Diabetes News for Jan. 07, 2001
New Type 2 Heart Disorder Revealed
Many complications associated with Type 2 are well known, clearly detectable and treatable. Now, new research indicates that a previously undescribed form of heart disease is common in people with Type 2, though not easily detectable.
The research was conducted by doctors at the Quebec Heart Institute, and can be read in the journal Diabetes Care (volume 24, pages 5-10, January 2001). Forty-six men aged 38-67 with Type 2 diabetes participated in the study. None of these exhibited any apparent signs of heart disease. However, when doctors performed Doppler echocardiography, which produces images of the heart in motion and measurements of blood flow in the lungs, it was clear that 60% of the participants had left ventricular diastolic dysfunction (LVDD).
Left ventricular diastolic dysfunction is an abnormality in the relaxation phase of the left ventricle, which is the main pumping chamber of the heart. The result is a build-up of pressure and fluid in the lungs or in the vessels that return blood to the heart. Early diagnosis of LVDD may help slow the rate of heart disease, as exercise may slow the progression of LVDD.
   
How To Prevent A Stroke
Because a stroke can be debilitating or even fatal, they are one of the greatest health fears. Now the risk for this health problem can be decreased by following some recommendations released by the American Heart Association.
The recommendations are published in the journal Circulation (volume 103, January 2/9, 2001). The two best ways to prevent stroke are to quit smoking and get tested for high blood pressure. Adults should have their blood pressure checked every two years, so that hypertension can be treated right away.
The American Heart Association also recommends that people with diabetes have good control of the disease to prevent stroke. Other recommendations include keeping cholesterol levels low, exercising, getting proper nutrition, and abstaining from harmful drugs. People should also be aware of risk factors such as age, gender, ethnicity, and family history.
The Right Time To Test For Diabetes
A regular part of an annual physical is a blood-sugar test to determine whether or not the patient has diabetes. However, the timing of the test may be essential in getting an accurate diagnosis.
Doctors at the National Institute of Diabetes and Digestive and Kidney Diseases in Bethesda, Maryland recently conducted a study to determine whether the time of day in which a person was tested for diabetes had an effect on the accuracy of the results. The study involved 12,900 adults who were given blood sugar tests. The researchers found that diabetes would go undiagnosed in half of the people being tested in the afternoon.
Because blood sugar levels vary throughout the day, it is logical that the timing of the test would determine its accuracy. The current recommendations for accurate tests indicate that a person should be tested in the morning, when blood sugars are normally high, and that a person should fast for eight hours prior to the test. The researchers suggest that those who must be tested in the afternoon should fast for four hours prior. This shorter fast, combined with the natural, daily fluctuation in blood sugar, means the test may find a lower-than-normal sugar level in those tested in the afternoon, thereby running the risk of missing a case of diabetes. Researchers believe that repeating the test on another day in the morning will insure accuracy.
Obesity Increases Need For C-Section
There are many well-known health problems associated with obesity, from diabetes to cardiovascular disease to arthritis. Now, research indicates that another risk factor to add to that list is an increased need for cesarean deliveries.
Doctors at the Milwaukee Clinical Campus of University of Wisconsin recently conducted a study involving 1,900 women who gave birth at a nurse-midwifery practice in Milwaukee. Of these women, 100 gave birth via cesarean section.
The researchers, who have published their study in the journal Obstetrics and Gynecology (January 2001), found that 8% of obese women had a cesarean section, as compared with only 4% of women of average weight. In addition, women who gained a lot of extra weight during their pregnancy doubled their risk for having a cesarean section. Other factors for an increased risk for a cesarean section included first pregnancy, first delivery, and a short stature.
Fitness Fights Artery Disease
It is no secret that exercise is good for you in many ways, as proven by study after study. The latest of these indicates that aerobic fitness can slow down the progression of artery disease.
This study was conducted at the University of Kuopio in Finland, and it is published in the Annals of Internal Medicine (volume 134; pages 12-20; January 2, 2001). In the study, 854 middle-aged men participated for four years. The researchers studied the extent of plaque build-up in carotid arteries with ultrasound tests, and used exercise tests to determine the men's aerobic capacity at the beginning and the end of the study.
The researchers found that the men who had done the worst on the exercise test at the beginning of the study had the greatest progression in atherosclerosis, which is a build-up of fatty plaque in arteries in the neck that can increase the risk of stroke. Low aerobic capacity was the strongest risk factor for plaque build-up, outweighing risk factors of diabetes, high blood pressure, and high cholesterol levels.
The researchers are hopeful about the ability of exercise to slow down artery disease, but say more research is necessary to determine how much exercise is needed to effectively slow the disease.
CVD Deaths Vary By Ethnicity
Each year, the American Heart Association issues a report of statistics related to stroke and heart disease. The latest report indicates that deaths from stroke and heart disease have gone down over the last decade. However, members of different ethnic backgrounds have very different rates of the disease.
According to the report, 40% of African American men and women have cardiovascular disease. Young African Americans have 2-3 times the risk of stroke that young white Americans do. Also, the mortality rate of African Americans from stroke is far higher than that of whites. African Americans between the ages of 35 and 54 have a risk of death from stroke that is four times higher than whites in the same age group. The risk is also higher in older age groups. In addition, 37% of African American men and women have high blood pressure, which is a key factor in stroke risk. This is compared to the 25% of white men and 20% of white women who have high blood pressure.
Native Americans also have a higher rate of cardiovascular disease and stroke. 64% of men and 61% of women have at least one cardiovascular disease risk factor, which include high blood pressure, smoking, diabetes, obesity, and high cholesterol levels. In fact, 52% of Native American women between the ages of 45 and 74 have diabetes, and 44% of Native American men of the same age group have diabetes. In all, Native Americans between the ages of 35 and 54 have nearly two times the risk of stroke than whites in the same age group.
The American Heart Association hopes that these statistics will lead to an increased awareness of the prevalence of stroke and cardiovascular disease in America, particularly among members of different ethnic groups. Hopefully, this awareness will lead to earlier diagnosis and treatment.
Although information about the mechanisms of diabetes has been increased in the last few years, doctors are constantly seeking more knowledge about the way in which diabetes develops. Researchers have conducted numerous studies with the participation of the Native American Pima tribe to solve the mystery, as this group has one of the world's highest rates of diabetes.
In a recent issue of the journal Diabetes Care (volume 24, pages 89-94, January 2001), researchers from the National Institute of Health's Clinical Diabetes and Nutrition Section in Phoenix, Arizona have published the results of their study of 254 Pima tribe members. The study lasted for nine years, and the participants were followed to determine which factors led to the development of diabetes.
The researchers found that the key factors in the decline of the ability to process blood sugar were insulin resistance and insulin secretory dysfunction. Both factors appeared to play an important role in the development of the disease from the beginning, and maintained their influential roles as the disease progressed. The researchers hope that an increased awareness of the factors that lead to diabetes will assist in developing ways of preventing the disease from occurring.
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