StemCell Therapy

In a new study, experts describe how drinking water can protect against metabolic syndrome. The researchers discovered that while fructose stimulates the release of vasopressin, a hormone linked to obesity and diabetes, water can suppress the hormone and alleviate these conditions in mice.

Study lead author Dr. Miguel A. Lanaspa is an associate professor at the University of Colorado School of Medicine who specializes in renal disease and hypertension.

The clinical significance of this work is that it may encourage studies to evaluate whether simple increases in water intake may effectively mitigate obesity and metabolic syndrome, said Dr. Lanaspa.

The researchers set out to investigate why vasopressin, which maintains the bodys water levels, is elevated in people with obesity and diabetes.

In an experiment based on a mouse model, the experts fed mice sugar water specifically fructose and noticed that it stimulated the brain to make vasopressin. As a result, the vasopressin stored the water as fat, causing dehydration that triggered obesity. When the mice were treated with non-sugary water, their obesity was reduced.

According to Dr. Lanaspa, this is the first time scientists have shown how vasopressin acts on dietary sugar to cause obesity and diabetes.

We found that it does this by working through a particular vasopressin receptor known as V1b. This receptor has been known for a while but no one has really understood its function. We found that mice lacking V1b were completely protected from the effects of sugar. We also show that the administration of water can suppress vasopressin and both prevent and treat obesity.

The researchers also discovered that dehydration can stimulate the formation of fat. This explains why vasopressin is so high in desert mammals as they do not have easy access to water, noted study co-author Dr. Richard Johnson. So vasopressin conserves water by storing it as fat.

The findings support previous observations that obese patients often exhibit signs of dehydration. The research also explains why high salt diets tend to cause obesity and diabetes.

The study revealed that water therapy effectively protects against metabolic syndrome, which is a collection of coexisting conditions including high blood pressure, high blood sugar, and high triglyceride levels. Metabolic syndrome greatly increases the risk of heart disease, stroke, and type 2 diabetes.

The best way to block vasopressin is to drink water, said Dr. Lanaspa. This is hopeful because it means we may have a cheap, easy way of improving our lives and treating metabolic syndrome.

Sugar drives metabolic syndrome in part by the activation of vasopressin. Vasopressin drives fat production likely as a mechanism for storing metabolic water, concluded said Dr. Johnson. The potential roles of hydration and salt reduction in the treatment of obesity and metabolic syndrome should be considered.

The study is published in the journal JCI Insight.

By Chrissy Sexton, Earth.com Staff Writer

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Water is a powerful weapon against obesity and diabetes Earth.com - Earth.com

HIGH POINT, N.C., Dec. 15, 2020 (GLOBE NEWSWIRE) -- vTv Therapeutics Inc.(Nasdaq: VTVT) today announced that the Phase 2 Elevage study of azeliragon in people with mild Alzheimers disease and type 2 diabetes did not meet its primary objective of demonstrating an improvement in cognition as assessed by the 14-item Alzheimers Disease Assessment Scale Cognitive Subscale (ADAS-cog14) relative to placebo. The 6-month trial investigated the efficacy and safety of 5 mg azeliragon administered orally once daily compared to placebo in 43 people with mild probable Alzheimers disease and type 2 diabetes. The azeliragon treated group (n=21) had a 1.8 point decline from baseline in ADAS-cog14 compared to a placebo (n=22) decline of 0.35. These differences were not statistically significant. Consistent with previous studies, azeliragon was generally well-tolerated with similar incidences of treatment-emergent adverse events overall and by system organ class in both treatment groups.

We will continue to analyze the data to determine if there are potential benefits or future applications for azeliragon in Alzheimers, dementia or related indications that we or other interested parties may seek to pursue, said Steve Holcombe, chief executive officer, vTv Therapeutics. On behalf of vTv Therapeutics, we would like to extend our most sincere and heartfelt gratitude to study participants, their families, physicians and caregivers for their commitment to this important study despite the challenging circumstances created by the COVID-19 pandemic.

AboutvTv TherapeuticsvTv Therapeutics Inc.is a clinical-stage biopharmaceutical company focused on developing oral small molecule drug candidates. vTv has a pipeline of clinical drug candidates led by programs for the treatment of type 1 diabetes, Alzheimers and related dementia, and inflammatory disorders. vTvs development partners are pursuing additional indications in type 2 diabetes, chronic obstructive pulmonary disease (COPD), genetic mitochondrial diseases, and chronic kidney disease. For more information, please visitwww.vtvtherapeutics.comor follow us on Twitter: @vTvTherapeutics.

Forward-Looking StatementsThis release contains forward-looking statements, which involve risks and uncertainties. These forward-looking statements can be identified by the use of forward-looking terminology, including the terms anticipate, believe, could, estimate, expect, intend, may, plan, potential, predict, project, should, target, will, would and, in each case, their negative or other various or comparable terminology. All statements other than statements of historical facts contained in this release, including statements regarding the timing of our clinical trials, our strategy, future operations, future financial position, future revenue, projected costs, prospects, plans, objectives of management and expected market growth are forward-looking statements. These statements involve known and unknown risks, uncertainties and other important factors that may cause our actual results, performance or achievements to be materially different from any future results, performance or achievements expressed or implied by the forward-looking statements. Important factors that could cause our results to vary from expectations include those described under the heading Risk Factors in our Annual Report on Form 10-K and our other filings with theSEC. These forward-looking statements reflect our views with respect to future events as of the date of this release and are based on assumptions and subject to risks and uncertainties. Given these uncertainties, you should not place undue reliance on these forward-looking statements. These forward-looking statements represent our estimates and assumptions only as of the date of this release and, except as required by law, we undertake no obligation to update or review publicly any forward-looking statements, whether as a result of new information, future events or otherwise after the date of this release. We anticipate that subsequent events and developments will cause our views to change. Our forward-looking statements do not reflect the potential impact of any future acquisitions, merger, dispositions, joint ventures or investments we may undertake. We qualify all of our forward-looking statements by these cautionary statements.

Contacts

Investors:

Corey DavisLifeSci AdvisorsCDavis@LifeSciAdvisors.com

or

Media:Glenn SilverLazar FINN Partners646-871-8485gsilver@lazarpartners.com

Source: vTv Therapeutics Inc.

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vTv Therapeutics Announces Topline Results of Phase 2 Elevage Study of Azeliragon in Patients with Mild Alzheimer's Disease and Type 2 Diabetes -...

Special Report

December 15, 2020 1:02 pm

People living with diabetes are at a higher risk of developing severe COVID-19. A study published in the Lancet Diabetes & Endocrinology journal examined the medical records of 61.4 million people in the U.K. and found that 30% of COVID-19 deaths occurred in people with diabetes.

About one in 10 Americans, or 34.2 million people, live with diabetes, according to the Centers for Disease Control and Prevention data through 2018. Other findings from the data show that one in three people in the country have prediabetes, higher than normal blood sugar level, which can turn into diabetes if left untreated, and that new cases have been skyrocketing among young people.

Some of the most severe diabetes complications include ketoacidosis, which can be fatal, kidney disease, amputation, and blindness. And there is a new risk associated with the disease.24/7 Tempo reviewed multiple studies and reports by independent health organizations, such as the American Diabetes Association, and JDRF, a leading Type 1 diabetes research group, to compile a list of the 10 biggest warning signs of diabetes.

There are three types of diabetes. People with Type 1 diabetes, about 5%-10% of those with the disease, make very little or no insulin a hormone made by the pancreas that helps regulate blood sugar levels in the body by allowing cells to store the broken down sugars, or glucose (the bodys energy source). They must take insulin every day to live. People with Type 2 diabetes dont use insulin well. Their body is not capable of regulating blood sugar levels. The third type, gestational diabetes, develops in pregnant women. Blood sugar levels usually return to normal after childbirth.

