Tag Archives: diabetes
Many people with heart failure also have diabetes or high blood pressure. But new research suggests those conditions, even when treated, aren’t well controlled, placing people at risk for worsening heart problems, according to the American Heart Association (AHA).
“We know that controlling hypertension and diabetes is critical for people with heart failure,” said Dr. Madeline Sterling, a primary care physician at Weill Cornell Medicine in New York City. “But few studies have been able to ascertain how well those risk factors have been controlled. This study really takes a big step forward in doing that.”
Sterling wrote an editorial accompanying the study that appeared in the American Heart Association’s journal Circulation: Heart Failure.
Heart failure occurs when the heart can’t pump as well as it should and fails to deliver enough oxygen to the body, making it harder for people to perform everyday tasks. Hypertension, another name for high blood pressure, and diabetes are major risk factors for heart failure, which affects more than 6 million people in the U.S., especially those who have other heart problems or who have had heart attacks.
In the new study, researchers analyzed 18 years of data from the National Health and Nutrition Examination Survey, a series of federal studies assessing the prevalence of major diseases and their risk factors among U.S. adults.
While just 8% of 1,423 people diagnosed with heart failure had poor glycemic control, defined in the study as a hemoglobin A1C level of 8% or higher, 21% of those being treated for diabetes failed to meet blood glucose goals. This did not vary by race or ethnicity.
Researchers also found 48% of people with heart failure had uncontrolled hypertension, which the researchers defined as a systolic blood pressure, the top number in a reading, of at least 130. Among people prescribed blood pressure-lowering medication, poor control was even higher, at 51%. Black adults had higher uncontrolled rates than their white peers, at 53% compared to 47%.
That higher rate of poor blood pressure control among Black adults with heart failure was not surprising since it mirrors racial disparities in blood pressure control in the general population, said Dr. Sadiya Khan, senior author of the study, funded in part by the AHA.
“This speaks to a larger problem, which is a systemic failing to control the leading risk factors that account for the greatest number of non-communicable deaths worldwide,” said Khan, an assistant professor of medicine at Northwestern University Feinberg School of Medicine in Chicago.
“The reasons for these disparities are manifold,” said Dr. Leah Rethy, a resident physician at the University of Pennsylvania Perelman School of Medicine and lead author of the study. They include the history of structural racism in the U.S., which is largely responsible for disparities in access to health care, proximity to green spaces where people can safely meet exercise goals and “all sorts of things that influence somebody’s life course up until the time they get heart failure,” she said.
While the vast majority of people in the study had insurance, they also reported incomes below the poverty line, which could affect their access to quality care or the ability to pay for medications, said Sterling, who was not involved in the research. The study also did not track whether people being treated for high blood pressure and diabetes were actually taking the medications prescribed to them.
The study documented only the prevalence of uncontrolled blood pressure and poor glycemic control, not why those risk factors were uncontrolled, Rethy said.
“We think there’s probably a number of reasons that include a lack of understanding or focus from providers about the importance of blood pressure control, but also perhaps a lack of accessibility to consistent and affordable primary and specialty care for adults with heart failure,” she said, “particularly those under age 65 who don’t qualify for Medicare.”
Sterling added that “it’s actually quite hard to control these risk factors. It’s not just a matter of giving people medications. This study is shedding light on this.”
Many people who have heart failure are older, frail and may have cognitive issues, so it may be difficult for them to perform the extensive self-monitoring needed to manage their health, she said. “A lot is put on patients to manage this at home, and it’s a challenge.”
But that doesn’t mean it’s an insurmountable one, Rethy said. The key is finding ways to help health care professionals and patients put into practice what researchers know about how to get blood pressure and blood glucose levels under control.
“There are many good medications and lifestyle interventions that we know work,” she said. “We shouldn’t think of it as too lofty to achieve. We have access to lots of tools to help fix it.”
There are many reasons to avoid getting diabetes, or to keep it controlled if you already have it: Higher risks for heart disease, stroke and for having a foot or leg amputation. But here’s another one: It’s a major risk factor for dementia.
While researchers are still investigating what causes that increased risk, one thing they do know is it’s linked to highs – and lows – in the body’s blood sugar levels.
“Whether it’s Type 1 or Type 2 diabetes, glycemic control is very important” for maintaining good brain health, said Rachel Whitmer, chief of the division of epidemiology at University of California, Davis and associate director of the school’s Alzheimer’s Disease Research Center. “This is another motivation to have good control.”
Good management of blood glucose levels is one of seven lifestyle changes people can make to support better heart and brain health, called Life’s Simple 7 by the American Heart Association. It’s a step that could potentially help more than 34.2 million people in the U.S. living with diabetes.
