Diabetes Watch

Pharmacy Times, Volume 0,0

Pharmacists: Diabetes Info at Your Fingertips

Novo Nordisk's Web resourceNovoMedLink.com provides relevanttools and resources tailored to a clinician'sspecific needs. Membership is free.

The pharmacist's home page includeslinks to product overviews, educationmaterial, device demonstrations, andmore. The product information and formularytool allows pharmacists to lookup pharmacology and safety profiles, prescribinginformation, and formulary statusof Novo Nordisk products. The eLearningcomponent has video programs thatoffer useful information on a variety oftopics. The patient educationmaterialsoffer patients helpful information on livingwith diabetes with Novo Nordisk'sChanging Life with Diabetes booklets,available in English and Spanish.

Pharmacists also can register formonthly eNewsletters with in-depthinformation on the latest clinical innovationsin diabetes care. Slide kits andjournal article reprints also can be downloadedabout the company's productsand the conditions they treat. To join,visit www.novomedlink.com.

Communication MayHelp Diabetic TeensManage Disease

Talk therapy may benefit teenagers with type 1 diabetes strugglingto manage their condition, suggested a study published inDiabetes Care (August 2008). The study involved 91 teenagerswith the disease who were patients at 1 of 4 pediatric diabetesclinics.

The centers were randomly assigned to either assess theteenagers' health-related quality of life, or stay with standardof care only. All of the participants had 3 routine pediatricianvisits at 3-month intervals. The intervention group completeda computer-based survey on health-related quality of life priorto each appointment, and the physicians discussed the resultsduring the visit.

The findings showed that the teenagers who had theirhealth-related quality of life assessed by their physician showedimprovements in their psychological well-being over 1 year.The researchers found that the participants had fewer behaviorproblems, improved self-esteem and mental health, and morequality of time with their families.

Dementia Linked withDiabetesDuration,Acuteness

Mayo Clinic researchers found developing diabetes before age65 and greater severity of the disease may be crucial in thedevelopment of mild cognitive impairment among the elderly.Of the 1969 participants between 70 and 80 years old and freeof dementia in 2004, 356 had diabetes.

The study results, reported in the August 11, 2008, issue ofArchives of Neurology, showed that rates of diabetes werecomparable in the 329 patients (20.1%) with mild cognitiveimpairment and the 1640 patients (17.7%) without dementia.Yet, mild cognitive impairment was associated with developingdiabetes before age 65, having diabetes for 10 yearsor longer, being treated with insulin, and having diabetescomplications.

Diabetes Goes Undiagnosedin Obese Patients

Obese patients with diabetes are just aslikely to go undiagnosed as their thinnerpeers with the disease, accordingto a study reported in Diabetes Care(September 2008). Whereas consensusis lacking on who should be screenedfor the disease, the researchers reportedthat early diagnosis is important forobese patients because research indicatesthey are less prone to be offeredpreventive care that can help ward offserious disease complications.

To determine the impact of a patient'sbody mass index (BMI) on the chancesof having undiagnosed diabetes, theresearchers looked at 5514 participantsin the 1999-2004 National Health andNutrition Examination Survey. Of the participants,10% had diabetes and 28% hadnot been diagnosed with the disease.The researchers determined that an individual'sBMI made no difference from astatistical standpoint on whether or notthey went undiagnosed; 22% of normalweightindividuals were undiagnosed,32% of overweight individuals were undiagnosed,and about 33% of obese individualswere undiagnosed.

The researchers added that moreresearch is warranted to understandwhether including overweight and obesityin diabetes screening programs maybe beneficial for public health.

F A S T F A C T: Diabetes is the leadingcause of kidney failure.

Continuous Monitoring Best for Blood Sugar Control

Published in the New England Journal ofMedicine (October 2008), new researchindicates that using continuous glucosemonitoring devices to help managediabetes results in better blood sugarcontrol in adults with insulin-dependentdiabetes (type 1). The studied included322 patients aged 8 to 72, at 10 sites.

Some patients were assigned to asmall continuous glucose monitoringdevice and the control group wasassigned standard blood sugar monitoring.

The participants were followed for 26weeks and their hemoglobin A1C levelswere monitored. The results found thatimprovements in blood sugar controlwere best in the continuous blood glucosemonitoring patients group aged 25and older. Their A1C levels decreasedduring the study period by an averageof 0.53%, compared with the controlgroup.

The patients in other age groups,however, fared no better than patientsusing the standard method.

Arsenic in Drinking WaterBoosts Diabetes Odds

Increased levels of arsenic in urine may be associated with agreater risk of developing type 2 diabetes, reported researchersin the August 20, 2008, issue of the Journal of the AmericanMedical Association. The findings are the first to link lowlevelexposure to arsenic with type 2 diabetes incidence in theUnited States.

The findings are based on an analysis of 788 US adultsaged 20 or older. The data showed that patients with type 2diabetes had a 26% higher level of total arsenic in the urine,compared with patients without the disease. The patientswith the highest levels of arsenic were nearly 3.6 times moreprone to have diabetes, compared with participants with thelowest levels.

The patients with the highest levels of dimethylarsinate (acompound into which inorganic arsenic is metabolized) had1.5 times the risk of diabetes as those with the lowest levels.The risk was determined after adjusting for organic arseniccompounds primarily from seafood, such as arsenobetaine andarsenosugars.

Common Genes May LinkFetal Growth, Diabetes

A study of Swedish twins found that a common genetic causeunderlies both the propensity to develop type 2 diabetesand low birth weight. The study, published in Epidemiology(September 2008), included 18,230 fraternal and identical twins(592 with type 2 diabetes) born between 1926 and 1958.

For the study, the researchers first looked at all twins asindependent individuals. As with previous research, the currentstudy found that low birth weight was more prevalent amongadults with type 2 diabetes. The researchers took the studya step further and analyzed the twins as pairs when one haddiabetes and the other did not. The results showed a continuedlink between low birth weight and diabetes among fraternaltwins. This link, however, was not seen between identical twinswho share the same genes.

Researcher Stefan Johansson, MD, explained, "Within a fraternaltwin pair, the lighter twin would face an increased riskof diabetes? But with an identical twin pair, the lighter andheavier twin have the same risk of developing diabetes laterin life."

Study LDL, Cancer Risk for Diabetes Patients

A study of 6107 patients with type 2diabetes showed that low or high levelsof low-density lipoprotein (LDL) cholesterolare linked with an increased rate ofcancer in this patient population. None ofthe participants were taking cholesterolloweringstatins.

The researchers found that LDL levelsbelow 2.80 mmol/L were associated withgreater risk of cancer of the digestiveorgans and peritoneum, genital and urinaryorgans, and lymphatic and blood tissues.LDL levels above 3.80 mmol/L wereconnected with an increased risk of oral,digestive, bone, skin, and breast cancer.The findings, published in the August26, 2008, issue of the Canadian MedicalAssociation Journal suggest "the use ofthese levels as risk markers may helpclinicians to assess their patients morefully," said the researchers.

F A S T F A C T: The rate of amputation for people with diabetes is 10 times higher thanfor people without diabetes.