Category Archives: Diabetes
Almost everything touches public health. From understanding care options to access to nutritious food to being able to breathe clean air—it all works together to prevent disease and promote healthy living. That includes the types of available transportation.
>>View NewPublicHealth’s infographic exploring the role of transportation in the health of our communities, “Better Transportation Options = Healthier Lives.”
The Transportation Research Board Subcommittee on Health and Transportation (H+T) was formed in the Summer of 2011 to provide a variety of disciplines the opportunity to share and compare transportation-related health research in an academic environment. It’s a place where engineers, public health professionals, planners, epidemiologists, advocates and others can identify, advance and publish research that advances our understanding of transportation infrastructure and policies affect public health. [Editor’s Note: Read NewPublicHealth’s coverage of last year’s Transportation Research Board conference.]
The H+T Subcommittee’s areas of interest and study include sustainable and active transportation modes (e.g., walking, biking, transit); mobility and accessibility; safety; transportation-related air pollution and noise impacts; and social cohesion and other social, physical and mental health impacts.
State and local government across the country are already utilizing engineering and design solutions to improve public health in their communities, according to The Network for Public Health Law, which provides information and technical assistance on issues related to public health and is funded by the Robert Wood Johnson Foundation.
“In Massachusetts and Minnesota, transportation officials are exploring infrastructures that allow for ‘active transportation’—like walking and bicycling—which can help prevent weight gain and lower the risks of obesity, diabetes and heart disease. In Washington and California, programs are incorporating transit-oriented development strategies to improve environmental health and access to healthy foods.”
>>Read more on how transportation can impact health.
HHS Launches HealthCare.gov to Help Americans Prepare for New Coverage Opportunities
The U.S. Department of Health and Human Services (HHS) has launched the new HealthCare.gov to help Americans prepare for new coverage opportunities through the Affordable Care Act. Open enrollment in the Health Insurance Marketplace begins in just a few months, on October 1. The website (also available in Spanish) includes social media integration, sharable content and engagement destinations, and will later incorporate web chat functionality. “The new website and toll-free number have a simple mission: to make sure every American who needs health coverage has the information they need to make choices that are right for themselves and their families—or their businesses,” said HHS Secretary Kathleen Sebelius. Read more on access to health care.
USPSTF Recommends Hep C Screenings for All ‘Baby Boomers’
All “Baby Boomers”—Americans born between 1945 and 1965—should be screened for hepatitis C, according to new final recommendations from the U.S. Preventive Services Task Force (USPSTF). Earlier recommendations in November had only suggested that doctors consider screening. The new recommendations appear in the Annals of Internal Medicine. Researchers concluded that even the “moderate” net benefit made screening worthwhile; they also recommended screening for people at higher risk, such as injection drug users. "New evidence came out since the draft recommendation, which gave us greater confidence in the linkage between a sustained viral response and important outcomes," said Albert Siu, MD, co-vice chair of the task force, to Reuters. The majority of the 3 million Americans who have hepatitis C are Baby Boomers, according to the U.S. Centers for Disease Control and Prevention. Read more on aging.
Study: Diet, Exercise Don’t Decrease Heart Health Risk for People with Diabetes
While the weight loss associated with diet and exercise does not necessarily improve heart health for people with type 2 diabetes, the positive lifestyle changes can decrease the chances of kidney failure and eye damage, according to a new study in the New England Journal of Medicine. "Intensive lifestyle intervention reduced the risk of chronic kidney disease by 31 percent," said study author Rena Wing. "So we had a very, very marked effect on the development of high-risk chronic kidney disease. We also showed a benefit in terms of self-reported eye disease." Researchers said one possibility for the lack of heart health improvement was the relatively small weight losses of both of the study groups—the one that incorporated exercise, and the one that did not. Frank Sacks, MD a professor of cardiovascular disease prevention at the Harvard School of Public Health who saw the study but did not participate, said he believed it was “stopped too soon,” which affected the results. Read more on diabetes and heart health.
New funding by the National Institutes of Health (NIH) is aimed at improving treatment for bacterial infections, treating alcohol dependence and determining effective drugs for long-term diabetes treatment.
