Posted by on February 7, 2012 - 12:57pm

Having diabetes may cause women to experience a greater degree of hearing loss as they age, especially if the metabolic disorder is not well controlled with medication, according to a new study from Henry Ford Hospital in Detroit.   Women between the ages of 60 and 75 with well-controlled diabetes had better hearing than women with poorly controlled diabetes, with similar hearing levels to those of non-diabetic women of the same age.The study also shows significantly worse hearing in all women younger than 60 with diabetes, even if it is well controlled.

Men, however, had worse hearing loss across the board compared to women in the study, regardless of their age or whether or not they had diabetes.  For the men in the study, there was no significant difference in hearing between those with diabetes that was well-controlled or poorly controlled, as well as those who did not have diabetes.   “Younger males in general have worse hearing, enough so to possibly mask any impact diabetes may have on hearing. But our findings really call for future research to determine the possible role gender plays in hearing loss,” says Dr. Handzo.

“A certain degree of hearing loss is a normal part of the aging process for all of us, but it is often accelerated in patients with diabetes, especially if blood-glucose levels are not being controlled with medication and diet,” says Derek J. Handzo, D.O., with the Department of Otolaryngology-Head & Neck Surgery at Henry Ford.  “Our study really points to importance of patients controlling their diabetes, especially as they age, based on the impact it may have on hearing loss.”

According to the American Diabetes Association, nearly 26 million people in the U.S. have diabetes, and another 34.5 million have some degree of hearing loss. Signs of hearing loss include difficulty hearing background noises or hearing conversations in large groups, as well as regularly needing to turn up the volume on a radio or TV.

These results have been presented at a conference and not yet published in a peer reviewed journal, so they should be considered preliminary data.

Posted by on February 2, 2012 - 7:54am

Last weekend I noticed a billboard on the highway that read:   Obesity is a disease, it is not a choice!   Nice way to avoid responsibility--put the blame elsewhere.   This billboard was promoting a weight loss program (not a bad idea, but a misleading headline!)  Remember the days when the main excuse for weight gain was "it's a hormonal problem, I can't do anything about it"  or "it's in my genes".   Yes , there are some hormonal issues (e.g. hypothyroidism)  and genetics  that can predispose you to  weight gain.    However, the rise in obesity and its associated health problems far surpasses the number of people who have a hormonal or genetic problem!

In a recent Chicago Tribune interview given by Dr. Donald Lloyd-Jones at Northwestern University about heart disease ( a major outcome of obesity), he points out that "your lifestyle and behavior choices can trump much of genetics."    As far as thyroid conditions, the number of people with thyroid problems averages about 16% of the population.   And some thyroid conditions actually make you lose weight.

In 2020 in the US, 83 percent of men and 72 percent of women will be overweight or obese. Currently, 72 percent of men and 63 percent of women are overweight or obese (people who are overweight have a BMI of 25 to 29, people who are obese have a BMI of 30 or greater).  Obesity is a huge factor when it come to diabetes risk.  In 2020, 77 percent of men and 53 percent of women will have dysglycemia (either diabetes or pre-diabetes). Currently, 62 percent of men and 43 percent of women have dysglycemia.

"We’ve been dealing with the obesity trend for the past three decades, but the impact we project on blood sugar is a true shock,” said Donald Lloyd-Jones, MD, chair and associate professor of preventive medicine at Feinberg. “Those are some really scary numbers. When blood sugar goes up like that all of the complications of diabetes come into play."

Less than five percent of Americans currently are considered to have ideal cardiovascular health. The modest six percent improvement in cardiovascular health that is projected for 2020 means better cholesterol and blood pressure numbers for Americans and fewer smokers. Improvements in treatment and control of cholesterol and blood pressure with medication and declines in smoking would partially account for this small boost, but they wouldn’t be enough to offset the weight and diabetes problems Americans face. Projected improvements in diet and physical activity also contribute to the six percent projection, but the absolute increase in Americans who consume ideal diets will remain less than two percent by 2020, if current trends continue.

