Dibetes, Obesity and the Workplace

A study in the U.S. recently found that there was a big difference in the way and the amount that people who had diabetes and were also obese worked compared to those who were of lower weight and didn’t have diabetes or had controlled diabetes..

Researchers surveyed 7,338 working adults about missed work time, reduced work effectiveness and experienced 20 to 34 percent of impairment of daily activities. The results they discovered showed that people who were obese and had type 2 diabetes lost 11 to 15 percent of work time (about 5.9 hours a week) because of health problems, compared with 9 percent of work time (about 3.6 hours a week) lost by people in a lower weight range.

The survey also found that obese people with type 2 diabetes rreported difficulty and obstacles in doing daily activities such as working with children, shoppng and exercising.and experienced 20 to 34 percent of impairment of daily activities in general.. he findings are in the May/June issue of the American Journal of Health Promotion.

“From an employer’s perspective, this study provides evidence that workplace wellness programs that include weight loss and weight management would be beneficial for obese employees with or at risk for diabetes,” Kathleen Fox, president of Strategic Healthcare Solutions and a co-author of the study, said in a news release from the Center for the Advancement of Health.

The study supports previously published research that found “the heavier people are, the most lost productivity at work,” Anne Wolf, an instructor at the University of Virginia School of Medicine, who specializes in researching the economic effects of obesity, said in the news release. This study was different, she said, in that it found an independent effect of diabetes on worker productivity.

“Employers who spend money in a lifestyle intervention will find their investment returned to them in the form of increased productivity and reduced absenteeism,” Wolf said.

Possible Once-Weekly Diabetes Drug

Amylin Pharmaceuticals Inc, a well known biotechnology company whose name is related to numerous medications, has asked the Food and Drug Administration to approve its highly anticipated once-weekly injectable diabetes treatment exenatide LAR.

The drug is an extended-release version of Byetta, which is injected twice daily and is a version of a protein found in Gila monster saliva. Wall Street sees Byetta and the new extended-release version as a way for Amylin to reinvigorate sales. Byetta sales fell over 30 percent in 2008 to $430.2 million because of safety concerns.

Because the drugs are injected either twice daily (Byetta) or the new extended release version at once-weekly, this will be a positive marketing tool for the company, as many diabetics must inject themselves many more times in a day. The thought of limiting the amount of injections is good news to them.

The drug’s competition would likely include Novo Nordisk’s once-daily injection liraglutide, which is currently under FDA review. Denmark-based Novo Nordisk received a split recommendation from its expert panel review at the FDA, with members expressing safety concerns over tumors associated with liraglutide. The FDA is not required to follow its panels’ advice, though it normally does.

There are new FDA safety guidelines for diabetes treatments which were issued last year after concerns about higher risk of heart attacks from Avandia, a diabetes medication fro GlaxoSmithKline. They will be looking carefully at all the new medications for diabetes, since many are of the same class of treatment, though all of them help increase the body’s indulin production.

Developers are looking closely at drugs that help diabetics control blood sugar because the drugs must be taken long-term to control the chronic condition meaning long term and continuous sales. The U.S. market for diabetes drugs is worth about $5 billion per year.

At any rate, we can only wait and see whether individuals with diabetes will receive some relief from the new weekly injection if the FDA approves it.

Link Between Schizophrenia and Diabetes

People with schizophrenia are at increased risk for type 2 diabetes, Medical College of Georgia researchers have found. In a study of 50 people newly-diagnosed with schizophrenia or a related psychotic disorder with no other known risk factors, 16 percent had either diabetes or an abnormal rate of glucose metabolism, says Dr. Brian Kirkpatrick, vice chair of the MCG Department of Psychiatry and Health Behavior. In a similar size control group of people without schizophrenia, none had signs of or had developed the disease.

People with diabetes cannot produce or properly use insulin, a hormone that converts glucose, starches and other food into energy.

“These findings point toward there being some shared environmental factors or genetic factors between the development of schizophrenia and diabetes,” he says.

Dr. Kirkpatrick presented his findings at the International Congress on Schizophrenia Research in San Diego March 28-April 1.

