Diabetic Live

Findings from a new study suggest that people who have previously suffered from kidney stones could have a higher risk of developing Type 2 diabetes later in life. Previous research has shown that kidney stones appear to be more common in individuals who have diabetes, but scientists have been unsure as to whether the reverse is true as well.

The new study was conducted at Taipei Medical University in Taiwan. Dr. Herng-Ching Lin and his colleagues analyzed medical records from over 94,000 Taiwanese adults and found that individuals with a history of kidney stones demonstrated a 30 percent increase in their chance of being diagnosed with diabetes over five years than were individuals who did not have kidney stones.

The medical records showed that out of 23,000 adults who had received treatment for kidney stones, 12.4 percent later developed Type 2 diabetes. Of the 70,700 adults who did not have kidney stones, only 9.6 percent developed diabetes.

According to the researchers, some of the overlap between kidney stones and diabetes could be caused by common risk factors between the two conditions. Older age and obesity are commonly listed among the risk factors for both.

However, the researchers accounted for age, obesity, and other health risks when investigating the relationship between kidney stones and diabetes, and they still found that individuals with kidney stones had a one-third higher risk of developing diabetes.

The researchers stated that they were uncertain about the mechanism that causes the relationship. They hypothesized, however, that both kidney stones and diabetes could be caused by some of the same processes.

Kidney stones are formed due to the presence of excessive amounts of crystal-forming substances, such as uric acid, calcium, and oxalate. The minerals cannot be diluted by the available fluid and form small stones which typically do not cause long-term damage but can be very painful when they pass through the urine.

According ot Lin’s research team, there is evidence suggesting that insulin, the hormone responsible for regulating blood glucose levels, could be associated to the formation of kidney stones in some way. Previous research in both animals and humans has suggested that elevated insulin levels can alter the chemical composition of urine, making the formation of kidney stones more likely. Since Type 2 diabetes is associated with high insulin levels due to the body’s inability to use it correctly, the two conditions could be related through the actions of insulin.

Lin’s team noted that their own study had limitations, namely the fact that they used existing medical records—which can be inaccurate—to arrive at their findings. The researchers also did not have access to information about the diet, exercise habits, and family history of the conditions due to the lack of that information in the medical records. Such data could have helped the researchers determine the source of the association between kidney stones and diabetes.

According to the research team, it’s still possible that the formation of kidney stones could be a warning sign that the individual could have an increased risk of developing diabetes. Those who find themselves diagnosed with kidney stones may also benefit from making lifestyle changes that reduce the chances of developing diabetes, including eating a healthy diet and getting more exercise.

Previous research has showed that people with diabetes and insulin resistance have highly-acidic urine, which is a risk factor for developing kidney stones, and especially uric acid kidney stones.

A new study suggests that doctors may be able to help diagnose diabetes and related warning signs through the use of a “muffin test.” The test would be a type of oral glucose tolerance test designed to identify diabetes and impaired glucose tolerance by analyzing the body’s ability to utilize glucose properly.

Oral glucose tolerance tests commonly require an individual to fast for one night and drink a high-sugar beverage the following day. Doctors monitor the individual’s physiological responses to the high dose of sugar, especially how long blood glucose levels remain elevated.

The study suggested that muffins might be a better food for conducting oral glucose tolerance tests—the test would be more tolerable for patients and it might even give doctors a more accurate idea of the individual’s response to food intake.

According to Dr. Michael Traub with Albert Einstein College of Medicine in New York, current glucose tolerance tests are unpleasant, especially for women. Dr. Traub, who worked on the study, suggested that consuming a muffin would be more pleasant than the glucose solution for most people, noting that many people feel ill following the test.

Dr. Traub commented that a muffin test might also provide more accurate results since it more closely matches what people actually eat.

According to the findings of the study, doctors were able to use muffins in oral glucose tolerance tests to predict impaired glucose tolerance; muffins were also cheaper than standard glucose drinks. Another researcher who did not take part in the study, however, noted that muffin tests may not be as effective as the study indicated and that it may not make the tests more convenient after all.

