Obesity Considered A Disease By The IRS
On April 2, the IRS ruled that obesity is a disease in its own right, and as such, people who are obese can claim weight loss costs as a medical deduction.
In order to take the deduction, taxpayers will need to participate in a weight-loss program for medical reasons. Medical expenses must total more than 7.5% of a person's adjusted gross income, and can only be taken by those taxpayers who itemize their deductions. Diet foods are not deductible.
This new tax ruling applies to all income tax returns since the year 1998. In order to claim this deduction for past years, taxpayers must file an amended return for that tax year. The IRS also included smoking cessation programs and treatment costs for alcoholism as qualifying deductible medical expenses. For details, see IRS Publication 502.
  
Federal Recommendations For Those With "Pre-Diabetes"
On March 27, the federal health officials coined a new term for those who are at especially high risk for developing Type 2 diabetes. The new diagnosis is called "pre-diabetes," and applies to anyone who is overweight and has blood sugar levels at higher-than-normal levels.
Physicians are now being asked to diagnose pre-diabetes in people who have blood glucose test readings that are higher than normal. In addition, people who are obese and younger than the age of 45 should be tested for diabetes if they have other risk factors, such as a family history of the disease, ethnicity other than white, or a history of diabetes during pregnancy.
When doctors find that their patients have pre-diabetes, they should urge these people to lose weight by exercising regularly and improving their diet. Health officials hope that these measures will help curb the increasing rates of obesity and diabetes in America.
Diabetes Prevention Requires Dramatic Lifestyle Change
People who are at risk of developing diabetes are often encouraged to make changes in their diet and exercise habits in order to prevent development of the disease. However, new research shows that the recommended changes may not be enough.
Recently, doctors at Otago University in Dunedin, New Zealand conducted a study to try to determine how much of a change in lifestyle is required to prevent diabetes. They divided 79 participants, who were all insulin resistant, to one of three groups. One of these groups was a control group, and there was no intervention done to prevent diabetes. Another group involved modest intervention, and these participants adopted a lifestyle of the currently recommended diet and exercise levels. The third group was one of intensive intervention. These participants got less than 26% of their total calorie intake from fat, ate more than 35 grams of fiber per day, and exercised to an intensity of 80-90% of their age-dependent maximum heart rate for 20 minutes, five times a week.
The study lasted for four months, at the end of which the intensive-intervention group had a 23% increase in their insulin sensitivity, as compared to a 9% increase in the modest group. The modest group's insulin sensitivity was not significantly greater than the control group's. In addition, those in the intensive group had an 11% increase in aerobic fitness, while those in the modest group had only a 1% increase.
Results of this study can be found in the journal Diabetes Care (volume 25, pages 445-452, March 2002). The researchers believe that public health standards should be reevaluated to make sure that people are being given effective health-management advice.
Diabetes As Inheritance?
Doctors remain uncertain of the causes of Type 1 diabetes, and research continues to try to solve this mystery. In a new study involving mice, researchers show that antibodies inherited from a person's mother might affect the development of diabetes.
The study was conducted by researchers at the University of Pennsylvania in Philadelphia, who published their findings in the journal Nature Medicine (volume 8, pages 331-333 and 399-402, April 2002). The researchers used female mice that had a disease similar to diabetes. However, these mice were unable to produce antibodies against insulin. Antibodies are proteins that are produced by the immune system in order to attack foreign substances.
The offspring of the mice who didn't have antibodies against insulin had reduced rates of diabetes. Researchers also found that mouse embryos that were genetically prone to develop diabetes implanted into mothers not prone to diabetes were then protected against the disease.
The researchers believe that these results show that maternal antibodies may determine whether the immune system behaves abnormally and leads to diabetes. Previously, scientists believed that antibodies against a person's own insulin-making cells were produced only after a person's T cells had begun attacking pancreatic cells. More research is needed to determine the exact relationship between maternal antibodies and the development of diabetes in their children.
Having Kids Later May Increase Health Problems
Although there is currently a trend to delay having children until later in life, a new study suggests that this might be accompanied by more health risks.
Recently, researchers at Ohio State University in Columbus analyzed data from the National Health and Nutrition Examination Survey III, which includes a sampling of Americans' health status taken between 1988 and 1994. The researchers focused on 24 long-term health indicators of over 6,000 women who had had children. The surveys were divided into three groups: women who had had all children before the age of 35 (84%), women who had had children before and after they were 35 (14%), and women who had had their first child after the age of 35 (2%).