“Since the 1960s cardiovascular disease death rates have substantially decreased, but if the weight and dysglycemia trends continue to grow past 2020, we are in danger of seeing those overall numbers start to reverse,” Mark Huffman, a cardiologist at Northwestern, said.  Achieving a healthy weight through diet and physical activity is the best way most Americans can improve their cardiovascular health, besides quitting smoking.

Just remember, you can have a bowl of cereal in the morning or a chocolate covered donut.    It's your choice...not some disease.

 

Posted by on January 16, 2012 - 7:44am

Older women who take statins may be at an increased risk for developing type 2 diabetes, researchers found.   In an analysis of data from the Women's Health Initiative, postmenopausal women who were on a statin at study entry had almost a 50% greater risk of diabetes than those who weren't on the cholesterol-lowering drugs, Yunsheng Ma, MD, PhD, of the University of Massachusetts School of Medicine, and colleagues reported online in the Archives of Internal Medicine.

Recent research has suggested a potential link between statins and the development of diabetes -- most notably a meta-analysis that found a 9% increased risk of the disease with statin use (QJM 2011; 104(2): 109-124), Ma said.  Yet how the risk of diabetes with statin use varies across populations hasn't been thoroughly explored, he added. So he and colleagues looked at data from the Women's Health Initiative to assess the risk in postmenopausal women.

Data were available for 153,840 women, mean age 63, who didn't have diabetes when they were enrolled in the study in 1993. About 7% of them were on statins at that time.  Through follow-up ending in 2005, there were 10,242 cases of new-onset diabetes.

In initial analyses, Ma and colleagues found that statin use at baseline was associated with an increased risk of diabetes, and that association remained significant in analyses controlling for age, race, and weight. The risk was seen with all types of statins.   Risks were increased for all ethnicities, although they did vary slightly, with the highest risks seen among Asians.

The researchers also found that obesity appeared to be protective against disease; statin use was associated with a higher risk of diabetes in women with a body mass index (BMI) under 25 than in those who had a BMI of 30 or higher.   They said differences in phenotype, such as weight distribution, may explain the association.

These findings suggest  that different populations have different risks for diabetes associated with statin use, and that women on statins should be monitored for diabetes and liver dysfunction. .  It also may suggest that  we may be overusing statins and should encourage more lifestyle interventions as a primary means of treating high cholesterol.

Culver added that the findings emphasize current guidelines that recommend lifestyle intervention as the primary means of treating high cholesterol.

"Too many people are put on a statin who don't have to be," Ma said. "Patients should go on a statin if they can't control [their cholesterol] through dietary intervention, but once they're on that statin they should still continue lifestyle intervention."

Suzanne Steinbaum, MD, director of women and heart disease at Lenox Hill Hospital in Bronx, N.Y., said in an email that it's not yet clear from this one study what the clinical implications are for postmenopausal women on statins.   "Due to the extensive use of statins in the aging female population, it is critical that more studies are done to help understand the association with statins and the development of diabetes," she wrote. "Women who are taking statins should be aware of the need to check their blood sugars, along with their liver function tests."

The researchers said the study was limited by its observational nature, and because individual statin analysis may be confounded by the fact that women may have changed statin type before developing diabetes

Primary source: Archives of Internal Medicine
Source reference:
Culver AL, et al "Statin use and risk of diabetes mellitus in postmenopausal women in the Women's Health Initiative" Arch In

 

Posted by on December 16, 2011 - 6:09am

Women who worked a rotating night shift had an increased risk of type 2 diabetes that was not completely explained by an increase in body mass index (BMI), according to results of a prospective study of women who were enrolled in the Nurses' Health Studies.  Nurses who had 1 to 10 years of night shift work  saw a 5% excess risk for type 2 diabetes compared to women who did minimal to no night shift work. That risk climbed to 40% after a decade of shift work, according to Frank Hu, MD, PhD, from Brigham and Women's Hospital/Harvard School of Medicine in Boston, and colleagues.