According to Dr. William Herman, director at the Michigan Diabetes Research and Training Center in Ann Arbor, results from muffin tests may be difficult to measure because no two muffins are exactly the same in nutritional content, especially in different areas of the world. A glucose drink, on the other hand, contains an exact amount of sugar and allows for more accurate measurements.

“Getting a standardized muffin across the United States and across the world I think would be challenging,” said Dr. Herman. Glucose drinks are “probably more convenient. Glucose solutions have a longer shelf-life. We know exactly what’s in them,” he continued.

The muffin study was conducted on 73 middle-aged women in their 40s and 50s. The women fasted for a night and were given muffins from a local bakery the next day. The researchers measured blood glucose levels two hours after the muffins were given. Another 12 women were given standard oral glucose tolerance tests with glucose drinks.

Eight of the group of 72 women demonstrated impaired glucose tolerance. The researchers reported that a standard glucose drink test would have missed more than half the cases of impaired glucose tolerance. The glucose drink test identified one woman as having impaired glucose tolerance; the muffin test identified another individual who the glucose drink test had missed.

A muffin is much cheaper than a glucose beverage test, according to Dr. Traub, at one dollar versus five dollars. None of the women appeared to have stomach problems from the muffins either, unlike the glucose drinks.

Answering Dr. Herman’s criticisms, Dr. Traub’s team commented that even though muffins might vary from area to area, the test should still provide consistent results. Still, they noted that additional research would be required to determine that the test is reliable.

Two former graduate students at MIT’s George R. Harrison Spectroscopy Laboratory have developed new spectrograph technology that could allow diabetics to monitor their blood glucose levels without pricking their fingers to draw blood for testing. Kong and Barman significantly reduced the size of the spectrograph, allowing the technology to be used in much more convenient spaces.

The spectrograph equipment would have previously required too much space to be practical for every day use. Kong and Barman reduced the size of a significant component of the spectrograph and brought the prototype equipment down to about the size of a shopping cart. Tests can be conducted quickly, taking only about a minute.

The Raman spectrograph developed by Kong and Barman tests blood glucose levels by aiming a low-powered laser through the thin area of skin between the thumb and forefinger of the patient being tested. The test has previously been conducted with the use of a compound parabolic concentrator (CPC). The test requires a high degree of collimation, however, which necessitated the use of a very large CPC.

Kong and Barman reduced the size of the equipment by using a smaller mirror—a compound hyperbolic concentrator (CHC)—which focuses the light into a narrow beam through the use of a lens.

“The new design is from five to 20 times smaller than if we used a CPC to achieve the same performance,” said Kong.

Ramachandra Dasari, associate director at the MIT lab, stated that the new smaller Raman spectrographs could have uses beyond simply testing blood glucose levels. They could also identify diseases through the presence of other chemical markers in the bloodstream and to study biopsies to determine if they contain cancerous cells.

“Our next step is to miniaturize this and make it portable,” stated Dasari. The team expects that a portable prototype of the spectrograph equipment will be built within the next couple of years.

The use of spectroscopy technology to diagnose diseases was first envisioned by Michael Feld, a professor of physics at MIT and former director of the Spectroscopy Laboratory. The Raman spectroscopy technique studies the frequency of vibrations that hold molecules together to identify chemical compounds that indicate certain diseases or conditions. The technology has been in development for about 15 years and may someday remove the need to prick fingers to obtain samples for blood glucose testing.

Kong and Barman have worked together in the past: they previously developed a new calibration method for the Raman spectrograph called Dynamic Concentration Correction, which corrects the inaccurate results that can occur in a blood glucose test due to the presence of glucose in the interstitial fluid, or the fluid that surrounds skin cells. The project had been facing difficulties because the spectrograph technology only seemed to penetrate about a half a millimeter under the skin, meaning that the glucose content of the interstitial fluid instead of the blood was being measured. Kong and Barman tested the technology in 10 volunteers, using the newly-calibrated Raman spectrograph to significantly improve the accuracy of blood sugar readings by an average of 15 percent and up to 30 percent in some of the participants.

