Research undertaken by a team at the Royal Infirmary of Edinburgh, Scotland, has revealed that treating people with diabetes for any cardiovascular problems could halve the number of individuals that die after developing a diabetic foot ulcer.
The research was undertaken following the introduction of a new cardiovascular policy in 2001, whereby a full assessment of each individual’s cardiovascular health was carried out upon presenting with a diabetic foot ulcer. This included checking blood pressure, cholesterol levels and heart function. Cardioprotective medicines, for example aspirin, statins, angiotensin-converting enzyme inhibitors and beta-blockers, were prescribed as needed.
The researchers found that the death rate among people with foot ulcers was 43.3% before the policy was introduced, and was reduced to 21.9% after it came into effect.
As diabetic foot ulcers have been previously linked to heart disease, the researchers realised that the appearance of a foot ulcer almost certainly indicated arterial damage somewhere else in the body.
Matthew Young, Consultant Physician at the hospital, was quoted by the BBC: “By applying the principles of cardiovascular risk reduction, we were able to offer them a more specialised package of care. If this was repeated across Scotland it would prolong the lives of thousands of patients, and tens of thousands across the UK as a whole.”
BBC News, 10 November 2008
Primary prevention of CVD with aspirin has no benefit in diabetes
A British study has revealed that the popular drug for preventing myocardial infarction and stroke, aspirin, confers no benefit in people with diabetes who have not yet suffered a cardiovascular event.
The authors found that, while it was effective in people with diabetes who had already developed coronary heart disease or suffered a stroke or myocardial infarction, regular aspirin use offered no benefit for those with diabetes or peripheral arterial disease who had not had a cardiovascular event.
The researchers gave almost 1300 people either aspirin plus an antioxidant or placebo, an antioxidant plus a placebo, or two placebos. They found that after 8 years, the number of heart attacks and strokes was similar between all groups.
Aspirin is advocated for primary prevention of heart disease in several guidelines; the message from investigator Jill Belch, University of Dundee, was that this recommendation may need to be re-thought. “We found no evidence to support the use of either aspirin or antioxidants in the primary prevention of cardiovascular events and mortality in people with diabetes,” wrote Jill in the British Medical Journal.
Reuters, 17 October 2008
Packaging chemical linked to increased diabetes and CVD
Bisphenol A (BPA), a chemical found in baby bottles, cans and other plastic products could increase the risk of developing heart disease and type 2 diabetes, according to a British study.
The researchers found that the chemical is present in easily detectable quantities in up to 90% of the population. BPA enters the body primarily through food and drink, but also through drinking-water and dental sealants, through the skin, or by inhalation of household dust.
The study investigated 1455 individuals by testing urine samples for BPA, and asking whether they had suffered from one of several conditions.
Of the participants, 79 had some form of cardiovascular disease (CVD), and 136 had diabetes. However, those with higher urine concentrations of BPA had a threefold higher risk of being diagnosed with some form of CVD compared with those who had a lower concentration of the chemical. Similarly, those with the highest BPA concentrations were 2.4 times more likely to have had diabetes diagnosed compared with those with low levels.
As reported in The Times, the authors of the study said that the results “deserve scientific follow-up”.
The Times, 17 September 2008
Stop wine-ing about exercise!
For those who are fed up with being told to get off the couch and go and do some exercise, a solution may be in sight.
A new drug similar to resveratrol (the compound found in red wine that we told you about in the last issue) could allow confirmed exercise- and salad-dodgers to eat as much as they like without putting on weight. Not only this, it may also prevent diabetes!
According to a story in the Daily Mail, the drug, which fools the body into thinking food is scarce and needs to access its fat stores for energy, is only 7 years away from the market.
Daily Mail, 5 November 2008
Obese? Take your children for a walk!
Overweight? Obese? If you have children they may well be the solution to your problem.
Under new plans announced by the Health Secretary, Alan Johnson, people who walk their children to school, as well as attending keep-fit and other exercise classes, will be given vouchers to spend on healthy food or sports gear.
While some critics have labelled this as tantamount to bribery, the Government believes that this may be the only way to help people to recognise that they have a weight problem.
Daily Telegraph, 11 November 2008
Attempts to achieve remission, or at least a substantial improvement in glycaemic control, should be the initial focus at type 2 diabetes diagnosis.
9 May 2024