Category: Diabetes 101

It may come as a surprise to many that diabetes can affect both humans and animals. Treatment for diabetes in humans is much easier because they’re usually willing to take steps to mitigate the effects of the disease, but it’s impossible to communicate the risks of diabetes to a pet. Any treatment plan for diabetes must be based on accommodating fluctuations in blood sugar; however, such fluctuations can be difficult to detect in pets.

Nadja Affenzeller and her colleagues at the University of Veterinary Medicine in Vienna may have found a solution to the problem. Affenzeller and her team have shown that a commercially-available blood glucose monitoring system can be utilized with dogs at any time, even when they’re outside of a clinic. The information provided by the glucose monitoring can help veterinarians in deciding on the dog’s treatment.

Diabetes, when it goes unmanaged, can lead to a significantly impaired life for both humans and pets. After an individual develops diabetes, care must be taken to maintain insulin levels near those of a non-diabetic. Recent advances in diabetes treatment have led to novel insulin therapies but such medications often require near-constant monitoring of blood glucose levels. Such information can be recorded while the patient is in the clinic but a variety of variables, such as stress, the time of the last meal, and exercise may affect the results. Therefore, it’s must more effective to obtain data on insulin levels while the individual is living his or her normal daily life.

Mennarini Diagnostics has developed a system called GlucoDay for continuous blood sugar monitoring in human diabetics. The system measures a wide range of glucose concentrations, which means that it could also be used in animals. Affenzeller and her team tested the GlucoDay system in ten diabetic dogs, all of which were believed to be receiving appropriate treatment with insulin. The test results were mostly positive, with the system being well-tolerated and working under the test conditions, aside from the loss of one apparatus in a fight and the breakdown of two of the systems before the end of the test.

The researchers were surprised by the results of the test: according to the GlucoDay monitoring, none of the dogs were receiving optimum treatment for diabetes. Using the data, scientists were able to make recommendations for more appropriate treatment, such as increasing dosage of insulin or altering diets.

Affenzeller commented that although the test showed that the dogs were not receiving proper care, the findings are not a sign of poor treatment by the doctors but rather an indication of the difficulty in accurately measuring glucose levels in animals such as dogs. “The information on the dogs’ glucose levels was easy to interpret and enabled us to improve the treatment in every single case,” said Affenzeller. “This doesn’t mean that the vets hadn’t done their work properly but shows how difficult it is to determine appropriate treatment without detailed information of this kind.” The constant monitoring of glucose levels that the GlucoDay system provides could be a catalyst for providing diabetes treatment for dogs that is just as effective as what humans receive.

The research paper, authored by Affenzeller along with Johann G. Thalhammer and Michael Wilmann, is titled “Home-based subcutaneous continuous glucose monitoring in ten diabetic dogs – a case series study” and is published in the journal “The Veterinary Record.”

Scientists in Australia have revealed that they could be on the verge of an exciting development in reversing Type 2 diabetes. The researchers’ discovery involves a specific gene and its disruption of insulin production in the pancreas in response to high-fat diets. The results of the study were published in the journal “Diabetes.”

Over 700,000 Australians have been diagnosed with Type 2 diabetes. There is currently no cure for the disease; caused by a variety of hereditary and environmental factors, including lack of exercise, poor diet, and obesity, Type 2 diabetes most commonly affects older individuals. The disease impairs the ability of the beta cells in the pancreas to produce insulin, which removes sugar from the blood stream and transports it to cells to be used as energy.

In those who follow a healthy diet and exercise regularly, the gene being studied by the Australian researchers — known as ld1 — generally does not activate, and so insulin production is not impaired. However, according to the researchers, a high-fat diet activates the gene and disrupts insulin production in the beta cells of the pancreas. Conducting their research at the Diabetes and Obesity Research Program at the Garvan Institute of Medical Research in Sydney, Australia, the research team based its findings on experiments conducted with mice and cell cultures.

Next on the research team’s agenda is to test whether medications might be developed to prevent the ld1 gene from activating and disrupting insulin production. Dr. Ross Laybutt with the Garvan Institute described how medications that target the gene could be used to reverse Type 2 diabetes. “The drugs could help the beta cells continue to produce insulin and protect them from the effects of a high-fat diet,” said Dr. Laybutt. “So even when you were having this high-fat diet your beta cells would be protected against the normal deterioration that occurs. That’s the potential. You wouldn’t have diabetes anymore because it only occurs when the beta cells fail to secrete enough insulin.”