Researcher have suspected for a long time that schizophrenia led to an increased risk of diabetes, Dr. Kirkpatrick says. For many years, however, there was no research available that was able to create the link.

To find out whether there was a link, he and colleagues at the University of Barcelona in Spain and the University of Maryland administered a two-hour oral glucose test to patients who had not yet been placed on anti-psychotic medication. Catching them before prescriptive treatment was important because researchers already knew that some of the most effective schizophrenia drugs also cause rapid weight gain – a risk factor for type 2 diabetes.

“We know the medicine causes problems but we wanted to know whether the disease also causes them,” he says.

Schizophrenia symptoms include memory and attention problems, hallucinations, disorganized thinking and behavior and delusions. Psychotic symptoms typically start in late adolescence and early adulthood. But researchers believe that developmental abnormalities they don’t yet know about also increase diabetes risk.

One recent study – based on data from the Clinical Antipsychotic Trials of Intervention Effectiveness Schizophrenia Trial – showed the prevalence rate of metabolic syndrome, a group of risk factors that include abdominal obesity, high lipid and cholesterol blood levels and insulin resistance, is more than 50 percent in women and about 37 percent in men with schizophrenia.

“Many people focus on the brain function part of the disease, but patients also have other medical problems that can’t be attributed to other factors,” Dr. Kirkpatrick says. “Bad things that happen in utero and at birth, such as prenatal famine and low birth weight, have both been shown to increase the risk of diabetes and schizophrenia. Problems in early development can leave a lasting impact.”

Establishing the link between the diseases may help scientists further understand the genetics of schizophrenia, he says.

“And that may eventually enable some sort of intervention strategy.”

Adapted from materials provided by Medical College of Georgia.

Mayo Clinic’s new Essential Diabetes Book

Diabetes is a life-threatening class of diseases in which the body fails to regulate sugar levels in the blood. It is one of the nation’s – and the world’s – costliest chronic illnesses. Recently, to mark the 21st Annual American Diabetes Alert Day, the Mayo Clinic, a private U.S. medical research institution, published an important new reference book on the disease.

It is a myth that eating too much sugar causes diabetes, but the disease is associated with obesity

The Mayo Clinic’s Essential Diabetes Book is a comprehensive and up-to-date manual on diabetes, intended for the general public. It sets out to educate people and to explode myths – such as the one that diabetes is caused by eating too much sugar. In fact, we learn, while diabetes is associated with obesity, its root causes are varied and complex.

“Probably the No. 1 cause of diabetes becoming so common, [as well as] pre-diabetes, is definitely our lifestyle,” says Dr. Maria Collazo-Clavell, the book’s medical editor and a specialist in the Mayo Clinic’s division of endocrinology, metabolism and diabetes.

“Most of us are heavier than we have been in the past and less active. So definitely being conscious about our eating habits, weight and activity become very important to preventing type 2 diabetes, particularly.”

One in 12 Americans has diabetes, and blacks and Hispanics have a greater risk than white Americans of developing type 2 diabetes

The new Mayo Clinic book includes sobering numbers on the scope of the disease in the United States. In addition to the 23.6 million people diagnosed with the disease – that’s I in 12 Americans – another 57 million people are pre-diabetic. This condition occurs when blood glucose levels are higher than normal, but not high enough for a type 2 diabetes diagnosis. Pre-diabetes is also dangerous because long-term damage to the heart and circulatory system might already have begun to occur.

Collazo-Clavell explains that race is also a major risk factor with this disease. Blacks and Hispanics are about one-and-a-half times more likely than white Americans to develop type 2, or adult diabetes. But she notes that type 1 diabetes, better known as juvenile diabetes, is more common among white Americans than black and Hispanic Americans.

Exercising, even for short periods of time, helps prevent diabetes

Collazo-Clavell says it can be challenging for diabetics and those at risk for the disease to eat healthful meals and exercise regularly in the midst of busy schedules. But the Mayo Clinic specialist says these are essential goals.

