DIABETES WATCH

Are Diabetes and Alzheimer?s Disease Connected?

Patients with diabetes may need to worry about developing mild cognitive impairment (MCI)?a condition that is often seen as a precursor to Alzheimer?s disease. The study included 918 men and women older than 65 with no MCI or dementia at the study?s onset.

The patients were assessed every 18 months with an in-person interview and physical and neurologic examinations. Of the participants, 23.9% had diabetes, 68.2% had high blood pressure, 33.9% had heart disease, and 15% had had a stroke. During follow-up, 334 of the participants developed MCI. The patients with diabetes faced a higher risk of MCI. Overall, 8.8% of the cases of MCI could be attributed to diabetes. Reporting in the Archives of Neurology (April 9, 2007), the researchers said that diabetes could add to plaque buildup in the brain, a characteristic of Alzheimer?s disease. They noted that more research is needed.

Type 1 Diabetes Treatment Is Improving

Children and adolescents? routine use of frequent blood glucose monitoring, new insulin formulations, more frequent insulin injections, or the use of insulin pump therapy is helping to improve their type 1 diabetes.

The researchers formed their conclusions after following 299 children with diabetes for 2 years. The findings for these patients, who were enrolled in 1997, were then compared with those of another 152 children who were enrolled in 2002 and also followed for 2 years. In addition to improved control of blood glucose levels, the participants in the more recent group were nearly 50% less likely to experience dramatic dips in blood glucose, compared with the earlier group. Furthermore, the more recent group had 25% fewer trips to the emergency department. (The findings were reported in the Journal of Pediatrics, March 2007.)

Watch for Low Testosterone, Finds Diabetes Study

Obese men with type 2 diabetes often have low levels of testosterone, putting them at risk for sexual dysfunction, according to a study reported in Diabetes Care (April 2007). For the study, 355 men older than age 30 with type 2 diabetes were screened. The researchers determined that 17% had low testosterone, and 25% had borderline low testosterone levels.

The findings indicated that erectile dysfunction was the primary symptom. The marker was found in >70% of men with diabetes with low testosterone levels, followed by low sex drive (63%). The researchers indicated that testosterone therapy also may result in improvements in insulin resistance, blood glucose control, cholesterol levels, and weight loss in men with reduced testosterone.

Diabetes Raises Hip Fracture Risk

Seniors with diabetes are more prone to hip fractures, compared with older individuals without the disease. The study was based on a comparison of hip fracture rates among 197,412 Ontario residents at least 66 years old with diabetes with rates among 401,400 patients of similar age without diabetes.

Over a period of 6 years, the researchers found a total of 22,267 hip fractures. The investigators noted that having diabetes considerably raised the risk of hip fracture in both men and women. Patients with type 2 diabetes have higher bone mineral density, and therefore healthier bones, possibly due to excess weight. ?However, they may still be at increased risk for hip fractures,? the researchers warned in Diabetes Care (April 2007).

Heart Disease Jumps in Diabetes Patients

Heart disease associated with diabetes is rising, according to a study reported in the March 27, 2007, issue of Circulation. The study examined data on 9540 individuals aged 45 to 64 who participated in the Framingham Heart Study.

The researchers used the data to compare risk factors for heart disease and cardiovascular events from 1952 to 1974 and from 1975 to 1998. The findings indicated that the risk for heart disease attributable to type 2 diabetes was 5.2% between 1952 and 1974 but rose to 7.8% between 1975 and 1998. The risk was greater in men with diabetes. The researchers also found that the rate of diabetes among patients with heart disease almost doubled between the time periods.