Women who were past the age of 50 who said that they'd had children after the age of 35 reported higher rates of developing risk factors for diabetes and high blood pressure, having vision and dental problems, and having heart attacks. These women's doctors also rated tehir health as slightly worse than the women who had had children at a younger age. However, women who had children at an older age did have improved cholesterol levels, increased bone density, fewer bladder infections, and fewer hearing problems.
Theses findings have been published in the journal Women's Health Issues (volume 12, pages 37-45, January/February 2002). More research is needed to determine the extent of the health ramifications of having children later in life.
Diabetes May Cause Sexual Problems In Women
Besides the increased risks of heart problems, nerve damage, and stroke, Type 1 diabetes may also increase the risk of sexual problems in women.
In a study conducted by researchers at Catholic University in Leuven, Belgium, 97 women with diabetes and 145 women without were studied in terms of sexual problems. Almost 11% of women with diabetes and 7% of women without reported at least two sexual problems. A greater proportion of women with diabetes said that they had decreased desire and lubrication, and increased pain, during intercourse.
Study authors also found a connection between depression and sexual dysfunction in all the women. Women who had sexual problems were over four times as likely as women who did not have these problems to be depressed. In addition, many more women with diabetes reported having marital problems. The researchers note that diabetes has physical and psychological effects, both of which can influence sexual function.
The researchers have published their findings in the journal Diabetes Care (volume 25, pages 672-677, April 2002). They emphasize that more research is needed to determine the link between diabetes and sexual problems in women, as their study included only a small number of women.
Aspirin Not Used Enough To Prevent Heart Attack
Despite the fact that numerous studies have shown that aspirin is an easy and cost-effective way to prevent heart attack in people with blocked arteries, a recent survey shows that it is underused as a treatment.
The survey was distributed by doctors at Duke University Medical Center to over 25,000 patients who had been referred there for coronary angiography. This is an x-ray exam that shows the level of a person's arterial blockage. The researchers found that those who never took aspirin were 85% more likely to die over the course of the five-year study than those who took aspirin regularly.
The researchers found that the number of people who did take aspirin regularly increased from 59% in 1995 to 80% in 1999. However, the researchers believe that at least 95% of people with blocked arteries should be taking this medication.
The researchers were also alarmed to find that people with heart failure, diabetes, or high blood pressure were less likely to be taking aspirin than people without these conditions, even though these conditions are risk factors for heart attack and stroke. In addition, women were less likely than men to take aspirin, although their risk for heart attack or stroke after menopause is as high as the risk of men. Also, people who had not had an angioplasty or bypass surgery to clear their arteries were less likely to be taking aspirin than those who had had these procedures.
These study results have been published in the American Journal of Cardiology (volume 89; pages 653-661; March 15, 2002). Researchers encourage people with heart disease risk factors to speak with their doctors about aspirin therapy.
Carpal Tunnel Difficult To Diagnose With Diabetes
Although people with diabetes have an elevated risk of developing carpal tunnel syndrome, current testing methods may not be accurate in diagnosing this condition.
Carpal tunnel syndrome develops when a nerve that passes through the wrist is compressed, causing numbness, weakness, tingling, and pain in the fingers and hand. People with diabetes often develop this syndrome, as they are at risk for several different nerve problems. The most common of these is a nerve injury called diabetic polyneuropathy.
To test for carpal tunnel syndrome, doctors usually use a noninvasive test called nerve conduction study. However, the criteria for interpreting the results of this test were created without including peole who had diabetic polyneuropathy and carpal tunnel syndrome. Recently, researchers at Harvard Medical School in Boston, Massachusetts evaluated 478 people to determine the accuracy of the diagnostic test and to see how often carpal tunnel syndrome occurs in people with diabetes.
Participants in the study with diabetes had mild, moderate, or severe neuropathy, or none at all. These people's health was compared to a control group of people without diabetes or neuropathy. The researchers found carpal tunnel syndrome in 2% of the control group, 14% of people with diabetes who didn't have neuropathy, and 30% of people with diabetes who did have neuropathy. For the people with diabetes, electrodiagnostic testing used to diagnose carpal tunnel syndrome was not accurate, and could not distinguish between those who did have carpal tunnel and those who did not.
The researchers have published their findings in the journal Diabetes Care (volume 25, pages 565-569, March 2002), and they advise doctors to focus on their patients' descriptions of symptoms rather than on inaccurate diagnostic tests in order to determine if a person has carpal tunnel syndrome.
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