Category Archives: Diabetes
EBOLA UPDATE: Canada to Donate Experimental Drug for Ebola Treatment
(NewPublicHealth is monitoring the public health crisis in West Africa.)
Canada announced late yesterday that it will donate 800 to 1,000 doses of its experimental Ebola vaccine for the World Health Organization (WHO) to use in West Africa. WHO declared yesterday that it was ethical to use untested drugs to combat the Ebola outbreak. "We see this as a global resource, something we need to put on the global table to say...how can we make best use of this asset? We're looking to do that as fast as we can,” said Greg Taylor, MD, deputy chief public health officer of the Public Health Agency of Canada, according to Reuters. Read more on Ebola.
CDC: 40 Percent of Americans Will Develop Diabetes
An estimated 40 percent of Americans will develop diabetes at some point in their lives, according to a new study in The Lancet Diabetes & Endocrinology. Researchers from the U.S. Centers for Disease Control and Prevention analyzed data on 598,216 adults from 1985 to 2011, finding that the increase in the diagnosis of diabetes and overall declining mortality means that people are also living longer with diabetes; years spent with diabetes increased by 156 percent in men and 70 percent in women. Researchers said the findings demonstrate a need for effective interventions to reduce the incidence of diabetes. Read more on diabetes.
FDA Approves Device that Could Increase the Number of Transplantable Lungs
The U.S. Food and Drug Administration (FDA) has approved a new device to preserve donated lungs that do not initially meet the standards for transplantation, but that might be transplantable given more time to evaluate their viability. Only approximately one in five donated lungs meet transplantation criteria. There were 1,754 lung transplants in the United States in 2012, with 1,616 potential patients remaining on the recipient list at the end of the year. “This innovative device addresses a critical public health need,” said Christy Foreman, director of the Office of Device Evaluation at the FDA’s Center for Devices and Radiological Health. “With this approval, there may be more lungs available for transplant, which could allow more people with end stage lung disease who have exhausted all other treatment options to be able to receive a lung transplant.” Read more on technology.
FDA: Pregnant Women Should Eat More Fish Lower in Mercury
Pregnant women should be eating more fish that is lower in mercury, according to new draft advice from the U.S. Food and Drug Administration (FDA) and the U.S. Environmental Protection Agency (EPA). According to the FDA, pregnant women should eat 8-12 ounces (2-3 servings) per week of fish that are lower in mercury to support fetal growth and development. “For years many women have limited or avoided eating fish during pregnancy or feeding fish to their young children,” said Stephen Ostroff, MD, the FDA’s acting chief scientist. “But emerging science now tells us that limiting or avoiding fish during pregnancy and early childhood can mean missing out on important nutrients that can have a positive impact on growth and development as well as on general health.” The draft advice also includes new guidelines for breastfeeding women, those who might become pregnant and young children. Read more on maternal and infant health.
Study: Direct, Indirect Costs of Autism are Substantial
It costs an average of $2.4 million to support a person with an autism spectrum disorder (ASD) and an intellectual disability throughout the course of their life in the United States and $1.4 million to support someone with an ASD but without an intellectual disability, according to a new study in the journal JAMA Pediatrics. With children, the largest contributors to that total are special education services and parental productivity loss. For adults, the largest contributors are residential care or supportive living accommodation and individual productivity loss; adult medical costs are also much higher. According to the researchers, these substantial direct and indirect economic effects illustrate the need to develop more effective interventions to alleviate the strain on families. Read more on pediatrics.
CDC: 29M People in the U.S. have Diabetes—and One in Four Don’t Realize It
More than 29 million people in the United States have diabetes—and one in four don’t even realize it, according to the U.S. Centers for Disease Control and Prevention (CDC). The total estimate is up from 26 million in 2010. According to the CDC, one in three U.S. adults (86 million) have prediabetes, meaning their sugar levels are high, but not high enough to be classified as type 2 diabetes; an estimated 15-30 percent of these people will develop type 2 diabetes within 5 years unless they lose weight and increase their physical activity. “These new numbers are alarming and underscore the need for an increased focus on reducing the burden of diabetes in our country,” said Ann Albright, PhD, RD, director of CDC’s Division of Diabetes Translation. “Diabetes is costly in both human and economic terms. It’s urgent that we take swift action to effectively treat and prevent this serious disease.” Read more on diabetes.
Study: Banning Chocolate Milk in Elementary Schools Also Decreases Overall Sales, Increases Waste
Banning chocolate milk in 11 Oregon elementary schools and replacing it with healthier fat-free white milk had the unintended consequence of reducing milk consumption overall, according to a recent study in the journal PLOS One. The study determined that the chocolate milk ban led to a 10 percent overall drop in milk sales; a 29 percent increase in the amount of wasted milk; drops in calcium and protein intake; and a 7 percent decrease in the number of students taking part in the Eugene School District's lunch program. "Given that the role of the federal school meal program is to provide nutritious meals to students who may otherwise have no access to healthy foods, I wouldn't recommend banning flavored milk unless you have a comprehensive plan in place to compensate for the lost nutrients when kids stop drinking milk altogether,” said Nicole Zammit, former assistant director of nutrition services at the Eugene School District in Oregon, in a Cornell University news release. The study was conducted by the Cornell Food and Brand Lab. Read more on nutrition.
CDC: Significant Drops in Five Major Diabetes-related Complications
The last two decades has seen declines in five major diabetes-related complications, according to a new study in the New England Journal of Medicine. Researchers at the U.S. Centers for Disease Control and Prevention (CDC) found declining rates of lower-limb amputation (about 50 percent), end-stage kidney failure (about 30 percent, heart attack (more than 60 percent) , stroke (about 50 percent) and deaths due to high blood sugar (more than 60 percent). “These findings show that we have come a long way in preventing complications and improving quality of life for people with diabetes,” said Edward Gregg, Ph.D., a senior epidemiologist in CDC’s Division of Diabetes Translation and lead author of the study. “While the declines in complications are good news, they are still high and will stay with us unless we can make substantial progress in preventing type 2 diabetes.” A recent study determined that approximately one in 10 U.S. adults have either type 1 or type 2 diabetes. Read more on diabetes.
FDA Sees Rising Number of Cases of Injuries Linked to E-cigarettes
The rising use of e-cigarettes has been accompanied by a rising number of injury complaints linked to e-cigarettes, including burns, nicotine toxicity, respiratory problems and cardiovascular problems, according to new data. From March 2013 to March 2014 there were more than 50 such complaints filed with the U.S. Food and Drug Administration (FDA), roughly the total reported over the previous five years. The findings come as the FDA prepares to regulate e-cigarettes and other "vaping" devices for the first time. Read more on injury prevention.
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.