- Antibiotic Resistance: Duke University has been awarded $2 million by the NIH for a clinical research network focused on antibacterial resistance. Funding could rise to close to $70 million by 2019. According to the NIH, bacterial infections resistant to antibiotic drugs were first reported more than 60 years ago and since then have become more common in both health care and community settings. In some cases, no effective antibiotics exist. The funding will be used to conduct clinical trials on new drugs, optimizing use of existing ones; testing diagnostics and conducting research on best practices for infection control.
- Alcohol Dependence: A new study funded by the NIH and published in the Journal of Addiction Medicine finds that the smoking-cessation drug varenicline (brand name Chantix), significantly reduced alcohol consumption and craving among people who are alcohol-dependent. “Current medications for alcohol dependence are effective for some, but not all, patients. New medications are needed to provide effective therapy to a broader spectrum of alcohol dependent individuals,” said says Kenneth R. Warren, PhD, acting director of the National Institute on Alcohol Abuse and Alcoholism, part of NIH. Participants who took varenicline, compared with those taking a placebo, decreased their heavy drinking days per week by nearly 22 percent.
- Diabetes: The NIH is currently recruiting volunteers for a study to compare the long-term benefits and risks of four widely used diabetes drugs in combination with metformin, the most common first-line medication for treating type 2 diabetes. The study is important because if doctors find that metformin is not effective enough to help manage type 2 diabetes, they often add another drug to lower blood glucose levels. However, there have been no long-term studies on which of the add-on drugs are most effective and have fewest side effects. The study will compare drug effects on glucose levels, adverse effects, diabetes complications and quality of life over an average of nearly five years and will enroll about 5,000 patients at 37 study sites.
Legislation Would Dramatically Expand FDA’s Oversight of Compounding Pharmacies
New legislation proposed from Representative Edward Markey of Massachusetts would give the U.S. Food and Drug Administration (FDA) authority over compounding pharmacies that make and ship over state lines sterile and non-sterile products. This would be more significant than a bill recently approved by a Senate committee, which would give FDA authority only over sterile products, leaving states with the authority over non-sterile products. This has left some concerned that states would be overtaxed by the effort. “State pharmacy regulators vary widely in their ability to oversee large-scale non-traditional compounding," wrote the Pew Charitable Trusts in comments to the Senate health committee that drafted the legislation, according to Reuters. The calls for increased oversight come in response to a 2012 meningitis outbreak which killed 53 people and was linked to steroids produced by the Framingham, Massachusetts-based New England Compounding Center. Read more on infectious diseases.
Study: Diners Dramatically Underestimate Calories in Fast Food
Diners at fast food restaurants dramatically underestimate their caloric intake, according to a new study in BMJ. "Teens underestimate the number of calories in their meals by as much as 34 percent, parents of school-age children by as much as 23 percent, and adults by as much as 20 percent," study Jason Block, MD, in a release from the Robert Wood Johnson Foundation. Researchers found that the average adult meal was 836 calories—but they thought, on average, it was 175 fewer calories. As many as 1 in 4 of the people surveyed missed the mark by at least 500 calories. "These findings tell us that many people who eat at fast-food restaurants may not be making informed choices because they don't know how many calories they're consuming," Block said. "Having the information is an important first step for anyone wanting to make changes." Read more on nutrition.
FDA Approves Marketing of A1c Test for Diabetes
The U.S. Food and Drug Administration is for the first time allowing the marketing of an HbA1c (or A1c) test for the diagnosis of diabetes. A1c tests measure the percentage of hemoglobin A1c bound the glucose; people with diabetes are unable to properly convert glucose. Nearly 26 million Americans are estimated to have diabetes, which untreated can lead to heart disease, stroke and other serious medical conditions. “Providing health care professionals with another tool to identify undiagnosed cases of diabetes should help them provide patients appropriate guidance on treatment before problems develop,” said Alberto Gutierrez, PhD, director of the Office of In Vitro Diagnostics and Radiological Devices at FDA’s Center for Devices and Radiological Health. Read more on diabetes.