Some diseases, including diabetes, have a particular odor and vague symptoms that seem completely normal daily activities like drinking coffee and eating cookies. Here are 18 ordinary habits that can be signs of serious health problems.

Click here to read about the 10 warning signs you may have diabetes.

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10 Warning Signs That You Might Have Diabetes - 24/7 Wall St.

The proportion of adults with diagnosed diabetes trebled in England between 1994 and 2019, according to latest research.

The findings, which relate to both type 1 and type 2 diabetes, are based on analysis of the latest results from the Health Survey for England 2019, which is commissioned by NHS Digital.

Covid-19 has rightly prompted greater focus on obesity reduction, which will also help with the problem of rising diabetes

Jenny Mindell

Researchers from University College London and the National Centre for Social Research analysed data from over 8,200 adults and 2,000 children living in private households in England

Their report shows the percentage of people who have been diagnosed with diabetes has risen since 1994, from 3% to 9% among men and from 2% to 6% among women.

They found total diabetes including both diagnosed cases and those found by the survey to have undiagnosed diabetes was much more common among people with lower incomes and obesity.

For example, 16% of people in the lowest income group had diabetes but only 7% in the highest income group.

Meanwhile, the proportion of adults with total diabetes increased from 5% of those with normal weight to 9% of adults with overweight and 15% of adults with obesity.

Additionally, the report highlighted that adults living in the most deprived areas were the most likely to be obese.

The difference was particularly pronounced for women, where 39% in the most deprived areas were obese, compared with 22% in the least deprived areas.

Professor Jenny Mindell, co-editor of the report, said: We have known for a long time that diabetes increases the risks of developing circulatory diseases and cancers.

We have seen this year that it also increases the risks of serious infection and death in people infected with Covid-19. Diabetes is much more common in people with obesity.

The Covid-19 pandemic has rightly prompted greater focus on obesity reduction, which will also help with the problem of rising diabetes, she added.

For the first time, the annual survey also asked about GP consultations, revealing that 69% of men and 82% of women had consulted a GP in the previous 12 months.

In addition, 84% of respondents had consulted their GP solely for a physical health problem, 5% for a mental health, nervous or emotional problem and 11% for both types of problem in the last 12 months.

Women were more likely than men to have discussed a mental health problem with their GP and to use counselling or therapy services for a mental health problem.

Consultations for mental health problems were more common among those from lower incomes 25% of adults in the lowest income group had one in the last year compared with 15% in the highest.

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Data shows diabetes levels in England have trebled in 25 years - Nursing Times

Compared with White people, those who are Black have higher cardiovascular risk when early-onset type 2 diabetes (T2D) develops, according to the results of a study published in Diabetes Care.

Studies have shown an increase in the incidence of early-onset T2D diagnosis and a greater risk for T2D among Black people when compared with White people, but the evaluation of ethnicity-specific temporal trends of early-onset T2D diagnosis and the impact of comorbidities at the time of diagnosis had not yet been conducted.

To investigate and compare the trends in early-onset T2D diagnosis of Black and White people as well as the trends of various risk factors at the time of T2D diagnosis, data from 606,440 individuals aged 18 to 70 years who were diagnosed with T2D between 2000 and 2018 were analyzed. Atherosclerotic cardiovascular disease (ASCVD) was defined by the presence of a clinical diagnosis of ischemic heart disease.

Over the past 2 decades, the rate of T2D diagnosis among Black patients within the age groups 18 to 39 and 40 to49 years has consistently been higher than that of their White counterparts (P <.01). The proportion of both Black and White patients diagnosed with T2D before 50 years of age increased significantly from 2012 to 2018 (P <.05).

Black patients had significantly higher mean hemoglobin A1c (HbA1c) than White patients across all age groups. Although no difference was seen in other age groups, Black patients 18 to 39 years of age had significantly higher body mass index (BMI) than their White counterparts (P =.02).

MACE-3 refers to 3-point major adverse cardiovascular events heart failure, myocardial infarction, or stroke. Black patients had a significantly higher risk for MACE-3 compared with White patients across all age groups, with the youngest age group having the highest relative risk (hazard ratio [HR], 1.63; 95% CI, 1.42-1.88) and the lowest relative risk observed in the oldest age group (HR, 1.11; 95% CI, 1.06-1.15).

Taken as a whole, the results of this study illustrated the increasing burden of early-onset T2D and the increased risk of MACE-3 for Black patients. Understanding the trends in diagnosis of early-onset T2D and the differences in the prevalence of related comorbidities among people of different ethnicities may improve healthcare practitioners ability to detect and manage this disease.

Limitations of this study include the use of electronic medical records, which may have resulted in errors in data collection due to condition coding, and the fact that the database did not link directly to hospitalized data.

Future investigation into potential explanations for the differences between ethnicities observed in this study are warranted.

Reference

Dibato JE, Montvida O, Zaccardi F, et al. Association of cardiometabolic multimorbidity and depression with cardiovascular events in early-onset adult type 2 diabetes: a multiethnic study in the US. Published online November 11, 2020. Diabetes Care. doi: 10.2337/dc20-2045

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Differences in Comorbidities and Diagnosis of Early-Onset Type 2 Diabetes by Ethnicity - Endocrinology Advisor

This article was originally published here

BMC Cardiovasc Disord. 2020 Dec 9;20(1):514. doi: 10.1186/s12872-020-01805-6.

ABSTRACT

BACKGROUND: This study aimed to reveal the association of diabetes mellitus and dialysis-dependent renal failure with the lesion severity and chronic total occlusion (CTO) in patients undergoing femoropopliteal endovascular therapy for intermittent claudication.

METHODS: This multicenter retrospective study analyzed the data of 2056 consecutive patients with moderate to severe intermittent claudication, who underwent endovascular therapy for de novo lesions in the superficial femoral artery to the proximal popliteal artery between 2010 and 2018 at five cardiovascular centers in Japan. The association of the clinical characteristics with severity of the lesions, as assessed by the Trans-Atlantic Inter-Society Consensus (TASC) II classification, was investigated using the ordinal logistic regression model. Their association with CTO, lesion length, and severity of calcifications was additionally analyzed using the binomial logistic regression model.

RESULTS: The prevalence of diabetes mellitus and dialysis-dependent renal failure was 54.7% and 21.4%, respectively; 12.5% of the patients had lesions corresponding to TASC II class D, and 39.3% of the patients had CTO. Current smoking and severe claudication were associated with more severe lesions assessed according to the TASC II classification; diabetes mellitus and dialysis dependence were inversely associated with disease severity. The adjusted odds ratios of diabetes mellitus and dialysis dependence were 0.82 (95% confidence interval 0.70-0.97; p = 0.018) and 0.76 (0.62-0.94; p = 0.009), respectively. Diabetes mellitus and dialysis dependence were also inversely associated with CTO (both p < 0.05). Furthermore, diabetes mellitus was inversely associated with a long lesion (p < 0.05). Diabetes mellitus and dialysis dependence were positively associated with severe calcification (both p < 0.05).

CONCLUSIONS: Diabetes mellitus and dialysis-dependent renal failure were inversely associated with the lesion severity, as assessed by the TASC II classification, and CTO in patients undergoing femoropopliteal endovascular therapy for intermittent claudication.

PMID:33297956 | DOI:10.1186/s12872-020-01805-6

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Inverse association of diabetes and dialysis with the severity of femoropopliteal lesions and chronic total occlusion: a cross-sectional study of 2056...

Dear Doctors: We keep hearing about Type 2 diabetes, and I'm embarrassed to say, I don't actually know what it is. What does it do, and how do I know if I have it?

