Diabetes

White Rice Consumption Associated With Increased Diabetes Risk

White rice ranks very high on the glycemic index, and scientists have recently found a possible link between white rice consumption and type 2 diabetes risk, according to research published in the March 2012 issue of British Medical Journal.

In a meta-analysis of 4 published prospective cohort studies evaluating white rice intake and incidence of type 2 diabetes, scientists calculated the relative risk ratios for type 2 diabetes in Asian and Western populations based on the highest and lowest consumption of rice in each group. They concluded that higher white rice consumption was associated with an elevated risk for developing type 2 diabetes.

“A dose-response analysis showed that each serving per day of white rice consumption was associated with an 11% increase in risk of diabetes in the overall population,” the authors wrote. They also noted that the association was stronger for Asians than for the Western populations.

The authors cited numerous limitations of their study, including the observational nature of the analysis and self-reporting of serving sizes.

Surgery More Effective Than Drug Therapy for Obese Diabetics

Bariatric surgery is dramatically more effective in the treatment of type 2 diabetes than conventional therapies focused on medication and diet modification in obese patients, according to a new study published online March 26, 2012, in the New England Journal of Medicine.

Study researchers randomly assigned 60 obese patients (body mass index ≥35) with a history of at least 5 years of diabetes and a glycated hemoglobin (A1C) level of 7.0% or more to either receive traditional medication therapy or undergo gastric bypass or biliopancreatic diversion surgery. At 2 years, a complete remission of diabetes was achieved by 95% of the biliopancreatic diversion group and 75% of the gastric bypass group. No patients in the medication therapy group were in remission at any point during the study.

In addition, the 2 surgical groups had greater percent reductions in average body weight from baseline than did patients receiving medication therapy. The researchers assert that in addition to weight loss, the surgery may have contributed to normalization of glucose levels as a result of changes to insulin-producing hormones in the gut.

Higher Glucose Levels Have a Protective Function in Heart Failure Patients With Diabetes

In a study published online in the American Journal of Cardiology, researchers found that for advanced heart failure patients with diabetes, having blood glucose levels above the normal target of 7% helped improve survival rates.

The authors assessed the relationship between the level of A1C in the blood and mortality outcomes by looking at the medical records of 845 patients with advanced heart failure, half of whom had diabetes. Patients were segmented further into 4 groups based on A1C levels, and their risk of death was calculated using statistical analysis.

Patients with the highest levels of A1C (level 4) had the highest survival rate at 65%, followed by a 61% rate at level 3, 42% at level 2, and 48% at level 1. The researchers concluded that the ideal range of A1C in heart failure patients with diabetes was 8.3% to 8.9%.

“We were surprised that the optimal level of [A1C] in this patient population with diabetes was higher than levels in current treatment guidelines,” said senior author Tamara Horwich, MD, assistant professor of cardiology at the David Geffen School of Medicine at UCLA. “We may find that doctors who treat patients who have both advanced heart failure and diabetes may not need to focus on aggressively lowering blood sugar, but rather keep it under moderate control.”