Regular blood glucose testing is an unavoidable part of life for most diabetics. Elevated blood sugar levels over long periods of time can damage organs and cause other complications while low blood sugar levels can cause fatigue and fainting.

Researchers located in the United Kingdom say that levels of a hormone called B-type natriuretic peptide could have a role in reducing risk of Type 2 diabetes. The study was published online in the journal “PLoS Medicine.”

According to the research team, B-type natriuretic peptide, also called BNP, provides a variety of functions in the cardiovascular system: it mediates vasodilation, antifibrotic effects, and natriuresis. The researchers wrote that the hormone also has lipolytic activity and cross-sectional studies have indicated that BNP levels, or levels of the inactive fragment of its pro-hormone, N-terminal fragment of pro-BNP (NT-proBNP), are decreased in individuals who are obese or have Type 2 diabetes or insulin resistance.

The researchers conducted a prospective case-cohort study, using data from three case-control studies that involved patients who had been diagnosed with Type 2 diabetes. They used this data to determine if a connection existed between Type 2 diabetes and NT-proBNP in the bloodstream. The research team also genotyped the variant rs198389 within the BNP locus and used those results in a meta-analysis that used data from 11 case-control studies in all.

The multivariable analysis from the case-cohort study suggested that higher levels of NT-proBNP were correlated with decreased risk of Type 2 diabetes. For every increase of one standard deviation in blood levels of NT-proBNP, patients demonstrated a 21 percent reduction in risk of developing type 2 diabetes. The researchers adjusted for confounding factors, including age, sex, body-mass index, use of tobacco, hereditary history of Type 2 diabetes, hypertension, systolic blood pressure, and cholesterol levels (HDL, LDL and triglyceride).

The researchers stated that their estimates regarding the correlation between Type 2 diabetes and rs198389 were accurate.

“The association between rs198389 and type 2 diabetes observed in case-control studies (OR=0.94 per C allele; 95% CI, 0.91-0.97) was similar to that expected (OR=0.96; 95% CI, 0.93-0.98) based on the pooled estimate for the log-NT-proBNP level to type 2 diabetes association derived from a meta-analysis of our study and published data (HR=0.82 per SD; 95% CI, 0.74-0.9) and the difference in NT-proBNP levels (HR=0.22 per SD; 95% CI, 0.15-0.29) per C allele of rs198389,” wrote the team.

Additionally, there appeared to be no association between the rs198389 genotype and factors that may have confounded results, such as age, sex, and BMI. The researchers wrote that the findings demonstrate there may be a causal relationship between BNP and Type 2 diabetes, and the issue warrants further research. If a link is proven, it may open the door for therapeutics involving the manipulation of BNP activity to reduce risk of Type 2 diabetes. However, additional research will be needed before a definite causal link is established.

“The evidence for a potential causal link between the BNP hormone system and type 2 diabetes also promotes BNP as a potentially interesting target of preventive interventions. Influencing BNP activity by pharmaceutical interventions has been proven to be feasible in the context of CV medicine,” they wrote.

BNP is secreted by the ventricles of the heart as a response mechanism to excessive stretching of cardiomyocytes—the cells that make up heart muscle tissue. Secretion of BNP is related to several physiological processes, including the reduction of central venous pressure and systemic vascular resistance. Secretion of BNP also promotes natriuresis, the process by which the kidneys excrete sodium through urine. Natriuresis reduces the sodium content of the blood by expelling it through urine.

The American Diabetes Association recently released a position statement which stated that, in helping young people transition into more responsible roles for managing their own diabetes, parents should gradually transfer the responsibilities associated with the disease to their children.

