Neuropathy And Spinal Damage Linked?Although people with diabetes often have painful nerve damage, called neuropathy, in their arms and legs, it is generally believed that this nerve damage is limited to the peripheral nerves. These are nerves that are outside the brain and spinal cord. However, a recent study indicates that this damage may extend to the spinal cord, or may in fact be caused by damage within the spinal cord. Doctors at the Royal Hallamshire Hospital in Sheffield, England, recently conducted a study in which they compared the spinal cords of 19 people with diabetes who had neuropathy, 10 people with diabetes who did not have nerve damage, and 10 people without diabetes. The researchers used MRI scans to study the participants' spinal cords. The results of the study, which have been published in The Lancet (volume 358; pages 35-36; July 7, 2001), indicated that the people with diabetes who had neuropathy had two sections of their spinal cord that were smaller in two regions as compared to the other two groups. Researchers believe that this shows that diabetic neuropathy is not confined to peripheral nerves, and that the spinal cord is indeed involved. The researchers do say that more research is needed to study more participants and also to determine exactly how the spinal cord and diabetic neuropathy are connected. Also, it is not known if damage to peripheral nerves causes parts of the spinal cord to shrink, or if damage to the spinal cord leads to damage in other nerves.    
Predicting Heart Risk With EthnicityFor white, middle-class people, the Framingham Heart Study has determined which risk factors can lead to heart disease. A new study shows that these predictors can also be applied to people of different ethnicities. The Framingham Heart Study resulted in a formula of weights assigned to heart disease risk factors like age, gender, blood pressure, LDL (''bad'') cholesterol, smoking, and diabetes. Based on a person's "score," doctors can predict a person's risk of developing heart disease. But this study was conducted with only white, middle-class participants. Recently, researchers from Boston University in Massachusetts tested the formula to see if it was applicable to African Americans, Japanese Americans, Latinos, and Native Americans. The study involved over 23,000 people, and the results have been published in The Journal of the American Medical Association (volume 286; pages 180-187; July 11, 2001). The researchers found that the formula accurately predicted heart disease risk for African Americans. For Japanese Americans, Latinos, and Native American women, the formula overestimated the risk of heart attack in the next five years. However, the researchers were able to "recalibrate" the formula so that it was accurate for these groups. More research is needed to determine exactly how doctors can apply the formula in assessing heart disease risk in people of a wide variety of ethnic groups.
Weighing In For Diabetes RiskThe fact that obesity leads to health problems should come as no surprise to anyone. This correlation is made even clearer by a study linking weight gain to diabetes risk. The study was led by doctors at Brigham and Women's Hospital and Harvard Medical School in Boston, Massachusetts, and has been published in the Archives of Internal Medicine (volume 161; pages 1581-1586; July 9, 2001). Almost 124,000 middle-aged men and women participated in the study, which lasted for ten years. Researchers examined the connection between body-mass index (BMI) and the risk of developing Type 2 diabetes, high blood pressure, heart disease, stroke, colon cancer, and high cholesterol. Body mass index is determined by dividing a person's weight (measured in kilograms) by his/her height, (measured in meters squared). A BMI of 25 or more means that the person is overweight, and a BMI of 30 or more means that a person is obese. The researchers found that those with a high BMI were far more likely to develop health problems than those with a low BMI. Overweight women were much more likely to develop gallstones, high blood pressure, high cholesterol, and heart disease. Overweight adults were over three times as likely to develop Type 2 diabetes than those with a low BMI. Those who were obese were 20 times as likely to develop diabetes. Even people with only a slightly-higher-than-normal BMI were more likely to develop a chronic disease than people with a normal BMI. Because of the health risks associated with being overweight or obese, the researchers urge people to seek their doctor's assistance in creating a treatment plan to lose the excess weight and adopt a healthier lifestyle.
Obesity May Leave You BreathlessBoth obesity and asthma are on the rise in the American population, a fact which recently prompted researchers from the Navy Environmental and Preventive Medicine Unit in Sigonella, Italy to try to see if the two health problems were linked. The researchers conducted a study of people who attended a military healthcare system in the northwestern part of the US. The results, which are found in the Archives of Internal Medicine (volume 161, pages 1605-1611, July 2001), indicate that people with asthma were 20% more likely than people without asthma to be "preobese," which means that they have a BMI between 25 and 29.9. People who were being treated with asthma medications, but who had not been officially diagnosed with asthma, were 40% more likely to be preobese. In addition, people with asthma were 3 to 6 times as likely to be obese than people without asthma. More research is needed to determine whether obesity causes asthma, or the other way around. In either case, researchers urge healthcare workers to encourage increased physical activity in people who are obese, which will help them to achieve a healthy body weight and reduce symptoms of asthma.
Stomach Band's Benefits Stretched?In early June, the US Food and Drug Administration approved a device called the Lap-Band, which is an adjustable band that is placed around the upper stomach to limit food intake. However, research on the device indicates that it may actually do more harm than good, and some doctors believe the FDA approval came prematurely. The study was conducted by researchers at the Medical College of Virginia at Virginia Commonwealth University in Richmond, who studied the device marketed by Inamed unit BioEnterics. Thirty-six of the first people treated with Lap-Band participated in the study for four years. Only four achieved satisfactory weight loss, which was a 50% weight reduction. More significantly, 41% of the participants needed surgical removal of the band within 10 days to 42 months of receiving the device. The reasons for removal ranged from infection to leakage to slippage. Other people experienced an expansion of the esophagus, which is the tube connecting the mouth to the stomach. The researchers, who published their findings in the Annals of Surgery (volume 233, pages 809-818, (June 2001), believe the FDA should reconsider approval of the device. When the FDA approved the Lap-Band, it was specified that the device should only be used in people who are at least 100 pounds overweight or at twice their ideal body weight. In addition, the FDA stipulated that people wanting to use Lap-Band should have tried dieting and exercising to lose weight first. The FDA also stated that almost 90% of people using the device had at least one side effect, including nausea, vomiting, heartburn, abdominal pain, and band slippage.
Insulin Pill Introduced In IsraelA new insulin pill has been developed by Emisphere Technologies, Inc., which is a biopharmaceutical company based in New York. On June 25, clinical trials of the pill were begun in Israel and The Netherlands. A study involving twelve participants without diabetes that was conducted at Hadassah University Hospital in Jerusalem indicated that insulin was found in the liver and bloodstream within thirty minutes of ingesting the pill. The company plans to begin trials involving adults with diabetes soon, but has not yet set a date to begin those trials. They must first obtain approval from the Israeli Health Ministry. |
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