Diabetes Watch

Pharmacy TimesJanuary 2011 Aging Population
Volume 77
Issue 1

Screening for Gestational Diabetes

An analysis of nearly 1 million patient records revealed that 1 in 3 pregnant women are not screened for gestational diabetes. Those who develop the condition are even less likely to undergo follow-up screening within 6 months of giving birth, according to the study published in the January issue of Obstetrics and Gynecology.

Early screening—both for gestational diabetes and postpartum type 2 diabetes—is a critical preventive step. Gestational diabetes causes adverse health effects for both mother and baby, and 40% to 60% of women who have it develop type 2 diabetes within 10 years.

“Regardless of ethnicity, weight, or age, many pregnant women are not being screened according to guidelines for gestational diabetes,” said study author Jon M. Nakamoto, MD, PhD, medical director at Quest Diagnostics. “We were particularly alarmed to find that women who develop the condition while pregnant are not being screened for diabetes postpartum.”

The study found that approximately 5% of women screened between the ages of 18 and 40 had gestational diabetes. Under new criteria being considered by the International Association of Diabetes and Pregnancy Study Groups, that number would have nearly doubled, the researchers noted.

Despite having the highest risk for gestational diabetes, obese women were the least likely to be screened. Ethnicity was also a factor, with gestational diabetes occurring most often in Asian American women, followed by Hispanic American women. “With diabetes at epidemic proportions, the need for patients to empower themselves through improved knowledge of their individual risks for this disease has never been more compelling,” said study investigator Harvey W. Kaufman, MD, senior medical director at Quest Diagnostics.

Dairy Trans Fat Linked to Lower Diabetes Risk

Consuming whole milk—in moderation —may help prevent long-term illness, a new study suggests. Research published in the Annals of Internal Medicine found that patients who consume more fat from dairy products have a lower risk of developing diabetes.

As part of the trial, researchers examined 3736 adults, 65 years and older, for blood levels of trans-palmitoleate, a naturally occurring fatty acid found in milk, cheese, yogurt, butter, and meat. Participants with higher levels of the compound were 60% less likely to be diagnosed with type 2 diabetes within 20 years than those with lower levels.

Lead researcher Dariush Mozaffarian, MD, associate professor at the Harvard School of Public Health in Boston, called the results “exciting,” but said further research is needed to address unanswered questions. For example, it’s not clear whether the benefits of trans-palmitoleate are worth consuming large quantities of full-fat dairy products, which could lead to weight gain and high cholesterol—risk factors for diabetes and heart disease.

Among the 700 study participants with the highest blood levels of trans-palmitoleate, just 38 developed diabetes, compared with 94 cases among those with the lowest levels of the fatty acid. Individuals in the top 20% for trans-palmitoleate showed a 62% lower risk of diabetes than those in the bottom 20%. Higher levels of the dairy fat were also associated with a better metabolic profile overall.

Dr. Mozaffarian said the results may prompt patients to think differently about the value of dietary fat. Future trials may determine whether the fat alone can lower diabetes risk.

Fast Fact: Lifestyle intervention reduces the development of diabetes by 58% over 3 years.

Almonds May Boost Insulin Sensitivity, Cut Heart Risk

A diet rich in almonds may improve insulin sensitivity and lower risk of heart disease in patients with prediabetes, according to recent research published in the Journal of the American College of Nutrition.

In a study of 65 patients with prediabetes, participants were assigned to follow either an almond-rich or nut-free diet for 16 weeks. Patients in the intervention group ate approximately 2 oz of almonds each day, accounting for 20% of their daily caloric intake. Those who consumed almonds showed reduced blood levels of low-density lipoprotein, or “bad” cholesterol, as well as dramatic improvements in insulin sensitivity.

Consuming almonds did not help participants lose weight, nor did it reduce systolic blood pressure or other measurable cardiovascular risk factors. According to the report, however, improvements in cholesterol and insulin sensitivity could help ward off cardiovascular disease and diabetes in patients who are at high risk for developing both conditions. For pharmacist-recommended diabetes products, go to www.OTCGuide.net.

Recent Videos
Practice Pearl #1 Active Surveillance vs Treatment in Patients with NETs