Diabetes Watch

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Fenofibrate Lowers Amputation Risk

Patients with diabetes can reduce their risk of amputation if they take the cholesterol drug fenofibrate. The 5-year trial included 9795 patients with diabetes. Of the participants, 4895 were given fenofibrate and the rest were given a placebo.

By the end of the study, 115 patients had lower-limb amputations. The chance of first-time amputation fell by 36% for patients taking the cholesterol medication, compared with the control group. "These findings could lead to a change in the standard treatment for the prevention of diabetes-related lower-limb amputations," wrote the researchers in The Lancet (May 23, 2009) special diabetes issue.

Laugh to Prevent Heart Attack

Laughter can help patients with diabetes improve their cholesterol levels and possibly lower their risk of a heart attack, according to findings recently presented at the American Physiological Society annual meeting.

For the study, the researchers assigned 20 adults with type 2 diabetes to a laughter group or control group. All of the patients had high blood pressure and high cholesterol. Both groups were taking diabetes, high blood pressure, and statin medicines. The laughter group was directed to view "self-selected" humor for at least 30 minutes every day (eg, watching sitcoms or funny movies). After 12 months, the investigators evaluated both groups through tests that mea- sure cholesterol levels and C-reactive protein levels.

The findings showed that the laughter group had a 26% increase in high-density lipoprotein ("good" cholesterol), compared with 3% in the control group. C-reactive protein levels fell 66% in the laughter group, compared with 26% in the control group.

Diabetes Can Hinder Women's Sex Life

A study published in the May 2009 issue of Diabetes Care indicated that more than one third of women with type 1 diabetes have some form of sexual difficulty. Depression also is a key factor connected to sexual problems in this patient population.

After 10 years, the participants (652 women with type 1 diabetes) completed a sexual function questionnaire, had a physical examination, an evaluation of mood, and laboratory testing. The findings showed that 35% of the women were classified as having sexual dysfunction-57% cited loss of libido, 51% had problems with orgasm, 47% reported reduced lubrication, 38% noted reduced arousal, and 21% experienced pain.

In addition to annual evaluation of diabetes complications, the researchers concluded, "Women with type 1 diabetes should also be regularly queried about the presence of depressive symptoms, sexual function, and sexual satisfaction."

Undiagnosed Diabetes Price Tag Equals $18 Billion New data on diabetes indicated that approximately 6.3 million Americans have the disease without knowing it, and complications from their undiagnosed disease cost $18 billion in US health care costs each year, according to a study released by the research company Lewin Group and published in the April 2009 issue of Population Health Management.

Chronic complications in individuals newly diagnosed with the disease include retinopathy, neuropathy, and cardiovascular disease. For the research, the investigators examined the health care use patterns of 29,770 individuals for a 2-year period leading up to a diabetes diagnosis, compared with medical claims for patients never diagnosed with the disease. The researchers estimated that undiagnosed diabetes in 2007 cost $2864 more per person.

Type 2 Diabetes Ups Pancreatitis Incidence

Pancreatitis is a risk associated with diabetes. In a study reported in the May 2009 issue of Diabetes Care, the researchers looked at the incidence of pancreatitis using a nationwide managed care claims database. The database included nearly 1 million adults enrolled for at least 12 continuous months between 1999 and 2005.

The researchers identified 337,067 patients with diabetes and a similar number of individuals without the disease. The findings found that the frequency of pancreatitis was 2.8-fold higher, and the occurrence of biliary disease 1.9-fold higher in patients with diabetes, compared with patients without diabetes. The researchers noted that younger patients with diabetes (aged 18-30 years old) had the relative risk of developing both conditions.

FAST FACT: An amputation due to diabetes occurs every 30 seconds around the world.