Health ShortsSeptember 2003Diabetes and Obesity: Twin Epidemics
The number of Americans classified as obese increased by 57 percent from 1991 to 1999. During the same period, the number diagnosed with type 2 diabetes rose by 38 percent. Nearly 19 percent of Americans are now obese; nearly 7 percent have type 2 diabetes.
Obesity is a major risk factor for type 2 diabetes.
[SOURCE: Centers for Disease Control and Prevention, cited in The Johns Hopkins White Papers, Diabetes, 2002] CAD Often Silent in Diabetics
One key symptom of coronary artery disease is angina or chest pain during exertion. Because of nerve problems related to their disease, diabetics may experience less pain sensation and not recognize the onset of a deadly heart attack. Diabetics have a risk of coronary artery disease two to four times that of other Americans, but, without regular screening, it often goes undetected.
[SOURCE: "Researchers Study Treatment Options for Coronary Artery Disease," Diabetes Week, October 14, 2002] Diabetics: Beware of Fad Diets
Whether you already have diabetes or want to prevent it, it's important to maintain a weight as close to normal as possible. Most doctors, however, warn diabetics against the high-protein, low-carbohydrate diets now in vogue. The jury is still out on the long-term effectiveness and safety of these diets, but there are indications that they could increase the risk of cardiovascular and kidney complications in certain susceptible individuals, including those with diabetes. According to American Diabetes Association guidelines, a diabetic should get no more than 20 percent of calories from protein in order to limit stress on the kidneys.
[SOURCE: "The Dangers of High-Protein, Low-Carbohydrate Diets for People with Diabetes," The Johns Hopkins White Papers, Diabetes, 2002] The More Exercise, the Better
A study of more than five thousand female nurses with type 2 diabetes found that those who exercised the most also had the lowest risk of a heart attack or stroke. Longer periods of exercise and greater intensity were both associated with a significantly lower risk of heart attack and stroke. Diabetics are able to participate in virtually any athletic activity but should talk with their doctors about possible hazards such as foot damage and low blood sugar attacks.
[SOURCE: Annals of Internal Medicine, January 16, 2001] Syndrome X-A Growing Danger
The metabolic syndrome or syndrome X-abdominal obesity, high blood pressure, high triglycerides and low HDL (good) cholesterol-is considered a precursor to type 2 diabetes and a major risk factor for heart disease. Most persons with syndrome X eventually become insulin resistant. Recent surveys indicate that about 47 million Americans-or about 25 percent of the population-have syndrome X. The prevalence of syndrome X increases with age, affecting about 40 percent of persons over age 60, but the incidence among younger persons has increased dramatically since the early 1990s.
[SOURCE: David T. Nash, "Insulin Resistance, ADMA Levels, and Cardiovascular Disease," JAMA, March 20, 2002] Heed the Pre-Diabetic Warnings
In addition to the 7 percent of Americans diagnosed with diabetes, another 11 percent have a condition known as pre-diabetes, with elevated blood sugar levels but not high enough for a diagnosis. About 7 percent of these persons go on to develop diabetes every year, and these individuals are 50 percent more likely to later have a heart attack or stroke compared to persons with normal blood sugar. With lifestyle changes, however, they can prevent or delay the onset of diabetes and heart disease. An individual with impaired glucose tolerance is typically overweight and at least somewhat insulin-resistant. Treatment involves weight loss, smoking cessation and measures to reduce blood pressure and serum cholesterol.
[SOURCE: The Johns Hopkins White Papers, Diabetes, 2003] C-Reactive Protein Increases Risk
Recent research has indicated that c-reactive protein (CRP)-a marker for inflammation or infection-is an important risk factor for heart disease. Other studies have concluded that inflammation may also play a role in the development of diabetes. In a study of 5,245 middle-aged Scottish males, subjects with the highest CRP levels had a three times greater risk of developing type 2 diabetes over a five-year period than those with the lowest levels. CRP predicted type 2 diabetes as effectively as widely accepted risk factors such as body weight or levels of blood sugar or triglycerides. A study of 27,628 women found that those with the highest CRP levels had a risk of developing diabetes 15.7 times greater than those with the lowest levels.
