DIABETES WATCH

Breakfast Is Hardest Meal of the Day

A national online survey commissioned by Abbott Nutrition's Glucerna Cereal found that 50% of diabetes respondents reported that food designed specifically for patients with diabetes would make their breakfast routine easier. Of the 505 individuals with type 2 diabetes, 32% rated taste as the most important factor in selecting a breakfast food.

The survey further found that 63% of respondents said they often eat food lacking in flavor to help manage their condition. Approximately 49% admitted having eaten something for breakfast that they knew would spike their blood sugar because they wanted their favorite breakfast food. The survey also showed that more than 1 in 5 (21%) of those who did not eat breakfast did so because it is too hard to find foods that help manage their diabetes.

Missing breakfast can have consequences beyond hunger, according to the survey: 58% reported having less energy; 43% eat more during the rest of the day; 38% experience drops in their blood sugar level when medication is taken on an empty stomach; and 34% become cranky. Abbott Nutrition recently launched a line of food products specifically indicated for patients with diabetes.

California Law Changes Schools? Diabetes Policy

New legislation in California requires that schools have an individual who is trained to help children with diabetes. The change stems from a 2004 lawsuit filed by 4 families. The agreement sets a policy requiring children with the illness to be provided services under federal laws that guarantee equal educational opportunities for children with disabilities.

The new policy also forbids schools from barring children from performing blood-sugar testing or requiring children with diabetes to attend a certain school. Currently, Indiana, Oklahoma, and Texas have legislation that permits schools' nonmedical staff members to be trained to give insulin and help children monitor their blood-sugar levels.

Complications After Trauma Seen with Diabetes

Patients with diabetes experience more complications after a trauma injury.

This finding is based on a study of 12,489 trauma patients with diabetes treated at 27 Pennsylvania trauma centers between 1984 and 2002. The researchers compared the data with information on 12,489 patients without the disease.

The researchers found that diabetes patients required care in the intensive care unit (ICU; 38.4% vs 35.9% of patients without the illness); required a longer ICU stay (7.6 days vs 6.1 days) required a longer period of ventilator support (10.8 days vs 8.4 days); and developed more infections (11.3% vs 6.3%).

"Future studies are needed to evaluate the effect of improved glycemic [blood sugar] control on hospitalized patients with diabetes mellitus involved in trauma," wrote the researchers in the Archives of Surgery (July 2007).

Diabetes Hinders TB Treatment Response

Treatment for tuberculosis (TB) is not as effective in patients with TB and diabetes, according to the results of a study reported in Clinical Infectious Disease (August 15, 2007).

The researchers based their conclusions on a study of 737 Indonesian patients with TB who underwent screening for type 2 diabetes. The participants were then followed while getting TB therapy. Of the patients, 14.8% had diabetes. Although initially having more symptoms, the patients with diabetes had TB that was comparable in seriousness with that in the patients without diabetes.

After 2 months of treatment, however, sputum test results were likely to be positive in patients with diabetes (18.1% vs 10% in nondiabetics). At 6 months, the diabetes patients were still significantly more prone to have positive sputum test results, compared with nondiabetic patients (22.2% vs 9.5%, respectively).

Grant Supports Latino Diabetes Association

The National Association of Chain Drug Stores Foundation recently announced a $15,000 grant to support the Latino Diabetes Association (LDA) in its education and outreach program in the greater Los Angeles (Calif) area. The program could become a template for other areas of the nation to adopt.

The LDA hopes to create positive outcomes for this population group. The association's Diabetes Prevention Program is offered free to all residents of Southern California who have developed or are at risk of developing diabetes. The LDA is encouraging community pharmacies in the surrounding area to join its cause. The association plans to develop a report that will educate personnel of neighboring community pharmacies about diabetes and encourage each location to develop its own diabetes outreach program.