Excess risk rocketed to almost 60% for those who had put in 20 years or more, the group reported. Other studies have suggested that rotating night shift work is associated with an increased risk for obesity and metabolic syndrome, both of which are conditions related to type 2 diabetes, they wrote.

Hu's group examined the relationship between the duration of rotating night shift work and the risk of type 2 diabetes in U.S. women who participated in Nurses' Health Studies (NHS) I and II. They also looked at whether greater weight gain was linked to duration of shift work.

Collectively, NHS I and II enrolled nearly 240,000 women. For this study, the women who completed the NHS questionnaire in 1988 or 1989 served as the baseline for this particular study. Participants were excluded if they had diabetes, heart disease, stroke, or cancer at baseline. Follow-up took place at 18 to 20 years.

Rotating night shifts were defined as working at least three nights a month in addition to days and evenings in that same month. The control group consisted of women who did not report a history of rotating night shift work.  In both cohorts, women who spent more years in night shift work were older, more likely to have a higher BMI, and be smokers.

In a secondary analysis, they found that night shift work was also associated with an elevated risk for obesity and excessive weight gain during the follow-up period.   They suggested that, beyond BMI, a reason for the link between shift work and type 2 diabetes may be "chronic misalignment between the endogenous circadian timing system and the behavior cycles." This misalignment has been pegged as a reason for metabolic and cardiovascular disorders, including increases in glucose and insulin, they wrote.

In an accompanying commentary, Mika Kivimäki, PhD, from University College London, and colleagues said the study "probably represents the most accurate estimate of shift work-type 2 diabetes association available to date, suggesting this effect is comparable in size to that of work stress in coronary heart disease and larger than the effect of work stress on type 2 diabetes."

They suggested that in an increasingly "24/7" society, efforts need to be made to prevent type 2 diabetes among shift workers by promoting healthy lifestyle and weight control. Also, prediabetic and diabetic employees need to be identified early and treated accordingly.
Source reference:
Hu FB, et al  PLoS Medicine 2011; 8(12).

 

Posted by on November 19, 2011 - 11:31am

Among patients with type 2 diabetes, women were more likely to have risk factors for chronic kidney disease than men, which may also put them at risk for poorer outcomes, according to at study reported at the American Society of Nephrology held in Seattle.

These findings are preliminary and need further study, but there is sufficient evidence to raise concerns about the quality of care diabetic women, compared to men, receive.  The report noted that the diabetic women in the study were more likely to be obese, had higher LDL cholesterol than the males in the study, and were less likely to have received a statin to help prevent heart problems.  After 5 years of followup, the women in the study were more likely to progress to a higher stage of chronic kidney disease and to progress to end-stage renal disease,   although mortality rates were similar between the sexes after accounting for diabetes-related complications.

Researcher Dr. Margaret Yu, University of Washington, reported that the findings indicate that clinicians should be more vigilant about the care their female diabetic patients receive "because I think there is this overall perception that women aren't as at risk for chronic kidney disease."

After five years of follow-up, the women in the study had poorer outcomes on average, even after adjustment for baseline stage of chronic kidney disease. Although there was a hint of lower mortality among female patients, the difference became nonsignificant after accounting for numerous end-organ diabetes complications.

Source:  Medpage Today

Posted by on November 17, 2011 - 11:25am

This sounds like a headline that  Jay Leno would satirize on his late night show!   Low-income women with children who move from high-poverty to lower-poverty neighborhoods experience notable long-term improvements in diabetes and extreme obesity, according to a new study.     While I appreciate that this study was the first to employ a important randomized experimental design to learn and document the connections between neighborhood poverty and health,  I can't help but be struck by the obvious:  Nice neighborhoods have good schools, parks, low crime, and  grocery stores---something the women in the study did not have before moving.