People in the UK with sleep problems are at an increased risk of dying, finds a new study from the University of Surrey and Northwestern University.
In a paper published by the Journal of Sleep Research, researchers reveal how they examined data* from half a million middle-aged UK participants asked if they had trouble falling asleep at night or woke up in the middle of the night.
The report found that people with frequent sleep problems are at a higher risk of dying than those without sleep problems. This grave outcome was more pronounced for people with Type-2 diabetes: during the nine years of the research, the study found that they were 87 per cent more likely to die of any cause than people without diabetes or sleep disturbances.
The study also found that people with diabetes and sleep problems were 12 per cent more likely to die over this period than those who had diabetes but not frequent sleep disturbances.
Malcolm von Schantz, the first author of the study and Professor of Chronobiology from the University of Surrey, said:
“Although we already knew that there is a strong link between poor sleep and poor health, this illustrates the problem starkly.”
“The question asked when the participants enrolled does not necessarily distinguish between insomnia and other sleep disorders, such as sleep apnoea. Still, from a practical point of view it doesn’t matter. Doctors should take sleep problems as seriously as other risk factors and work with their patients on reducing and mitigating their overall risk.”
Professor Kristen Knutson of Northwestern University, the senior co-author of the study, said:
“Diabetes alone was associated with a 67 per cent increased risk of mortality. However, the mortality for participants with diabetes combined with frequent sleep problems was increased to 87 per cent. In order words, it is particularly important for doctors treating people with diabetes to also investigate sleep disorders and consider treatments where appropriate.”
Eating a diet rich in fruit and vegetables is associated with less stress, according to new research from Edith Cowan University (ECU).
The study examined the link between fruit and vegetable intake and stress levels of more than 8,600 Australians aged between 25 and 91 participating in the Australian Diabetes, Obesity and Lifestyle (AusDiab) Study from Baker Heart and Diabetes Institute.
The findings revealed people who ate at least 470 grams of fruit and vegetables daily had 10 per cent lower stress levels than those who consumed less than 230 grams. The World Health Organization (WHO) recommends eating at least 400 grams of fruit and vegetables per day.
Diabetic ketoacidosis (DKA), a serious but common complication of type 1 diabetes, is linked to lower IQ scores and worse memory in children with type 1 diabetes, according to a study led by UC Davis Health researchers. The study published Sept. 22 in Diabetes Care is also the first large-scale work to differentiate between DKA’s impact on children with a new diagnosis and children with a previous diagnosis of type 1 diabetes.
DKA happens when diabetes goes undiagnosed or is poorly managed. With DKA, blood sugar gets very high as acidic substances called ketones build up to dangerous levels in the body. Early signs of DKA include excessive thirst, frequent urination, and nausea, abdominal pain, weakness and confusion.
A new study, which involved participants eating pizza well after feeling ‘full’ in order to test what immediate effects this had on the body, finds that our metabolism is surprisingly good at coping with over-indulgence.
Researchers with the Centre for Nutrition, Exercise and Metabolism at the University of Bath compared the effects of normal eating (i.e. ‘eat until you are comfortably full’) with maximal eating (i.e. ‘eat until you cannot manage another bite’).
They found that the young, healthy men (aged 22 – 37) who volunteered for the trial consumed almost twice as much pizza when pushing beyond their usual limits, doubling their calorie intake, yet, remarkably, managed to keep the amount of nutrients in the bloodstream within normal range.
With more than 30 million Americans diagnosed with diabetes, and another 87 million diagnosed with obesity, both conditions have become national epidemics.
The two diseases cause a number of complications, including neuropathy, which causes damage to the peripheral nerves. Neuropathy is characterized by numbness or tingling and can sometimes be accompanied by pain.
Brian Callaghan, M.D., the Fovette E. Dush associate professor of neurology, has sounded an alarm through his recent clinical research, which has demonstrated that, in addition to peripheral nerve damage, diabetes and obesity can also cause cognitive dysfunction, effecting thinking, reasoning or memory.
Here, Callaghan discusses his latest work and ways to identify and treat the condition:
Breathing dirty air takes a heavy toll on gut bacteria, boosting risk of obesity, diabetes, gastrointestinal disorders and other chronic illnesses, new University of Colorado Boulder (CU) research suggests.
The study, published online in the journal Environment International, is the first to link air pollution to changes in the structure and function of the human gut microbiome—the collection of trillions of microorganisms residing within us.
The gaseous pollutant ozone, which helps make up Denver’s infamous “brown cloud”—is particularly hazardous, the study found, with young adults exposed to higher levels of ozone showing less microbial diversity and more of certain species associated with obesity and disease.