Study: Single Can of Sugary Soda Can Increase Diabetes Risk 22 Percent
Drinking even a single 12-ounce can of sugary soda once a day can up the risk of diabetes by 22 percent, according to a new study out of Imperial College London. Researchers looked at the data of approximately 350,000 European residents. "Given the increase in sweet beverage consumption in Europe, clear messages on the unhealthy effect of these drinks should be given to the population," said study leader Dora Romaguera, according to Reuters. Previous studies have also shown a link between sugary drinks and increased risk of obesity and type 2 diabetes, which affects approximately 310 million people, according to the World Health Organization. Read more on diabetes.
Teen Years in the ‘Stroke Belt’ Ups Risk of Stroke Later in Life
Growing up as a teenager in the U.S. “stroke belt”—an area in the country’s southeast—can increase the risk of stroke later in life by as much as 17 percent, according to a new study in the journal Neurology. Risk factors including high blood pressure and diabetes are only partially responsible for the increase risk. "Many social and behavioral risk factors, such as smoking, are set in place during the teenage years, and teens are more exposed to external influences and gain the knowledge to challenge or reaffirm their childhood habits and lifestyle," said study author Virginia Howard, with the School of Public Health at the University of Alabama at Birmingham, in a release. Across all age groups the risk was double for black Americans when compared to white Americans. Researchers were careful to note that the findings do not demonstration causation. Read more on strokes.
Poultry Probably Source of China’s New Bird Flu Strain
Researchers believe that poultry-to-human transmission from “wet” markets is likely responsible for the new H7N9 bird flu strain that has killed 22 people in China and infected more than 100. Wet markets sell and immediately slaughter poultry. So far the strain does not seem to pass easily between people, so the researchers feel relatively confident that closing the markets and slaughtering the birds will control the outbreak. “Overall, the evidence, in terms of epidemiology and virology, suggests that it is a pure poultry to human transmission, and that controlling [the epidemic in humans] will therefore depend on controlling the epidemic in poultry,” said Kwok-Yung Yuen of the University of Hong Kong, according to MSNBC. The findings were published in the journal Lancet. Read more on infectious disease.
Excess Weight More Harmful to Minority Children with Asthma
Excess weight has a greater negative impact on Hispanic and African-American children with asthma than it does on Caucasian children with asthma, according to a new report in the Journal of Asthma. The added weight impedes lung function. Hispanic and African-American children also experience higher rates of asthma than do Caucasian children. Deepa Rastogi, MD, MS, senior author and attending physician in the Division of Respiratory and Sleep Medicine, The Children's Hospital at Montefiore, said this information can help physicians identify and treat asthma early. “Physicians might want to measure the degree of airway obstruction in Hispanic and African-American children who are both overweight or obese and asthmatic. Early identification of a drop in lung function can assist in better patient management.” Read more on obesity.
Study: 30 Percent of Chemo Drugs Used Off-label
Approximately one-third of chemotherapy drugs are used to combat cancers for which they were not approved, according to a new study in the Journal of Clinical Oncology. "The main criticism of off-label prescribing has been the concern that it jeopardizes patient safety because the full risk-benefit ratio is often not completely understood," said Monika Krzyzanowska, MD, MPH, of the University of Toronto. Still, lead researcher Rena Conti, an assistant professor of health policy and economics at the University of Chicago, said they cannot determine the effectiveness of the off-label treatments, according to Reuters. "We don't know what the outcomes are. We can't make a judgment of whether the off-label use we document… is appropriate or inappropriate." Read more on cancer.
Poll: One in Eight American Adults has Type 2 Diabetes
One in eight American adults—or 29 million people—suffer from type 2 diabetes, according to a Harris Interactive/HealthDay poll. The poll also found that one in three have a parent, sibling, spouse or child with diabetes. Despite those high numbers, only 21 percent of the people polled think of themselves as “well-versed” on the chronic condition, according to HealthDay. "Diabetes is very insidious,” said Ronald Tamler, MD, clinical director of the Mount Sinai Diabetes Center in New York City. “You don't know you're in trouble until the complications hit or until it's so out of control you have uncontrolled urination and thirst." Read more on diabetes.
