DIABETES WATCH

Pharmacy Times, Volume 0, 0

Smoking and Type 2 Diabetes Not a Good Mix

Smokers with type 2 diabetes maywant to kick the habit. Researchers inItaly found that these patients are >2times as likely to have impaired kidneyfunction, compared with nonsmokers.Although research has shown kidneydamage with type 1, or juvenile diabetes,its effects have not been studied atlength in type 2 diabetes.

The study, reported in Diabetes Care(November 2006), looked at a measure ofkidney function called glomerular filtrationrate (GFR) in 158 smokers and 158nonsmokers, all of whom had diabetes.GFR measures how fast tiny blood vesselsin the kidneys are able to filter wasteproducts out of the blood. The findingsindicated that 12% of nonsmokers had alow GFR, compared with 21% of thesmokers.

The researchers found the effects werethe greatest in patients who had diabetesfor a short period; in this group, the smokerswere >4 times as likely as nonsmokersto have low GFR, pointing to impairedkidney function. The investigators alsodiscovered elevated levels of oxygen-freeradicals in the smokers, which they concludedmay have helped advance thedamage.

Heart Transplants OKfor Diabetics

A new study found credible evidence thatsurvival from a heart transplant in patientswith diabetes and no other health problemsis on par with nondiabetics. The study analyzedthe United Network for Organ Sharingrecords for survival rates of >20,000patients who had heart transplants between1995 and 2005. The group included 3687patients with diabetes.

The researchers found that patients withoutdiabetes had a median survival rate of10.1 years, compared with a survival rate of9.3 years in patients with diabetes. Theinvestigators said the difference was notstatistically significant.

"The question is not whether a person hasdiabetes but how much damage the diabeteshas done," said Mark Russo, MD, MS, one ofthe study's authors. "A person should not bedisqualified from transplantation solely becauseof diabetes." (The findings were reportedon-line November 6, 2006, in Circulation.)

Fuel Up on Coffee

Individuals who love coffee may be lowering their chances of developingtype 2 diabetes, compared with individuals who refrain from the beverage,according to a study reported in Diabetes Care (November 2006). The studyinvolved 910 men and women aged 50 and older, who were diabetes free whenthe 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 wasfound among patients with impaired glucose tolerance. Although the researcherswere unable to pinpoint how much coffee individuals needed to consume to producethe 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 >500men and women in Finland with impaired glucose. Half of the participantswere given intensive diet and exercise counseling, while the other half actedas a control group.

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

Disease Reaches Epidemic Levels in Asia

The news is not good for individuals with type 2 diabetes inAsia. The researchers found that the disease is reaching epidemiclevels and afflicting individuals at a younger age livingon the continent.

Reporting in The Lancet (November 11, 2006), the researcherscautioned that these patients would endure complicationsfrom type 2 diabetes longer, die sooner than individualsin other regions, and that the epidemic may overwhelm thehealth care system in Asia. The investigators blamed the pandemicon rapidly changing behavior patterns, such as fast foodand a sedentary lifestyle, and suggested immediate lifestylemodifications.

"Preventive action should begin urgently, and lifestylechanges such as weight control and exercise are the firststep," according to the study. The study asked governments toimplement well-targeted, clear action plans.