Pharmacy Times

Diabetes Watch

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Diabetes Diagnosis Ups Stroke Risk

Individuals who begin treatment for type 2 diabetes face 2 times the risk of stroke, compared with the general population, according to the results of a study reported in Stroke (June 2007). The study included 12,272 adults with the disease.

The researchers reported that, during an average follow-up of 5 years, 1122 (9%) of the patients had a stroke. After factoring in age, the incidence rate was equal to 642 strokes per 100,000 person-years. The occurrence of stroke in the general population, however, is 313 per 100,000 person-years.

As a result, lead investigator Thomas Jeerakathil, MD, said, that ?patients with type 2 diabetes and their physicians need to aggressively control cardiovascular risk factors, such as hypertension (high blood pressure), smoking, and elevated cholesterol, soon after diagnosis to reduce risk.?

Eat Healthy to Stave Off Diabetes

A diet that includes less red meat and fat and more whole grains, vegetables, and fiber may cut the risk of developing diabetes. In a study, researchers followed 80,000 participants in the Nurses? Health Study from 1984 to 2002.

During that period, the women answered 5 questionnaires concerning their eating habits, which were used to create an ?Alternate Healthy Eating Index? score. The index measures diet quality according to 9 components.

Overall, the findings indicated that 5183 women developed type 2 diabetes during the 18-year follow-up period. Women with the highest scores on the Alternate Healthy Eating Index, however, were 36% less apt to develop diabetes, compared with women with the lowest scores. (The findings were reported in Diabetes Care, July 2007.)

Experts Predict Diabetes to Continue Unabated

Presentations at the recent American Diabetes Association annual meeting indicated that the diabetes epidemic will continue.

From 1963 to 2005, for example, there were periods of sharp increases in the occurrence of diabetes cases. The lead author of the first presentation, Linda S. Geiss, MA, chief of diabetes surveillance at the Centers for Disease Control and Prevention (CDC), and her colleagues reviewed data from the National Health Interview Survey. They found that from 1990 to 2005 the cases of diabetes increased from 26.4 per 1000 individuals to 54.5 per 1000 individuals?a 4.6% increase each year. Geiss believes that the epidemic is largely being driven by obesity.

In another presentation, researchers showed that diabetic retinopathy cases will increase to 16 million by 2050. Currently, 5.5 million individuals have the disease. Jinan Saaddine, MD, a medical epidemiologist at the CDC, said that steps need to be taken to prepare for the increase, such as better disease management.

Cinnamon Helps Keep Blood Sugar Low

A small study of 14 healthy volunteers showed that their blood sugar rose to a lesser degree when they ate rice pudding with cinnamon. For the study, the participants had their blood sugar measured before and after eating a bowl of plain rice pudding and a bowl of cinnamon rice pudding.

One explanation for the effect appears to be that cinnamon slows the rate at which food travels from the stomach to the intestines, according to the researchers. Using ultrasound scans, the researchers found that the participants showed a decreased rate of gastric emptying when they ate cinnamon rice pudding.

The findings, reported in the June 2007 issue of the American Journal of Clinical Nutrition, added credence to past studies that cinnamon may help in blood-sugar control. The researchers said that it is too early to recommend cinnamon as a therapy for patients with diabetes. The investigators noted another small study that showed that, when patients with type 2 diabetes added cinnamon to their diets for 40 days, their blood sugar and cholesterol levels appeared to drop.

Self-adjusted Levemir Dosing Improves Blood Sugar

A 6-month analysis of 5604 patients with type 2 diabetes showed that patients were able to adjust their own dosage of insulin detemir (rDNA origin) injection (Levemir) and achieve improvements in blood sugar comparable to dosing adjusted by their primary care physician.

For the study, patients were randomized to either the 303 Algorithm (self-adjusting their Levemir dose every 3 days based on fasting plasma glucose [FPG]) or Standard-of-Care (Levemir dose physician-adjusted according to standard of care) treatment groups. The results showed that the average A1C decreased from 8.5% at baseline to 7.9% at 26 weeks for the 303 Algorithm group, and from 8.5% to 8% for the Standard-of- Care group (P = .001). Compared with baseline, FPG values fell by 34 and 21 mg/dL for the 303 Algorithm and Standard-of-Care groups, respectively (P < .0001).

At 26 weeks, 88% of all patients remained on once-daily Levemir therapy. (The findings were presented recently at the American Diabetes Association annual meeting.)