Study: IVF Does Not Affect Risk of Breast, Gynecological Cancers
In vitro fertilization (IVF) does not increase a woman’s risk of breast and gynecological cancers, according to a new study in the journal Fertility & Sterility. Researchers looked at the medical records of 67,608 women who underwent IVF between 1994 and 2011 and 19,795 women who sought treatment, did not receive it. They found no increase in the chance of being diagnosed with breast or endometrial cancer and only a slight increase in ovarian cancer depending on the times treated, which might have been the result of chance. Previous studies had linked IVF to increased risk of breast cancer and borderline ovarian tumors. Read more on cancer.
Studies Link Excessive Television as Kids, Violence as Adults
Reducing the amount of violent television programming a child watches may also reduce their aggression levels, according to two new studies in the journal Pediatrics. A New Zealand study found higher rates of criminal convictions in people who had watched more television as children, while a U.S. study found kids who watched “pro-social” programming were better behaved than their peers who watched regular programming. "It's not just the bad behaviors that they get from TV. They can get good behaviors, too," said the U.S. study's lead author, Dimitri Christakis, MD, MPH, director of the Center for Child Health, Behavior and Development at Seattle Children's Research Institute. The link between television and violence has been difficult for researchers to study because of the presence of so many other factors, but the findings do support previous research showing a link between watching too much television early in life and antisocial problems, according to study co-author Bob Hancox, MD, an associate professor in the department of preventive and social medicine at the University of Otago in Dunedin. Read more on violence.
NIH: Diabetes Control Much Improved in Past Two Decades
People are increasingly meeting the recommended goals for the top markers of diabetes control, according to a new study in the journal Diabetes Care. The "ABC's" of diabetes control include A1C (which assesses blood sugar levels), blood pressure and cholesterol. About 19 percent of people with diabetes met all three of the goals in 2010, up from only 2 percent in 1988. The National Institutes of Health and the U.S. Centers for Disease Control and Prevention conducted and funded the study. Still, the researchers say continued improvement is needed, especially for younger people and certain minority groups. Read more on diabetes.
FDA Approves Three New Type 2 Diabetes Treatments
The U.S. Food and Drug Administration (FDA) has approved three new drugs for the treatment of type 2 diabetes. Nesina tablets, Kazano tablets and Oseni tablets are all used to control blood sugar. Alogliptin is a new active ingredient that “helps stimulate the release of insulin after a meal, which leads to better blood sugar control,” said Mary Parks, MD, director of the Division of Metabolism and Endocrinology Products in the FDA’s Center for Drug Evaluation and Research, in a release. The American Academy of Pediatrics has also released its first ever guidelines for treating type 2 diabetes in kids ages 10 to 18. Read more on diabetes.
Study: Car Commuters Gain More Weight than People Who Use Other Transportation
People who commute to work by car gain more weight than their cohorts who use other forms of transportation, according to a new study in the American Journal of Preventive Medicine. Researchers compared car commuters to those who took trains, buses and bikes, finding the car drivers put on an average of four pounds over four years, as compared to three pounds for the other commuters. The only people in the study who did not gain weight were those who exercised enough weekly and never drove to work. Lawrence Frank of the School of Community and Regional Planning at the University of British Columbia in Vancouver, Canada, said a possible explanation for the results for car drivers is “[p]eople who have longer commutes tend to purchase a lot of their food and run a lot of errands on their way to and from work,” according to Reuters. Read more on obesity.
TV Alcohol Ads May Increase Risk of Alcohol-related Problems for Kids
Watching alcohol ads on television may increase the chance of young kids having alcohol-related problems, but teaching kids about the realities of alcohol and the effects of persuasive messages in the media can help reduce the effects, according to a new study in the journal Pediatrics. "This study provides evidence that exposure to alcohol advertising in seventh grade and liking those alcohol advertisements on television is associated with higher levels of drinking in the eighth and ninth grades," said lead researcher Jerry Grenard, an associate professor in the School of Community and Global Health at Claremont Graduate University in California, in a release. "Examples of problems include failing to do homework, attending school drunk, passing out and getting into fights.” Researchers said the policymakers and the alcohol industry should work together to limit youth exposure. Read more on substance abuse.
