Tag Archives: type 2 diabetes

Insight: Think Preventive Medicine Will Save Money? Think Again

Captured by Reuters

It seems like a no-brainer.

Since about 75 percent of healthcare spending in the United States is for largely preventable chronic illnesses such as Type 2 diabetes and heart disease, providing more preventive care should cut costs.

If only.

In a report released on Tuesday, the non-profit Trust for America’s Health outlined a plan “to move from sick care to health care” by putting more resources into preventing chronic disease rather than treating it, as the current system does. There is a strong humanitarian justification for prevention, argued Trust Executive Director Jeffrey Levi in an interview, since it reduces human suffering.

But the report also makes an economic argument for preventive care, highlighting the possibility of reducing healthcare spending — which in 2011 reached $2.7 trillion, just shy of 18 percent of gross domestic product — by billions of dollars. And that has health economists shaking their heads.

“Preventive care is more about the right thing to do” because it spares people the misery of illness, said economist Austin Frakt of Boston University. “But it’s not plausible to think you can cut healthcare spending through preventive care. This is widely misunderstood.”

A 2010 study in the journal Health Affairs, for instance, calculated that if 90 percent of the U.S. population used proven preventive services, more than do now, it would save only 0.2 percent of healthcare spending.

Some disease-prevention programs do produce net savings. Childhood immunizations, and probably some adult immunizations (such as for pneumonia and the flu), are cost-saving, found a 2009 analysis for the Robert Wood Johnson Foundation. The vaccines are cheap, and large swaths of the population are vulnerable to the diseases they prevent. The cost of providing them to everyone is less than that of treating the illnesses they prevent.

Counseling adults about using baby aspirin to prevent cardiovascular disease also produces net savings. The counseling is inexpensive, the aspirin even cheaper and the costs of heart disease, which strikes one in three U.S. adults, are enormous. Screening pregnant women for HIV produces net savings, too.

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‘Do Your Best’ Not a Good Enough Goal to Improve Diabetes Diet

Captured by Emily Caldwell

A specific goal to eat a set number of daily servings of  low-glycemic-index foods can improve dietary habits of people with Type 2 diabetes, according to new research.

Study participants were given a goal to eat either six or eight daily servings of foods with a low glycemic index – carbohydrates that are digested slowly and are less likely to spike blood-sugar levels than would carbohydrates with a high glycemic index.

Overall, most participants reached the eight-serving goal, partly because researchers discovered that many people were already consuming about six servings of low-glycemic-index foods each day.

The participants also ate about 500 fewer daily calories and added vegetables, fruits and nuts and seeds to their diet – all foods that are on the low end of the glycemic index.

Participants’ confidence about being able to meet these dietary recommendations was key to their ability to reach the goal. People who had more confidence about the goal were more committed, and higher commitment levels led to a better likelihood that they would reach the goal.

Goal-setting theories are applied widely in the workplace and in sports management, but little research has examined the effectiveness of setting goals in a clinical setting to improve health – even though goal-setting is a common technique used by health-care providers.

“We ask people to set goals because they motivate action,” said Carla Miller, associate professor of human nutrition at Ohio State University and lead author of the study. “Telling people to ‘go out and do your best’ is not effective. It’s not specific enough, or targeted enough, or timely.

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Electronic Health Records Could Improve Care for Type 2 Diabetics

Source: Health behavior News Service

Use of electronic health records shows promise for improving care and outcomes in patients with type 2 diabetes, but still has considerable room for improvement, according to a new study in the journal Health Services Research.

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Researchers Test a Drug-Exercise Program Designed to Prevent Type 2 Diabetes

Source: Newswise

Study suggests that exercise and one of the most commonly prescribed drugs for diabetes, metformin, each improves insulin resistance when used alone, but together, metformin blunted the full effect of a 12-week exercise program in pre-diabetic men and women.

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ASU, Pfizer Partner on $5M Type 2 Diabetes Biomarker Project

Captured by Arizona State University

Arizona State University will lead a four-year, $5 million expanded initiative sponsored by the National Institutes of Health to discover proteins, or biomarkers, to help predict cardiovascular disease and to assess potential new treatments in people with type 2 diabetes.

