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The Hottest Diabetes Research-Part 2

Posted on: Tuesday, 2 November 2004, 03:00 CST

Last month we brought you news from the American Diabetes Association's 64th Scientific Sessions in Orlando, Fla. This month we continue our coverage.

Speak Up For Your Heart-And Your Kidneys, Too!

Type 2 Diabetes is a major risk factor for cardiovascular disease and heart attack. People with type 2 diabetes have the same risk of having a heart attack as people without diabetes who already have had one. Therefore, the American Diabetes Association and other health organizations recommend that high LDL ("bad") cholesterol and high blood pressure-two major factors in the development of cardiovascular disease-be managed and treated aggressively in people with type 2.

But that's not happening.

According to researchers in the Analysis and Understanding of Diabetes and Dyslipidemia: Improving Treatment (AUDIT) study, a worldwide study of diabetes specialists in 50 countries, many diabetes care professionals still do not recognize the substantial risk diabetes poses for cardiovascular disease and therefore do not treat cholesterol as aggressively as recommended-until their patients with diabetes have already developed cardiovascular disease.

For example, the Association recommends that people with diabetes aim for an LDL level of less than 100 mg/dl. Among doctors who were surveyed, 85 percent have set that goal for their patients with type 2 who already have cardiovascular disease. But only 59 percent of the doctors surveyed have that goal for their patients with type 2 who do not have established cardiovascular disease.

But even when doctors and diabetes care professionals are aware of the need for aggressive cholesterol management, that doesn't mean their patients are achieving their LDL goals. A study by researchers in Detroit, Mich., and West Point, Pa., indicates that even though screening for cholesterol among people with type 2 is up from 37 percent to 67 percent, only 37 percent of people with diabetes actually get their LDL down to below 100 mg/dl-and that includes people who filled prescriptions for cholesterol-lowering drugs.

The news for blood pressure treatment isn't much better. In a multicenter research study, 2,458 people with type 2 diabetes received free blood pressure screenings. Of those, 1,384 people- more than half-had uncontrolled high blood pressure of at least 140/ 90 mmHg.

High blood pressure is bad news not only for the heart, but for the kidneys, too. It's a leading risk factor for kidney disease, a fact borne out by the study. Of the 1,384 people in the study who had uncontrolled high blood pressure, 860 had some form of chronic kidney disease, ranging from mild to severe.

The message? If no one on your health care team talks about your cholesterol or your blood pressure, speak up-your heart and your kidneys depend on it.

Weight And Neuropathy

Type 1 When you hear about weight and diabetes, you usually hear about type 2. But people with type 1 would be wise to control their weight as well: A study conducted by researchers in Antwerp, Belgium, indicates that neuropathy is more common in people with type 1 who are overweight than in their counterparts of normal weight.

The researchers studied 475 people with type 1. Among the participants, 240 were normal weight and 235 were overweight, with body mass indexes (BMIs) of at least 25. Researchers screened participants for neuropathy. They also noted the participants' AlCs and how long each participant had diabetes. (Having a high AlC and having diabetes for a long time are risk factors for neuropathy.)

As would be expected, participants with higher AlCs (over 8 percent) were more likely to have neuropathy. Participants who had diabetes longer were more likely to have neuropathy, as well. However, the researchers also found that 47 percent of the overweight participants had neuropathy, compared with 37 percent of the participants who weren't overweight.

The researchers concluded that although AlC and duration of diabetes are still the main indicators of neuropathy risk, being overweight may play a role in developing neuropathy as well.

ouchless blood glucose testing

Each year at the Association's Scientific Sessions, researchers present the latest information about non-invasive and pain-free blood glucose monitoring. This year, there were presentations about several devices and monitors in development. Coverage of the subject deserves its own article-one you'll find in a future issue of Diabetes Forecast.

Terri Kordella is associate editor of Diabetes Forecast.

Copyright American Diabetes Association Nov 2004

Source: Diabetes Forecast

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