Thursday, 28 July 2011

In Pregnancy, Diabetes-Obesity Combo a Major Red Flag

In Pregnancy, Diabetes-Obesity Combo a Major Red Flag

Type 2 diabetes and obesity in pregnancy is a daunting duo, according to new research published this month in The Journal of Maternal-Fetal and Neonatal Medicine. The study shows that both conditions independently contribute to higher risks, opening the door to a wide range of pregnancy, delivery and newborn complications.

Study authors say the findings are important because obesity and type 2 diabetes are skyrocketing in women of childbearing age. A study in The Journal of the American Medical Association reports that between 2007 and 2008 the prevalence of obesity among adult women in the United States was more than 35 percent. A report from the Centers for Disease Control and Prevention states that approximately 11 percent of women above the age of 20 had diabetes in 2010.

Loralei Thornburg, M.D., senior study author and a high-risk pregnancy expert at the University of Rochester Medical Center, emphasizes that the research is needed now more than ever. “We’ve never seen the degree of obesity and type 2 diabetes in women that we are seeing right now, because for a very long time diabetes was a disease of an older population, so we rarely dealt with it in prenatal care. We hope this new knowledge will help physicians better understand and care for this rapidly expanding group of high-risk women.”

While numerous studies have established that obesity, in the absence of diabetes, is associated with problems in pregnancy – preterm birth, birth trauma, blood loss and a prolonged hospital stay, to name a few – less is known about type 2 diabetes and what causes difficulties when the two conditions coexist. Researchers from Rochester wanted to determine if obesity alone accounts for the increased risks in this “dual-diagnosis” group, or if diabetes plays a role as well.

To determine the influence of obesity and type 2 diabetes when the conditions coexist in pregnancy, Thornburg and lead study author Kristin Knight, M.D., used clinical records and the hospital’s birth certificate database to identify 213 pairs of women who delivered babies at the Medical Center between 2000 and 2008. Each pair included a diabetic and a non-diabetic patient with approximately the same pre-pregnancy body mass index (BMI). The majority of women in the study were overweight, obese or morbidly obese.

“We matched the pairs pound for pound, because if obesity was the main problem, we’d see similar outcomes between women, whether they had diabetes or not. But if we saw different outcomes between pairs, we’d know the diabetes was impacting outcomes as well,” said Thornburg.

Using mathematical models and controlling for outside factors, such as age and tobacco use, researchers found that the patients with type 2 diabetes had overall worse pregnancy, delivery and newborn outcomes than their BMI-matched counterparts. Specifically, diabetic patients had higher rates of preeclampsia, cesarean delivery, shoulder dystocia, preterm delivery, large for gestational age infant, fetal anomaly and admission to the neonatal intensive care unit.

“Women and their physicians need to be aware that each condition on its own increases risk in pregnancy, so when they coexist the situation is even more worrisome,” said Knight, a maternal fetal medicine fellow at Rochester. “Pregnancy is a time of great change, and fortunately many women are very open to making modifications during this period in their life. Anything a woman can do to improve her condition, from controlling blood sugar and exercising, to eating nutritious foods and maintaining an optimal weight, will help her deliver a healthier baby.”

Knight originally focused her research on the effects of type 1 and type 2 diabetes on pregnancy. In a previous study, she found that women with type 2 diabetes, most of whom were also obese, had poorer outcomes. Consequently, her research turned to obese, type 2 diabetics and their experiences in pregnancy.

“If a woman enters pregnancy obese, but hasn’t developed type 2 diabetes, she is in a better place than if she had both,” concluded Thornburg.

Thursday, 21 July 2011

Mum Sheds 66kg to Beat Diabetes

Mum Sheds 66kg to Beat Diabetes

AS ROCKHAMPTON'S Sandra Beutel watered her red begonia, she was reminded of the 30kg weight-loss milestone she'd reached on her huge journey of losing more than 66kg.

“Every 10 kilos I would lose, I would treat myself to a gift of some sort,” the 41-year-old said.

One gift to myself was a plant and every time I went to water it I could say that I lost 30kg to get this.”

Her two-year fitness transformation took the mother-of-three from 140kg to her goal of 74kg – a weight she hasn't been since her early teens – which she reached yesterday.

“After having my twins, I was around the 100kg mark, which is when I started to gain more weight,” Sandra said.

But after having her third child four years ago, Sandra was given the ultimatum that would eventually decide her fate.

“I had gestational diabetes and my doctor said I either had to start taking medication or lose weight, and I opted to lose weight,” Sandra said.

Sandra turned to Weight Watchers to start dropping the kilos, and has now been nominated for the group's annual Healthy Life Awards after losing 46% of her body weight.

“I am able to do a whole lot more than I ever have done before,” she said.

“My children are able to put their arms around me without any trouble at all, and my son loves that I am able to go bike riding with him.”

