Rise in Type 1, 2 diabetes among US youths: study

WASHINGTON: Both type 1 and type 2 diabetes are rising significantly among young people in the United States, according to new research that warns of a growing epidemic in American youth.

Type 1 diabetes rose 21 percent among children and teenagers from between 2001 and 2009, said the study in based on three million children and adolescents.

Type 2 diabetes increased 30 percent over the same period, according to the study published in the Journal of the American Medical Association on Saturday.

Type 1 diabetes appears most often in children and is a disorder in which the pancreas does not make insulin, leading to too much glucose in the blood. Those with type 1 diabetes need to take insulin for the rest of their lives.

Type 2 diabetes is more common, and occurs when blood sugar levels are too high and the body doesn´t make insulin well enough. It can be controlled through healthy diet, exercise and medications.

The population studied came doctor-diagnosed cases from five centers in California, Colorado, Ohio, South Carolina, and Washington state, and included some American Indian reservations in Arizona and New Mexico.

Type 1 diabetes was studied in youths aged 0 to 19, and Type 2 in those aged 10-19.

Researchers said more study is needed to determine the reasons for the rise.

Previous studies have found similar rises of Type 1 diabetes, and some scientists have projected that the population with this disease would nearly triple -- from 179,387 in 2010 to 587,477 in 2050.

The JAMA study also found that type 1 diabetes was on the rise among minority youths as well as whites.

"The increase in prevalence among US minorities documented herein is of concern, given that minority youth are more likely to have poor glycemic control, known to be associated with the serious complications of type 1 diabetes."

The study also projected that type 2 diabetes would increase four-fold -- from 22,820 in 2010 to 84,131 in 2050.These increases "are important because such youth with diabetes will enter adulthood with several years of disease duration, difficulty in treatment, an increased risk of early complications," the study said, cautioning that the disease could be even more common in generations to come. (AFP)

Diabetes research: good news for caffeine addicts?

PARIS: People who boosted their coffee intake by "moderate to large" doses in a US-based study had a lower risk for adult-onset diabetes than those with stable consumption, researchers said Friday.

An analysis of studies that tracked the diet and lifestyles of more than 120,000 health sector workers, showed that those who increased their daily caffeine dose by about 1.5 cups a day over a four-year period had an 11-percent lower chance in the subsequent four years of developing type 2 diabetes, the team found.

This was in comparison to those whose intake remained constant.

"Furthermore, those who had moderate to large decreases in intake (about two cups a day) had an 18 percent higher risk," a research team in Diabetologia, the journal of the European Association for the Study of Diabetes.

"Changes in coffee consumption habit appear to affect diabetes risk in a relatively short amount of time," concluded the team led by Shilpa Bhupathiraju of the Harvard School of Public Health in Boston.

Those with the highest coffee consumption, three cups or more per day, had the lowest risk of type 2 diabetes -- 37 percent lower than those who consumed a cup or less per day, said the paper, backing other studies that linked coffee to lower diabetes risk.

The findings were based on monitoring more than 95,000 women enrolled in two nurses´ health studies in the United States, and nearly 28,000 male participants in a separate health professionals´ study.

It measured their consumption patterns for four years, and then looked at subsequent diagnoses of type 2 diabetes.

The outcome may reflect a "true change in risk", but may also be explained by people cutting out coffee after being diagnosed with conditions like high blood pressure or elevated cholesterol associated with risk for type 2 diabetes, said the study authors.

Experts who analysed the new research for the Science Media Centre, said the team had merely evaluated potential short-term benefits and provided no evidence that long-term coffee intake lowered diabetes risk.

The research measured changes in consumption rather than absolute intake, said the analysts.

"No recommendations for coffee intake can be derived from this paper," said a summary, adding the statistical analysis of the data was "potentially misleading".

The researchers had found that neither changes in consumption of tea, nor of decaffeinated coffee, was associated with risk of type 2 diabetes -- a high blood sugar disease often linked to obesity. (AFP)

Snoring as a risk factor for type II diabetes mellitus: Study

NEW YORK: To examine the association between snoring and risk of developing type II diabetes mellitus, the authors analyzed data from the Nurses' Health Study cohort.

This analysis included 69,852 US female nurses aged 40–65 years without diagnosed diabetes, cardiovascular disease, or cancer at baseline in 1986. Snoring patterns were ascertained by questionnaire.

