DIABETES WATCH

Control Diabetes and Reduce Stroke Risk

An analysis of 50,000 stroke patients with diabetes found that manyfailed to manage their symptoms before the stroke. The patients had highrates of obesity, hypertension, cholesterol disorders, and poor control ofglucose at the time of the stroke.

The researchers found that patients with undiagnosed diabetes whenthe stroke happened had poorer control of the risk factor for diabetes,compared with patients diagnosed with diabetes prior to their stroke. Theinvestigators cautioned that stroke patients with undiagnosed diabetesface a greater risk of recurrent stroke or heart complications. The study'sdata came from the American Stroke Association's Get with theGuidelines-Stroke program. (The findings were recently reported at theAmerican Stroke Association's annual meeting.)

Study Finds Kidney Stone Link

The prevalence of kidney stones is increasing throughout theworld, and data amassed by researchers at the Mayo Clinic inRochester, Minn, hinted that diabetes may be a predisposingfactor—specifically, for kidney stones composed of uric acid.

For the study, the researchers identified all of the state'sOlmsted County residents diagnosed with kidney stonesbetween 1980 and 1999. All of the 3561 patients were matchedby age and gender with an equal number of controls. Theresearchers also studied patients diagnosed with diabetes, highblood pressure, and obesity. The findings showed that diabeteswas significantly linked with a diagnosis of kidney stones.

The researchers also took a random sample of 269 participantswith kidney stones and matched them with 260 individualswithout kidney stones. The investigators found that whenthey scrutinized the cases according to stone type, the occurrenceof diabetes was 40% among the 10 participants with uricacid stones, compared with 9% for the 112 with calcium stonesand 7% without kidney stones. After taking into account thepatients'body mass index, the patients with uric acid kidneystones had 5 times the risk for diabetes. (The findings wererecently reported in the American Journal of Kidney Disease.)

Pupil Size May Indicate ProblemsLater On

Tests of pupil function may help calculate how prone youngchildren with diabetes are to develop microvascular disease—adisease of the small blood vessels. The tests are used to indicatehow well the automatic nervous system is working.

Reporting in Diabetes Care (January 2007), Australianresearchers discovered that tiny pupil size in adolescents withtype 1 diabetes predicted weakening of the retina, or retinopathy,and also microalbuminuria, 12 years later. For the study, theresearchers analyzed data on 335 adolescents with type 1 diabeteswho had tests of cardiovascular and pupillary regulationby the autonomic nervous system in the early 1990s.

Of the patients, 137 participated in the follow-up study. Thefindings indicated that 10% of patients had had severe retinopathythat required laser therapy, 15% had moderate retinopathy,and 44% had mild retinopathy. In all, 19% had microalbuminuria.Although no relationship was found between baseline cardiovasculartests and the development of complications, theresearchers concluded that small pupil size at baseline wasindependently connected with the development of microalbuminuriaand retinopathy.

Get Off the Couch!

A study, reported in Diabetes Care (February2007), indicated that only 39% of adults with diabeteswere physically active, compared with 58%of participants without the illness. The findingswere based on data from the Medical ExpenditurePanel Survey, which included 23,000 adults. Therespondents answered questions about whetherthey participated in moderate or vigorous activity30 minutes or more at least 3 times a week. Of theparticipants that did not have diabetes but had riskfactors for it, the researchers indicated that themore risk factors the individuals had, the lesschance the individuals were to be active.

Despair Contributes to ED in Men with Diabetes

Depression symptoms represent a key factor adding to the risk of erectile dysfunction (ED) in men with type 2 diabetes. Theresearchers noted that there appears to be a vicious cycle, in which sadness may prompt the development of ED, while ED symptomsperpetuate depression symptoms. Therefore, ED in patients with diabetes is not solely related to organic factors.

During the study, the participants completed questionnaires every 6 months for 3 years. Of the patients, 500 reported ED at thestudy's onset, and an additional 192 developed the condition during follow-up. The researchers also noted a greater prevalence of high blood pressure (46% vs 32%) and lipid abnormalities (23% vs 13%). The study identified other characteristics associated with the development of ED, including longer duration of diabetes, older age, and a history of smoking. Patients with ED were more prone to be treated with insulin or diuretics. (The findings were reported in the Journal of Urology, January 2007.)