The research team found that high-fat diets caused the ld1 gene to activate in the lab mice, which triggered the onset of Type 2 diabetes. However, when the mice were fed the same high-fat diets but the researchers blocked their ld1 genes, the mice did not develop diabetes. Additional research showed that pancreatic tissue from patients with diabetes contains increase levels of ld1; the gene is also known to promote the growth of cancerous cells.

Although the genetic relationships that cause diabetes are complex, Dr. Laybutt commented that ld1 seems to be the gene that begins the onset of diabetes by controlling other genes. “This gene is a master regulator of the other genes that make the beta cells work properly… When ld1 switches on it directly affects other genes which confer the ability of the beta cells to secrete insulin. Fat in the diet also switches on the gene as well as high glucose and stress too,” he said.

Dr. Laybutt cautioned that it will likely be years before a medication could be developed based on the findings. “It would be a five to 10 year process. Establishing the clinical benefits of a drug and the safety of drugs takes a lot of time. It would be in that sort of time frame before there would be a marketable drug for Type 2 diabetes to target this gene.”

A study released Monday suggests that children who have been diagnosed with diabetes are at increased risk of developing asthma. In addition, blood glucose regulation seems to be more difficult for children who have both asthma and diabetes. The study was published in the journal “Pediatrics.”

The study’s researchers analyzed data from 2,000 children with diabetes, aged 3 to 21.  Eleven percent of them also had asthma; the rate of asthma among non-diabetic children and young adults is around 9 percent. The reason for the difference in asthma rates was not immediately clear, according to the researchers.

The children with Type 2 diabetes were also shown to be more likely to have asthma than those with Type 1 diabetes. Sixteen percent of the children with Type 2 diabetes had asthma compared to 10 percent of the children with Type 1 diabetes.

Type 1 diabetes occurs more often in children. It results from irregular function of the autoimmune system, which destroys the pancreatic beta cells responsible for producing insulin, the hormone that helps move glucose from the blood and into the body’s cells so that it can be used for energy. Their lack of insulin, known as insulin deficiency, means that Type 1 diabetics have to take injections of insulin or use an insulin pump to deliver the hormone and ensure that their blood sugar levels do not rise too high.

The children and young adults involved with the study who had both Type 1 diabetes and asthma were more likely to demonstrate poor blood sugar control compared to those who did not have asthma: 15.5 percent for children with both diseases compared to 9 percent for children who only had diabetes.

For the purposes of the study, poor blood sugar control was defined as demonstrating a hemoglobin A1C level — a measure of blood glucose control over long periods of time — of over 9.5 percent. The ideal hemoglobin A1C levels for adults are below 7 percent, while children could be healthy with levels of up to 8.5 percent.

According to Mary Helen Black with Kaiser Permanente Southern California, the correlation between diabetes and higher asthma rates points to obesity as a risk factor for the development of asthma. “It’s pretty well-established that there’s an obesity-asthma connection,” said Black. She also believes that there is a “real biological connection” between diabetes and asthma, which may work together to make effective blood sugar control more difficult.

Previous research has shown an increased risk of dips in lung function in people with poorly-controlled diabetes, so the connection has some precedent. However, the mechanisms behind the relationship are unknown.

Black commented, however, that an additional chronic illness may simply make it more difficult for diabetes to control their blood sugar. “It can be incredibly challenging to manage both conditions,” she said.

The research team did find that children and young adults with both diseases who were taking prescription asthma medication displayed better blood sugar control.

Leukotriene modifiers, a type of asthma medication sold as Accolate, Zyflo, and Singular, seemed to be especially helpful in controlling blood sugar: study participants taking those medications showed a less than five percent incidence of poor blood sugar control, compared to 30 percent of Type 1 diabetics who were on asthma medication.

The researchers commented that they aren’t sure whether the asthma medication plays an active role in regulating blood sugar. According to Black, it may just be that kids with better asthma control are more likely to have better diabetes control as well.

