Heart Disease, Diabetes, Depression a Deadly Mix

(HealthDay News) -- Heart disease, diabetes and depression can be a lethal triple-play -- boosting a patient's death risk by 20 percent to 30 percent, new research shows.

"We do not know what this increased risk is due to, but it could either be that depression influences crucial aspects of self-care behaviors needed to manage diabetes or that a more severe disease process is reflected in more depressive symptoms," said lead researcher Anastasia Georgiades, a research associate in the department of psychiatry and behavioral science at Duke University in Durham, N.C.

Georgiades was expected to present the findings Friday at the American Psychosomatic Society annual meeting in Budapest, Hungary.

In their study, the Duke team followed 933 heart patients for more than four years. During that time, there were 135 deaths among patients with type 2 diabetes and/or depression, the researchers found. Read more...

Immunice for Immune Support

Children of Centenarians Face Lower Heart Risks

(HealthDay News) -- Longevity runs in families, the saying goes, and new research shows there may be genetic and physiological reasons for the phenomenon.

The children of people who live to 100 and beyond are themselves much less likely to develop cardiovascular diseases, such as heart disease and stroke, and even diabetes, researchers found.

But they aren't impervious to non-cardiovascular health problems, such as cancer, dementia and depression.

The findings stem from an analysis of health data collected over a decade by the New England Centenarian Study, which focuses on people aged 97 and older and their family members. It's the first study to track the health of children of centenarians as they age.

"This confirms what we were already suspecting, and definitely suggests that there is a genetic component to the ability to create exceptional longevity," said study author Emily R. Adams, a third-year medical student at Boston University School of Medicine.

Adams and her Boston University colleagues, Dr. Dellara F. Terry and Dr. Thomas Perls, director of the New England Centenarian Study, presented their findings in the November issue of the Journal of the American Geriatrics Society.

For the 10-year study, initial and follow-up questionnaires regarding health status were presented to 440 children of centenarians, as well as to 192 men and women whose parents had not lived past 100. The average age of the participants was 72 when the study began in 1997.

The researchers found that compared to the average adult, children of centenarians had a 78 percent lower risk for a heart attack, an 83 percent lower risk for a stroke, and an 86 percent lower risk for developing diabetes.

They were also 81 percent less likely to die during the course of the study.

The researchers said the findings generally reinforce the important role that genetics play in reaching extreme old age, and specifically highlight the cardiovascular leg up children of centenarians appear to inherit from their parents.

But, Adams added, while good genetic lineage may portend a longer life, it doesn't guarantee protection against all diseases.

"You might expect that centenarian offspring would do better as they age, and that is true. They do follow a different trajectory, and go down a less steep slope," she said.

But, Adams noted that the study found that children of centenarians do not, for example, experience significantly lower rates of arrhythmias, cancer, macular degeneration, dementia, depression, fractures, osteoporosis and thyroid disease.

"It's really with the vascular diseases that they fared better," she said.

Jay Olshansky, a senior research scientist at the University of Chicago's Center on Aging, said future work in this arena will focus on trying to isolate the mechanism behind genetic longevity.

"This study looked at outcomes and is directly in line with what you would expect," said Olshansky, who's also a professor with the university's school of public health. "But that is where this research is going next -- to find out how this very strong genetic component to living long plays out.

"But the bottom line," he added, "is that we already know that the genes that are associated with exceptional longevity already exist, and that they are concentrated in subgroups of the population. And the rest of us don't have those genes, or don't have all of them. Those who do have won the genetic lottery for making it out to exceptional old age. And, unfortunately, if you haven't won, there's no chance you can make it."

More information
To learn more about centenarians, visit the Howard Hughes Medical Institute.

Diabetic Eye Disease Rates Soaring

(HealthDay News) -- The number of Americans with diabetic retinopathy is expected to increase from 5.5 million to 16 million by the year 2050, according to a U.S. Centers for Disease Control and Prevention study.

