FEBRUARY 01, 2008

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.

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