Researchers at UCLA demonstrated that the common over-the-counter dietary supplement gamma-Aminobutyric acid (also known as GABA) may aid in inhibiting the development of insulin resistance and glucose tolerance, two conditions that are known to be precursors to the development of both Type 2 diabetes and metabolic syndrome.

In the preclinical study, researchers gave GABA to mice that were obese, had developed insulin resistance, and were in the early stages of Type 2 diabetes. GABA is a naturally-produced compound similar to amino acids that plays an important role in inhibitory processes in the central nervous system of all mammals. When the researchers gave GABA to the mice, they found that the compound worked to suppress the inflammatory immune responses that are associated with the development of Type 2 diabetes.

According to the investigation’s authors, GABA aided in preventing progression of Type 2 diabetes; in addition, it improved insulin sensitivity and glucose tolerance in the mice, even after they had already developed Type 2 diabetes. They also identified regulatory immune cells that play a role in GABA’s inhibition of inflammation.

The research team commented that future studies on the effects of GABA on conditions associated with Type 2 diabetes could provide new medications based on the compound that treat metabolic syndrome and Type 2 diabetes related to obesity.

GABA has become popular in recent years as a dietary supplement promising everything from weight loss to muscle gain to reduced anxiety and depression to better sleep. Since GABA is an inhibitor, it is frequently promoted as a compound that stops excessive brain activity, allowing the individual to relax and eliminate anxiety. “It’s the brakes of your brain. It stops activity,” says Karl Doghramji, M.D., director of the Sleep Disorders Center at Thomas Jefferson University Hospital in Philadelphia.

It is thought that GABA reduces the effects of glutamate, a neurochemical that increases agitation and excitement. By taking GABA, individuals may be able to silence their overactive thoughts and, for example, get a better night’s sleep. Deficiencies in GABA levels are thought to cause a lack of “delta” sleep — the “deep” stage of sleep that begins about 45 minutes after one falls asleep. Lacking this type of sleep could be damaging to an individual’s mental health, according to Dr. Doghramji; those suffering with depression, anxiety, and other disorders often don’t get enough delta sleep.

Research shows that long-term deficiencies in delta sleep can cause more serious problems. One in three people who suffer with recurrent insomnia has some kind of psychiatric disorder, while 25% of those individuals also have anxiety problems.

However, there isn’t sufficient evidence yet to determine whether GABA supplements have an effect on improving sleep patterns and moods. “We just don’t have any data on them. We do not know how much GABA is really in the supplement or the product’s purity. There are no studies backing up the claims made by the supplement manufacturers.”

According to the New York University Langone Medical Center, there is no evidence that GABA supplements are effective in reducing symptoms from anxiety “presumably because the substance itself cannot pass the blood-brain barrier and enter the central nervous system.” Because they do not actually affect brain chemistry, GABA supplements are most likely ineffective in treating mood disorders, though they may still have some utility in treating hypertension.

Having insects liquefy and digest the dead tissue from your wounds might not be the most appealing idea, but a research team in Hawaii has done just that — using maggots to clean infected and dead tissue from wounds in diabetics — with very positive results.

Doctors typically use scalpels or enzymes to remove dead or infected tissue from wounds in diabetic patients, whose natural wound-healing processes are impaired by a reduction in bloodflow to their extremities. Doctors call this process debridement; however, with traditional tools such as scalpels, it is often ineffective.

“These problem patients with diabetes really need better treatments in order to salvage their limbs,” said Dr. Lawrence Eron with Kaiser Hospital and the University of Hawaii in Honolulu. “Maggot debridement treatment is overwhelmingly effective,” he added. “After just one treatment these wounds start looking better.”

Dr. Eron and his colleagues presented the findings of an investigation into the use of maggots for debridement purposes to their peers at a scientific meeting in Chicago. The results of the investigation have not been reviewed by independent, outside experts.

The investigation was conducted on 37 individuals with diabetes who had artery disease that reduced circulation to the extremities and impaired their wound-healing capacities. All of the patients had wounds that had proven difficult to heal, with some of them lasting for up to five years.

Dr. Eron’s team placed 50 to 100 maggots — species Lucilia sericata — on the patients’ wounds. The insects were left on the wounds for two days and then replaced with new ones; the treatment averaged five days across the group of patients.