Diabetic retinopathy, which is damage to the small blood vessels in the retina, is the leading cause of blindness among working-age adults in the United States. In 2004, about $500 million was spent on direct medical costs for diabetic retinopathy, according to background information in the study.

"People with diabetes mellitus also have a higher prevalence of other eye diseases, such as cataracts and glaucoma, than the general population," the researchers wrote. "Vision loss related to eye disease among people with diabetes is an important disability that threatens independence and can lead to depression, reduced mobility and reduced quality of life."

For their study, Dr. Jinan B Saaddine and colleagues analyzed data from the 2004 National Health Interview Survey and the U.S. Census Bureau to predict the number of Americans with diabetes who will have diabetic retinopathy, vision threatening diabetic retinopathy, glaucoma and cataracts in 2050, when the country's population is expected to be 402 million.

Along with the increase in diabetic retinopathy cases from 5.5 million to 16 million, the researchers also projected that:

• The number of cases of vision threatening diabetic retinopathy will increase from 1.2 million to 3.4 million.
• Among Americans 65 and older, the number of cases of diabetic retinopathy will rise from 2.5 million to 9.9 million, and the number of cases of vision threatening diabetic retinopathy will increase from 500,000 to 1.9 million.
• Cataract cases among whites and blacks age 40 or older with diabetes will increase 235 percent.
• Cataract cases among people age 75 and older with diabetes will increase 637 percent for black women and 677 percent for black men.
• Glaucoma cases among Hispanics age 65 and older with diabetes will increase 12-fold.

"In summary, our projections have shown higher numbers than previously estimated for diabetic retinopathy, vision threatening diabetic retinopathy, cataracts, and glaucoma among Americans with diabetes. Efforts to prevent diabetes and to optimally manage diabetes and its complications are needed," the researchers concluded.

The study was published in the December issue of the journal Archives of Ophthalmology.

More information
The American Diabetes Association has more about diabetes-related eye complications.

Leukemia Drug Holds Promise as Type 1 Diabetes Treatment

By Sean Kelley

Istockphoto
Scientists have successfully used a leukemia drug to reverse type 1 diabetes—at least in mice. Researchers at the University of California, San Francisco and Plexxikon, a pharmaceutical research firm, studied two cancer drugs—Gleevec (imatinib) and Sutent (sunitinib)—in non-obese diabetic mice, which were prone to developing diabetes.
Both drugs are tyrosine kinase inhibitors, which interfere with cell communication and growth and are used to fight tumors. Gleevec is prescribed for chronic myelogenous leukemia and Sutent is used to treat advanced kidney cancer and a type of stomach cancer. Read More

Health Tip: Living With an Insulin Pump

(HealthDay News) -- An insulin pump offers many benefits for diabetics, including better blood glucose control and greater convenience.

The American Diabetes Association offers these suggestions while getting used to your pump:

• Take your insulin at the same time each day.
• Carry an extra insulin pen or additional insulin with you when traveling.
• Talk to a dietitian about how to adjust your diet when you start using the pump.
• When you turn off your pump, devise a way to remind yourself to turn it back on.
• Regularly record and review all of your information, including blood glucose levels, carbohydrates, corrective doses and exercise.
  

Aspirin Doesn't Prevent First Heart Attack, Stroke

(HealthDay News) -- Contradicting current recommendations, a new trial finds that aspirin does not reduce the risk of heart attack and stroke for people with diabetes or peripheral arterial disease.

Aspirin clearly is effective in secondary prevention, reducing the risk for people who already have had a heart attack or stroke, said study author Dr. Jill Belch, a professor of vascular medicine at the University of Dundee in Scotland. Her report was published in the online issue of the BMJ.

However, in the study of 1,276 people who had not yet suffered a heart attack or stroke but were at high risk because they had diabetes or peripheral arterial disease (partial blockage of leg arteries), "we found that they did not benefit from daily aspirin," Belch said. The study showed that aspirin is ineffective in primary prevention, she noted.

