/publications/issue/2008/2008-04/2008-04-8513

DIABETES WATCH

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Women Should Not Restrict Insulin

Women with type 1 diabetes who want to prevent weight gain should not cut back on insulin, according to a study reported in Diabetes Care (March 2008). The study involved 234 women and teens with the disease.

At the study onset, the researchers found that 30% of the women were limiting the amount of insulin they took at least part of the time. The women were followed for 11 years, and any deaths or complications from their disease were noted. The findings indicated that women who restricted their insulin were more prone to higher rates of complications (eg, kidney disease). The researchers also noted that women who limited their insulin were more likely to die young. Women who skipped insulin shots and then died during the study also exhibited more symptoms of eating disorders.


Diabetics on Dialysis: A1C Test Unreliable

New research indicates that the hemoglobin A1C test is not reliable for patients undergoing hemodialysis. Health care experts believe that a more accurate measure is the amount of glycated albumin in the bloodstream, because it does not depend on the survival of red blood cells. The glycated albumin test, however, is not currently available in the United States.

The current study, reported in Kidney International (February 20, 2008), compared A1C and glycated albumin testing on blood samples from 307 patients with diabetes. Of the participants, 258 were on hemodialysis. The result "supports the glycated albumin test as a more accurate measure of long-term blood sugar control among diabetic patients who are on hemodialysis," said Barry I. Freedman, MD, senior author of the study.


Eat Your Veggies

A study of 64,191 middle-aged Chinese women found that greater consumption of vegetables may lower the odds of developing type 2 diabetes by almost 30%. A greater intake of fruit was not associated with any benefits, reported researchers in the March 2008 issue of the Journal of Nutrition.

Using a food-frequency questionnaire, the researchers reported that the women had average fruit and vegetable intakes of 239.4 g and 236 g per day, respectively. The investigators assessed dietary intakes at the start of the study and again after 4.6 years.

During the study, 1608 cases of type 2 diabetes were documented. Consumption of the most vegetables, averaging 428 g per day, was linked with a 28% lower risk of developing type 2 diabetes, compared with the consumption of the lowest average amount (121.5 g per day). One study limitation was that the research focused only on Chinese women, which limits the ability to generalize the results to other populations.

Despite study limitations, the researchers said that the findings add to the body of evidence associating vegetable intake with a lower risk of diabetes. The study, however, does not prove causality.


Disabilities Greater for Senior Diabetics

Seniors with diabetes face greater physical limitations that could hinder their independence.A study of >800 adults aged 65 or older found that those with diabetes had difficulty walking and performing routine tasks.

Overall, 46% of those with diabetes needed some mobility aid (eg, cane or walker), compared with 31% of individuals without the disease. In addition, 4% of patients with diabetes were "highly dependent" on another individual to care for them, compared with 1% of those without diabetes. Reporting in Diabetes Care (February 2008), the researchers noted that the patients with diabetes also had more coexisting health problems, including high blood pressure, that could have added to their physical limitations.


Pollution May Raise Diabetes Risk

University of Cambridge researchers may have found a link between persistent organic pollutants (POPs) and insulin resistance.

The study, reported in the January 26, 2008, issue of the Lancet, said peer-reviewed research showed that individuals with high levels of POPs in their blood were at greater risk for adult-onset diabetes (type 2 diabetes). The investigators further explained that current research into type 2 diabetes focuses on obesity and genetics, with little consideration for the possible effect of environmental factors.

"Of course correlation does not automatically imply causation," said researcher Oliver Jones, PhD. "But if there is indeed a link, the health implications could be tremendous."

F A S T   F A C T : Of the US population, 7% have diabetes.