“We cage the maggots in a mesh-like material. Nylon panty hose might be used. And then we seal them so they don’t get out,” said Dr. Eron.

Of the 37 patients, 21 had successful outcomes, with success being defined as the eradication of infection, total removal of the dead tissue associated with the wound, formation of new connective tissue in the wound and more than 3/4 closure of the wound.

Among the patients in which the treatment failed, three experienced complications with infected bones, two experienced heavy bleeding, and one had excessive inflammation around the wound.

Five of the wounds were infected with MRSA, a “superbug” known to be extremely resistant to antibiotics; those wounds healed successfully with the use of the maggots. A bacterium called MSSA infected nine other wounds; six of those were successfully treated. Among the patients there were 10 cases of wounds infected with group B streptococci; all of those wounds healed successfully, according to Dr. Eron.

As many patients would understandably be apprehensive about having live maggots inserted into their wounds, Dr. Eron noted that it’s important to explain the process and the mechanisms behind its success to patients. “A lot of patients might be somewhat wary of having live insects placed into their wounds so we explain how it works and what possible problems might occur,” he said.

The maggots secrete a digestive substance into the wounds that break down dead tissue. They feed on this tissue, where it is further digested in the gut of the maggot. The process effectively cleans the dead tissue surrounding the wound; the digestive substance that the maggots secrete also encourages development of granulation tissue, a type of connective tissue that forms when wounds heal.

“After this, we go on to do further treatment with hydrogels, grafts of cell culture tissue, or negative pressure dressings,” said Dr. Eron. “But to get to this point where these techniques will work, you really need to clean up the wound, get rid of dead tissue, and get robust granulation tissue into the wound. And this is where the maggots help.”

A recent preliminary study suggests that people taking the prescription drugs Januvia (sitagilptin) or Byetta (exenatide) to treat Type 2 diabetes may be at an increased risk of developing pancreatitis as well as pancreatic cancer.

In addition, the study discovered that Byetta could potentially increase risk of developing thyroid cancer. The researchers commented noted that the results weren’t conclusive and that further investigation would be necessary before a definite link could be identified.

“We have raised concern that there may be a link, but we haven’t confirmed it,” says Dr. Peter Butler, lead researcher on the project and the director of the Larry L. Hillblom Islet Research Center at the University of California in Los Angeles. “We need to do more work to figure out whether this is real or not,” continued Dr. Butler.

Byetta and Januvia are prescribed to Type 2 diabetics to help keep blood glucose levels in a healthy range. The medications encourage the production of a hormone called glucagon-like peptide 1 (GLP-1).

Although Januvia and Byetta, both relatively new injectable drugs that treat Type 2 diabetes, have some benefits over older medications, Dr. Butler warns that every new medication requires thorough research to determine any complications that could arise from its use. “When new drugs come out, the long-term side effects of these drugs are not well understood,” said Dr. Butler.

Dr. Butler’s team used data from the U.S. Food and Drug Administration’s database of adverse events in patients taking Byetta and Januvia between 2004 and 2009. Any time a patient experiences an adverse event, it is reported by the patient’s physician and recorded in the database.

Dr. Butler’s team found that patients who were being treated with Byetta and Januvia displayed six times more reported cases of pancreatitis. Those taking Byetta showed a 2.9-fold increase in pancreatic cancer while those taking Januvia showed a 2.7-fold increase in pancreatic cancer. The researchers also noted that there was an increase in reported cases of thyroid cancer among patients prescribed Byetta.

However, Dr. Butler stated that the data does not necessarily point to an increase in those complications among patients taking the medications but could be a result of an increase in the number of doctors actually reporting those adverse events.

“It is important to avoid alarmism and have people stop medicines that they may be benefitting from when the risk is not yet defined,” said Dr. Butler. “If the drug and you are working well together, I wouldn’t say there is any reason to stop the drug, based on the evidence we have right now,” he said. “But if you have any concern you should talk to your doctor about it.” Butler also noted that losing weight is the greatest deterrent to pancreatic cancer in patients with Type 2 diabetes.

Dr. Mary Ann Banerji, director of the Diabetes Treatment Center at SUNY Health Science Center Brooklyn, New York City, agrees with Dr. Butler, stating that the data “should not be blown out of proportion.”