However, the ADA also noted in its “Diabetes Care for Emerging Adults” position statement that most of the work in preparing young individuals for proper diabetes care in adulthood falls to health care professionals. Doctors should begin preparing young people with diabetes and their families for the transfer to an adult clinician at least a year before the switch occurs.

The ADA’s statement arrived through the ADA Transitions Working Group, a multidisciplinary group involving representatives from the American Association of Clinical Endocrinologists, Endocrine Society, Pediatric Endocrine Society, and the American Academy of Pediatrics. The panel of representatives reviewed issues that occur as a result of the transition from pediatric diabetes care to adult diabetes care, which affect both the patients and their health care professionals. The statement focused on individuals age 18-30 years old—an age group that the statement described as “emerging adults”—and covered both Type 1 and Type 2 diabetes. The statement was authored by Dr. Anne Peters of the University of Southern California in Los Angeles and Dr. Lori Laffel with Joslin Diabetes Center and Harvard University in Boston.

According to the statement, the transition from pediatric to adult care is a tumultuous one for diabetics; it’s described as a “high risk period” and “a perfect storm during which interruption of care is likely for multiple reasons.”

“This is a critical time when patients not only assume responsibility for their diabetes self-care and interactions with the health care system but when they become more independent,” wrote the authors. Individuals may be moving away from their parents’ homes at the time of the transition and the lack of supervision and increased independence puts them at risk for mismanaging their diabetes. The statement noted that tens of thousands of individuals in the United Sates are currently estimated to be moving from pediatric to adult diabetes care every year.

Other factors that may contribute to difficulties in managing diabetes include the loss of health insurance or inadequate coverage. There may also be a lack of professionals who are specifically trained to meet the needs of the age group. According to the statement, additional research and improved training would help health care professionals meet the medical and psychological needs of those transitioning.

The statement identified eight factors relevant to diabetes treatment that this age group faces, including poor glycemic control; higher risk of acute complications; use of alcohol, tobacco, and drugs; and the differences between adult and pediatric diabetes care. The authors noted that these factors, along with other factors that can cause gaps in diabetes treatment, can lead to increased risk of diabetes-related complications in both the short term (hypoglycemia) and long term (retinopathy and nephropathy). Young adults with diabetes also face a higher relative risk of death than those without diabetes.

The authors recommended that health care professionals providing pediatric diabetes care should offer information about medications, diabetes-related comorbidities, and the patient’s self-assessing abilities to the physicians who will be providing adult care for their patients. The preparations for the patient should be individualized and developmentally-appropriate, requiring the patient to take on responsibilities in glucose monitoring and appointment scheduling.

The statement concluded that, throughout the next decade, they expect the growth of “evidence-based strategies that support best practice for the growing numbers of young adults with type 1 and type 2 diabetes who will be making this important transition.”

A recent investigation found that U.S. adults who have been diagnosed with diabetes are about two times more likely to contract hepatitis B infections. The findings prompted a recommendation to the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices that individuals with diabetes should be vaccinated for hepatitis B.

According to Meredith L. Reilly, an epidemiologist with the CDC, inadequately cleaned blood glucose monitors are one of the major causes of hepatitis B infection among diabetics. Reilly presented the findings at a poster at the CDC Advisory Committee meeting.

Dr. Trudy V. Murphy is head of the vaccine unit of the Division of Viral Hepatitis at the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention in Atlanta. Dr. Murphy made the suggestion of vaccination to the CDC, stating that “over the past several years, we’ve observed outbreaks of hepatitis B among patients with diabetes in places where they undergo assisted blood glucose monitoring, with more than one person using the monitor.” Out of 28 outbreaks of hepatitis B at long-term care facilities, 24 were traced back to equipment and practices involved in different aspects of blood glucose monitoring.

Dr. Murphy’s recommendations to the CDC Advisory Committee include hepatitis B vaccinations for patients with both Type 1 and Type 2 diabetes. The CDC will place more emphasis on transmission prevention methods such as avoiding needle or lancet sharing and more thorough cleaning of equipment. Dr. Murphy stated that vaccinations will work in concert with other methods as an “additional measure to ensure protection.”