To be fair, this is well designed study that provides sound evidence that "environments in low-income neighborhoods can contribute to poor health".   Good evidence is important to make a case for change.   Now that we have proof,  what are we, as a nation, going to do about it?   Our economic situation locally and nationally is pretty grim right now and we can't afford to give out housing vouchers to everyone who wants to move. Hopefully, the results of this study, will be used appropriately by our legislators in creating real policy for change and not political platitudes!

To read more about the study click HERE.

 

 

Posted by on November 12, 2011 - 10:14am

November is National Diabetes Month and World Diabetes Day is Nov. 14.    Nearly 26 million Americans have diabetes, and more than one-quarter of them do not know it. Left untreated, diabetes can lead to serious complications, such as heart disease, stroke, kidney disease, blindness and amputation. An estimated 79 million adults have pre-diabetes, a condition that places them at increased risk for developing type 2 diabetes and heart disease. Some important resources to help are listed below.

Making lifestyle changes — whether to manage or prevent diabetes — is not easy. Even if you know what to do to improve your health, figuring out how to do it and fitting it into your daily routine can be a big challenge. Making changes in how you care for your health is a matter of trying and learning.

For example, people know that being physically active can help them lose weight. But do they know how to become more active and keep it up over time? In support of this effort, the National Diabetes Education Program (NDEP), is providing tools and resources to help people find ways to deal with the stress that can prevent people from achieving their health goals — whether they have diabetes or are at risk for it.

The NDEP offers the following tips for making a plan and taking small, but important steps to help you reach your goal:

Think about what is important to you and your health.
What changes are you willing and able to make?
Decide what steps will help you reach your health goals.
Choose one goal to work on first. Start this week. Pick one change you can start to make immediately.
Don't give up. It's common to run into some problems along the way. If things don’t go as planned, think about other ways to reach your goal.

The NDEP provides videos, tips sheets, and other educational materials to help people make a plan to prevent type 2 diabetes and diabetes related complications. To  access, click HERE.

 

Posted by on September 19, 2011 - 7:47am

Menopause has little to no impact on whether women become more susceptible to diabetes, according to a one-of-a-kind study.

Postmenopausal women had no higher risk for diabetes whether they experienced natural menopause or had their ovaries removed, according to the national clinical trial of 1,237 women at high risk for diabetes, ages 40 to 65.“In our study, menopause had no additional effect on risk for diabetes,” says study lead author Catherine Kim, M.D., M.P.H., an associate professor of internal medicine and obstetrics and gynecology at the University of Michigan Health System. “Menopause is one of many small steps in aging and it doesn’t mean women’s health will be worse after going through this transition.”

Kim and colleagues in the Diabetes Prevention Program Research Group will publish their results in the August issue of Menopause.  The findings also shed light on the impact of diet and exercise and hormone replacement therapy on the health of postmenopausal women.

Previous evidence has suggested that menopause would speed the progression to diabetes because postmenopausal women have relatively higher levels of the hormone testosterone, which is considered a risk factor for diabetes. But the recent study shows healthy outcomes for postmenopausal women.

The women in the study were enrolled in the Diabetes Prevention Program, a clinical trial of adults with glucose intolerance, meaning tests show their body’s struggle to process glucose, or blood sugar, into energy.

Glucose intolerance is often a pre-stage to diabetes, a condition common later in life and is diagnosed when the body has abnormally high levels of blood sugar. Age, weight, physical activity and family history can contribute to type 2 diabetes.

But Diabetes Prevention Program researchers have shown lifestyle intervention and the blood sugar-lowering drug metformin can prevent diabetes in those with glucose intolerance. The interventions work well in women who have gone through menopause.

Menopause is the end of monthly periods and chance for pregnancy and estrogen production by the ovaries stops. In the United States, menopause happens around age 51 or 52.

The research is considered the only menopause study that specifically analyzed the impact of diabetes on women who had natural menopause and those who had their ovaries removed. Most other studies mixed them together or excluded one group.