Nearly 26 million Americans have diabetes, the seventh leading cause of death in the U.S. The disease is a major cause of heart disease, stroke, kidney disease, blindness and amputation. The national cost of diabetes was an estimated $174 billion in 2007, the majority for direct medical costs.

Controlling blood sugar (glucose) levels is vital for treating diabetes and preventing or slowing complications. However, heart attack and stroke remain leading causes of death in diabetes.

“There are no standard biomarkers to identify people with type 2 diabetes who are more likely to develop cardiovascular disease. We assembled a highly integrated, multidisciplinary research team to discover, validate and translate novel protein biomarkers for cardiovascular complications in type 2 diabetes and their use in drug development,” said project leader Randy Nelson, director of the Molecular Biosignatures Analysis Unit at ASU’s Biodesign Institute. Nelson is an expert in proteomics, a scientific discipline that studies the structure and function of the proteins that constitute an organism.

The project is supported under an NIH program that encourages scientists from different disciplines to collaborate on a single, critically important research problem that has the potential to advance clinical research.

“Identifying markers to predict heart and blood vessel diseases in people with type 2 diabetes is challenging but important,” said Salvatore Sechi, Ph.D., who oversees the project for the NIH’s National Institute of Diabetes and Digestive and Kidney Diseases.  “We are looking to the project’s team of experts in proteomics, drug development, biostatistics and clinical studies to advance the difficult search for markers that may be useful for both diagnosis and for assessing potential new drug therapies.” Read more…

Natural Compound Helps Reverse Diabetes in Mice

Captured by Washington University in St. Louis 

Researchers at Washington University School of Medicine in St. Louis have restored normal blood sugar metabolism in diabetic mice using a compound the body makes naturally. The finding suggests that it may one day be possible for people to take the compound much like a daily vitamin as a way to treat or even prevent type 2 diabetes.

This naturally occurring compound is called nicotinamide mononucleotide, or NMN, and it plays a vital role in how cells use energy.

“After giving NMN, glucose tolerance goes completely back to normal in female diabetic mice,” says Shin-ichiro Imai, MD, PhD, associate professor of developmental biology. “In males, we see a milder effect compared to females, but we still see an effect. These are really remarkable results. NMN improves diabetic symptoms, at least in mice.”

The research appeared recently online in Cell Metabolism.

Imai says this discovery holds promise for people because the mechanisms that NMN influences are largely the same in mice and humans.

“But whether this mechanism is equally compromised in human patients with type 2 diabetes is something we have to check,” Imai says. “We have plans to do this in the very near future.”

All cells in the body make NMN in a chain of reactions leading to production of NAD, a vital molecule that harvests energy from nutrients and puts it into a form cells can use. Among other things, NAD activates a protein called SIRT1 that has been shown to promote healthy metabolism throughout the body, from the pancreas to the liver to muscle and fat tissue.

According to the study, aging and eating a high-fat diet reduce production of NMN, slowing the body’s production of NAD and leading to abnormal metabolic conditions such as diabetes. NAD cannot be given to the mice directly because of toxic effects. But after administering NMN, levels of NAD rise and the diabetic mice show dramatically improved responses to glucose. In some cases, they return to normal. Read more…

Parents ‘want child gene tests’

Captured by BBC News

Parents believe the benefits of testing their children for the genetic risk of some diseases outweigh the negative consequences, according to US scientists.

In the study, published in the journal Pediatrics, parents who were offered a genetic test supported their children also being tested.

The authors say doctors and politicians need to be more aware of the issue.

Genewatch UK said children should never be tested for adult conditions.

Genetic testing used to be confined to specialist clinics, but direct-to-consumer testing is now possible.

People send a sample to a company in the post and are told if they have any genes which carry an increased risk of illness.

In this study, 219 parents were tested for 15 genetic variants linked to heart disease, osteoporosis, high blood pressure, high cholesterol, type 2 diabetes and colon, skin and lung cancer.