During 10 years of follow-up, 1,957 women were diagnosed with type II diabetes. In analyses adjusted for age and body mass index, snoring was associated with risk of diabetes (for occasional snoring vs. nonsnoring, relative risk (RR) = 1.48 (95% confidence interval (CI): 1.29, 1.70); for regular snoring vs. nonsnoring, RR = 2.25 (95% CI: 1.91, 2.66); p for trend < 0.0001).

Further adjustment for other diabetes risk factors and sleeping-related covariates only slightly attenuated the risk (for occasional snoring, RR = 1.41 (95% CI: 1.22, 1.63); for regular snoring, RR = 2.03 (95% CI: 1.71, 2.40); p for trend < 0.0001). Analyses stratified by body mass index, smoking history, or parental history of diabetes showed a consistent association between snoring and diabetes within the categories of these variables.

These results suggest that snoring is independently associated with elevated risk of type II diabetes.

Surgery is best for managing diabetes in heavy people

WASHINGTON: When it comes to managing type 2 diabetes in overweight people, stomach-shrinking surgeries are still more effective than trying to shed pounds with pills and lifestyle changes, researchers said Monday.

Three years into a US study that compares various approaches -- gastric bypass, sleeve gastrectomy and simply trying medical counseling, diet, exercise and weight loss medications -- the findings show that the two surgical procedures are still superior at reducing blood sugar and weight.

Researchers said their findings could provide a way to help the some 23 million American adults who have type 2 diabetes, most of whom are overweight or obese.

Fewer than half of adults with diabetes are able to get their blood sugar under control with medication, experts say.

The latest results from the largest randomized controlled trial of its kind were published in the New England Journal of Medicine and discussed at the American College of Cardiology annual meeting.

"Bariatric surgery was more effective than medical therapy in achieving glycemic control with weight loss as the primary determinant of this outcome," said study author Sangeeta Kashyap, associate professor medicine at Cleveland Clinic Lerner College of Medicine.

"We concluded that bariatric surgery should be considered as a treatment option for the treatment of type 2 diabetes in patients who are moderately and severely overweight."

- More weight lost by surgery -

The research included 150 overweight people with uncontrolled diabetes that had persisted for at least eight years when they began the study, despite taking three or more medications.

They were randomly assigned to undergo one of the two surgeries plus counseling, or simply expert therapy in health changes without surgery.

After three years, just five percent of patients who did not have surgery had achieved the desired level of glycemic control, defined as a three-month average blood glucose level of six percent or lower.

That target is slightly more aggressive than the American Diabetes Association recommendation of seven percent.

The surgery groups did much better, with 37.5 percent of gastric bypass and 24.5 percent of sleeve gastrectomy patients meeting the mark, after starting at an average blood sugar level of 9.2 percent.

Weight loss was five to six times greater in patients who had one of the surgeries.

The gastric bypass group lost on average a quarter of their body weight while the sleeve gastrectomy patients shed 21 percent. Those on medical therapy alone lost four percent.

- Quality of life -

Meanwhile, people who did not undergo surgery reported no improvements in quality of life, according to eight measures including body pain, general health, energy and fatigue.

Gastric bypass patients reported five improvements and sleeve patients reported two. There were no major complications among those who underwent the surgeries.

Gastric bypass involves reducing the stomach to below three percent of its natural volume, then connecting a new gastric pouch that bypasses the stomach and goes straight to the intestine.

In sleeve gastrectomy, part of the patient's stomach is removed to reduce its volume by about 75 percent.

Gastric bypass outperformed the sleeve gastrectomy in the study, which was funded by the National Institutes of Health, the Cleveland Clinic and Ethicon, a division of pharmaceutical giant Johnson and Johnson which sells surgical products for weight loss.

Amit Khera, associate professor at the University of Texas Southwest Medical Center, who was not involved in the study, described the research as "important" because it addresses the longer-term benefits from surgery versus counseling and weight loss attempts alone.

"In the surgical arm, it does seem to be quite durable," he told reporters.

"Normalizing blood sugar seems to be retained at three years. That is a really important observation."

On the other hand, people who did not have surgery showed early improvements in their blood sugar, dropping close to the target of 7.5 in the first year.

But that group was back up to 8.4 percent in year three.

The study, called the Surgical Treatment and Medications Potentially Eradicate Diabetes Efficiently (STAMPEDE) trial, is designed to follow its patients for a total of five years.