It is now realized that the focus in treating diabetes shouldn’t be so much on controlling blood sugar. New medical guidelines point to the importance of the following interventions (in order of benefit):
smoking cessation (most important)
blood pressure control
metformin drug therapy
lipid reduction
glycemic control (least important).
This isn’t to say that blood sugar isn’t important; but the others should be dealt with first.
Previous research has indicated that about a quarter of older adults who become mildly depressed will go on to become seriously depressed within a year or two. A study comparing problem-solving therapy for primary care — a seven-step approach delivered by non-mental-health professionals to help patients resolve difficulties and thus improve coping skills and confidence — with a program of dietary coaching (same number of sessions and hours), has found that elderly adults with mild symptoms of depression responded equally well to both treatments.
Two studies help explain why kidney disease increases the risk of cardiovascular diseases such as high blood pressure and vascular calcification. The mediator seems to be a hormone called FGF23, which is sensitive to the level of phosphates in the body.
Phosphate rich foods include processed cheese, Parmesan, cola, baking powder and most processed foods.
A study in which 157 healthy adult volunteers were asked to regulate their emotional reactions to unpleasant pictures, has found that those who showed greater brain activation when regulating their negative emotions also had higher blood levels of interleukin-6 (a marker for inflammation) and increased thickness of the carotid artery wall (a marker of atherosclerosis).
The finding helps explain why stress increases the risk for stroke and heart attack.
A study involving 614 patients with type 2 diabetes (mean age 62) has found that longer duration of diabetes was associated with more brain volume loss, particularly in the gray matter. Roughly, for every 10 years of diabetes, the brain was similar to that of a non-diabetic person who was two years older.
However, the study did not confirm any association of diabetes characteristics with small vessel ischemic disease.
Type 2 diabetes greatly increases a person's risk of developing cardiovascular disease, but a new study shows that cardiovascular risk factors such as elevated blood pressure and cholesterol levels differ significantly between men and women with diabetes.
The study, involving 680 diabetics, found that blood pressure and LDL cholesterol levels were significantly higher in women, and women were significantly less likely to have these factors under control. Some 17% of men had control of these factors, compared to 6% of women.
A mouse study has found that introduction of oral bacteria into the bloodstream increased risk factors for atherosclerotic heart disease, including cholesterol and inflammation, suggesting that the same bacteria that cause gum disease also promotes heart disease. The findings are consistent with recent evidence that patients with gum disease are at higher risk for heart disease.
The findings were presented at the annual meeting of the American Society for Microbiology.
A large study, involving 3,690 older adults, has found that drugs with strong anticholinergic effects cause memory and cognitive impairment when taken continuously for a mere two months. Moreover, taking multiple drugs with weaker anticholinergic effects, such as many common over-the-counter digestive aids, affected cognition after 90 days’ continuous use. In both these cases, the risk of cognitive impairment doubled (approximately).
A new study adds to growing evidence of a link between sleep problems and Alzheimer’s. The interesting thing is that this association – between sleep apnea and Alzheimer’s biomarkers — wasn’t revealed until the data was separated out according to BMI.
Because long-term cognitive decline can occur in some older adults after undergoing surgery, there has been some concern that exposure to anesthesia may be associated with increased dementia risk. It is therefore pleasing to report that data from the very large, long-running Mayo Clinic Study, the Rochester Epidemiology Project, has found that receiving general anesthesia for procedures after age 45 is not a risk factor for developing dementia.