Dr. Banerji does not prescribe Byetta or Januvia to patients with a family history of thyroid cancer or pancreatitis, but other drugs such as metformin and insulin come with their own risks. “You prescribe them on an individual basis, because, in the end, all of medicine is individual,” said Dr. Banerji. “We should use these drugs judiciously along with metformin.

A small retrospective study recently presented at the annual meeting of the European Society for the Study of Diabetes has demonstrated that elevated accumulation of fat, inflammation, and fibrosis of the liver are associated with a higher risk of cardiovascular disease. The risks are especially high for those who have been diagnosed with diabetes.

“What we are realizing is that [nonalcoholic fatty liver disease] is adding extra cardiovascular risk to people with diabetes, and to those without, on top of that which is already existing,” says Dr. Christopher Byrne, a lead investigator working on the study.

Dr. Byrne, who is a professor of endocrinology and metabolism at the University of Southampton in England, suggested that the findings of the study demonstrate that patients who have documented liver disease may require more aggressive therapies in response to the additional risk they face. Those therapies should target the liver in addition to the heart.

The study was conducted on 112 patients who had been diagnosed with nonalcoholic fatty liver disease, proven by biopsy. The study showed that the participants’ Kleiner scores were highly-correlated with Framingham Risk Score (FRS) as well as QRISK2 — both indicators of cardiovascular risk. The Kleiner score is a histologic measure of non-alcoholic fatty liver disease severity.

“Nonalcoholic fatty liver disease represents a spectrum of fat-mediated liver conditions causing progressive hepatocellular damage,” says Sarah Hudson, a medical student at the University of Southamptom. “There is increasing evidence of an increased cardiovascular risk associated with progression of nonalcoholic fatty liver disease,” continued Hudson. She also noted that the preferred method of determining the severity of non-alcoholic fatty liver disease was through histopathologic tests.

The primary goal of the study was to determine whether Kleiner score is correlated with risk of cardiovascular disease and whether the score was higher in individuals who were already known to have increased cardiovascular risk, especially those who had also been diagnosed with diabetes.

Kleiner scores provide an assessment of a variety of factors, including steatosis, lobular inflammation, fibrosis, and hepatocyte ballooning. As liver disease becomes more severe, Kleiner score increases correspondingly.
The mean age of participants in the study was 48 years; mean Kleiner score among the patients was 5.3, while median FRS and 13 and median QRISK2 score was 8. Mean body mass index (BMI) of the participants was about 34kg/m2.

Not only were Kleiner scores found to be highly-correlated with cardiovascular risk according to both FRS and QRISK2 models, but they were also higher in a group of 32 participants who had been diagnosed with diabetes versus non-diabetic individuals. It was discovered that the increased risk of cardiovascular disease in correlation with non-alcoholic fatty liver disease was independent of hyperglycemia and increased body weight.

“We need more prospective studies to see what markers may be used to help stratify who requires biopsy and how best to manage people who have got NAFLD,” noted the study’s authors.

“Up until now we’ve been very poor in providing cardiovascular risk reduction treatments for patients with NAFLD,” said Dr. Byrne. “But what we don’t know is whether those lifestyle changes are good at decreasing liver inflammation, or decreasing liver fibrosis.”

Dr. Byrne, along with other members of a research team, are now studying the use of highly-purified omega-3 fatty acid ethyl esters in the treatment of fatty liver disease. This form of fish oil has been available in Europe for at least a decade as Omacor and in the United States as since 2004 as Lovaza.

According to a recent study published in the October 1 issue of the “The American Journal of Cardiology,” percutaneous coronary intervention (or PCI) of chronic total occlusions (CTOs) is associated with reduced mortality in people with diabetes and can also reduce the need for coronary artery bypass grafting.

Headed by Bimmer E. Claessen, M.D., with the Cardiovascular Research Foundation of New York City, the study analyzed the long-term clinical outcomes after PCI of CTOs in patients who were known to be either diabetic or non-diabetic. The study used data from 1,742 patients who were classified according to whether they had been diagnosed with diabetes or not (1,347 were non-diabetic and 395 were diabetic). Study participants who underwent PCI of CTOs in the period between 1998 and 2007 were evaluated for five-year clinical outcomes. Patients were stratified according to several factors, including status of diagnosis of diabetes, successful versus failed CTO PCI, and for the use of drug-eluting (DES) versus bare-metal stents (BMS). The study participants received follow-up examinations for an average of three years.

