JANUARY 01, 2007

Smoking and Type 2 Diabetes Not a Good Mix

Smokers with type 2 diabetes may want to kick the habit. Researchers in Italy found that these patients are >2 times as likely to have impaired kidney function, compared with nonsmokers. Although research has shown kidney damage with type 1, or juvenile diabetes, its effects have not been studied at length in type 2 diabetes.

The study, reported in Diabetes Care (November 2006), looked at a measure of kidney function called glomerular filtration rate (GFR) in 158 smokers and 158 nonsmokers, all of whom had diabetes. GFR measures how fast tiny blood vessels in the kidneys are able to filter waste products out of the blood. The findings indicated that 12% of nonsmokers had a low GFR, compared with 21% of the smokers.

The researchers found the effects were the greatest in patients who had diabetes for a short period; in this group, the smokers were >4 times as likely as nonsmokers to have low GFR, pointing to impaired kidney function. The investigators also discovered elevated levels of oxygen-free radicals in the smokers, which they concluded may have helped advance the damage.

Heart Transplants OKfor Diabetics

A new study found credible evidence that survival from a heart transplant in patients with diabetes and no other health problems is on par with nondiabetics. The study analyzed the United Network for Organ Sharing records for survival rates of >20,000 patients who had heart transplants between 1995 and 2005. The group included 3687 patients with diabetes.

The researchers found that patients without diabetes had a median survival rate of 10.1 years, compared with a survival rate of 9.3 years in patients with diabetes. The investigators said the difference was not statistically significant.

"The question is not whether a person has diabetes but how much damage the diabetes has done," said Mark Russo, MD, MS, one of the study's authors. "A person should not be disqualified from transplantation solely because of diabetes." (The findings were reported on-line November 6, 2006, in Circulation.)

Fuel Up on Coffee

Individuals who love coffee may be lowering their chances of developing type 2 diabetes, compared with individuals who refrain from the beverage, according to a study reported in Diabetes Care (November 2006). The study involved 910 men and women aged 50 and older, who were diabetes free when the study commenced.

In an 8-year follow-up, the former and current coffee drinkers were about 60% less likely to have developed type 2 diabetes. The coffee's protective effect was found among patients with impaired glucose tolerance. Although the researchers were unable to pinpoint how much coffee individuals needed to consume to produce the protective effect, the study's patients were not heavy coffee drinkers

Healthy Living Cuts Diabetes Risk

Lifestyle changes may make a difference when it comes to diabetes. Finnish researchers compared the effects of lifestyle modifications on >500 men and women in Finland with impaired glucose. Half of the participants were given intensive diet and exercise counseling, while the other half acted as a control group.

During a 7-year follow-up of the Finnish Diabetes Prevention study, the researchers identified a major difference between the 2 groups. The study indicated a 15% to 20% reduction in diabetes risk in the intervention group. The researchers explained that losing weight, cutting back on saturated fats, eating more fiber, and exercising 30 minutes daily can have a positive effect. (The findings were reported in The Lancet, November 11, 2006.)

Disease Reaches Epidemic Levels in Asia

The news is not good for individuals with type 2 diabetes in Asia. The researchers found that the disease is reaching epidemic levels and afflicting individuals at a younger age living on the continent.

Reporting in The Lancet (November 11, 2006), the researchers cautioned that these patients would endure complications from type 2 diabetes longer, die sooner than individuals in other regions, and that the epidemic may overwhelm the health care system in Asia. The investigators blamed the pandemic on rapidly changing behavior patterns, such as fast food and a sedentary lifestyle, and suggested immediate lifestyle modifications.

"Preventive action should begin urgently, and lifestyle changes such as weight control and exercise are the first step," according to the study. The study asked governments to implement well-targeted, clear action plans.