Diabetes Watch

Pharmacy Times, Volume 0, 0

Diabetes Diagnosis Ups Stroke Risk

Individuals who begin treatment for type 2 diabetes face 2times the risk of stroke, compared with the general population,according to the results of a study reported in Stroke (June2007). The study included 12,272 adults with the disease.

The researchers reported that, during an average follow-up of5 years, 1122 (9%) of the patients had a stroke. After factoringin age, the incidence rate was equal to 642 strokes per 100,000person-years. The occurrence of stroke in the general population,however, is 313 per 100,000 person-years.

As a result, lead investigator Thomas Jeerakathil, MD, said,that ?patients with type 2 diabetes and their physicians need toaggressively control cardiovascular risk factors, such as hypertension(high blood pressure), smoking, and elevated cholesterol,soon after diagnosis to reduce risk.?Eat Healthy to Stave Off Diabetes

A diet that includes less red meat and fat and more wholegrains, vegetables, and fiber may cut the risk of developing diabetes.In a study, researchers followed 80,000 participants inthe Nurses? Health Study from 1984 to 2002.

During that period, the women answered 5 questionnairesconcerning their eating habits, which were used to create an?Alternate Healthy Eating Index? score. The index measures dietquality according to 9 components.

Overall, the findings indicated that 5183 women developedtype 2 diabetes during the 18-year follow-up period. Womenwith the highest scores on the Alternate Healthy Eating Index,however, were 36% less apt to develop diabetes, comparedwith women with the lowest scores. (The findings were reportedin Diabetes Care, July 2007.)Experts Predict Diabetes to Continue Unabated

Presentations at the recent American Diabetes Associationannual meeting indicated that the diabetes epidemic will continue.

From 1963 to 2005, for example, there were periods of sharpincreases in the occurrence of diabetes cases. The lead authorof the first presentation, Linda S. Geiss, MA, chief of diabetessurveillance at the Centers for Disease Control and Prevention(CDC), and her colleagues reviewed data from the NationalHealth Interview Survey. They found that from 1990 to 2005 thecases of diabetes increased from 26.4 per 1000 individuals to54.5 per 1000 individuals?a 4.6% increase each year. Geissbelieves that the epidemic is largely being driven by obesity.

In another presentation, researchers showed that diabeticretinopathy cases will increase to 16 million by 2050. Currently,5.5 million individuals have the disease. Jinan Saaddine, MD, amedical epidemiologist at the CDC, said that steps need to betaken to prepare for the increase, such as better disease management.

Cinnamon Helps Keep Blood Sugar Low

A small study of 14 healthy volunteers showed that theirblood sugar rose to a lesser degree when they ate rice puddingwith cinnamon. For the study, the participants had their bloodsugar measured before and after eating a bowl of plain rice puddingand a bowl of cinnamon rice pudding.

One explanation for the effect appears to be that cinnamonslows the rate at which food travels from the stomach to theintestines, according to the researchers. Using ultrasound scans,the researchers found that the participants showed a decreasedrate of gastric emptying when they ate cinnamon rice pudding.

The findings, reported in the June 2007 issue of the AmericanJournal of Clinical Nutrition, added credence to past studies thatcinnamon may help in blood-sugar control. The researchers saidthat it is too early to recommend cinnamon as a therapy forpatients with diabetes. The investigators noted another smallstudy that showed that, when patients with type 2 diabetesadded cinnamon to their diets for 40 days, their blood sugar andcholesterol levels appeared to drop.Self-adjusted Levemir Dosing Improves Blood Sugar

A 6-month analysis of 5604 patients with type 2 diabetesshowed that patients were able to adjust their own dosage ofinsulin detemir (rDNA origin) injection (Levemir) and achieveimprovements in blood sugar comparable to dosing adjusted bytheir primary care physician.

For the study, patients were randomized to either the 303Algorithm (self-adjusting their Levemir dose every 3 days basedon fasting plasma glucose [FPG]) or Standard-of-Care (Levemirdose physician-adjusted according to standard of care) treatmentgroups. The results showed that the average A1Cdecreased from 8.5% at baseline to 7.9% at 26 weeks for the303 Algorithm group, and from 8.5% to 8% for the Standard-of-Care group (P = .001). Compared with baseline, FPG values fellby 34 and 21 mg/dL for the 303 Algorithm and Standard-of-Caregroups, respectively (P < .0001).

At 26 weeks, 88% of all patients remained on once-dailyLevemir therapy. (The findings were presented recently at theAmerican Diabetes Association annual meeting.)