“Whatever physical activity someone can do, it is worth doing. What often happen is that people have so many other limitations that keep them from adhering to this perfect, beautiful 30- to 45-minute program that they are supposed to do four to five times per week. But what we learned is that short bouts of activity are just as helpful as prolonged bouts of activity.”

Collazo-Clavell also cautions people with diabetes to be diligent about their management and treatment regimens, because long-term diabetes complications can be irreversible.

“It is never too late to start caring for your health and protecting your health, but the sooner somebody does it, the better a life they will lead because they will not limit their lives. They would not have the risk of having amputation. The risk of having to go on dialysis and the risk of developing blindness will be significantly lower, so they can continue to enjoy their lives.”

Advanced medical technologies can help people better control their diabetes

Diabetics today can also benefit from advanced medical technologies, from insulin pumps to simple, relatively painless glucose monitoring.

With President Obama’s decision to allow federal funding of embryonic stem cell research, Collazo-Clavell says she is optimistic about the future of managing and curing diabetes. But she says diabetics shouldn’t expect any medical breakthroughs soon.

“Once you accomplish, for example, stem cells that can produce insulin and that are viable, often the application to a diverse population of patients becomes quite challenging. So I still feel that we have to focus on helping our patients manage their diabetes day in and day out and not wait for that cure that we have been waiting for for a long time.”

Collazo-Clavell hopes the Mayo Clinic’s new Essential Diabetes Book will be both a helpful guide for diabetics and a wake-up call to the general public about a serious and increasingly common disease.

Excerpts from article by Mohamed Elshinnawi

Online Calculator Predicts Risk of Developing Diabetes

As we have mentioned quite often, there is continuous, aggressive research around the world regarding diabetes. It seems that daily we hear about a new medication, a different type of glucose meter, a food or vitamin/herb that helps with regulating glucose, and many, many more positive tools in the fight against diabetes.

There is now another tool in that fight. British scientists have developed an online tool for predicting your risk of developing adult-onset diabetes. The researchers examined medical records of more than 2.5 million people over 15 years, excluding patients who already had diabetes or whose records were incomplete. They found nine significant risk factors: age, ethnicity, body mass index, smoking status, socioeconomic level, family history of diabetes, diagnosis of cardiovascular disease, hypertension and use of steroid drugs.

They calculated the relative importance of each of these factors, and incorporated them into a formula, or algorithm, that quite accurately predicts the 10-year risk for Type 2 diabetes.

Their study has been recently published online and there is now an interactive online version of the algorithm at www.qdscore.org. According to Dr. Julia Hippisley-Cox, the lead author, two of its features — postal code and ethnicity — were specific to Great Britain, but that the algorithm will “give you a fairly accurate notion anyway,” even without specifying those two factors.

Dr. Hippisley-Cox, who is a professor of epidemiology at Nottingham University, added that for individuals who fill out the online test and are deemed at risk, weight control or weight loss – especially through a healthy diet – and exercise are essential. “Those are the interventions that have been tested,” she said. “If you play around with the obesity measure, you can see how your risk will change if you lose weight.”

Studies in diabetes have come a long way. Looking back even a decade ago researchers could barely imagine if and when these incredible sources of assistance in the fight against diabetes would ever become realities and how long it would take. Here we are now in a time when research is snowballing, information and tools are becoming more and more available at little or no cost and researchers have actually found a way to predict whether or not you are a candidate for diabetes. The amazing insinuation with this most current finding is that if you find out in advance, there may be things that help you avoid ever getting diabetes or at least delaying the onset and minimizing the effects if you do develop the disease.

What do you think they will think of next?

Are You at Risk?

Today, on its 21st annual American Diabetes Alert Day, the American Diabetes Association wants you to take a moment to gauge your risk for having or developing type 2 diabetes with its quick-and-simple risk test. Why? Because 1 in 5 Americans is at risk for getting type 2 diabetes—in which the body fails to respond to or produce enough of the vital hormone insulin—and because roughly 25 percent of Americans living with diabetes don’t even know they have it, according to ADA statistics.