Lower Risk of Schizophrenia with Juvenile Diabetes

The frequency of schizophrenia in patients with type 1 diabetes is less than half of that seen in individuals without diabetes, according to the results of a study that were reported in the Archives of General Psychiatry (August 2007).

The findings were based on a nationwide study of 896,175 individuals who were born between 1950 and 1959 in Finland and who were followed from 1969 to 1991. Of the participants, 5009 had type 1 diabetes. The researchers noted that the results of previous studies appear to contradict the findings of the current study. The earlier studies had suggested a possible association between type 1 diabetes and a greater risk of schizophrenia. The findings of another study had indicated an excess chance of type 1 diabetes in close relatives of patients with schizophrenia.

The researchers concluded that additional studies of families with schizophrenia and type 1 diabetes are warranted to examine the potential of a genetic, immunologic, or infectious role in these 2 diseases.

Patient Tips to Manage Care

John Buse, MD, director of the Diabetes Care Center at the University of North Carolina, Chapel Hill, offers 5 tips:

1. Overweight patients should be screened for diabetes with a fasting glucose test, beginning at the onset of puberty and at least every 3 years. Individuals who are not overweight should start getting tested at age 45.

2. Patients with diabetes or prediabetes should engage in moderate-intensity exercise, such as a brisk walk for at least 30 minutes at least 5 days a week. Overweight patients should reduce calories with a goal of losing at least 5% of body weight.

3. Patients with diabetes should have an A1C test, which measures glucose levels, at least twice a year, as well as regular blood pressure checks and yearly cholesterol checks.

4. Patients with diabetes should have annual checkups for complications, including a dilated eye examination, a measurement of the urine microalbumin-to-creatinine ratio, and a comprehensive foot examination.

5. Patients with diabetes should work with their health care team to try to control their diabetes, its related disorders, and its complications.

Study Finds Gestational Diabetes and Cancer Correlation

A study of 37,926 women found that gestational diabetes may be linked with a significant increased risk for pancreatic cancer.

The researchers looked at women in Israel who gave birth from 1964 to 1976. By connecting birth data with the Israel Cancer Registry, the analysis indicated that, among 410 women with gestational diabetes, 5 had cases of pancreatic cancer diagnosed 14 to 35 years later. The rate was >7 times greater, compared with women without pregnancy-related diabetes.

Mary C. Perrin was the lead author of the study, which was reported online in BMC Medicine (August 16, 2007). She stated: "I want to emphasize that this needs to be confirmed in other studies. And in any case, the absolute risk of developing pancreatic cancer after gestational diabetes is very low."

Study Focuses on Diabetes in Pregnancy

Research suggests that treating women who develop diabetes during pregnancy significantly lowers the risk that their children will become obese during childhood. The results of a large study were reported in the September 2007 issue of Diabetes Care.

The study found that, the higher the mother's blood sugar levels, the greater the child's chance of being obese by age 5 to 7. This situation held true even if the mother was not diagnosed with diabetes. For the study, the researchers examined the medical records for 9439 patients in Oregon, Washington, and Hawaii who gave birth between 1995 and 2000 and were screened for diabetes. Their children were weighed between ages 5 and 7.

The findings showed that 24% of the children whose mothers had normal blood sugar levels were overweight and 12% were obese. For the mothers with untreated high blood sugar, 35% of the children were overweight and 20% were obese. Among the mothers treated for diabetes, 28% of their children were heavy and 17% were obese.

No statistical difference was seen between the treated and normal-level groups after taking into account other factors for childhood obesity, such as weight gain during pregnancy. The researchers calculated that children from the untreated highest levels were 89% more prone to be overweight and 82% more likely to be obese, compared with children whose mothers had normal levels.

FAST FACT: According to federal statistics, an estimated 20.6 million Americans older than 20 years--almost 10% of that age group--now have diabetes.

FAST FACT: Nearly 73,000 Americans die from diabetes annually, more than from any disease except heart disease, cancer, stroke, and pulmonary disease.