Diabetes Watch

FEBRUARY 01, 2009

Screen Diabetics for Sleep Disorders

Strong preliminary evidence links type 2 diabetes with sleep apnea. As a result, the International Diabetes Federation Task Force on Epidemiology and Prevention recommends that physicians assess their diabetic patients for sleep apnea symptoms and screen patients with sleep apnea for metabolic disease.

In a study published recently in Endocrine Practice, researchers looked at data from 279 men and women with type 2 diabetes. Overall, 36% had obstructive sleep apnea. The findings indicated men with diabetes were particularly at risk. Men younger than 45 had more than a one-third increased chance of developing sleep apnea, and that risk doubled above age 65. Women younger than 45 had a slim chance of having sleep apnea, between 5% and 8%. The odds were different for women aged 65 and over. This group had a one-third increased chance of having the sleep disorder.

Mental Function May Decrease with Diabetes

A study investigating how illness affects brain power found that type 2 diabetes slows an individual?s ability to process certain types of information quickly and accurately. The study, reported in Neuropsychology (January 2009), showed small but considerable differences between patients with diabetes and their healthy counterparts on tests of brain function and speed.

The current study had 465 men and women between 55 and 81 years old, 41 of whom had diabetes, complete memory, learning, and executive function tests. Whereas the patients with type 2 diabetes did just as well as their healthy peers on tests of memory, fluency, and speed, this group did worse on some tests of executive functioning. The researchers are not clear how diabetes might influence the brain. The effects of the disease on blood vessels, as well as insulin and blood sugar regulation and variability, may be contributors.

Cut Carbs to Improve Blood Sugar

Obese individuals with type 2 diabetes should consider a low-carbohydrate diet to help blood sugar levels, according to study results reported in Nutrition & Metabolism (December 2008). Furthermore, the diet allows some patients to eliminate or lower their medication.

The researchers compared the effectiveness of 2 diets on 84 obese patients with type 2 diabetes assigned to a low-carbohydrate (<20 g/day) ketogenic diet or to a low-glycemic, reduced-calorie diet for 24 weeks. Patients on the reduced carbohydrate diet showed more improvement in A1C, shed more pounds, and had an increase in their high-density lipoprotein levels. It was possible for 95.2% of those in the low-carbohydrate ketogenic group and 62.1% in the low-glycemic, reduced-calorie diet to stop or reduce diabetes medications.

Obese Teens: Stomach Surgery May Stop Diabetes

A study of 78 teens, published in the January 2009 issue of Pediatrics, found that gastric bypass surgery for obese teens could help them prevent the long-term risk of diabetes.

For the study, 11 patients underwent gastric bypass surgery, while the remaining 67 patients received traditional care for their diabetes. The surgery group had an average 34% reduction in their weight, and their diabetes went into remission. The nonsurgical group only saw a weight loss of <2 lb and still needed their diabetes medication.

Lead researcher Thomas H. Inge, MD, PhD, said, "These early surgical research findings suggest that diabetes may not be a diagnosis kids have to live with for the rest of their lives. In fact, there is good reason to be optimistic about their future cardiovascular health."

Are Diabetes Patients? Needs Met at Nursing Homes?

Long-term care facilities, such as nursing homes, are not ready to meet the challenges of treating patients with diabetes. Statistics indicated that as many as 1 in 4 nursing home residents have diabetes.

A new study found that while 98% of nursing home residents with diabetes had their blood glucose levels monitored, only 38% met short-term glucose goals. The study, however, showed that 67% of nursing home residents with the disease met their long-term goals, which translates to a score of <7% on the A1C tests.

Helaine Resnick, director of research at the Institute for the Future Aging Services for the American Association of Homes and Services for the Aging, raised one concern on the findings. She said that no one has yet to come up with specific guidelines for caring for the elderly with diabetes.

F A S T   F A C T: The number of adults aged 40 and older with diabetic retinopathy will reach 16 million in 2050.