   
Can A Blood Pressure Drug Prevent Diabetes?For many people with high blood pressure, a daily dose of the Researchers at McMaster University in Canada have expanded on their previous study of ramipril, which indicated that it can reduce deaths, heart attacks, and other diabetes complications in people with and at risk for the disease. The subsequent research indicates that the drug may even prevent people at high risk for diabetes from ever developling the disease. Ramipril, which is marketed as Altace, works by blocking the formation of angiotensin, which regulates blood pressure. The enzyme can lead to the constriction of blood vessels, which can raise blood pressure. The study included 5,720 people aged 55 and above who had a vascular disease or other risk factors for diabetes. Participants either received a placebo or ramipril for about four and a half years. Researchers found that 102 people taking ramipril developed diabetes, while 155 people taking the placebo developed the disease. The results of the study are published in the Journal of the American Medical Association (volume 286, pages 1882-1885, October 2001) and in a previous report in the New England Journal of Medicine (2000; volume 342: pages 145-53), but its authors say that further research must be conducted before ramipril can be prescribed for diabetes prevention. For more information on the benefits of ACE inhibitors in people with diabetes on Bandolier's Evidence-Based Medicine Site. or view this slide presenting their benefits in the HOPE Trial.
Pain-Free Heart Attacks May Be Most LethalThe most common signs of heart attack, such as chest pain and shortness of breath, are widely known. However, a recent study shows that heart attacks without these signs are more likely to lead to death. Researchers from Leeds General Infirmary in northern England studied almost 2,000 people who had been treated for heart attack in 20 different hospitals in norther England over three months. They found that over 20% did not have chest pains preceding their heart attack. When the researchers compared the survival rates of the people who did and did not have chest pains, they found that those who did have the pains lived longer. The scientists also report in the medical journal Heart (volume 86, number 4, October 2001) that heart attacks without pain are especially common among people who have both diabetes and heart disease. People who have these diseases are twice as likely to die within one month and three times as likely to die within one year than people without these diseases. The researchers encourage physicians to be informed of beneficial treatment strategies for people suffering from a heart attack, whether or not that attack is accompanied by recognizable signs.
Inflammation May Lead To DiabetesFor many elderly people who have recurring infections and injuries, inflammation is rather common. In response to this, there may be higher levels of C-reactive protein (CRP) in their bloodstream. Researchers are now finding that high levels of CRP may be linked to chronic diseases like diabetes and heart disease. In a study conducted by researchers at Emory University in Atlanta, Georgia, researchers measured the levels of CRP, white blood cells, and platelets in over 4,000 people without diabetes who were 65 or older. The study spanned four years, and within that time, 45 people dveloped Type 2 diabetes. Results of the study, which are published in the journal Diabetes (volume 50, pages 2384-2389, October 2001), indicate that the people with the highest levels of CRP were twice as likely to develop diabetes as those with the lowest levels of CRP. This was true regardless of age, gender, BMI, or blood glucose or insulin levels. Researchers believe further studies are needed before CRP can be used to determine diabetes risk, but do believe that inflammation is in some way connected to the development of the disease.
Fat Cells Could Send Signals To Nerve CellsBecause of the increasing rates of obesity, many researchers are focusing on understanding this disease and the way it develops. A new study shows that fat cells may be able to communicate with nerve cells outside the brain, and may therefore exert some control over the use of fat in the body. In a recent issue of the Proceedings of the National Academy of Sciences (volume 98; page 12385; October 16, 2001), doctors from the Johns Hopkins University School of Medicine in Baltimore, Maryland describe their research with fat cells. The researchers grew fat cells and nerve cells in one container, and separated the cell types by a thin membrane. The researchers found that the fat cells were able to send a chemical signal to the nerve cells in order to increase the production of neuropeptide Y (NPY). This is a signal that causes the brain to store fat cells instead of burning them, and to encourage further eating. The researchers were unable to determine the exact chemical that is sent by the fat cells. The study authors hope that further research will allow scientists to control the signaling of fat cells in order to control obesity.
Kids' Weight Increasing WorldwideThere have been many reports in the United States about the increasing number of children becoming obese. Now, a study reports that this may be a worldwide phenomenon. The study was conducted by researchers at the University of North Carolina at Chapel Hill, and has been published in the International Journal of Epidemiology (October 2001). In the study, researchers examined health data on over 3,000 children in China, almost 7,000 children in Russia, and over 6,000 children in the US. Health surveys from US children indicated that about 11% were obese, and over 14% were overweight. Six percent of children in Russia were obese, and ten percent were overweight. In China, 3.6% of children were obese, and 3.4% were overweight. The study also revealed information about the way socioeconomic status has an effect on children's risk of obesity. Children in China and Russia who had wealthy families weighed more on average than children from poorer families. By contrast, children in poor families in the US tended to be more obese than children from wealthy families. Researchers found that in China, richer people have more access to meat and high-energy foods than poorer people, thereby making them more likely to be obese. By contrast, people in the US who have a greater socioeconomic status usually eat more vegetables and fruits than people in lower classes. In addition, researchers found that childhood obesity occurred more often in urban areas of China and rural arease of Russia, but that there was no pattern in the United States. Access to food and healthcare is generally more consistent in the US than in the other countries. The study authors believe that worldwide education needs to occur in order to stop the rise of childhood obesity, and that this is vital to improving the health of the world's children.
Pollution Especially Dangerous With DiabetesWhen there are high levels of polution in the air, many people find it more difficult to breathe. However, the situation may be especially dangerous for people with diabetes and heart disease. In a recent study, researchers from the Harvard School of Public Health in Boston, Massachusetts studied the effects of levels of particulates in the air on hospital admissions in Cook County, Illinois between 1988 and 1994. Particulates include dust, soot, and other particles that are largely the byproducts of combustion in power plants and car engines. After studying hospital records, the researchers found that when particulate levels were high, so were hospital admissions for heart disease. People with diabetes were more than twice as likely to be admitted than people without diabetes. Levels of particulates that led to hospitalizations were well below 100 parts per million, which is much lower than the Environmental Protection Agency's allowance for levels of up to 150 parts per million. Other research has already indicated that high pollution levels increase the risk for heart attack, raise blood pressure, increase heart rate, and lead to problems with implanted heat defibrillators. The levels of particulates that were measured during the study period and shown to be correlated with adverse health were ``well below'' 100 parts per million. The EPA allows for levels of up to 150 parts per million for such particles. The researchers have published their findings in the American Journal of Respiratory and Critical Care Medicine (volume 164, issue 7, October 2001), and hope that the study educates people about the dangers of pollution, particularly when combined with diabetes.
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angiotensin converting enzyme (ACE)
inhibitor drug ramipril may be a necessity. However, there may be more than one benefit to this drug-- it may also prevent diabetes.