   
Obesity and Diabetes Triple Birth Defect RiskMotivation for healthy living is usually high for pregnant women to avoid birth defects in their newborns. Unfortunately, the odds may already be stacked against the newborn before the pregnancy begins. New research reported in the November issue of Epidemiology (2000; vol 11: pgs. 689-694) shows that women with Type 2 diabetes and obesity are almost three times more likely to deliver a newborn with birth defects than women without diabetes and obesity. The authors of the study say the findings based on nearly 23,000 women show that obesity and diabetes may act in combination to raise the risk of birth defects. They estimate that about 65% of major birth defects among women who were both obese and diabetic were caused by the interaction of these two conditions. Women with only one of these conditions were not more likely to deliver babies with birth defects. Obese women without diabetes were not more likely to deliver a child with a birth defect compared to normal-weight women. Similarly, normal-weight women with gestational diabetes, which occurs during pregnancy, were not at increased risk of having children with major defects. The birth defects most likely for the babies of at-risk women with Type 2 diabetes and obesity were craniofacial defects, such as cleft palate, and abnormal limb development.
Obese Patients Get Doctors' RespectObese people experience discrimination and negative reactions in many areas of life. But how do their doctors act? The findings of a new study published in the September/October issue of the Archives of Family Medicine show that very few patients, only .4% to 8%, report negative interactions with doctors when discussing their weight. This perception is important for patients because access to health care is driven in part by a concern that doctors may have a negative attitude toward their weight. Studies have shown that obese women delay or avoid breast exams and Pap smears, as well as more general medical care, possibly because they anticipate negative interactions. To study obese patients' attitudes towards their primary care doctor and their medical care, 259 obese women aged 34 to 54 were interviewed. Even though patients reported the care they received for their general health was unbiased, they were not satisfied with the care they received for their weight. Over half of the women said that their doctor had not discussed weight-loss methods with them, and three-fourths said they looked to their doctor for help on weight control. Since obesity is rising at epidemic proportions and is a leading cause for heart disease, diabetes and high blood pressure, the way in which it is dealt with by doctors is very important for impacting many patients' health.
New Source Found For Stem Cell TransplantsStem cells are unique cells that can transform into many different types of cells, such as brain cells for people with Alzheimer's disease or Parkinson's disease. They can also replace damaged beta cells in Type 1 diabetes and increase insulin production in those with Type 2 diabetes. Now a new source of stem cells provides encouragement that this transformation may occur in ways other than expected. A study published in the November issue of Nature Medicine (2000; vol. 6: pgs. 1282-1286) reports that adult human stem cells transplanted into a sheep distributed throughout the sheep and survived for up to a year without being rejected. Though fetal stems cells have been shown previously to have similar flexibility, this study suggests for the first time that adult stem cells may have special immunologic properties that allow transplantation between individuals or even between species without rejection or the need for toxic immunosuppressive drugs. Since adult cells are more plentiful and less controversial than fetal cells, this study suggests an effective approach for solving one major hurdle in the beta cell transplantation problem. With repeated cell divisions, cells lose telomeres from the gene, so adult stem cells may not last as long as fetal cells following transplantation. However, without the political and religious baggage associated with fetal cells, and with a larger and more reliable source, the hope is that adult stem cells may allow researchers to focus on effective health solutions.
Hopes Dashed For New Neuropathy DrugIn a new study, people who have neuropathy caused by diabetes did not benefit from one form of recombinant human nerve growth factor (rhNGF). Although the findings of animal studies and small human studies suggested this factor would likely provide benefit, a recent large human study showed that people who suffered from polyneuropathy had no relief from their symptoms of weakness, numbness, and pain while on rhNGF. The researchers compared 418 patients who received injections of rhNGF three times a week for 48 weeks with 461 patients who received injections of a placebo. Those who received the rhNGF actually had worse symptoms that those who receive the placebo. The findings are published in the November 1st issue of The Journal of the American Medical Association (2000; vol. 284: pgs 2215-2218).
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