhanced immune function and improvde vaccine responses.if they take a daily multivitamin and mineral supplement. The researchers recommend that daily intake levels of zinc should be 20 milligrams (but no higher for long term use), selenium should be 100 micrograms, and vitamin E should be 200 milligrams.

Another result of the study showed that elderly people who have recurrent urinary tract infections would benefit from a daily intake of cranberry juice, in order to reduce unnecessary use of antibiotics.

Diabetes Screening For Florida Babies

Because of an increased awareness of risk factors for diabetes and knowledge about preventative measures, a new program will be instated at the University of Florida College of Medicine to screen babies for signs of Type 1 diabetes. The program is being funded by a 10 million endowment from the American Diabetes Association. Up to 200,000 babies born in Florida each year will be offered a diabetes screening, and those at high risk for the disease will be monitored for life.

Florida is the first state to have this screening, and it is expected to begin within one-and-a-half years.