Latest Research on Diabetes Mellitus
Diabetes mellitus is an extremely common medical condition where the body is incapable of utilizing glucose and insulin appropriately. Insulin is a hormone manufactured by the pancreas that allows glucose to be converted into energy by the body’s tissues and muscles. A person with diabetes does not properly absorb glucose, and when the glucose circulates in the bloodstream, it damages the body’s organs and tissues over time (CDC, 2011).
Affecting millions of people, diabetes is the fastest growing long term medical condition around the world. The latest statistics from the American Diabetes Association (ADA, 2011) indicate than almost 26 million people living in the United States are afflicted by diabetes. It is also estimated that 7 million people are undiagnosed. Medical experts predict that approximately 33% of Americans will have diabetes by the year 2050. With diabetes numbers growing at this rate, as time goes on, it is likely that more and more diabetic patients will need to use the services of both doctors and prescription options.
Treatment with Metformin Linked to Lower Risk for Dementia
According to a recent report in HealthDay News, type 2 diabetic patients who begin treatment with metformin have a decreased risk of developing dementia. Metformin is one of the most common oral hypoglycemic medications used in obese diabetic patients. These research results are from a recent study presented at the annual conference of the 2013 International Alzheimer's Association.
The physician researchers analyzed the correlation between type 2 diabetes and dementia in approximately 15,000 patients who were 55 years of age or older. The participants were in a specific diabetes registry and began single oral diabetic medication therapy between 1999 and 2001. During a five year follow up period, almost 1,400 patients (10 percent) developed dementia, and 55 percent took metformin (Health Day, 2013).
When a comparison was made with patients using sulfonylureas, researchers discovered that only those taking metformin had a reduced risk of getting dementia. The hazard ratio was 0.79 after various adjustments were made for age, race, education and length of time with diabetes. A hazard ratio is defined as a measurement of the frequency of a particular event happening in one test group compared to the frequency of it occurring in another group over a period of time.
As compared to the subjects taking metformin, those who took sulfonylureas, thiazolidinediones, and insulin had a greater chance of developing dementia. The hazard ratios ranged from 1.18 to 1.28. Study investigators concluded that type 2 diabetic patients taking metformin had a five year reduced risk of dementia when compared to diabetics utilizing other forms of diabetic therapies. These results are considered to be preliminary evidence that the benefits of insulin sensitizers, like metformin, could go beyond control of glycemia to neurocognitive health as well.
Hypertension and Preeclampsia Doubled Risk for Diabetes in Pregnant Women
According to an article published in Endocrine Today in April of this year, women who have either preeclampsia or gestational hypertension during their pregnancy have two times the risk of developing diabetes when they are followed up to 16 years post pregnancy. This is according to the results of a study done in Ontario, Canada (Feig, 2013).
Gestational hypertension is generally defined as blood pressure in excess of 140/90, with no protein in the urine, diagnosed after 20 weeks of gestation. The accepted definition of preeclampsia is gestational hypertension with proteinuria (greater than 300 mg of protein found in a 24 hour urine specimen). It has already been established that women with preeclampsia or gestational hypertension show resistance to insulin during pregnancy. This is independent of glucose intolerance or obesity (CDC, 2011).
Canadian researchers conducted a study of more than 1 million pregnant women, in the age group of 15 to 50 years, who gave birth in Ontario between 1994 and 2008. Subject categories included having just preeclampsia (22,933 subjects), only gestational hypertension (27,605 patients), gestational diabetes alone (30,852 women), gestational diabetes with preeclampsia (1,476), gestational diabetes as well as gestational hypertension (2,100) or none of the above conditions (925,102).
According to resulting data, the incidence rate for diabetes per 1,000 person-years was 6.47 for subjects who had preeclampsia and 5.26 for those with gestational hypertension versus 2.81 in patients who had neither condition. Additional data indicated that having just preeclampsia or only gestational hypertension were also risk factors for resulting diabetes later on.
Furthermore, women with a diagnosis of gestational diabetes had an increased chance of going on to develop diabetes later in life. However, the presence of either preeclampsia or gestational hypertension, in combination with gestational diabetes, increased the risk for postpartum diabetes even more. These Canadian researchers suggest their results have maternal health implications. Hence, a history of either gestational hypertension or preeclampsia should alert health care professionals to the requirements for preventative counseling and increased vigilance in diabetes screening.
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