“This is one of those diseases that you really can’t ignore,” says Richard M. Bergenstal, ADA’s president-elect tfor medicine and science and a Minnesota-based endocrinologist. “You really need to realize its risk and take action.” Diabetes, especially when untreated, can harm the eyes, nerves, kidneys, and heart. Increasingly, researchers believe it may also harm the brain; studies have been examining its link with Alzheimer’s disease and cognitive decline.

Despite the fact that many Americans have heard about the factors that put them in peril of developing type 2 diabetes—such as being overweight or physically inactive, or having high blood pressure or abnormal cholesterol—many admit that they aren’t doing much to improve their odds of staying diabetes free, reveals a new ADA-commissioned Harris Interactive survey of more than 2,500 adults released today to coincide with Alert Day. About half of respondents said they eat poorly, maintain an “unhealthy weight,” and shun doctor’s visits. Strikingly, more than half of them rated “developing a chronic illness” as the worst thing that could happen to them, worse than losing their job, getting divorced, or accruing hefty financial debt. “I don’t know why there’s this gap between awareness and behavior,” says Bergenstal.

What’s more, research has indicated that people with prediabetes—that is, those not yet diabetic but who have higher-than-normal blood sugar levels—can sharply cut their risk of going on to develop type 2 diabetes if they shed some pounds, improve their diet, and do at least 150 minutes of weekly physical activity (brisk walking counts). These lifestyle changes work better than medication, according to a study that appeared in the New England Journal of Medicine in 2002. “There are things you can do to prevent getting diabetes,” or at least to delay its development, says Bergenstal. If it does progress, however, early diagnosis and treatment to stave off its consequences are best, he says: “Trying to undo complications is much harder than preventing them.”

Still, many type 2 diabetics live with the disease for years before they’re diagnosed, says Bergenstal. Some even develop complications—which typically take about five to 10 years to arise—by the time they’re diagnosed.

Pamela Brown, 59, a database designer from Joppa, Md., has no idea how long she had the disease before a free diabetes screening revealed that her blood sugar levels were alarmingly high. Prior to that diagnosis, she had attributed all her various symptoms—increased thirst, frequent urination, and sudden-onset blurred vision—to other plausible causes. She had recently stepped up her workout routine, for example, and thus was chugging much more water; a lifetime of vision problems led her to assume that it was just time for new prescription lenses.

Though diabetes does run in her family, Brown figured she wouldn’t be affected. She saw no reason to discuss her risk with her doctor. “I could have had it for five years and not known, because who checked?” she says. “It’s nothing to take for granted.” (With twice-daily insulin injections and some diet tweaks, Brown now has things under control.)

If the ADA’s test indicates that you’re at high risk for having or developing type 2 diabetes, Bergenstal advises seeing your doctor to get screened. People who have an elevated risk for type 2 diabetes include African-Americans, American Indians, Latinos, those with a family history of the disease, people older than age 45, or women who have had gestational diabetes.

Reported and quoted from USA Today

More Stem Cell Diabetes Information

Stem cells and diabetes

A woman whose son was diagnosed with type 1 diabetes almost 12 years ago has been living with the situation and she and her son have been learning together about the disease and how to care for it and stay as active and healthy as possible. Her son manages the disease quite well, but there isn’t a day that goes by that she doesn’t think ovr and over about a cure and what that would mean to him and the thousands who suffer from this disease. For this reason, I was the fact that President Barack Obama signed an executive order last week which lifts the restrictions on federal funding of embryonic stem cell research is an incredible gift that offers great hope.

There is the huge debate continuing throughout the country – and the world- regarding whether stem cell research is a good thing a bad thing, helpful, not helpful, moral, immoral and a million other things. There are many sides to this debate, but if you have a child, loved one or friend with diabetes or an endless array of diseases and disorders that could be helped by research using stem cells, most of them feel it is an essential step to take. And if you talk to most of these individuals they are not looking to take embryos that would ever have a chance of becoming a baby and using it to help their situation. They are trying to keep from wasting the thousands that are literally being tossed into the trash never to be used to help anyone. Instead of throwing these out, why not try to help people instead. It’s like throwing out food that could help thousands of starving people while they watch. Why not use the food to ease their hunger? Why not use what is available to help people with diabetes and other illness rather than throw them out?