[SOURCE: Diabetes, May, 2002; JAMA, July 18, 2001] Diabetics: Eat More Fish, Nuts
Women with type 2 diabetes who ate fish regularly had a significantly lower risk of heart disease than those who rarely ate fish, according to a study conducted by Frank B. Hu, M.D. of the Harvard School of Public Health. Another study by Dr. Hu found that women eating an ounce of nuts or a tablespoon of peanut butter at least five times a week reduced their risk of diabetes by 30 percent compared with those rarely eating nuts. [SOURCE: "Diabetic Women Gain Significant Health Benefits from Eating Fish," Women's Health Weekly, May 1, 2003; "A Nutty Way To Prevent Diabetes: Eating Nuts and Peanut Butter May Help Protect You Against Type 2 Diabetes," Natural Health, May-June, 2003] RSV in Minority Populations
Some groups of Native American and Native Alaskan children have higher rates of hospitalization due to respiratory syncytial virus than the general population. While 31.2 per 1000 American infants under the age of one are hospitalized for RSV-related bronchiolitis, the rate for Alaska Natives is 150 per 1000. Likewise, Navajo and White Mountain Apache infants have exhibited a higher rate of severe RSV. Researchers have been unable to determine the cause of this discrepancy. They suggest, however, that parents may attempt to limit RSV infections by limiting smoking in the home and by breast feeding.
[SOURCE: "Infection Requiring Hospitalization Is Higher in Some Native American Children," Vaccine Weekly, October 30, 2002] Maternal Antibodies Offer Protection
A study in Mozambique revealed that maternal antibodies provide substantial protection against severe respiratory syncytial virus infection in infants. Although no vaccine is available for RSV, this study suggests that, in the future, maternal vaccination during pregnancy could provide protection for infants.
[SOURCE: "Maternal RSV Immunization Important to Prevent Infant Infections," Vaccine Weekly, September 11, 2002] Plenty of Flu Vaccine, No Delays
Influenza vaccine will be available in plentiful supply with no delays this year, according to the U.S. Centers for Disease Control and Prevention. The CDC recommends that everyone who wants a flu shot get one early-preferably in October-so their bodies have time to develop immunity before the flu season starts. Because of production delays the last two years, the CDC requested that older and otherwise vulnerable persons be allowed to get their shots first. That will not be the case this year. More than 36,000 Americans die and 114,000 are hospitalized each year because of the flu. Yet only about 65 percent of adults who are at risk of severe complications get vaccinated.
[SOURCE: "Plenty of Flu Vaccine This Year, CDC Says," Reuters Health, August 21, 2003] Who Is at Risk of Flu Complications?
About 10 to 20 percent of Americans can expect to get the flu this year, and all will experience at least a week of misery and downtime with fever, cough, sore throat, a runny or stuffy nose, headache, muscle aches and fatigue. Some persons will get severe, often life-threatening, complications such as pneumonia. The risk of severe complications is high if you: - are age 50 or over,
- have kidney disease, diabetes, heart disease, asthma, emphysema or compromised immunity for any reason,
- are a health care worker.
[SOURCE: "Influenza Vaccine," American Family Physician, February 15, 2003] Wash Your Hands and Stay Healthy
If you want to protect yourself from colds and flu this winter, there's one very simple thing you can do: wash your hands. Research has shown that frequent hand washing can reduce by 30 to 80 percent your risk of getting an upper respiratory infection. Washing means wetting your hands under warm water, scrubbing with soap to a count of five, rinsing to a count of five and drying thoroughly. Frequently means at least before every meal, after using the toilet, after handling pets and after wiping your nose.
[SOURCE: Richard Kent Zimmerman, et al, "Vaccines for Persons at High Risk Due to Medical Conditions, Occupation, Environment, or Lifestyle," Journal of Family Practice, January, 2003] Colorado Hardest Hit by West Nile Virus
Colorado is the state hardest hit by West Nile virus this year with six deaths out of 10 nationwide. All were among elderly women. To prevent West Nile virus, the Centers for Disease Control urges everyone to use insect repellent, stay away from stagnant water and eliminate mosquito breeding grounds such as standing water.
[SOURCE: "Health Official Delivers West Nile Aid for Colorado," Reuters Health, August 21, 2003] | 