The researchers identified similar procedural success both in patients who had diabetes and those who didn’t. In all, 96.4% of patients with diabetes and 94% of those without the disease received stent implantation after successful CTO PCI. It was also discovered that successful CTO PCI was associated with a significantly reduced long-term mortality risk in patients with diabetes, at 10.4% compared to 13%, as well as a significant reduction in requirements for coronary artery bypass grafting at 2.4% compared to 15.7%. Usage of drug-eluting stents versus bare-metal stents was associated with a decrease in target vessel revascularization in patients both with and without diabetes (17.6% for the former and 26.5% for the latter). Insulin-dependent diabetes was identified in multivariate analysis as a factor that independently predicted mortality in the cohort that had been diagnosed with diabetes.

“Successful CTO PCI in patients with DM was associated with a reduction in mortality and the need for coronary artery bypass grafting,” wrote the authors of the study.

Three of the researchers announced that they had interests associated with the study. Two of the authors associated with the study disclosed that they had financial ties to Cordis Corporation, while one other author disclosed financial ties to Boston Scientific Corporation.

Percutaneous coronary intervention (PCI), more commonly known as angioplasty, is a surgical procedure used to treat narrowed coronary arteries in the heart due to the buildup of cholesterol plaques. It has been shown to improve quality of life and to be more cost-effective than other procedures such as coronary artery bypass grafting in treating patients who have medically refractory myocardial ischemia.

The procedure is sometimes described as “balloon angioplasty” due to the use of an inflated balloon to crush the cholesterol plaque against the arterial walls and break it down. Although balloon inflation within the artery is generally performed in all angioplasties, the procedure typically includes other operatons such as atherectomy, the implantation of stents, and brachytherapy — the use of radiation to inhibit restenosis.

Stents are small mesh tubes that are implanted into the artery to ensure that it stays open. Stenting has been shown to reduce symptoms related to coronary artery disease in addition to reducing cardiac ischemia. Stents can be made of several different kinds of material. Stainless steel is the most commonly used material but it is not always compatible with the human body and steel stents sometimes result in restenosis and thrombosis.

A study recently reported in the journal “Pediatrics” has demonstrated that pregnant women with well-managed diabetes may not be at increased risk of giving birth to preterm infants or infants with very low birth weight.

“With modern management and adequate glycemic control in pregnancies complicated by diabetes mellitus, the risk of respiratory distress syndrome in near-term and term newborns may not be increased beyond that of a nondiabetic control population,” wrote the authors of the study. The investigation was headed by Yoram Bental M.D., with the Department of Neonatology at Laniado Hospital in Israel and the Israel Institute of Technology in Haifa; also affiliated were researchers with the Israel Neonatal Network. “We hypothesized that maternal …DM increases the risk for mortality, respiratory distress syndrome (RDS), and major complications of prematurity,” continued the authors.

The research team used data collected from the Israel National Very Low Birth Weight Infant Database, covering the years 1995 to 2007. Pregnant woman with diabetes were categorized as either pregestational or gestational; the independent effects of diabetes in pregnant women on infant mortality, RDS, and other complications related to premature birth were analyzed with multivariable logistic regression. The two groups of mothers — those with pregestational and gestational diabetes — demonstrated similar results so their data was pooled together in further analysis.

Mothers with diabetes were more likely to have received a complete course of prenatal steroids compared to women who had not been diagnosed with diabetes. The infants of diabetic mothers showed slightly higher gestational age and birth weight than those of non-diabetic women, but the two groups also demonstrated a similar distribution of birth weight percentiles and mean birth weight z scores. The group of diabetic mothers had higher Apgar scores, enough to be considered statistically significant.

The two groups of mothers did not have significantly different rates of delivery room mortality, RDS, and other complications associated with premature birth. In fact, the group of non-diabetic mothers had a significantly higher rate of total mortality and bronchopulmonary dysplasia. Among the mothers with diabetes, adjusted odds ratios were not significantly increased for risk of mortality, RDS, bronchopulmonary dysplasia, periventricular leukomalacia, necrotizing enterocolitis, patent ductus arteriosus, retinopathy of prematurity, or intraventricular hemorrhage.