The executive order includes a requirement that the National Institutes of Health develop and issue guidelines to ensure that this research is conducted in an ethical manner. Politics has no place in science, and with the NIH’s long history of establishing and enforcing proper guidelines governing medical research, many people are confident that the research on newly accessible stem cell lines will be held to the highest ethical standards.

Hopefully the situation will be sorted out sooner rather than later so that more people can be helped and kept alive – rather than suffer from further delays that could be the cause of many more deaths.

Watching for Diabetes Risk Fators

Most people don’t know if they are at risk for Type-2 diabetes. They don’t even know what the risks are. In fact, about 20,000 people in Vigo and the surrounding counties in Indiana and Illinois have Type-2 diabetes. About 5,000 or more of them don’t know it yet. Then there are the individuals who have what is called pre-diabetes, don’t know it and don’t know what to do about it.

Tuesday is Type 2 American Diabetes Alert Day. This is an important day for many reasons. One essential reasons is that if you and everyone in your family r circle of friends should learn as much as possible about diabetes.

“Everyone should be aware of the risk factors for Type-2 diabetes,” says the American Diabetes Association. “People who are overweight, under-active … and over the age of 45 should consider themselves at risk for the disease. African-Americans, Latinos, Native Americans and people who have a family history of the disease are at an increased risk for Type-2 diabetes.”

Unlike Type-1 diabetes, which is an autoimmune disease in which the body attacks and kills the cells that make insulin, Type-2 stems from genetics and lifestyle issues and involves insulin resistance and relative insulin deficiency. Because of this differece, type 2 diabetes can be treated and controlled in various ways.

Early diagnosis of Type-2 is important, because years of having high blood glucose puts you at risk for complications such as heart disease, blindness, kidney disease, stroke, amputation and a host of other unwelcome conditions. The problem is, you can have Type-2 diabetes for up to 10 years without knowing it. In fact, many people find out they have diabetes when complications begin to appear.

You can get a free blood-glucose test from various hospitals, medical centers, doctor’s offices and more. Check your community health calendar and call your local hospital or clinic to get information.

When you have diabetes — both Type-1 and Type-2 — a wound, even if it’s very minor, can lead to an emergency. Sustained high blood glucose can lead to decreased blood flow, causing injuries to heal more slowly. Also, many people with diabetes have nerve damage resulting in reduced sensation, particularly in their feet. Injuries — including severe ones — frequently go undetected unless you’re diligent in checking your feet daily. Even a minor injury can turn into an ulcer, which could lead to amputation.

Some symptoms of diabetes include excess thirst, increased urination, unusual tiredness, blood pressure issues and more. If you have any of these symptoms or more, see your doctor. If you have a combination of some of these symptoms, it is important to keep track of them and very important to talk to your doctor to make sure you are doing what is necessary to keep the symptoms under control in a healty and balanced way.

Some Information reprinted from Tribune Star
 

American Diabetes Association on President Obama’s Stem Cell Research Order

The debate about stem cell research has gone back and forth and back again. In the public. In the medical field. In between the President and lawmakers. And today, President Obama at least put some boundaries on the situation by signing a bill with some specifics in allowing stem cell research.The order will expand embryonic stem cell research. There are safeguards that respect the people who want to be sure that these stem cells and embryos are not misused or abused.

The American Diabetes Association applauds President Obama for issuing an Executive Order that will advance stem cell research by lifting existing restrictions on the use of embryonic stem cells, while maintaining strict ethical guidelines.

“The ethical use of stem cell research holds the promise of accelerating medical advancements in many fields. This brings hope to the nearly 24 million American adults and children with diabetes who face its many complications including heart disease, amputation, and blindness. Diabetes is also deadly — it is a leading cause of death in the United States,” said R. Paul Robertson, MD, President Medicine & Science, American Diabetes Association.

The American Diabetes Association has long been a strong advocate for ending the current restrictions on stem cell research. “As a person with type 1 diabetes, I’m encouraged by President Obama’s decisive action on advancing this very important area of research that has the potential for finding a cure for diabetes and so many other devastating diseases,” said George Huntley, CPA, Chair, American Diabetes Association.