"The number of heart attacks and strokes was exactly the same over eight years for those taking aspirin and those taking placebo," Belch said.

The same was true of the antioxidants given in the trial, she said, which was no surprise. "All the antioxidant studies over the past 10 years have been negative," Belch said.

Both the American Heart Association and the U.S. government recommend aspirin for people who have not had heart attacks or strokes but are at high risk for cardiovascular trouble because of conditions such as diabetes.

Those recommendations probably should be changed, said Dr. William R. Hiatt, a professor of medicine at the University of Colorado, who wrote an accompanying editorial.

The newly reported study "is consistent with six other studies on primary prevention, and all those studies were negative," Hiatt said.

The current recommendations are based on analysis of studies that found some primary prevention benefit in subgroups, he said. "Overall, if you do not have heart disease, the risk of bleeding outweighs any benefit you get from aspirin," Hiatt said.

The U.S. Preventive Services Task Force recommendation for use of aspirin in people at high risk of heart disease cited five studies that included 50,000 people. But its report noted that "no trial showed a significant all-cause mortality difference between aspirin-treated and control groups."

Hiatt said that he served on an advisory committee of the U.S. Food and Drug Administration that reviewed a request in 2003 by Bayer to extending the labeling of aspirin to include primary prevention in heart disease. "We couldn't support that request," he said.

Advertisements urging people to take aspirin to benefit the heart are accurate for those who already have had an event, both Belch and Hiatt said.

"It works if you've already had a heart attack," Belch said. "But there is no proof for primary prevention, no proof at all."

"The evidence is solid that aspirin should be given to people with known heart disease," Hiatt said. "But the evidence for people who have risk factors for heart disease is different."

More information
Risks and possible benefits of aspirin for the heart are reviewed by the U.S. Food and Drug Administration.

Moderate Aerobic Exercise Lowers Diabetics' Liver Fat

(HealthDay News) -- In people with type 2 diabetes, regular aerobic exercise and weightlifting may reduce levels of fat in the liver by as much as 40 percent, according to Johns Hopkins researchers.

High liver fat levels are common in type 2 diabetes patients and contribute to heart disease risk.

The study included 77 diabetic women and men who were divided into two groups. For six months, one group did three 45-minute sessions of moderate aerobic exercise (bicycling, running on a treadmill, or brisk walking) and three 20-minute sessions of weightlifting per week. The other group didn't do any formal aerobic fitness or gym classes.

MRI scans showed that people in the exercise group had lower levels of liver fat by the end of the study (5.6 percent) than those in the non-exercise group (8.5 percent).

The exercise group also had better fitness and less body weight and fat than those in the non-exercise group. Those who did the aerobic/weightlifting program: had 13 percent higher averages for peak oxygen uptake levels during treadmill testing; were 7 percent stronger; had 6 percent lower body fat and body weight; and had 2-inch smaller waistlines (an average of 39 inches vs. 41 inches).

"The benefits in improved fitness and fatness are clear, and physicians should really have all people with type 2 diabetes actively engaged in an exercise program," lead investigator Kerry Stewart, a professor of medicine and director of clinical and research exercise physiology at the Johns Hopkins School of Medicine and its Heart and Vascular Institute, said in a Hopkins news release.

The findings were presented Sept. 18 at the American Association of Cardiovascular and Pulmonary Rehabilitation annual meeting, in Indianapolis.

"People with type 2 diabetes have added reason to be active and to exercise, not just because it is good for health, but also because our study results pinpoint a key benefit to trimming the fatty liver that complicates their illness and which could accelerate heart disease and liver failure," Stewart said.

About 14 million Americans have type 2 diabetes.

More information
The American Diabetes Association has more about type 2 diabetes.

Health Tip: When Diabetics Get Sick

(HealthDay News) -- Controlling illness is important for anyone, but prudent medical care is even more vital for diabetics. Hormones released during illness and other times of stress can affect blood sugar levels.