Dear Reader: To understand diabetes, we should first talk about glucose. That's the sugar our bodies make from the foods that we eat, and which our cells use as their main source of fuel. Glucose travels throughout the body via the blood, which is why it's also often referred to as blood sugar. However, it's not immediately available to the cells. That's where insulin, a hormone manufactured by the pancreas, comes into play. Insulin helps transport glucose from the blood into the cells, where it can be used as energy.

When someone has diabetes, it means that the insulin part of that energy equation isn't working properly. Either the body isn't manufacturing enough -- or any -- insulin, or it isn't responding properly to the insulin that is present. That leads to blood-glucose levels that are too high.

Over time, high blood levels of glucose are dangerous. Adverse health effects include damage to the circulatory system, vision problems, nerve damage, stomach or intestinal problems, slow healing, kidney disease and an increase in the risk of heart disease and stroke. Extremely high blood sugar levels can lead to coma, and even death.

In Type 1 diabetes, the pancreas makes little or no insulin. It often develops early in life, but can occur at any age. This type of diabetes is managed with diet and exercise, plus the use of medications and insulin.

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Insulin is at the heart of both types of diabetes - The Times and Democrat

Data presented during the 2020 San Antonio Breast Cancer Symposium found that adhering to a diabetes risk reduction diet improved survival for women with stage 1 to 3 breast cancer compared to women who did not follow this specific diet.

Diabetes may be common in women with breast cancer, especially since 75%, or more than 2.6 million women, are at least 60 years or older, which means breast cancer survivorship must be managed in consideration with aging-related comorbidity such as diabetes, said Tengteng Wang, PhD, a research fellow at Harvard T.H. Chan School of Public Health during the virtual presentation of the study.

Type 2 diabetes, in particular, is a risk factor for breast cancer incidence and may be a predictive factor for breast cancer mortality. In addition, breast cancer increases the likelihood of developing type 2 diabetes.

Identifying modifiable strategies to prevent type 2 diabetes among breast cancer survivors may be very important to improve their survival outcomes, said Wang.

Researchers analyzed data from 8,320 women with stage 1 to 3 breast cancer from 2 large cohort studies: the Nurses Health Study (1980-2014) and the Nurses Health Study II (1991-2015). Validated questionnaires were completed every 2 to 4 years to collect information on diet among other factors.

This study focused on a diabetes risk reduction diet with 9 dietary components including higher intakes of nuts, cereal fiber, coffee, polyunsaturated-saturated fat ratio and whole fruits, in addition to a lower glycemic index of diet and lower intakes of sugar-sweetened beverages/fruit juices, trans fat and red meat.

The [diabetes risk reduction diet] has been associated with 14% lower type 2 diabetes risk in [a] previous publication of the Nurses Health Study, said Wang.

Researchers calculated an average score of adherence to this diabetes risk reduction diet through repeated measures of diet after a diagnosis of breast cancer. Follow-up was conducted for a median of 16 years after cancer diagnosis.

During follow-up, 2,146 deaths occurred, of which 948 were related to breast cancer. Women with higher diet adherence scores after diagnosis had a 33% lower risk for all-cause mortality (HR = 0.67; 95% CI, 0.58-0.78; P for trend < .0001) and a 17% lower risk for mortality related to breast cancer (HR = 0.83; 95% CI, 0.67-1.02; P for trend = .03) compared with women with lower diet adherence scores.

Our results did not differ by breast tumor ER status or stage, said Wang.

During the discussion portion of the presentation, Wang said that she and her colleagues analyzed what may be the potential mechanism for this association. She said, We looked at how [diabetes risk reduction diet][ influenced gene expression in [the] breast tumor for [a] subgroup of our breast cancer patients, and according to our pathway analysis, the [diabetes risk reduction diet] is more associated with the pathway related to immune regulation and also cell proliferation, so this is, I think, an interesting finding.

When further adjusting for neighborhood socioeconomic status, the association between diet adherence and mortality risk was slightly attenuated, with patients with greater adherence having a 31% lower risk for all-cause mortality (HR = 0.69; 95% CI, 0.6-0.8; P for trend < .0001) and a 14% lower risk for mortality from breast cancer (HR = 0.86; 95% CI, 0.7-1.07; P for trend = .06).

Women who improved their adherence to a diabetes risk reduction diet after breast cancer diagnosis had a lower risk for breast cancer mortality compared with those with consistently low adherence to this diet (HR = 0.81; 95% CI, 0.65-1).

In conclusion, we felt that a greater adherence to the [diabetes risk reduction diet] after breast cancer diagnosis was associated with better survival outcomes, which means promoting dietary changes consistent with prevention of type 2 diabetes may be very important for breast cancer survivors, said Wang.

A version of this story appeared on CURE as Dietary Changes to Reduce Diabetes Risk May Also Increase Survival for Breast Cancer.

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Diabetes Risk Reduction Diet Adherence Improved Survival for Patients with Breast Cancer - Cancer Network

TheStandards of Medical Care in Diabetes2021provides the latest in comprehensive, evidence-based recommendations for the diagnosis and treatment of children and adults with type 1, type 2, or gestational diabetes; strategies for the prevention or delay of type 2 diabetes; and therapeutic approaches that can reduce complications, mitigate cardiovascular and renal risk, and improve health outcomes.

This update presents:

Today, theStandards of Careis available online and is published as a supplement to the January 2021 issue ofDiabetes Care.

"The American Diabetes Association is committed to improving the lives of all those affected by diabetes through this publication of the most widely respected guidelines for health professionals," said Dr. Robert Gabbay, Chief Scientific and Medical Officer at the American Diabetes Association.

Updates to the Standards of Care are established and revised by the ADA's Professional Practice Committee(PPC). The committee is a multidisciplinary team of 16 leading U.S. experts in the field of diabetes care and includes physicians, diabetes care and education specialists, registered dietitians, and others with experience in adult and pediatric endocrinology, epidemiology, public health, cardiovascular risk management, microvascular complications, preconception and pregnancy care, weight management and diabetes prevention, and use of technology in diabetes management. Two designated representatives of the American College of Cardiology (ACC) reviewed and provided feedback on the "Cardiovascular Disease and Risk Management" section, and this section received endorsement from ACC. "As a world leader in diabetes care, the ADA is proud to set the standards!" said Boris Draznin, MD, PhD, Chair of the Professional Practice Committee.

The online version of the Standards of Care will continue to be annotated in real-time with necessary updates if new evidence or regulatory changes merit immediate incorporation through the living Standards of Care process. The ADA also publishes the abridged Standards of Careyearly for primary care providers in its journal, Clinical Diabetes, and offers a convenient Standards of Care appas well as a Standards of Care pocket chart. Other Standards of Care resources, including a webcastwith continuing education credit and a full slide deck, can be found on DiabetesPro.

About Diabetes CareDiabetes Care,a monthly journal of the American Diabetes Association (ADA), is the highest-ranked, peer-reviewed journal in the field of diabetes treatment and prevention. Dedicated to increasing knowledge, stimulating research and promoting better health care for people with diabetes, the journal publishes original articles on human studies in clinical care, education and nutrition; epidemiology, health services and psychosocial research; emerging treatments and technologies; and pathophysiology and complications. Diabetes Care also publishes the ADA's recommendations and statements, clinically relevant review articles, editorials and commentaries. Topics covered are of interest to clinically oriented physicians, researchers, epidemiologists, psychologists, diabetes care and education specialists and other health care professionals.

