Diabetes News for January 9, 2000

A Few Drinks A Week Lowers Diabetes Risk

Previous studies suggest that having a drink or two a day protects against cardiovascular disease. Now researchers at the Cooper Institute in Dallas are providing evidence that moderate drinking may also reduce the risk of diabetes.

Their study suggests that men who drink moderately (5 to 10 drinks per week) have a lower risk for Type 2 diabetes than either abstainers/infrequent drinkers (0 to 5 drinks per week) or heavy drinkers (over 10 drinks per week). This finding was reported in the January issue of Diabetes Care by Dr. Ming Wei and colleagues who examined rates of Type 2 diabetes in over 8,600 Texan men.

It is believed that moderate drinking reduces insulin resistance while heavy alcohol consumption actually increases it. Insulin resistance leads to Type 2 diabetes. The researchers believe that up to 24% of Type 2 diabetes may be linked to excess alcohol intake. The study does not recommend that abstainers take up drinking to lower their diabetes risk, but heavy drinkers may want to cut back to lower their risk.

Nurse Practitioners As Effective As Doctors

Researchers who randomly assigned patients with asthma, diabetes or high blood pressure to receive care for six months from either nurse practitioners or doctors report that patients do equally well with either care provider.

The study results published in the Journal of the American Medical Association followed 1,316 patients recruited from emergency rooms in New York while being treated for problems other than asthma, diabetes or high blood pressure. The participants were mostly poor immigrants who were young, primarily female, Spanish-speaking and on Medicaid.

What measurements were used to determine how well the patients did? The results of care were measured by breathing capacity in asthmatics, blood-sugar control in diabetics and blood pressure in people with hypertension. Also the patients were found to have similar numbers of referrals to specialists, hospitalizations and costs, and they were equally satisfied with caregivers.

An accompanying editorial by a doctor not involved in the study raised the question whether a six-month study was long enough to see the full spectrum of complex medical problems such patients could face.

Abbott And SpectRx Develop Continuous Glucose Monitor

The competition for the best glucose monitoring device for people with diabetes continues with the announcement that Abbott Laboratories and SpectRx are partnering to develop and market a continuous glucose monitor.

The continuous glucose monitoring sensor developed by SpectRx is worn on top of the skin and provides readings once a minute. It measures glucose levels in interstitial fluid (ISF) through micropores created with a laser in the dead outer layer of skin. A patch containing a glucose sensor is placed on top of the skin. A study of 20 people with diabetes wearing the system presented at the 1999 American Diabetes Association meeting showed a correlation coefficient (r) of 0.90, when compared to a finger stick method, over a glucose range of 60 to 400 mg/dL.

Under the agreement, Abbott has exclusive worldwide marketing rights while SpectRx will receive a royalty on sales of disposables and have the option to manufacture the devices for Abbott.

Southerners Suffer More High Blood Pressure

Southerners, regardless of age, race, or sex are more likely to suffer from high blood pressure than people in other parts of the United States. This creates concern because high blood pressure, along with smoking, obesity, lack of exercise and diabetes, is a leading cause of stroke.

These findings of a recent study based on data from a group of 6,278 whites and blacks questioned in the Third National Health and Nutritional Examination Survey between 1988 and 1994 were published in the latest edition of Stroke: Journal of the American Heart Association.

The study by lead author Dr. Thomas Obisesan of Howard University Hospital in Washington, D.C., found a higher rate of high blood pressure regardless of age, gender or race. For instance, among Southern black men aged 40 to 59, 44 percent had hypertension compared to 37 percent outside the region. The rate for Caucasian men aged 40 to 59 in the South was 33 percent as against 23 percent elsewhere in the US. African-American women with hypertension in the same age group were 50 percent in the South compared with 39 percent in the rest of the country.

Why is the rate of hypertension higher in the South? The reasons are unclear but may include differences in health care, socioeconomic status, or environmental or dietary factors.

Chronic Dieting And Genes Cause Weight Gain

A study reported in the December issue of the American Journal of Clinical Nutrition suggests that chronic dieting increases the risk of major weight gain in the long run, especially if there is a genetic predisposition to gain weight. Young men and middle-aged women of normal weight who attempted to diet at the beginning of the study seemed to be at the greatest risk, the risk of gaining more than 22 pounds over the next 15 years.

In this study researchers used questionnaires filled out by 3,536 men and 4,193 women aged 18 to 54 over a period of 6 to 15 years. They recorded weight, weight-loss attempts, and complicating factors such as smoking, alcohol use, educational level, social class and marital status, at the beginning of the study and again at two points later in the study. Men between 18 and 29 years and women between 30 and 54 years were at the greatest risk regardless of any of the complicating factors.

Average weight gain was not always related to dieting attempts, suggesting that it is possible for some people to maintain weight loss. But, according to the study, almost all normal weight people who attempted to diet when the study began gained weight over 6 to 15 years..

Death From Heart Attack: Geography Is Destiny

High blood pressure is more likely to lead to a deadly heart attack for men living in some geographic areas then others.

The risk of death from coronary heart disease always increases as blood pressure rises, but men at a high blood pressure reading in America or Northern Europe are three times more likely to die of a heart attack than men with the same blood pressure from Japan or the Mediterranean, according to researchers reporting in the New England Journal of Medicine.

Researchers from the Netherlands enrolled 12,031 middle-aged men between 40 and 59 in the study between 1958 and 1964 and followed them for 25 years. The men lived in six geographic areas. In every region, the risk of death from coronary heart disease increased 28 percent for each 10-point increase in systolic pressure or 5-point in diastolic pressure (systolic is the first number and diastolic is the second). But the number of deaths greatly depended on the place.

After adjusting for age, smoking and cholesterol levels, the study found the highest rates of death among Northern European and American men. Japanese and Mediterranean European men had the lowest.

The results of the research suggest that lifestyle factors, such as a diet low in meat and dairy but high in fish, fruits and vegetables, should be encouraged. Furthermore, people in high risk areas such as the US and Northern Europe should be treated more aggressively for slight elevations of blood pressure instead of waiting until the blood pressure is at a level traditionally considered high of 140 over 90 and higher. 

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