Campaign Emphasizes Reliable A1C Test
A campaign of the National Institute of Diabetes and
Digestive and Kidney Diseases is highlighting the importance
of using accurate ways to test hemoglobin A1C in
individuals with diabetes who have sickle cell trait or other
inherited forms of variant hemoglobin.
The 2 booklets, "Sickle Cell Trait and Other Hemoglobinopathies
and Diabetes: Important Information for
Physicians" and "For People of African, Mediterranean, or
Southeast Asian Heritage: Important Information about
Diabetes Blood Tests," explain the specific needs for testing
blood glucose control in these patients. In diabetes patients
of African, Mediterranean, and southeast Asian descent,
several circumstances may suggest the presence of a
hemoglobin variant:
- An A1C result does not match with the results of self
blood glucose monitoring
- An A1C result is different than expected or from a previous
test result after a change in laboratory methods
- An A1C result is >15%
For more information, visit www.diabetes.niddk.nih.gov.
Weight Loss May Help Diabetic Hearts
In a recent study, researchers identified risk factors for
coronary artery disease (CAD) progression in 222 adults with
type 1 diabetes. They also examined if changes in these factors
influenced the progression to CAD. The participants had
2 electron beam tomographic screenings 4 years apart.
Progression was defined as an increase >2.5 in the square
root-transformed coronary artery score.
Researchers determined an increase in weight was the
most influential modifiable risk factor connected with CAD
progression, increasing the risk by 38%. They concluded that
for patients with type 1 diabetes to slow the progression of
CAD, and for other health reasons, weight control is crucial.
The findings were reported in the November 15, 2007, issue
of American Journal of Cardiology.
Does Smoking Cause Diabetes?
Individuals who smoke have a 44% increased risk of developing
type 2 diabetes, compared with nonsmokers, reported
researchers in the Journal of the American Medical Association
(December 12, 2007).
The findings are based on an analysis of 25 studies examining
the association between smoking and diabetes. The
risk was even greater for heavy smokers. The participants
who smoked at least 20 cigarettes a day faced a 61% higher
risk of diabetes, compared with nonsmokers.
The researchers also found that quitting smoking reduced
the risk. Former smokers had a 23% higher risk than nonsmokers,
but lower than that of current smokers. Carole Willi, MD,
noted that the researchers could not conclude that smoking
was the reason for diabetes in those who developed it.
Eating Disorders Frequent in Diabetic Girls
Girls with type 1 diabetes face a greater
prevalence of disturbed eating behavior
and eating disorders, according
to the findings of a 5-year study. At
study onset, higher rates of disturbed
eating behaviors were seen in 126 girls
with type 1 diabetes between the ages
of 9 and 13 years, compared with their
counterparts without the disease (8%
vs 1%).
At the 5-year follow-up, of the 98 girls
with diabetes who remained in the
study, 43 reported that they had restricted
their eating, 6 reported binge-eating
episodes, 3 reported self-induced
vomiting, and 25 reported
intense excessive exercise for weight
control.
The participants with disturbed eating
behavior also had a considerably
higher average body mass index, at
26.1%, versus 23.5% in other girls. The
findings were reported in the November
2007 issue of Diabetes Care.
Self-management Course Proves Helpful
A self-management program has been shown to help
patients with type 2 diabetes reduce both their weight and
their blood pressure and maintain these benefits over time.
The Netherlands study included 196 patients with type 2 diabetes
between 50 and 70 years old. The patients were receiving
either usual or intensive medical diabetes management
as part of the Dutch arm of an ongoing type 2 diabetes treatment
study.
A group of patients was randomly assigned to participate
in a 3-month self-management course, while others were
not. The course included 2 (1-hour) individual sessions and 4
(2-hour) biweekly group sessions with a trained nurse.
Reporting in Diabetes Care (November 2007), researchers
found that 9 months after completing the course these patients
had a net reduction in body mass index (BMI) of 0.39,
whereas nonparticipants had a net increase in BMI of 0.38.
F A S T F A C T : Inaccurate hemoglobin A1C readings, whether falsely high or low, may lead to overtreatment or undertreatment of diabetes.