About the American Diabetes AssociationEvery day more than 4,000 people are newly diagnosed with diabetes in America. More than 122 million Americans have diabetes or prediabetes and are striving to manage their lives while living with the disease. The American Diabetes Association (ADA) is the nation's leading voluntary health organization fighting to bend the curve on the diabetes epidemic and help people living with diabetes thrive. For 80 years the ADA has been driving discovery and research to treat, manage and prevent diabetes, while working relentlessly for a cure. We help people with diabetes thrive by fighting for their rights and developing programs, advocacy and education designed to improve their quality of life. Diabetes has brought us together. What we do next will make us Connected for Life. To learn more or to get involved, visit us at diabetes.org or call 1-800-DIABETES (1-800-342-2383). Join the fight with us on Facebook (American Diabetes Association), Twitter (@AmDiabetesAssn) and Instagram (@AmDiabetesAssn).

Contact:Daisy Diaz, 703-253-4807[emailprotected]

SOURCE American Diabetes Association

http://www.diabetes.org

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ADA Releases 2021 Standards of Medical Care in Diabetes Centered on Evolving Evidence, Technology, and Individualized Care - PRNewswire

ANNAPOLIS, MDGovernor Larry Hogan today announced the commitment of more than $94 million in new investments across Maryland to help people with prediabetes and diabetes prevent or manage their disease during the COVID-19 pandemic.

The $94 million of new investments I am announcing today will be used to help Marylanders across the state battle diabetes, said Governor Hogan. Even in the midst of a pandemic, diabetes continues to be one of the most devastating health issues in our state. And having diabetes puts individuals at risk of serious illness from COVID-19, so this comes at an important time.

There are currently more than 2.1 million Marylanders with either diabetes or prediabetes, more than 34% of the total population, and many dont even know it. Diabetes is the 6th leading cause of death in Maryland, and people with Type 2 diabetes have a greater risk of serious illness from COVID-19, according to the Centers for Disease Control and Prevention (CDC).

Taken together, the measures being funded represent the first major community-based initiatives resulting from the Diabetes Action Plan, published last November.Developed with extensive input from community partners and diabetes experts, the Diabetes ActionPlan catalogs the state of this disease among Maryland residents and outlines comprehensive community-based prevention, management and treatment initiatives.

Todays initiatives announced by the governor include:

Regional Catalyst Grant Program

Recently the Health Services Cost Review Commission (HSCRC) announced the award of its new competitive Regional Partnership Catalyst Grant Program, an investment of more than $86.3 million in Maryland hospitals and their community health resource partners to support diabetes prevention, education, and self-management training programs. The HSCRC grant provides an initial five-year funding stream to help hospitals launch interventions that can be sustained at the end of the grant.

CareFirst Investments in Community Health

CareFirst BlueCross BlueShield will invest more than $6.6 million in four Maryland communities as part of a multi-year initiative to combat social and health disparities for people who are at risk for or have been diagnosed with diabetes. Thispledge will focus on steps and strategies that can be taken to intervene in areas where extensive data shows community and social factors contribute to the onset of diabetes. This work will be done in partnership with Local Health Improvement Coalitions (LHICs) and local health departments. LHICs are comprised of local partners, working with the health officers to create meaningful public-private partnerships supporting community wellness.

CHRC Partners with MDH and UMD to Support Local Health Coalitions

Marylands Community Health Resource Commission (CHRC), consistently supportive of the Diabetes Action Plan, recently awarded $1 million to Marylands local health departments to help LHICs expand capacity and build on innovative partnerships, services, and programming in communities at high-risk for diabetes.In an effort to maximize the impact of the grant funding, MDH will provide technical assistance to LHICs,in partnership with the Horowitz Center for Health Literacy in the School of Public Health, University of Maryland.

In addition, last year the CHRC issued 12 awards totaling $2.2 million to support projects in local communities in support of the Maryland Diabetes Action Plan through promoting food security and addressing other social determinants that impact diabetes.Addressing diabetes is a top funding priority of the CHRC, focusing on the Diabetes Action Plan recommendations to employ local action integrated with community approach in the fight against diabetes.

Along with these investments, Marylands Medicaid program added the National Diabetes Prevention Programs (NDPP) as a covered benefit last fall, providing both in-person and virtual access for eligible HealthChoice enrollees who may not have otherwise been able to afford it. The DPP is available through all nine of its Managed Care Organizations statewide.

Marylanders are urged to speak to their physician about their risk for diabetes, and go online to know their risk. An easy 60-second risk test from the American Diabetes Association can help everyone: https://www.diabetes.org/risk-test

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Governor Larry Hogan Announces $94 Million in Funding to Support Diabetes Prevention and Treatment for Marylanders - The Southern Maryland Chronicle

Why Global Citizens Should Care

Noncommunicable diseases (NCDs), such as cancers and diabetes, are now the leading cause of death in the world, according to the World Health Organizations (WHO) 2019 Global Health Estimates report published Wednesday.

The top10 diseases accounted for 55% of the 55.4 million deaths worldwide that were reported in 2019.

It is important to understand which diseases people die from to measure how people live and to ensure that health care systems areprepared to respond to patients needs, according to the WHO.

The WHOdefines NCDs as chronic diseases that are usually the result of genetic, physiological, environmental, and behavioral factors. In comparison, communicable diseases are transmitted between people, such as HIV/AIDS, tuberculosis, malaria, and tropical diseases.

At the global level, 7 of the 10 leading causes of death were NCDs in 2019. This is a dramatic rise from 2000, when only 4 of the top 10 diseases were classified as noncommunicable.

These new estimates are another reminder that we need to rapidly step up prevention, diagnosis,and treatment of noncommunicable diseases, WHO Director-GeneralDr. Tedros AdhanomGhebreyesussaid.

Related Stories Dec. 9, 2020 Thomson Reuters Foundation Poor Countries Are at Risk of Missing Out on COVID-19 Vaccines as Rich Nations Hoard Supplies

While the WHOs list outlines the top causes of death globally, the leading causes of death within eachcountry arevaried. The causes of death across high-,middle-,and low-income countries showthe difference between lifestyle and health care around the world.

In 2019, heart disease remained the number one killer globally and accounted for 16% of total diseases around the world, according to the report.

Heart disease has been the leading cause of death globally for the last 20 years. The number of people who died from the disease in 2019 rose to almost 9 million.

Related Stories Nov. 20, 2020 The WHO Just Introduced a Plan to Eliminate Cervical Cancer Around the World

For the first time, Alzheimers disease and other forms of dementia entered the top 10 causes of global death.The report also showed that women were more at risk of degenerative diseases, as 65% of Alzheimers and other forms ofdementia deaths were women.

Diabetes also entered the top 10 list in 2019. The number of people who died from the disease has increased by 70% since 2000. Men are more at risk of this disease and there was an 80% rise in death among men in the past two decades.

While Alzheimers disease, dementia, and diabetesare all classified as NCDs, none of themwere amongthe top 10 causes of death in low- or middle-income countries.

Related Stories Nov. 30, 2020 Malaria Will Kill More People Than COVID-19 in Sub-Saharan Africa This Year: WHO

Deaths from communicable diseases declined globally from 2000 to 2019, however, they are still a challenge in lower- and middle-income countries. In low-income countries, 6 of the top 10 causes of death were communicable diseases.

HIV/AIDS was nolonger listedamong the top 10 global diseases in 2019. Deaths from HIV/AIDS have decreased by 51% globally since 2000.However, in low-income countries, HIV/AIDS, malaria, and tuberculosis remainedin the top 10.

Dr. Samira Asma, assistant director-general for the division of data, analytics,and delivery for impact at the WHO, explained the importance of collecting data on worldwide deaths in the report.

The WHO Global Health Estimates are a powerful tool to maximize health and economic impact, she said. We call upon governments and stakeholders to urgently invest in data and health information systems to support timely and effective decision-making.