Study Links Diabetes, Rise in Severe Vision Problems
Diabetes may be responsible for a significant increase in serious vision problems in U.S. adults, according to a new study in the Journal of the American Medical Association. From 1999 to 2008, the rate of severe problems climbed 21 percent for adults ages 20 and older. "There has been a change on two fronts during the last seven to 10 years. One is that visual impairment is increasing, and this is visual impairment that can't be fixed with glasses. The other is that 20- to 39-year-olds are now losing vision as well," said Fang Ko, MD, an study author, ophthalmologist and resident at the Wilmer Eye Institute at Johns Hopkins University School of Medicine in Baltimore. There were other contributing factors, but researchers identified diabetes as a consistent contributor. While diabetes has become more manageable, the study’s findings demonstrate the need for people to be more away about the risk factors that can lead to the disease. Read more on diabetes.
Americans Living Longer, But Not Always Healthier
While Americans are living longer on average, chronic diseases mean that those extended lives are not always healthier, according to the United Health Foundation's 2012 America's Health Rankings. In 2009, the American life expectancy was 78.5 years. "As a nation, we've made extraordinary gains in longevity over the past decades, but as individuals we are regressing in our health," said Reed Tuckson, MD, a medical adviser at the United Health Foundation and chief of medical affairs at the UnitedHealth Group. Preventable chronic conditions include diabetes, obesity and high blood pressure. Read more on aging.
Study: Junk Food Taxes Can Improve Nutrition, Health
Junk food taxes that help subsidize fruits and vegetables can help improve eating habits and overall public health, according to a new study in the journal PLoS Medicine. A price increase of as little as 1 percent would cut the consumption of fatty foods by 0.02 percent, while a 10 percent jump in the price of soda would cut consumption by as much as 24 percent. While the rates might seem relatively low, researchers believe the positive health benefits would be greater for low-income families, who are at higher risk for poor health due to inadequate nutrition. Read more on nutrition.
Study: Many Insurers Not Covering Tobacco Treatments Mandated by Affordable Care Act
Many health insurers are not providing coverage for tobacco cessation treatments mandated by the Affordable Care Act (ACA), according to a new study by the Georgetown University Health Policy Institute and commissioned by the Campaign for Tobacco-Free Kids with funding from Pfizer, Inc. Researchers found that many of the policies contained “confusing or conflicting language” that made it difficult for consumers to determine whether cessation treatments are covered by their insurance, according to a Tobacco-Free Kids release. They recommend that federal and state regulators clarify for insurers the requirements under the ACA. "Tobacco use is a leading risk factor for cancer, heart and lung disease and other serious chronic conditions,” said Matthew L. Myers, president of the Tobacco-Free Kids. “Covering effective tobacco cessation treatments is a smart way for insurers to avoid the cost of future illness, and it is the law." Read more on tobacco.
AAP: Pediatricians Should Prescribe Emergency Contraception in Advance
The American Academy of Pediatrics (AAP) is recommending that pediatricians provide advance prescriptions for emergency contraception for girls under 17, who are banned by federal law from getting the drug over the counter. This will enable them to get treatment more quickly. "It's just common sense that requiring a prescription is a barrier," said Bill Alpert, chief program officer of the National Campaign to Prevent Teen and Unplanned Pregnancy. "If an august and respected medical group like AAP is suggesting providing emergency contraception to minors is OK, that is a big deal." See more on teen pregnancy.
CDC: Number of Kids with Diabetes to Jump Dramatically by 2050
The number of American kids with type 2 diabetes could climb nearly 50 percent by 2050, according to a new research from the U.S. Centers for Disease Control and Prevention in Diabetes Care. Type 1 could increase by about 23 percent. Assuming the rates stay even, in 2050 there could be 203,000 U.S. children with type 1 and 30,000 with type 2. The numbers jump dramatically if the rate current rate increases, demonstrating the need for addressing the causes of diabetes today. "We need to think as a society that diabetes is a public health issue that must be addressed," said Robert Ratner, MD, chief scientific and medical officer for the American Diabetes Association. "In the last century, we've dealt with things like sanitation and clean water as public health issues. Well, the current epidemic of diabetes and the potential growth is a public health risk that we need to address. Even staying where we are is unsustainable." Read more on diabetes.