Diabetes Watch

Pharmacy Times, Volume 0, 0

Screen Diabetics for Sleep Disorders

Strong preliminary evidence links type 2diabetes with sleep apnea. As a result,the International Diabetes FederationTask Force on Epidemiology and Preventionrecommends that physiciansassess their diabetic patients for sleepapnea symptoms and screen patientswith sleep apnea for metabolic disease.

In a study published recently inEndocrine Practice, researchers lookedat data from 279 men and womenwith type 2 diabetes. Overall, 36% hadobstructive sleep apnea. The findingsindicated men with diabetes were particularlyat risk. Men younger than 45had more than a one-third increasedchance of developing sleep apnea, andthat risk doubled above age 65. Womenyounger than 45 had a slim chance ofhaving sleep apnea, between 5% and8%. The odds were different for womenaged 65 and over. This group had a one-thirdincreased chance of having thesleep disorder.

Mental Function May Decrease with Diabetes

A study investigating how illness affectsbrain power found that type 2 diabetesslows an individual?s ability to processcertain types of information quicklyand accurately. The study, reported inNeuropsychology (January 2009), showedsmall but considerable differences betweenpatients with diabetes and theirhealthy counterparts on tests of brainfunction and speed.

The current study had 465 men andwomen between 55 and 81 years old,41 of whom had diabetes, completememory, learning, and executive functiontests. Whereas the patients withtype 2 diabetes did just as well as theirhealthy peers on tests of memory, fluency,and speed, this group did worse onsome tests of executive functioning. Theresearchers are not clear how diabetesmight influence the brain. The effects ofthe disease on blood vessels, as well asinsulin and blood sugar regulation andvariability, may be contributors.

Cut Carbs to Improve Blood Sugar

Obese individuals with type 2 diabetes should consider a low-carbohydratediet to help blood sugar levels, according to studyresults reported in Nutrition & Metabolism (December 2008).Furthermore, the diet allows some patients to eliminate orlower their medication.

The researchers compared the effectiveness of 2 diets on84 obese patients with type 2 diabetes assigned to a low-carbohydrate(<20 g/day) ketogenic diet or to a low-glycemic,reduced-calorie diet for 24 weeks. Patients on the reducedcarbohydrate diet showed more improvement in A1C, shedmore pounds, and had an increase in their high-density lipoproteinlevels. It was possible for 95.2% of those in the low-carbohydrateketogenic group and 62.1% in the low-glycemic,reduced-calorie diet to stop or reduce diabetes medications.

Obese Teens: StomachSurgery May Stop Diabetes

A study of 78 teens, published in the January 2009 issue ofPediatrics, found that gastric bypass surgery for obese teenscould help them prevent the long-term risk of diabetes.

For the study, 11 patients underwent gastric bypass surgery,while the remaining 67 patients received traditional care fortheir diabetes. The surgery group had an average 34% reductionin their weight, and their diabetes went into remission.The nonsurgical group only saw a weight loss of <2 lb and stillneeded their diabetes medication.

Lead researcher Thomas H. Inge, MD, PhD, said, "These earlysurgical research findings suggest that diabetes may not bea diagnosis kids have to live with for the rest of their lives. Infact, there is good reason to be optimistic about their futurecardiovascular health."

Are Diabetes Patients? Needs Met at Nursing Homes?

Long-term care facilities, such as nursinghomes, are not ready to meet the challengesof treating patients with diabetes.Statistics indicated that as many as 1 in 4nursing home residents have diabetes.

A new study found that while 98% ofnursing home residents with diabeteshad their blood glucose levels monitored,only 38% met short-term glucose goals.The study, however, showed that 67% ofnursing home residents with the diseasemet their long-term goals, which translatesto a score of <7% on the A1C tests.

Helaine Resnick, director of research atthe Institute for the Future Aging Servicesfor the American Association of Homesand Services for the Aging, raised oneconcern on the findings. She said thatno one has yet to come up with specificguidelines for caring for the elderly withdiabetes.

F A S T F A C T: The number of adults aged 40 and older with diabetic retinopathy will reach 16 million in 2050.