Continued here:
Noncommunicable Diseases Like Cancer and Diabetes Are the Top Causes of Death Globally: WHO - Global Citizen

By: Express Explained | Updated: December 12, 2020 5:18:59 pmA significant finding of their study says that owning a dog with diabetes was associated with a 38 per cent increased risk of diabetes in the owner.(Thinkstock)

A new study published in the British Medical Journal (BMJ) says that diabetes in dogs may indicate an elevated risk of type 2 diabetes in their owners.

The study

The study included more than 175,000 dog owners and nearly 90,000 cat owners along with their dogs and cats. The dog and cat owners included in the study were all middle-aged or older at the start of the study and were followed through for a period of six years (January 1, 2007 December 31, 2012).

Through this period, researchers analysed the incidence of type 2 diabetes in the pet owners and canine and feline diabetes in their pets.

So what does the research say?

Authors of the study, which was conducted at Uppsala University in Sweden in collaboration with three other universities, say that owners of a dog with diabetes are more likely to develop type 2 diabetes than owners of a dog without diabetes. A similar shared risk of diabetes could not be detected for cat owners and their pets, the researchers have said.

What could explain this association?

A significant finding of their study says that owning a dog with diabetes was associated with a 38 per cent increased risk of diabetes in the owner. Beatrice Kennedy, one of the senior authors of the study was quoted as saying in a press release that the association of diabetes between dogs and their owners might be explained by physical activity patterns, possibly also by their shared dietary habits and adiposity. The WHO defines adiposity as having a body mass index (BMI) of over 30 kg per metre square.

Significantly, if the reason for the association of a shared risk of the disease between dogs and their owners is indeed a result of their physical activity patterns, it would also explain why the researchers did not see a shared risk association of the disease between cats and their owners. Follow Express Explained on Telegram

Humans and dogs have lived together for at least 15,000 years, and continue to share their everyday lives for better or worse. In this unique study, we show that there might be common lifestyle and environmental factors that influence the risk of diabetes in the household, both in the dogs and in their owners, Tove Fall, another author of the study was quoted as saying.

What is type 2 diabetes?

Type 2 diabetes is the most common type of diabetes and occurs when blood glucose or blood sugar is too high and is most likely a result of excess body weight and physical inactivity. According to the World Health Organisation (WHO), this type of diabetes was seen only in adults but is now also occurring increasingly frequently in children. Overall, 422 million adults in the world have diabetes, including type 1.

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Explained: What a new study says about the shared risk of diabetes between dog and cat owners and their pets - The Indian Express

THE WOODLANDS, Texas, Dec. 11, 2020 (GLOBE NEWSWIRE) -- Lexicon Pharmaceuticals, Inc. (Nasdaq: LXRX), announced today that it has received Fast Track designation from the U.S. Food and Drug Administration (FDA) for the development of LX9211 in diabetic peripheral neuropathic pain.

The FDAs Fast Track designation of LX9211 reflects the serious unmet medical need of people suffering from diabetic peripheral neuropathic pain, said Praveen Tyle, Ph.D., executive vice president of research and development. We look forward to working closely with the FDA throughout the clinical development process to bring this potential new innovative treatment to patients as quickly as possible.

Lexicon is currently enrolling patients with diabetic peripheral neuropathic pain in a Phase 2 proof-of-concept study of LX9211 and is preparing to initiate a second Phase 2 clinical trial of LX9211 in post-herpetic neuralgia.

The FDAs Fast Track designation is designed to facilitate the development and expedite the review of drugs that are being developed to treat serious conditions and fill unmet medical needs. The purpose of the designation is to expedite the timeline for bringing important new drugs to patients. Programs receiving Fast Track designation may benefit from early and frequent interactions with the FDA over the course of drug development. In addition, the Fast Track designation program provides eligibility for accelerated approval and priority review if relevant criteria are met and enables sponsors to submit individual sections of a New Drug Application (NDA) for review on a rolling-submission basis.

About LX9211

LX9211 is a potent, orally delivered, selective small molecule inhibitor of adapter-associated kinase 1 (AAK1). Lexicon identified AAK1 in its target discovery efforts as a promising approach for the treatment of neuropathic pain, and identified LX9211 and another development candidate in a neuroscience drug discovery alliance with Bristol-Myers Squibb from which Lexicon holds exclusive development and commercialization rights. Preclinical studies of LX9211 demonstrated central nervous system penetration and reduction in pain behavior in models of neuropathic pain without affecting opiate pathways.

About Lexicon Pharmaceuticals

Lexicon is a biopharmaceutical company with a mission of pioneering medicines that transform patients lives. Through its Genome5000 program, Lexicon scientists studied the role and function of nearly 5,000 genes and identified more than 100 protein targets with significant therapeutic potential in a range of diseases. Through the precise targeting of these proteins, Lexicon is pioneering the discovery and development of innovative medicines to safely and effectively treat disease. Lexicon advanced one of these medicines to market and has a pipeline of promising drug candidates in discovery and clinical and preclinical development in neuropathic pain, heart failure, diabetes and metabolism and other indications. For additional information, please visit http://www.lexpharma.com.

Safe Harbor Statement

This press release contains forward-looking statements, including statements relating to Lexicons financial position, long-term outlook on its business and the clinical development and therapeutic and commercial potential of its drug candidates. In addition, this press release also contains forward looking statements relating to Lexicons growth and future operating results, discovery and development of products, strategic alliances and intellectual property, as well as other matters that are not historical facts or information. All forward-looking statements are based on managements current assumptions and expectations and involve risks, uncertainties and other important factors, specifically including Lexicons ability to meet its capital requirements, successfully conduct preclinical and clinical development and obtain necessary regulatory approvals of LX9211, sotagliflozin and its other potential drug candidates on its anticipated timelines, achieve its operational objectives, obtain patent protection for its discoveries and establish strategic alliances, as well as additional factors relating to manufacturing, intellectual property rights, and the therapeutic or commercial value of its drug candidates. Any of these risks, uncertainties and other factors may cause Lexicons actual results to be materially different from any future results expressed or implied by such forward-looking statements. Information identifying such important factors is contained under Risk Factors in Lexicons annual report on Form 10-K for the year ended December 31, 2019, as filed with the Securities and Exchange Commission. Lexicon undertakes no obligation to update or revise any such forward-looking statements, whether as a result of new information, future events or otherwise.

For Inquiries:

Chas SchultzExecutive Director, Corporate Communications and Investor RelationsLexicon Pharmaceuticals(281) 863-3421cschultz@lexpharma.com

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Lexicon Pharmaceuticals Receives Fast Track Designation From the FDA for LX9211 for Diabetic Peripheral Neuropathic Pain - GlobeNewswire

The risk for increased COVID-19 severity in people with type 1 diabetes appears similar to that of type 2 diabetes, contrary to some official advice from the Centers for Disease Control and Prevention (CDC). The new finding indicates that people with both types should be priority for receiving a vaccine, investigators say.

The study is the first to prospectively evaluate both inpatients and outpatients and to examine COVID-19 severity factors in addition to death in people with type 1 and type 2 diabetes separately, and was published online December 2 in Diabetes Care.

Among the patients, who were seen at Vanderbilt University Medical Center in Nashville between March and August 2020, those with both type 1 and type 2 diabetes had between a three- and fourfold greater risk for COVID-19 hospitalization and greater illness severity than people without diabetes after adjustments for age, race, and a number of other risk factors.

This finding is important since as of December 1, 2020, the CDC has classified the diabetes types differently in terms of underlying medical conditions that increase the risk for severe COVID-19.

Adults of any age with type 2 diabetes are considered "at increased risk of severe illness" from the virus that causes COVID-19 whereas CDC says those with type 1 "might be at an increased risk."

Lead author of the new paper Justin M. Gregory, MD, told Medscape Medical News: "I think this needs revision based on the current evidence. I think the data presented in our study and that of Barron et al in Lancet Endocrinology 2020 indicate the need to place type 1 diabetes at parity with type 2 diabetes."