The American Diabetes Association suggests that diabetics should call the doctor if they aren't sure how to care for themselves, or if they have these warning signs:

• If symptoms of illness, possibly including fever, have continued for a couple of days without improvement.


• If diarrhea or vomiting has continued for more than six hours.


• If there are moderate or large amounts of ketones in your urine.


• If, even after taking enough insulin to account for your illness, your blood sugar is 240 or higher before meals and stays there for more than 24 hours.


• If you have symptoms of ketoacidosis or dehydration, which may include chest pain, difficulty breathing, dry or cracked lips, and breath that smells like fruit.

A New Way to Calculate Your Disease Risk

By Dena Rifkin, MD

Here’s a sobering realization: No matter how well I take care of my patients, all of them—that’s right, all of them—are going to die someday. This pessimistic thought came to me this week as I was reviewing some of the recent cardiac-risk calculators.

These tools, many of which were based on a landmark observational research program in Framingham, Mass., allow physicians to estimate an individual’s risk of cardiac death over the next 10 years, or over a lifetime. Surprisingly few variables count in this calculation: age, gender, smoking history, blood pressure, presence of diabetes, and cholesterol level. Read More

Health Tip: Feeling Thirsty?

(HealthDay News) -- An occasional glass of water should satisfy most cases of thirst. But if it seems like you're excessively thirsty all the time, it may be a sign of a serious health problem.

Here are common causes of excessive thirst, courtesy of the U.S. National Library of Medicine:

• Significant blood loss or loss of body fluids, caused by an underlying health condition.
• Diabetes or diabetes insipidus.
• A side effect of certain drugs, including anticholinergics, demeclocycline, diuretics or phenothiazines.
• Significant loss of water or salt, possibly caused by not drinking enough water, profuse sweating, diarrhea or vomiting.

Health Tip: Managing a Chronic Illness

(HealthDay News) -- Managing a chronic illness, such as diabetes or high blood pressure, may seem overwhelming.

Here are helpful suggestions for people with a chronic illness, courtesy of the American Academy of Family Physicians:

• Take a look at your unhealthy behaviors, and choose one or several that you want to work on and improve.


• Come up with a specific plan and goals for dealing with each unhealthy behavior.


• Devise alternate plans to help you stick to your goals -- for example, how to handle weather that affects your exercise plans.


• Make sure your goals are realistic, and that you feel confident that you can reach them.
  Talk to your doctor about your goals, and discuss your progress.

Could Where I Live Raise My Risk of Breast Cancer?

By Anne Krueger

My fellow blogger Sean Kelley recently wrote about how fat his home state is. (He lives in Alabama, second fattest state in the nation, according to stats from the Centers for Disease Control and Prevention.) One of Sean’s points was that it’s no surprise that fat Alabama also has a high incidence of diabetes. There is a proven obesity-diabetes link.

That got me thinking about a disease that weighs more heavily on my mind. Could where I live (Tennessee) affect my risk of getting breast cancer? And how does a person figure out how healthy her state is, anyway? Read More

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News of Allergy Cures Doesn’t Get My Hopes Up

By Sean Kelley

The week that my son was diagnosed with severe food allergies, Duke University Medical Center researchers reported that a peanut-allergy cure might be only five years away. At the time, I reacted the same way I do to claims that scientists are on the verge of curing diabetes: I’ll believe it when I see it.
I’m not a natural cynic. I tend to trust people in general as well as information from authoritative sources. Want to play a practical joke on someone? I’m your man. Read More

Wireless Devices Will Save Diabetics’ Lives

By Sean Kelley

I’m a complete gadget geek. (I built my first computer in the 1970s—when I was 5. My first “laptop” experience was just 10 years later with a hulking device that actually had a phone-cradle modem.)

