DIABETES WATCH

Pharmacy Times, Volume 0, 0

Women Should NotRestrict Insulin

Women with type 1 diabetes who want to prevent weightgain should not cut back on insulin, according to a studyreported in Diabetes Care (March 2008). The study involved234 women and teens with the disease.

At the study onset, the researchers found that 30% of thewomen were limiting the amount of insulin they took atleast part of the time. The women were followed for 11years, and any deaths or complications from their diseasewere noted. The findings indicated that women whorestricted their insulin were more prone to higher rates ofcomplications (eg, kidney disease). The researchers alsonoted that women who limited their insulin were more likelyto die young. Women who skipped insulin shots and thendied during the study also exhibited more symptoms of eatingdisorders.

Diabetics on Dialysis:A1C Test Unreliable

New research indicates that the hemoglobin A1C test isnot reliable for patients undergoing hemodialysis. Healthcare experts believe that a more accurate measure is theamount of glycated albumin in the bloodstream, because itdoes not depend on the survival of red blood cells. The glycatedalbumin test, however, is not currently available in theUnited States.

The current study, reported in Kidney International(February 20, 2008), compared A1C and glycated albumintesting on blood samples from 307 patients with diabetes. Ofthe participants, 258 were on hemodialysis. The result "supportsthe glycated albumin test as a more accurate measureof long-term blood sugar control among diabetic patientswho are on hemodialysis," said Barry I. Freedman, MD, seniorauthor of the study.

Eat Your Veggies

A study of 64,191 middle-agedChinese women found that greaterconsumption of vegetables may lowerthe odds of developing type 2 diabetesby almost 30%. A greater intake of fruitwas not associated with any benefits,reported researchers in the March2008 issue of the Journal of Nutrition.

Using a food-frequency questionnaire,the researchers reported thatthe women had average fruit and vegetableintakes of 239.4 g and 236 g perday, respectively. The investigatorsassessed dietary intakes at the start ofthe study and again after 4.6 years.

During the study, 1608 cases of type2 diabetes were documented. Consumptionof the most vegetables, averaging428 g per day, was linked with a28% lower risk of developing type 2diabetes, compared with the consumptionof the lowest average amount(121.5 g per day). One study limitationwas that the research focused only onChinese women, which limits the abilityto generalize the results to otherpopulations.

Despite study limitations, the researcherssaid that the findings add tothe body of evidence associating vegetableintake with a lower risk of diabetes.The study, however, does notprove causality.

Disabilities Greater forSenior Diabetics

Seniors with diabetes face greater physical limitations thatcould hinder their independence.A study of >800 adults aged 65or older found that those with diabetes had difficulty walking andperforming routine tasks.

Overall, 46% of those with diabetes needed some mobilityaid (eg, cane or walker), compared with 31% of individuals withoutthe disease. In addition, 4% of patients with diabetes were"highly dependent" on another individual to care for them,compared with 1% of those without diabetes. Reporting inDiabetes Care (February 2008), the researchers noted that thepatients with diabetes also had more coexisting health problems,including high blood pressure, that could have added totheir physical limitations.

Pollution May RaiseDiabetes Risk

University of Cambridge researchers may have found a linkbetween persistent organic pollutants (POPs) and insulinresistance.

The study, reported in the January 26, 2008, issue of theLancet, said peer-reviewed research showed that individualswith high levels of POPs in their blood were at greater risk foradult-onset diabetes (type 2 diabetes). The investigators furtherexplained that current research into type 2 diabetesfocuses on obesity and genetics, with little consideration forthe possible effect of environmental factors.

"Of course correlation does not automatically imply causation,"said researcher Oliver Jones, PhD. "But if there is indeeda link, the health implications could be tremendous."

F A S T F A C T : Of the US population, 7% have diabetes.