"These studies indicate both conditions carry an adjusted odds ratio of three to four when compared with people without diabetes for hospitalization, illness severity, and mortality," he stressed.

There were no phase 3 vaccine data available for the vaccine at the time that Gregory, of the Ian M. Burr Division of Pediatric Endocrinology and Diabetes, Vanderbilt University School of Medicine, Nashville, and colleagues were writing their manuscript in late summer, so the article does not mention this.

But now, Gregory says, "Based on the initial press releases from Pfizer and Moderna, I am now optimistic that these vaccines might mitigate the excess morbidity and mortality from COVID-19 experienced by patients with diabetes."

"I am eager to see what we learn on December 10 and 17 [the scheduled dates for the meetings of the US Food and Drug Administration's Vaccines and Related Biological Products Advisory Committee to review the Pfizer and Moderna vaccines, respectively]."

But with the winter pandemic surge in the meantime, "Our investigation suggests that as COVID-19 hospitalizations rise, patients with both type 1 and 2 diabetes will comprise a disproportionally higher number of those admissions and, once hospitalized, demonstrate a greater degree of illness severity," he and his colleagues say.

"In light of these data, we call on our colleagues to emphasize the importance of social distancing measures and hand hygiene, with particular emphasis on patients with diabetes, including those in the most vulnerable communities whom our study affirms will face the most severe impact."

The new study data came from electronic health records at Vanderbilt University Medical Center, comprising 137 primary care, urgent care, and hospital facilities where patients were tested for SARS-CoV-2 regardless of the reason for their visit.

Between March 17 and August 7, 2020, a total of 6451 tested positive for COVID-19. Of those, 273 had type 2 diabetes and 40 had type 1 diabetes.

Children younger than 18 years accounted for 20.0% of those with type 1 diabetes and 9.4% of those without diabetes, but none of the type 2 group. The group with type 2 diabetes was considerably older than the type 1 diabetes and no-diabetes groups, 58 years versus 37 and 33 years, respectively.

Before adjustment for baseline characteristics that differed between groups, patients with type 1 diabetes appeared to have a risk for hospitalization and greater illness severity that was intermediate between the group with no diabetes and the group with type 2 diabetes, the researchers say.

But after adjustment for age, race, sex, hypertension, smoking, and body mass index, people with type 1 diabetes had odds ratios of 3.90 for hospitalization and 3.35 for greater illness severity, which was similar to risk in type 2 diabetes (3.36 and 3.42, respectively), compared to those without diabetes.

The investigators then conducted a detailed chart review for 37 of the 40 patients with type 1 diabetes and phone surveys with 15 of them.

The majority (28) had not been hospitalized, and only one was hospitalized for diabetic ketoacidosis (DKA) within 14 days of positive SARS-CoV-2 testing.

This contrasts with a report from the T1D Exchange, in which nearly half of 33 patients with type 1 diabetes and COVID-19 had been hospitalized with DKA. The reason for the discrepancy may be that more severe patients would more likely be referred to the T1D Exchange Registry, Gregory and colleagues hypothesize.

Clinical factors associated with COVID-19 severity (P < .05) in their study included a prior hypertension diagnosis, higher A1c, at least one prior DKA admission in the past year, and not using a continuous glucose monitor (CGM).

Hospitalizations were twice as likely and illness severity nearly twice as great among those with type 1 diabetes who were Black versus White. Just 8% of those with private insurance were hospitalized, compared with 60% of those with public insurance and 67% with no insurance (P = .001).

"Whereas previous reports have indicated proportionally higher rates of hospitalizations from COVID-19 among Black patients and those with public insurance, this study is the first to show a similar finding in the population with type 1 diabetes," Gregory and colleagues write.

Only 9% of patients using a CGM were hospitalized versus 47% who used blood glucose meters (P < .016). Similarly, hospitalizations occurred in 6% using an insulin pump versus 33% using multiple daily injections (P < .085).

But they note, "Our analysis cannot exclude the possibility that greater amounts of diabetes technology use are a surrogate for higher socioeconomic status."

This research was supported by the National Institute of Diabetes and Digestive and Kidney Diseases, JDRF, and the Appleby Foundation. The authors have reported no relevant financial relationships.

Diabetes Care. Published online December 2, 2020. Abstract

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Excerpt from:
Prioritize COVID-19 Vaccination in Both Types of Diabetes, Say Docs - Medscape

The University of Kentucky Public Relations & Strategic Communications Office provides a weekly health column available for use and reprint by news media. This week's column is by Laura Hieronymus, a doctor of nursing, master licensed diabetes educator and the associate director of education and quality services at the Barnstable Brown Diabetes Center and Daniel Stinnett a registered dietitian and master licensed diabetes educator in the Bluegrass Care Clinic.

LEXINGTON, Ky. (Dec. 7, 2020) Americans savor winter holiday meals; however, not always in a good way. Statistics show the December holiday season is one of the top three in terms of food consumption with the average adult taking in about 3,000 calories in one meal. Additional calories throughout the day can add up to two and a half times what an average adult needs for their daily energy needs. When you have diabetes, the added intake can affect blood glucose levels and potentially lead to symptoms such as fatigue, sluggishness, and even weight gain. During the holiday season, an overabundance of foods is often the rule rather than the exception. The following strategies may be helpful as you navigate your food intake:

Holiday celebrations often include beverages with alcohol. If you choose to drink do so in moderationgenerally considered no more than two drinks per day for men and one per day for women. Lighten up with lite beer, a wine spritzer, or calorie-free mixers. Avoid those specialty drinks such as Egg Nog (300+ calories), White Russian (4.5 ounces, 170+ calories), and 12 ounces of Christmas Ale (7.5% alcohol, 200+ calories) can be calorie-laden. Track your alcohol intake and avoid drinking on an empty stomach. If you become less attentive you will likely relax your focus on your overall calorie intake of food. Dont drink and drive.

Remember you can always counterbalance those extra holiday calories by staying active. Walk some extra steps after you eat, participate in interactive games or dance to your favorite music.

Stay informed by monitoring your blood glucose to help you make better decisions. Tomorrow is another day, so if things dont go as planned, learn from your experience and determine what you might do differently next time.

Above all, be safe and stay healthy. And, in the year of the 2020 pandemic do yourself and others a favor by staying socially distant, washing your hands, and wearing your mask. We all win.

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Diabetes and Healthful Holiday Strategies | UKNow - UKNow

By Tom McLaughlin

Successful diabetes management may soon begin closer to home with the help of easily accessible, online interactive learning thanks to a new Rutgers UniversityCamden research project.

The research project teaches family members communication strategies to help their loved ones manage Type 2 diabetes successfully.

The innovative Family Members as Coaches for Patients with Type 2 Diabetes pilot project, funded by the New Jersey Health Foundation, teaches people with Type 2 diabetes and their family members a host of effective communication strategies in order to help their loved ones manage the disease successfully.

Most diabetes management occurs in the home and with the help and sometimes hindrance of family members, says Kristin August, associate professor of psychology and director of the Health Sciences Center at RutgersCamden. Consequently, our focus is on figuring out if family members can be versed in more positive forms of communication that will ultimately lead to better diabetes management and improved family functioning.

The research project partners RutgersCamden with Cooper University Health Care, Jefferson Health, and Virtua Health to bring together small groups of dyads pairs comprised of a person with Type 2 diabetes and a family member for four monthly, virtual sessions. The participants learn communication strategies such as active listening and providing positive feedback, among others. The patients behaviors and attitudes are assessed via surveys and focus groups at the beginning of the intervention, immediately following it, and three months later.

August notes that most diabetes management occurs in the home and with the help and sometimes hindrance of family members.