“With modern management and adequate prenatal care, IDM born very low birthweight do not seem to be at an excess risk of developing RDS or other major complications of prematurity compared with non-IDM,” wrote the study authors.

Limitations in the study’s methodology that could potentially affect results include a lack of prospective recording of the degree of glycemic control or the type of diabetes with which the mothers had been diagnosed.

The study’s authors concluded that diabetes should not be considered as an extra risk factor in the development of RDS in infants. “Whenever financial limitations are important in the strategic planning of delivery room care of premature infants, and in particular if the issue of prophylactic surfactant is to be discussed, we suggest that IDM should not be considered as an extra risk of developing RDS,” wrote the authors. “This suggestion is probably strengthened from the fact that safe therapeutic alternatives to prophylactic surfactant exist, such as early nasal continuous positive airway pressure. However, this speculation has not been proved and may not be valid in cases of poor glycemic control.”

The Israel National Very Low Birth Weight Infant Database receives partial support from the Israel Center for Disease Control and the Ministry of Health.

Previous research has suggested the possibility that having diabetes could increase an individual’s lifetime risk of also developing thyroid cancer. A new report, however, has solidified that claim, demonstrating that the association holds true for retirement-age Americans. The findings were published in the journal “Thyroid.”

The study was conducted by epidemiologists affiliated with the National Cancer Institute (NCI) and the National Institutes of Health (NIH). After analyzing the results of the study, the researchers found that patients age 50 to 71 who had been diagnosed with diabetes showed a one-quarter increase in 10-year risk of developing thyroid cancer.

The study used data from nearly 500,000 men and women who had participated in the NIH-American Association of Retired Persons (AARP) Diet and Health Study. The study was conducted in 1995 and 1996.

At the beginning of the study, the researchers collected information about the health of the participants through the use of questionnaires. Questions were related to pancreatic health, body mass index (BMI), the presence of diabetes, and other health factors.

Ten years later, the researchers conducted follow-up examinations on many of the participants. The study used data collected from the follow-up tests.

Researchers found that almost one in 10 volunteers had been diagnosed with diabetes at the time of the initial questionnaire. Upon follow-up examination, those who had diabetes at baseline were noted to develop thyroid cancer at a greater average frequency than those who had not been diagnosed with diabetes.

On average, those who had been diagnosed with diabetes were 25% more likely than non-diabetics to be diagnosed with thyroid cancer. The women in the study showed a particularly high risk of developing cancer.

Diabetic men experienced a 4% increase in their chances of developing thyroid cancer, but diabetic women saw their chances of developing thyroid cancer increase much more dramatically, by 46%.

The results are very similar to findings that were published a decade ago in the journal “Clinical Diabetes.” In an issue of the journal from 2000, endocrinologist Patricia Wu with the University of California in San Diego estimated that 6.6% of the population of the United States has some form of thyroid disease. Diabetics are more likely to experience thyroid problems; about 10.8 percent suffer with thyroid conditions, according to Dr. Wu.

The mechanisms underlying the relationship between diabetes and thyroid cancer are unclear. However, some scientists believe that the diseases are related in that they are both disorders of the endocrine system. Additionally, Thyroid Today notes that both diabetes and thyroid conditions are typically linked to increased body mass, age-related risk, and autoimmune problems.

Scientists have been somewhat baffled in recent years by thyroid cancer, specifically the rate at which is occurs. A paper published in the journal “Cancer” states that thyroid carcinomas are more common than doctors once thought. The National Cancer Institute (NCI) estimates that 11 out of every 100,000 Americans are diagnosed with thyroid cancer each year. However, the report in “Cancer” states that the figure was significantly lower until recently.

From 1988 to 1998, thyroid carcinoma diagnoses rose by an average of 3.5% every year. From 1998 to 2005, that number rose by 6.7% every year. The researchers commented that the reason behind the increase in cancer diagnoses needed to be explored.

“Reasons for this increase, including environmental, dietary and genetic causes, need to be explored. To our knowledge, there is no new evidence to suggest that the exposure of human beings to radiation, a well known environmental risk factor, has increased over time to account for the observed increase in thyroid cancer,” said the researchers.