DIABETES WATCH

Pharmacy Times, Volume 0, 0

Drug Therapy for Prostate Cancer May Up Diabetes Risk

Men with prostate cancer face new risks—diabetes andheart disease, according to a Harvard study. Theresearchers collected data on 73,196 men, aged 66 andolder, diagnosed with prostate cancer from 1992 to 1999.The participants were followed through 2001. Of thepatients, one third were given a gonadotropin-releasinghormone (GnRH) agonist drug.

The results of the study, reported in the Journal of ClinicalOncology (September 20, 2006), indicated that men receivinga GnRH agonist had a 44% increased risk of diabetes, a 16%increased risk of coronary heart disease, an 11% greater risk ofa heart attack, and a 16% increased risk of sudden cardiacdeath. The researchers also found that men who had bilateralorchiectomy (removal of the testes) faced a 34% increased riskof developing diabetes. Heart disease, heart attack, or suddencardiac death did not rise in this group.

Japanese Adults with Diabetes Face Cancer Threat

Cancers of the liver, pancreas, andkidney are a higher risk for Japaneseadults with diabetes, according to astudy reported in the Archives ofInternal Medicine (September 25,2006). Although researchers havesuspected that there may be a correlationbetween diabetes and cancer,no conclusive evidence hasbeen obtained.

The study looked at the associationin 97,771 Japanese patients(45,548 men and 51,223 women),aged 40 to 69, who were enrolled inthe study between 1990 and 1994.At the study onset, the participantswere asked to complete a lifestylequestionnaire that included informationabout smoking, alcohol consumption,medical history, physicalactivity, and food and beverageintake. The patients were also askedif they had ever been diagnosed withdiabetes or taken diabetes medications.

At the beginning of the study,6.7% (3097 men) and 3.1% (1571women) had a history of diabetes. Bythe study's follow-up in 2003, 6462participants had developed cancer,including 3097 men (366 of whomhad diabetes) and 2555 women (104with diabetes). The study's findingsindicated that men with diabeteshad a 27% higher danger of developingcancer, compared with patientswithout the disease. Specifically, therisk was higher for liver, kidney, andpancreatic cancer. Of the women,those with diabetes had a 21%greater risk of cancer, comparedwith women without the disease.There was a dramatically higher riskfor stomach and liver cancer and aborderline higher risk for ovariancancer, however.

Changing Diabetes Bus Tour Hits the Road

"A global drive to change diabetes" is the mottoNovo Nordisk is using for its Changing DiabetesBus—a 1 1/2-year initiative around the world toraise awareness about diabetes. Individuals passingby, as well as patients with diabetes, or healthcare professionals and decision makers, can learnsomething new about diabetes.

Each corner of the bus features a key theme inthe fight against diabetes. Furthermore, plasmavideo screens, computers, and the opportunity tohave a diabetes test or a body mass index measurementtaken will keep visitors busy and entertainedwhile they receive an overview of the past,present, and possible future scenarios of diabetes.

The Changing Diabetes Bus is an important partof reaching the goal of calling for change on a globallevel. Novo Nordisk is supporting the Unite forDiabetes campaign led by the InternationalDiabetes Federation. The mission of this campaignis to secure support from governments around theworld to call for adoption of a United NationsResolution on diabetes by World Diabetes Day onNovember 14, 2007.

Disease Worse for Younger Patients

Younger individuals are more apt to experience a worseningof type 2 diabetes, compared with patients diagnosed at anolder age. The current study looked for nongenetic factors thatinfluence a continuous rise in glycosylated hemoglobin A1C(HbA1C). The researchers followed >1200 patients with type 2diabetes for 7 years after their diagnosis.

The researchers found that HbA1C improved at 1 year afterdiagnosis. During the subsequent 6 years, however, HbA1Cincreased as expected. The participants required insulin therapyafter an average 2.5 years. After 7 years, 47% of the patientswere taking insulin therapy. Specifically, the patients who wereyounger than 50 when they were diagnosed with type 2 diabetesexperienced a greater increase in HbA1C.

The increase in HbA1C concentrations in patients diagnosedbefore the age of 50 was associated with an impaired ability ofpancreas cells to produce insulin. In a follow-up study, theresearchers plan to investigate whether genetic factors canalter these relationships. (The study's findings were recentlypresented at the 42nd annual meeting of the EuropeanAssociation for the Study of Diabetes.)