Diabetes education helps patients gain the tools necessary to manage their diabetes successfully, says August, who leads the project with Kathleen Jackson, a clinical assistant professor in the Rutgers School of NursingCamden. Coaching, which involves a structured, supportive relationship, helps them to become more confident and motivated in their abilities to follow their regimen. We posit that the most effective coaches can be patients family members.

The first cohort of 11 dyads attended the monthly meetings from October 2019 through March 2020, when the COVID-19 pandemic brought the sessions, data collection, and recruitment to a standstill. The researchers then adapted the project to implement virtual sessions, which began this November.

According to August, they spent several months figuring out the logistics of hosting the group sessions, breakout rooms, and one-on-one conversations. They also modified visual aids to present the information on a computer, and utilized an existing, online version of their assessment survey.

The RutgersCamden researchers further taught participants how to use the software and to minimize distractions in their home environment. Erika Pitzer, a senior health sciences major and one of four RutgersCamden undergraduate students assisting August on the project notes that the dyads and the diabetes educator are still in the same virtual room together and are thus still able to build a solid rapport.

Kathleen Jackson, a clinical assistant professor in the Rutgers School of NursingCamden, leads the project with August.

I was actually surprised at how well they all adapted to the online platform, says the Cumberland County resident. The participants were all talking and asking questions of one another, and not just the facilitator.

August says that Pitzer and her fellow RutgersCamden students have been particularly vital to the virtual implementation of the project. In addition to their regular responsibilities conducting literature reviews, taking notes on the sessions, transcribing what was said, and offering their own perspectives of what transpired the students have been busy recruiting patients since the in-person diabetes education classes were canceled. That includes developing a project Facebook page, creating a recruitment video, and personally reaching out to prospective participants and other diabetes programs across the state.

In the long run, we may be able to reach even more people with this virtual implementation of the program, says August. This is particularly important during the COVID-19 pandemic. People with diabetes have a higher risk for severe illness, so managing their condition right now is more important than ever.

As it turns out, the RutgersCamden students are learning invaluable life skills as well. Pitzer notes that the switch to remote learning and a virtual implementation of the research project has required her to strengthen her focus, organizational skills, and overall resilience.

Erika Pitzer, a senior health sciences major, is one of four RutgersCamden undergraduate students assisting researchers on the project.

Its a challenge, but I am better because of this course, she says. As a student, that will translate to the rest of my courses and even my future career in medicine.

She credits August, as well as RutgersCamdens supportive academic environment including her advisors in the Honors College for making the transition to remote instruction easy for students.

I have never felt alone in that transition, she says. I am constantly reminded of the resources available on campus and my Honors College advisors are always there to answer even the silliest, smallest questions. There is always constant communication.

The RutgersCamden researchers will report findings on the diabetes family coaching project next November. However, preliminary survey data show that patients feel empowered to have a person available to help coach them through their diabetes management. Moreover, the patients felt that the positive communication strategies were beneficial to their personal relationships in general.

Funded by a Rutgers Community Design for Health and Wellness award, the researchers further plan to host focus groups with primary-care offices in spring 2021 to assess the ability to introduce the program in those settings, as part of a larger-scale implementation of this project. The long-term goal, says August, is to supplement diabetes education more generally with coaching and a package of informational materials for diabetes programs as well as public health programs to use.

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Innovative Research Project Teaches Families How to Manage Type 2 Diabetes Together - Rutgers-Camden NewsNow

Peripheral neuropathy is common in US adults and is associated with an increased risk of death, even in the absence of diabetes, researchers report today in the Annals of Internal Medicine.

The findings do not necessarily mean that doctors should implement broader screening for peripheral neuropathy at this time, however, the investigators say.

"Doctors don't typically screen for peripheral neuropathy in persons without diabetes," said senior author Elizabeth Selvin, PhD, MPH, professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland, in an email.

"Our study shows that peripheral neuropathy as assessed by decreased sensation in the feet is common, even in people without diabetes," Selvin explained. "It is not yet clear whether we should be screening people without diabetes since we don't have clear treatments, but our study does suggest that this condition is an underrecognized condition that is associated with poor outcomes."

Patients with diabetes typically undergo annual foot examinations that include screening for peripheral neuropathy, but that's not the case for most adults in the absence of diabetes.

"I don't know if we can make the jump that we should be screening people without diabetes," said first author Caitlin W. Hicks, MD, assistant professor of surgery, Division of Vascular Surgery and Endovascular Therapy, Johns Hopkins University School of Medicine. "Right now, we do not exactly know what it means in the people without diabetes, and we definitely do not know how to treat it. So, screening for it will tell us that this person has this and is at higher risk of mortality than someone who doesn't, but we do not know what to do with that information yet."

Nevertheless, the study raises the question of whether physicians should pay more attention to peripheral neuropathy in people without diabetes, said Hicks, who is the director of research at the university's diabetic foot and wound service.

To examine associations between peripheral neuropathy and all-cause and cardiovascular mortality in US adults, Hicks and colleagues analyzed data from 7116 adults aged 40 years or older who participated in the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2004.

The study included participants who underwent monofilament testing for peripheral neuropathy. During testing, technicians used a standard 5.07 Semmes-Weinstein nylon monofilament to apply slight pressure to the bottom of each foot at three sites. If participants could not correctly identify where pressure was applied, the test was repeated. After participants gave two incorrect or undeterminable responses for a site, the site was defined as insensate. The researchers defined peripheral neuropathy as at least one insensate site on either foot.

The researchers determined deaths and causes of death using death certificate records from the National Death Index through 2015.

In all, 13.5% of the participants had peripheral neuropathy, including 27% of adults with diabetes and 11.6% of adults without diabetes. Those with peripheral neuropathy were older, were more likely to be male, and had lower levels of education, compared with participants without peripheral neuropathy. They also had higher BMI, were more often former or current smokers, and had a higher prevalence of hypertension, hypercholesterolemia, and cardiovascular disease.

During a median follow-up of 13 years, 2128 participants died, including 488 who died of cardiovascular causes.

The incidence rate of all-cause mortality per 1000 person-years was 57.6 in adults with diabetes and peripheral neuropathy, 34.3 in adults with peripheral neuropathy but no diabetes, 27.1 in adults with diabetes but no peripheral neuropathy, and 13.0 in adults without diabetes or peripheral neuropathy.

Among participants with diabetes, the leading cause of death was cardiovascular disease (31% of deaths), whereas among participants without diabetes, the leading cause of death was malignant neoplasms (27% of deaths).

After adjustment for age, sex, race, or ethnicity, and risk factors such as cardiovascular disease, peripheral neuropathy was significantly associated with all-cause mortality (hazard ratio [HR], 1.49) and cardiovascular mortality (HR, 1.66) in participants with diabetes. In participants without diabetes, peripheral neuropathy was significantly associated with all-cause mortality (HR, 1.31), but its association with cardiovascular mortality was not statistically significant.

The association between peripheral neuropathy and all-cause mortality persisted in a sensitivity analysis that focused on adults with normoglycemia.

The study confirms findings from prior studies that examined the prevalence of loss of peripheral sensation in populations of older adults with and without diabetes, said Elsa S. Strotmeyer, PhD, MPH, associate professor of epidemiology at the University of Pittsburgh, Pittsburgh, Pennsylvania. "The clinical significance of the loss of peripheral sensation in older adults without diabetes is not fully appreciated," she said.

A limitation of the study is that peripheral neuropathy was not a clinical diagnosis. "Monofilament testing at the foot is a quick clinical screen for decreased lower-extremity sensation that likely is a result of sensory peripheral nerve decline," Strotmeyer said.

Another limitation is that death certificates are less accurate than medical records for determining cause of death.