I’m also a diabetic, and I’ve played with a lot of the gadgets aimed at type 2s like me. It hasn’t always been much fun: In 1999, when I was diagnosed, I was shocked by the poor design of the products. The glucose monitors were clunky, inaccurate, and hard to configure. Most came with a vial of solution and code numbers that had to be plugged in to obtain a proper reading. Only a couple of expensive models could connect to a computer, and those required custom software. Read More

Summer Heat and Diabetes Wrecked My Game

By Sean Kelley

I was having a glorious round of golf on a recent Saturday. All I had to do was par the 18th hole to shoot 85 on a PGA Tour course—quite an accomplishment for a duffer like me. I looked forward to the glory after a hot, sunny round. I completely forgot about my diabetes.

I sliced my tee shot in the water, something I hadn’t done all day. I drowned the next shot as well. By the time I found another ball in my bag, I was seeing spots and feeling weak. Hypoglycemia was creeping in. Read More

Diabetics of the World Unite!

By Sean Kelley My fellow diabetics, now is the time for us to come together. According to the news last week, there are 24 million diabetics in the United States. (I know, some six million of you don’t know you’re diabetic yet, but sooner or later you’re going to ask why you’re going to the bathroom six times a night.)

We now represent a significant part of the American landscape. There are more diabetics than members of the NRA, PETA, and Daughters of the American Revolution combined!

I know, you think the American Diabetes Association is doing a fine job representing us. (I think they’re doing a fine job, too.) And there are places like dLife and Diabetic Connect where we already gather. But they’re just groups and websites. We could be a movement!

Think of it: the 24 Million Diabetic March. We could storm the capital and build a mountain of blood sugar strips on the White House lawn to make our numbers known. It’s possible—we have heft (for once I’m not talking about waistlines and BMI).

We could even make demands. This will take some discussion, but I think we should start by asking for access to better health care and sugar-free donuts that actually taste like Krispy Kreme.

But seriously, when a disease reaches critical mass—the Centers for Disease Control and Prevention estimates 57 million Americans have prediabetes (a condition in which individuals have elevated blood glucose levels that are not high enough to be classified as diabetes…yet)—it demands attention all on its own. So, what exactly would we be fighting for? Read More

All This Talk of Diabetes Mortality Is a Downer

By Sean Kelley

Last week I went to San Francisco for the American Diabetes Association’s Scientific Sessions, a huge annual gathering of endocrinologists, scientists, nurse educators, and pharmaceutical companies. The latest research on type 1 and type 2 diabetes was delivered, theories discussed, and news announced.

There was much discussion of uncomfortable subjects: neuropathy, nephropathy ,cardivascular disease, hypoglycemia , death. While not fatal itself, diabetes has lots of excellent ways to kill you through related conditions: stroke, heart disease, and kidney failure spring immediately to mind. Read More

Diabetic Dilemma: Dinner With an Endocrinologist

By Sean Kelley

When I was diagnosed with diabetes, I learned to avoid dining with two types of health professionals: nurses who specialize in diabetes and nutritionists. Both could quickly become food cops.

The best examples of this were my mother and the woman who is now my wife. Having had plenty of experience nursing diabetics, they quoted low carb verse and scripture every time we dined. Over the years they have all but muted their comments, and I rarely object to their company at the dinner table. Read More

Turning My Black Thumb Against Diabetes

Year 2 in my quest to use my organic garden as a tool for better health
by Sean Kelley When my wife and I bought our farm eight years ago, it seemed out of place for us. Despite growing up in rural Alabama, I know more about Gianni Versace than John Deere. Patti owns horses, but having livestock (or 1,200-pound lawn ornaments) does not make you a farmer. Neither does owning a farm.

In fact, most of the growth on our farm in recent years is due more to neglect than intervention on our part. Nature is reclaiming our eight-acre plot.

If owning a farm is out of character, gardening is anathema. Not only do I associate digging in the earth with constant adolescent battles with my father (whose idea of a father-son activity was often limited to early morning turns with a spade and hoe), but I have inherited my mother's black thumb.

(She once killed an entire household of Christmas cacti by feeding them what she thought was plant food, but was—in fact—bleach; I swear I heard plants screaming.)

