DIABETES WATCH

Birth Control Advice Is Urged Despite the risk of birth defects, 50% of women with diabetes do not receive counseling on birth control from their physicians.

According to researchers, an unplanned pregnancy is a concern for women with diabetes because of the health risk to their babies. If blood sugar is under control, however, the odds are better of having a problem-free pregnancy and delivery.

A study, reported in Obstetrics & Gynecology (May 2006), analyzed data on 40,304 physician visits by women aged 14 to 44 from 1997 to 2000.

The findings showed that only 4% of physician visits by women with diabetes included contraceptive discussions. Diabetic women were 58% less likely to talk about contraceptives during physician visits, compared with healthy women. with a small increase in risk.

Nonsmokers: Antioxidants May Lower Diabetes Risk

Nonsmokers have less risk of developing diabetes because of higher amounts of carotenoids in their blood, according to the results of a study reported in the American Journal of Epidemiology (May 15, 2006). Previous studies have tied smoking with low levels of carotenoids. Furthermore, in other studies, elevated levels of carotenoids have been linked to a reduced risk of diabetes. It was uncertain, however, whether the atypical smoker with a higher carotenoid level still had a decreased chance of diabetes.

The current study examined this hypothesis by analyzing data from 4493 participants, aged 18 to 30, enrolled in the Coronary Artery Risk Development in Young Adults study.The researchers concentrated on 148 cases of diabetes that arose during follow-up from 1985 to 2001. The findings suggested that rising carotenoid levels at the start of the study were connected with a decreasing chance of developing diabetes among nonsmokers. For smokers, however, this result was not observed, and high carotenoid levels were actually linked

Is Amputation Necessary?

The International Diabetes Foundation reported recently that nontraumatic amputations are happening quite frequently. Physicians, however,may be too quick to amputate, considering that 85% of the procedures may be preventable. Nontraumatic amputations are caused by arterial blockages associated with diabetes, smoking, obesity, and vascular- system problems.

Aside from the emotional and physical toll on patients, amputations are more life-threatening and more costly than revascularization, which reestablishes the blood supply. Patients with diabetes are especially at risk for nontraumatic amputations. They account for 82,000 nontraumatic lower extremity amputations (LEAs) in the United States, according to the American Diabetes Association. The Centers for Disease Control and Prevention has indicated that >60% of LEAs occur in patients with diabetes.

PDAs May Help Patients Adhere to Diet

Personal digital assistants (PDAs) may help patients with diabetes follow a lowglycemic index (GI) diet. A pilot study of 15 patients with type 2 diabetes showed improved blood glucose control after the patients were given a PDA to help them follow a low-GI diet.

During the study, the participants received nutritional counseling on low-GI eating and then used PDAs with specialized software to help document their overall GI for the day. The participants could look up the GI score for a food, and the software kept track of their meals and GI scores for the previous 30 days. After 6 months, the researchers observed that patients'glycosylated hemoglobin had lowered by 0.5%, on average. Calorie intake, body weight, and blood pressure also showed signs of decline. (The findings were published on-line in the May 17, 2006, European Journal of Clinical Nutrition.)

Blood Pressure Drugs May Up Diabetes Risk

Hypertension drugs may lead to an increased risk of developing type 2 diabetes, according to research reported in Diabetes Care (May 2006). The investigators found the link after examining data from studies that followed 3 large groups of women and men in the Nurses Health Study (NHS) I and II and the Health Professionals Follow-up Study (HPFS). The studies included 41,193 older women from NHS I; 14,151 younger women from NHS II; and 19,472 men from the HPFS. All of the participants had high blood pressure but not diabetes at the onset, and they were followed for 8, 10, and 16 years, respectively.

The researchers identified 3589 new cases of type 2 diabetes during the follow-up. The patients who faced a greater risk of developing diabetes were taking thiazidetype diuretics. In fact, the risk was increased by 20% in older women, 45% in younger women, and 36% in men, compared with patients not taking the diuretic.

Older women taking beta-blockers had a 32% higher chance of diabetes, compared with patients not taking a beta-blocker, and for men the risk was 20% higher.