Sandra said it was getting so bad she had to inject herself with insulin and take naps during the day.

“Now I don't have to do that anymore, I feel so much more energised and able to do so much throughout the day.”

Weight Watchers will have an open day at their Canning St office on August 27 at 9.30am, where Sandra and other successful members from the Rockhampton area will speak to anyone interested in joining from the community.

Sandra will also be the Rockhampton Weight Watchers ambassador for the month of August as part of the open day.

Thursday, 14 July 2011

Study Links Diabetes, Heart Disease to TV Viewing

Study Links Diabetes, Heart Disease to TV Viewing

PARENTS who are less concerned about the number of hours their children and wards spent watching TV programmes and movies should note this, a new study from the Harvard School of Public Health (HSPH) ,published in the Journal of the American Medical Association has revealed that prolonged TV viewing is associated with increased risk of type 2 diabetes, cardiovascular disease and premature death.

According to a senior research author and Professor of Nutrition and Epidemiology at HSPH, Frank Hu, the message is simple, "cutting back on TV watching can significantly reduce risk of type 2 diabetes, heart disease, and premature mortality,"

"We should not only promote increasing physical activity levels but also reduce sedentary behaviours, especially prolonged TV watching," he added.

Hu and the first author of the study Anders Grontved, a doctoral student and visiting researcher in the HSPH Department of Nutrition, conducted a meta-analysis, a systematic assessment of all published studies from 1970 to 2011 that linked TV viewing with increased risk of type 2 diabetes, cardiovascular disease, and premature death.

Eight large prospective cohort studies from the United States, Europe, and Australia met the researchers" criteria and were included in the meta-analysis.

The results showed that more than two hours of TV viewing per day increased risk of type 2 diabetes and cardiovascular disease, and more than three hours of daily viewing increased risk of premature death.

"Sedentary lifestyle, especially prolonged TV watching, is clearly an important and modifiable risk factor for type 2 diabetes and cardiovascular disease," Grøntved added.

Monday, 4 July 2011

Pollutants Linked to Diabetes in New Study

Pollutants Linked to Diabetes in New Study

People with higher levels of pesticides and other pollutants in their blood may be more likely to get type 2 diabetes, suggests a new study of elderly Swedes.

The findings add to a growing body of evidence that these chemicals might drive changes in the body that lead to diabetes, researchers say, although they don't prove that one causes the other.
Taken together, the data suggest that there is more to the blood sugar disease than eating too much and not getting enough exercise, said Dr. David Carpenter, head of the Institute for Health and the Environment at the University at Albany in New York.
The pollutants, including pesticides and poly-chlorinated biphenyls, or PCBs, are largely found in meat and fatty fish. Some of them, including PCBs — once used in paint, plastics, and for electrical equipment manufacturing — are heavily regulated and no longer used in many countries.
However, "the exposure to these chemicals in the general population still occurs because they have widely contaminated our food chain," study researcher Dr. Duk-Hee Lee, of Kyungpook National University in Daegu, South Korea, told Reuters Health in an email.
In the current study, Lee and colleagues sought to follow up on previous findings that had linked these chemicals with type 2 diabetes.
They recruited a group of 725 diabetes-free elderly adults in Sweden and took blood samples to measure their levels of the pollutants. Then, the researchers followed them for the next five years.
Thirty-six of the study participants were diagnosed with type 2 diabetes over that time. When Lee's team accounted for other diabetes risks such as weight, exercise, and smoking, people who had high levels of PCBs were up to nine times more likely to get diabetes than those with very low pollutant levels in their blood.
The link was smaller for some pesticides, while others weren't linked to diabetes at all, according to the findings, which are published in the journal Diabetes Care.
The authors note that the number of new diabetes cases was low, and the findings can't prove that PCBs or other pollutants cause diabetes.
But research suggesting that's the case is piling up, said Carpenter, who was not involved in the new study.
More than eight percent of the U.S. population has diabetes, according to the National Institutes of Health — most of them type 2 diabetes.
Many studies have linked type 2 diabetes to overweight, lack of exercise and high blood pressure. In the new study, a big waistline was also a diabetes risk factor.
The authors speculate that long-term exposure to environmental pollutants could affect cells in the pancreas that secrete insulin, a hormone that regulates blood sugar.
It would make sense that heavier people are more at risk of diabetes, Carpenter added, because they're also probably eating more fatty meat and fish high in these chemicals — and they have more fat themselves where these chemicals are stored.
While researchers try to clear up just which pollutants may be linked to diabetes and how, strategies for preventing diabetes don't change much, Carpenter said.
"I think the message isn't really so different as it was when we thought diabetes was only a lifestyle disease," he said. "It is important to reduce your consumption of animal fat," and to be aware of how much fatty fish you're eating.
Lee added that eating more vegetables and other plant-based foods, as well as exercising, can help the body get rid of these pollutants.