“We know from previous research that air pollutants can have a whole host of adverse health effects,” said senior author Tanya Alderete, an assistant professor of integrative physiology, pointing to studies linking smog with Type 2 diabetes, weight gain and inflammatory bowel diseases. “The takeaway from this paper is that some of those effects might be due to changes in the gut.”
Eat less; move more; live longer remains the mantra of this blog. Following is a super discussion of the relationship between body weight and heart health from Tufts Health & Nutrition Letter.
Excess body weight increases risk for cardiovascular disease (CVD), as well as type 2 diabetes, certain cancers, and many other illnesses. However, not everyone who is overweight or obese develops these illnesses; and simply having a “normal” body weight or body mass index (BMI)-a measure of body weight relative to height-is no guarantee of low risk. “The relationship between BMI and risk for CVD and death is complex,” says Edward Saltzman, MD, academic dean for education at Tufts’ Friedman School of Nutrition Science and Policy. “Elevated BMI does increase CVD risk, but risk is also impacted by things like body-fat percentage, waist circumference, age, duration of obesity, race, ethnicity, gender, and other genetic factors,” as well as lifestyle elements such as smoking and level of physical activity. Continue reading
Herewith another entry in our arsenal against that destroyer of lives – Alzheimer’s Disease, from the Tufts Health & Nutrition Letter.
Alzheimer’s disease accounts for 60 to 80 percent of the loss of memory and other cognitive abilities collectively known as dementia. There is no known food or diet that can prevent or cure Alzheimer’s dementia, but diet may help delay onset and slow progression.
What sets Alzheimer’s apart from other forms of dementia is the excessive buildup of beta-amyloid protein fragments into plaques, as well as defective tau proteins that form tangles in the brain. These changes lead to the death of the nerve cells responsible for everything from memory to movement. There are currently no known dietary factors that can impact the formation of these plaques and tangles, but diet may act in other ways to influence Alzheimer’s and other forms of dementia.
Truth be told I never heard of Lion’s mane mushrooms before today. However, this article in Medical News Today piqued my curiosity. I would like to hear from any readers who may have had experience with the mushrooms in one form or another.
Lion’s mane mushrooms (Hericium erinaceus) are white, globe-shaped fungi that have long, shaggy spines. People can eat them or take them in the form of supplements. Research suggests that they may offer a range of health benefits, including reduced inflammation and improved cognitive and heart health. Continue reading
New University of California Riverside research shows soybean oil not only leads to obesity and diabetes, but could also affect neurological conditions like autism, Alzheimer’s disease, anxiety, and depression.
Used for fast food frying, added to packaged foods, and fed to livestock, soybean oil is by far the most widely produced and consumed edible oil in the U.S., according to the U.S. Department of Agriculture. In all likelihood, it is not healthy for humans.
It certainly is not good for mice. The new study, published this month in the journal Endocrinology, compared mice fed three different diets high in fat: soybean oil, soybean oil modified to be low in linoleic acid, and coconut oil. Continue reading
The study involved a group of people from Tyneside who previously had Type 2 diabetes but had lost weight and successfully reversed the condition as part of the DiRECT trial, which was funded by Diabetes UK and led by Professors Roy Taylor and Mike Lean (Glasgow University).
The majority remained non-diabetic for the rest of the two year study, however, a small group went on to re-gain the weight and re-developed Type 2 diabetes.
Professor Roy Taylor, from the Newcastle University Institute of Translational and Clinical Research, explained what the advanced scanning techniques and blood monitoring revealed.
He said: “We saw that when a person accumulates too much fat, which should be stored under the skin, then it has to go elsewhere in the body. The amount that can be stored under the skin varies from person to person, indicating a ‘personal fat threshold’ above which fat can cause mischief.
I count myself as one of those confused about whether and to what extent eggs are a healthy addition to my diet. Love the protein, not so thrilled with the fats… Here is what the Tufts Health & Nutrition Letter has to say about it.
Exercise appears to be a tree that bears rich fruit. Indeed, it even benefits unborn children according to this study.
Men who want to have children in the near future should consider hitting the gym.
In a new study led by Kristin Stanford, a physiology and cell biology researcher with The Ohio State University College of Medicine at the Wexner Medical Center, paternal exercise had a significant impact on the metabolic health of offspring well into their adulthood.
Laurie Goodyear of the Joslin Diabetes Center and Harvard Medical School co-led the study, published in the journal Diabetes.
“This work is an important step in learning about metabolic disease and prevention at the cellular level,” said Dr. K. Craig Kent, dean of the Ohio State College of Medicine.
Recent studies have linked development of type 2 diabetes and impaired metabolic health to the parents’ poor diet, and there is increasing evidence that fathers play an important role in obesity and metabolic programming of their offspring. Continue reading