Against these natures, I tilled up soil on the property last year to plant an organic garden. I had two goals: Make the farm work for us for a change and get more fresh vegetables into our diet. It wasn't a complete disaster, but our harvest of heirloom tomatoes, cucumbers, lettuces, and herbs was modest.

Now I'm back at it with renewed purpose. I'm still trying to stick to organic farming principles, but my primary goal is exercise. At the same time, that exercise will (hopefully) produce healthy fare for our table that's in line with my diabetic diet. The strategy has lots of benefits:

• A garden requires constant attention, meaning more exercises. Gardening can burn 300 calories an hour;
• Eating fruits and vegetables lowers diabetes risks and helps you lose weight
• A 2007 study by Saint Louis University found children eat more fruits and veggies when they're home grown—something we proved with our daughter (pictured with me above) last summer when she began to actually eat things we grew that she wouldn't eat from a store.

Monday night I put in 20 tomato bushes, a variety of peppers, leeks, basil, and eggplant. Trailing clumps of soil back into the house, I thought about all the energy I expended fighting the tiller, breaking up clay, and clomping around the property. I still hate digging in the dirt, but the benefits I can harvest for my health have potential that may turn my black thumb green.

What is Fucoxanthin?

From Cathy Wong,


Fucoxanthin is a type of carotenoid found naturally in edible brown seaweed such as wakame (Undaria pinnatifida) and hijiki (Hijikia fusiformis), which are used widely in Asian cuisine. Wakame is the seaweed used in miso soup.

Fucoxanthin is also found in much smaller amounts in red seaweed (the kind typically used in Japanese sushi rolls) and green seaweed.

Both wakame and hijiki are available at Japanese specialty food stores, some health food stores and online. Although brown seaweed is the richest source of fucoxanthin, you would have to eat an unrealistic amount of it daily to get fucoxanthin levels close to those used in research studies.

Fucoxanthin is also available as a nutritional supplement in capsule form and can be found in some health food stores and online.

Why Do People Use Fucoxanthin?
Weight Loss
Fucoxanthin is being explored for weight loss.

So far, only animal studies have been done. Japanese researchers have found that fucoxanthin (isolated from wakame) promotes the loss of abdominal fat in obese mice and rats. Animals lost five to 10% of their body weight.

Although it's not fully understood how fucoxanthin works, it appears to target a protein called UCP1 that increases the rate at which abdominal fat is burned. Abdominal fat, also called white adipose tissue, is the kind of fat that surrounds our organs and is linked to heart disease and diabetes. Fucoxanthin also appears to stimulate the production of DHA, one of the omega-3 fatty acids found in fatty fish such as salmon.

Although it's promising and already a popular nutritional supplement, more research is needed to determine if fucoxanthin will work in the same way in humans. If it does prove to be effective, fucoxanthin could be developed into a diet pill for obesity.

Diabetes

Fucoxanthin has also been found in animal studies to decrease insulin and blood glucose levels. Researchers hypothesize that fucoxanthin anti-diabetes effect may be because fucoxanthin appears to promote the formation of DHA (the omega-3 fatty acid found in fish oil). DHA is thought to increase insulin sensitivity, improve triglycerides and reduce LDL ("bad") cholesterol.

Cancer

Preliminary research in test tubes suggests that fucoxanthin may have anti-tumor effects. No studies have looked at whether this holds true in humans or if taken orally. It's far too early for fucoxanthin to be used as a complementary treatment for cancer.

Side Effects
Because there hasn't been research on fucoxanthin in humans, the possible side effects aren't known.

People shouldn't consume large amounts of wakame or other types of seaweed as a source of fucoxanthin. Seaweed is rich in iodine and excessive consumption may result in iodine poisoning. High levels of iodine can interfere with the function of the thyroid gland. Also, consuming excess amounts of iodine-rich foods isn't recommended if there is a known allergy or hypersensitivity to iodine.