APRIL 01, 2007

Control Diabetes and Reduce Stroke Risk

An analysis of 50,000 stroke patients with diabetes found that many failed to manage their symptoms before the stroke. The patients had high rates of obesity, hypertension, cholesterol disorders, and poor control of glucose at the time of the stroke.

The researchers found that patients with undiagnosed diabetes when the stroke happened had poorer control of the risk factor for diabetes, compared with patients diagnosed with diabetes prior to their stroke. The investigators cautioned that stroke patients with undiagnosed diabetes face a greater risk of recurrent stroke or heart complications. The study's data came from the American Stroke Association's Get with the Guidelines-Stroke program. (The findings were recently reported at the American Stroke Association's annual meeting.)

Study Finds Kidney Stone Link

The prevalence of kidney stones is increasing throughout the world, and data amassed by researchers at the Mayo Clinic in Rochester, Minn, hinted that diabetes may be a predisposing factor—specifically, for kidney stones composed of uric acid.

For the study, the researchers identified all of the state's Olmsted County residents diagnosed with kidney stones between 1980 and 1999. All of the 3561 patients were matched by age and gender with an equal number of controls. The researchers also studied patients diagnosed with diabetes, high blood pressure, and obesity. The findings showed that diabetes was significantly linked with a diagnosis of kidney stones.

The researchers also took a random sample of 269 participants with kidney stones and matched them with 260 individuals without kidney stones. The investigators found that when they scrutinized the cases according to stone type, the occurrence of diabetes was 40% among the 10 participants with uric acid stones, compared with 9% for the 112 with calcium stones and 7% without kidney stones. After taking into account the patients'body mass index, the patients with uric acid kidney stones had 5 times the risk for diabetes. (The findings were recently reported in the American Journal of Kidney Disease.)

Pupil Size May Indicate Problems Later On

Tests of pupil function may help calculate how prone young children with diabetes are to develop microvascular disease—a disease of the small blood vessels. The tests are used to indicate how well the automatic nervous system is working.

Reporting in Diabetes Care (January 2007), Australian researchers discovered that tiny pupil size in adolescents with type 1 diabetes predicted weakening of the retina, or retinopathy, and also microalbuminuria, 12 years later. For the study, the researchers analyzed data on 335 adolescents with type 1 diabetes who had tests of cardiovascular and pupillary regulation by the autonomic nervous system in the early 1990s.

Of the patients, 137 participated in the follow-up study. The findings indicated that 10% of patients had had severe retinopathy that required laser therapy, 15% had moderate retinopathy, and 44% had mild retinopathy. In all, 19% had microalbuminuria. Although no relationship was found between baseline cardiovascular tests and the development of complications, the researchers concluded that small pupil size at baseline was independently connected with the development of microalbuminuria and retinopathy.

Get Off the Couch!

A study, reported in Diabetes Care (February 2007), indicated that only 39% of adults with diabetes were physically active, compared with 58% of participants without the illness. The findings were based on data from the Medical Expenditure Panel Survey, which included 23,000 adults. The respondents answered questions about whether they participated in moderate or vigorous activity 30 minutes or more at least 3 times a week. Of the participants that did not have diabetes but had risk factors for it, the researchers indicated that the more risk factors the individuals had, the less chance the individuals were to be active.

Despair Contributes to ED in Men with Diabetes

Depression symptoms represent a key factor adding to the risk of erectile dysfunction (ED) in men with type 2 diabetes. The researchers noted that there appears to be a vicious cycle, in which sadness may prompt the development of ED, while ED symptoms perpetuate depression symptoms. Therefore, ED in patients with diabetes is not solely related to organic factors.

During the study, the participants completed questionnaires every 6 months for 3 years. Of the patients, 500 reported ED at the study's onset, and an additional 192 developed the condition during follow-up. The researchers also noted a greater prevalence of high blood pressure (46% vs 32%) and lipid abnormalities (23% vs 13%). The study identified other characteristics associated with the development of ED, including longer duration of diabetes, older age, and a history of smoking. Patients with ED were more prone to be treated with insulin or diuretics. (The findings were reported in the Journal of Urology, January 2007.)