"Past studies have indicated that peripheral nerve decline is related to common conditions in aging such as the metabolic syndrome and cardiovascular disease, cancer treatment, and physical function loss," Strotmeyer said. "Therefore it is not surprising that is related to mortality as these conditions in aging are associated with increased mortality. Loss of peripheral sensation at the foot may also be related to fall injuries, and mortality from fall injuries has increased dramatically in older adults over the past several decades."

Prior research has suggested that monofilament testing may play a role in screening for fall risk in older adults without diabetes, Strotmeyer added.

"For older adults both with and without diabetes, past studies have recommended monofilament testing be incorporated in geriatric screening for fall risk. Therefore, this article expands implications of clinical importance to understanding the pathology and consequences of loss of sensation at the foot in older patients," she said.

The study was funded by the National Institute of Diabetes and Digestive and Kidney Diseases and the National Heart, Lung, and Blood Institute. Hicks, Selvin, and a coauthor, Kunihiro Matsushita, MD, PhD, disclosed NIH grants. In addition, Selvin disclosed personal fees from Novo Nordisk and grants from the Foundation for the National Institutes of Health outside the submitted work, and Matsushita disclosed grants and personal fees from Fukuda Denshi outside the submitted work. Strotmeyer receives funding from the National Institute on Aging and the National Institute of Arthritis and Musculoskeletal and Skin Diseases and is chair of the health sciences section of the Gerontological Society of America.

Ann Intern Med. Published online December 7, 2020. Abstract

Jake Remaly is a staff journalist at Medscape Medical News and MDedge. He has covered healthcare and medicine for more than 5 years. He can be reached at jremaly@mdedge.com.

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Peripheral Neuropathy Tied to Mortality in Adults Without Diabetes - Medscape

Meghan Trainor insists her baby is healthy amid her battle with gestational diabetes.

The No Excuses singer revealed recently she has been diagnosed with the condition - which causes high blood sugar to develop during pregnancy, and usually disappears after giving birth - as she is currently expecting a baby boy with her husband Daryl Sabara.

And Meghan has now reassured fans that her condition is manageable, and both she and her unborn baby are doing fine.

She told the Today show: "Got a little tiny bump in the road - I got diagnosed with gestational diabetes, but it's manageable and it's okay. And I'm healthy and the baby's healthy. I just have to really pay attention to everything I eat.

"It's nice to learn so much about food and health, and [it's] nice to hear that so many women experienced this."

Meghan, 26, spoke about her gestational diabetes diagnosis late last month, when she said she knew she had to get tested for the condition because it runs in her family.

She said: "My family, we got gestational diabetes in my family, my mom had it for a month while she was pregnant and I mentioned it to my doctor and they tested me and were like, Okay, your blood sugars are pretty high. So I was like, Oh my God, Im sorry - I had a Pop-Tart and they were like, It doesnt work like that but lets focus on eating the right stuff and working out."

But unfortunately, the health scare hasnt helped to shun any of her cravings, which have all been for sugary foods.

She added: I just noticed that my whole life Ive been at nighttime, 'I want a giant bowl of popcorn, I want Salty Crunch' and now Im like, 'I really want a brownie or like Oreos, sugar...' and thats never been me.

"Im never like, 'Oh ice cream', and now Im like, 'I want a tub'. Also, like candy - I want a whole thing of Gushers right now."

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Meghan Trainor on gestational diabetes diagnosis: 'I'm healthy and the baby's healthy' - messenger-inquirer

Muscat: About 60 per cent of COVID-19 patients with diabetes or blood pressure do not survive its effects, a study by a group of doctors in Oman has found.

The study, which was conducted by 13 medical professionals and three research students, discovered that 61 per cent of COVID patients admitted to intensive care who also had diabetes, and 59 per cent of those with blood pressure, died from the disease.

This indicates to us that diabetes and blood pressure are some of the most important factors causing severe COVID-19 infection and death, said Dr Fahad Al Kindi, a senior consultant doctor in cardiovascular diseases at Sultan Qaboos University, and one of the doctors involved in the research.

The death rate of COVID-19 patients in intensive care in some countries has gone up to 40 per cent, but by the grace of God, the death rate here is only 14 per cent, and we intend to bring this number down to as low a figure as we can, by all the means available to us, he added.

The study involved the examination of COVID patients admitted to intensive care units in three hospitals in Muscat, Sultan Qaboos University Hospital, Al Nahda Hospital, and the Royal Hospital. It was done in two phases, the first running from March to May, and the second from June to August.

In the second stage of our scientific research, we decided to expand the number of patients involved in the study, said Al Kindi.

The more patients included in it, the greater the accuracy of our findings. In fact, that the results of the second stage were identical to those of our first shows that our initial discoveries were accurate, Al Kindi further said.

We were also able to discern the average ages of patients who died from the disease, which was different from the ages of those who recovered from the coronavirus, he explained, The average age of COVID patients who died from the disease is 60, while the age of those who recovered is about 48 years.

Following this study, the team of researchers now plan on studying the effects of COVID-19 on those who have recovered from the disease, and look at any problems they now face that are linked to the symptoms they presented when they were first admitted to the ICUs.

Also included in this next study will be the long-term complications they suffer from because of COVID-19, how any chronic diseases they suffer from continue to affect their recovery, and whether their body parts have been damaged or rendered defective due to this virus.

We took into our study all of the medical information of the patients we examined, from the time they entered the hospital, until they left, recalled Al Kindi. The system of medical records maintained by hospitals in Oman is detailed and accurate, and so helped us monitor the status of patients, including their symptoms, what medications they were on, and the extent of their bodies response to the drugs.

We collected all of the relevant patient information, including the nature of tests done on them, and then compared the treatment plans used for patients who had died from the disease, to those who had recovered from them, he added.

Excerpt from:
Effects of COVID-19 found to be worse in patients with diabetes, blood pressure - Times of Oman

Doctors at Vanderbilt Medical Center said people with diabetes should be prioritized for the COVID-19 vaccine.

NASHVILLE, Tenn. Doctors at Vanderbilt Medical Center say people with diabetes need to be prioritized for the COVID-19 vaccine. They also said there are certain side effects they need to be aware of.

Researchers at Vanderbilt said they studied more than 6,000 COVID-19 patients since March. They have compared the overall impact of the illness between those with Type 1 Diabetes, Type 2 Diabetes, and those who dont have Diabetes.

Researchers say 90% of Diabetic patients in the United States have Type 2 Diabetes. Around 10% (or 1.6 million people) have Type 1 Diabetes in the U.S.

They say while studies have suggested that those with Type 2 Diabetes are at higher risk for more serious complications and being hospitalized with COVID-19, little is known about the risk for individuals with Type 1 Diabetes.

Before we know it, we are going to have to decide which patients we need to prioritize to receive immunization for COVID-19, said Dr. Justin M. Gregory MD, MSCI.

Dr. Gregory not only researches how COVID-19 impacts Diabetic patients; he also lives with Type 1 Diabetes. Now, with a COVID-19 vaccine on its way, he says people with diabetes dont need to be the very first to get vaccinated.

Not above healthcare workers, not above people in nursing homes, but soon thereafter, Dr. Gregory said.

He said thats because those with Type 1 or Type 2 Diabetes are three times more likely to have a severe illness than those who dont have the medical condition. When it comes to getting the vaccine, they should expect certain side effects, including flu-like symptoms.

When people with Diabetes have flu-like symptoms, we know that makes their blood sugar levels go up, Dr. Gregory said. When people with Type 1 Diabetes and to some extent Type 2 Diabetes are getting these vaccines, they need to be positioning themselves and being really really on top of their diabetes control, as if they were sick.

He mentions that even though patients blood sugar might be more difficult to control a few days after, he still encourages them to get vaccinated.

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Vanderbilt doctors urge priority COVID-19 vaccination for Diabetic patients - WBIR.com