The American Diabetes Association is leading the fight against the deadly consequences of diabetes and fighting for those affected by diabetes. The Association funds research to prevent, cure and manage diabetes; delivers services to hundreds of communities; provides objective and credible information; and gives voice to those denied their rights because of diabetes. Founded in 1940, its mission is to prevent and cure diabetes and to improve the lives of all people affected by diabetes. For more information, please call the American Diabetes Association at 1-800-DIABETES (1-800-342-2383) or visit www.diabetes.org. Information from both these sources is available in English and Spanish.

Diabetes, Obesity and Heart Disease Increase Dementia

As if Diabetes or Obesity or Heart Disease are not difficult enough to deal with alone or in combination, there are now research resuts that show the strong possibility these illnesses, especially when a person has two or more of them, increases the chances of dementia, AKA Alzheimer’s disease. Not only are the chances of contracting dementia more possible if an individual has one or all of these health issues, the dementia will develop more quickly than it would if these other diseases aren’t present.

One expert thinks that papers, published in the March issue of Neurology, deliver an important, strong message, which is that people can take steps to reduce their risk of developing dementia and Alzheimer’s disease. Since there has been little or no information available linking all these illness to dementia and Alzheimer’s, most individuals think about lifestyle factors in preventing heart disease, he says, but they do not think about losing mental abilities in addition to the other ilnesses.

It is important that this issue be front and center in talking about the fact that this may influence our risk of developing cognitive impairment and Alzheimer’s disease down the road.”

In one report, Dr. Kristine Yaffe, a professor at the University of California, San Francisco, and director of the Memory Disorders Clinic at the San Francisco Veterans Affairs Medical Center, found that among older women, obesity, high blood pressure and a low level of HDL, the “good” cholesterol — collectively labeled metabolic syndrome — were each associated with a 23 percent increase in risk for cognitive impairment.

Yaffe’s research team collected data on 4,895 women who averaged 66 years old and who had no cognitive impairment at the start of the study. Among the 497 women with metabolic syndrome, about 7 percent developed cognitive impairment, compared with 4 percent of the women without the condition.

“As the obesity and sedentary lifestyle epidemic escalates throughout the world, identification of the role of these modifiable behaviors in increasing risk for development of deleterious outcomes, such as cognitive impairment, is critical,” the authors concluded.

In a second study, Yaffe’s group found a cognitive risk for obese men, too. For that study, the researchers collected data on 3,054 older men and women.

Comparing people’s scores on tests given at the beginning of the study and again three, five and eight years later, the researchers discovered that obese men were more likely to show signs of cognitive decline. However, there was no correlation between obesity and cognitive decline among women, the study reported.

“The greatest dementia risk was found in underweight individuals at older ages,” the researchers concluded. “These findings suggest the predictive ability of BMI [body-mass index] changes across time.” They added that the findings “help explain the ‘obesity paradox’ as differences in dementia risk across time are consistent with physical changes in the trajectory toward disability.”
They found that people with higher total and LDL, or “bad,” cholesterol levels and diabetes had a more rapid cognitive decline after developing Alzheimer’s disease.

The study “provides further evidence for the role of vascular risk factors in the course of Alzheimer’s disease,” the researchers concluded. “Prevention or treatment of these conditions can potentially slow the course of Alzheimer’s disease.” Obesity, Diabetes and Heart Disease May Speed Dementia

More and more data are showing the connection between lifestyle and cognitive decline, Petersen stressed. “This series of articles underlines that,” he said. And people need to improve these lifestyle factors in middle age, he said.

“People should start paying attention now, regardless of your age or stage in life,” he said. “It may be when you are in midlife, when you are in your 40s or 50s, what you do then with respect to your lifestyle — your diet, your weight, your activity level — may have a bigger impact on what’s going to happen to you at age 70 and beyond than if you wait until you start getting a little forgetful or a little bit fuzzy.”

More information:

The U.S. National Institute of Neurological Disorders and Stroke has more on dementia.

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