According to the new study, for every year 100 women were observed, 11.8 premenopausal women developed diabetes, compared to 10.5 among women in natural menopause and 12.9 cases among women who had their ovaries removed.

However for women whose estrogen production ended as a result of having their ovaries removed, and engaged in lifestyle changes, cases of diabetes were extremely low. For every year 100 of these women were observed, only 1.1 women developed diabetes.Lifestyle changes included losing 7 percent of their body weight and exercising for at least 150 minutes a week. For instance, a 180-pound postmenopausal woman would see benefits from losing 12.6 pounds.

The results among this group were surprising considering almost all of the women who had their ovaries removed were on hormone replacement therapy, a regime that women and doctors fear puts them at risk for a host of health issues. Study authors say more research is needed on the role of hormone therapy and diabetes risk.

“Physicians can be empowered to tell women that lifestyle changes can be very effective, and that menopause does not mean that they have a higher risk of diabetes,” Kim says.

Source: University of Michigan Health System

Posted by on July 1, 2011 - 7:50am

New videos to help people make lifestyle changes and cope with the demands of diabetes were announced by the U.S. Department of Health and Human Services’ National Diabetes Education Program (NDEP). The series of three- to five-minute videos, which can be found HERE.  This site (Diabetes HealthSense) addresses topics such as setting goals to improve health, living with diabetes, finding the support you need, as well as segments on diabetes prevention and physical activity.

The video series is the latest addition to NDEP’s offerings in lifestyle change. The videos are being released to coincide with the redesign of NDEP’s online library of behavior change resources, Diabetes HealthSense. Diabetes HealthSense provides users with a searchable database of research, tools, and programs to address the wide array of psychosocial and lifestyle-change challenges associated with diabetes self-management. Resources included in Diabetes HealthSense have been reviewed by a team of leading independent experts on psychosocial issues with specific expertise in the science of behavior change.

Visitors to the Diabetes HealthSense site can view videos featuring expert professionals who are volunteers to NDEP — as well as people living with diabetes or working to prevent type 2 diabetes — about setting goals and making lifestyle changes. Initial videos (with more in the series to follow) include the following topics:

  • setting goals to improve your health
  • managing type 2 diabetes
  • living with type 2 diabetes: finding the support you need
  • preventing type 2 diabetes
  • maintaining a healthy weight
  • practical tips and action steps: physical activity

Additionally, visitors can choose what they’d like help with, such as how to cope with stress and emotions, eat healthy, or be active. They can also utilize tracking tools for calories or physical activity, or online programs to help them manage their weight or stop smoking.  People at risk for diabetes will also find this site helpful.

 

 

Posted by on February 22, 2011 - 10:39am

A new report Women at High Risk for Diabetes: Access and Quality of Health Care, 2003–2006 was released on February 14, 2011 by the Centers for Disease Control and Prevention (CDC) and the Agency for Healthcare Research and Quality (AHRQ) . The full report can be downloaded or free print copies ordered HERE .

Using the most scientifically based measures and national data sources available, this collaborative effort compared the quality of preventive health care received by U.S. women at high risk for diabetes with that for U.S. women not at high risk for diabetes. The report presents quality measures across several crucial elements of health care: access to care, general health and wellbeing, and use of preventive care and behaviors.
Among the report’s major findings:
·         Regardless of diabetes risk status, minority women, women with low levels of education, or women who lived in low income families more often reported having fair-to-poor health.
·         Regardless of diabetes risk status, women with a high school education or less were significantly more likely than women with more than a high school education to have been uninsured all year.
·         Women at high risk for diabetes who had a high school education or less were significantly less likely than women at high risk for diabetes who had more than a high school education to have tried to lose weight in the past year.
·         Women at high risk for diabetes were significantly less likely than women not at high risk for diabetes to report that they were physically active 150 minutes per week, the level of moderate physical activity per week recommended as part of a strategy to prevent or delay onset of type 2 diabetes.

Additional resources on diabetes and women can be found HERE.

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