Individuals with diabetes must take extra care to avoid exposure to blood since other blood-borne pathogens can threaten their health. Hepatitis B, in particular, poses a threat to diabetics since it is highly infectious in residual blood and can remain infectious on a surface for seven days. According to Dr. Murphy, a drop of blood small enough to be invisible could still contain enough hepatitis B virus to infect an individual who has diabetes. Additionally, the design of blood glucose monitors makes them difficult to clean thoroughly, and an especially thorough cleaning can damage the equipment.

After conducting investigations into the hepatitis B outbreaks, the CDC reviewed the cases of the disease reported in 2009 and 2010 at sites involved in the CDC’s Emerging Infections Program. The CDC reviewed data from 865 people who had contracted hepatitis B; 95 of those individuals also had diabetes. An analysis showed that individuals age 23-59 with diabetes were 2.1 times more likely to be infected with hepatitis B compared to those without diabetes. The analysis also adjusted for gender, age, ethnicity, and other risk factors for the disease. Individuals age 22 or younger with diabetes were 1.9 times more likely to contract hepatitis B, a statistically significant number, while those 60 or older were 50 percent more likely—which was not statistically significant, according to Ms. Reilly.

The hepatitis B (HBV) virus causes an inflammation of the liver and is spread through contact with body fluids of another individual who has a hepatitis B infection. The disease is commonly spread through needles such as those used for taking blood work or testing blood sugar, which makes it common among individuals with diabetes and health care professionals who perform such tests.

Both Dr. Murphy and Meredith L. Reilly had no disclosures.

New research suggests that drinking less than a couple of glasses of water every day increases an individual’s risk of having elevated blood sugar levels in an unhealthy range.

The study found that adults who drank half a liter of water per day (about two glasses) were more likely to demonstrate blood sugar levels in the pre-diabetes range than those who drank more water. Pre-diabetes is a condition in which blood sugar levels are elevated but not high enough to be characterized as being related to diabetes.

The study does not prove, however, that drinking water directly lowers the risk of developing diabetes. According to Lise Bankir of the French research organization INSERM, the findings demonstrated a correlation between water intake and blood glucose levels but did not show a cause and effect relationship between the two. Bankir did comment that a causal relationship is possible.

“There are good arguments to suggest that there could be a real cause-and-effect relationship in the association we have found,” she said. “But this is not a proof.”

The research team stated that vasopressin, sometimes called diuretic hormone, is the link that may tie reduced water consumption to increased blood sugar levels. The hormone regulates water retention levels, causing the kidneys to retain water when we’re dehydrated. The research suggests that elevated vasopressin levels could also result in elevated blood glucose levels.

According to Bankir, vasopressin receptors can be found in the liver, which produces sugar. The study demonstrated that vasopressin injections in healthy individuals caused blood sugar levels to spike temporarily.

Researchers studied 3,615 French adults, age 30 to 65, who had normal blood sugar levels at baseline—the beginning of the study. Around 19 percent of the study participants stated that they drank less than half a liter a day; the rest of the participants drank a liter or more.

Researchers followed up with the participants for nine years, finding that 565 of the participants developed elevated blood glucose levels while 202 developed Type 2 diabetes. The research team found that the individuals who drank at least a half a liter of water per day were 28 percent less likely to develop elevated blood glucose levels than those who drank less than a half a liter of water every day.

Still, the findings did not demonstrate a definite statistical link between consumption of water and the risk of developing diabetes. Bankir stated that the sample size was “too small to get a significant results” and a larger cohort would be required before a causal relationship could be proven.

Individuals who drink less water are more likely to drink high-sugar drinks such as soda and juice in replacement. Such beverages are often the culprit for high blood glucose levels. However, Bankir’s team adjusted for several factors that could influence results, including the consumption of sugary drinks, exercise levels, and body weight. Even after the adjustments, individuals who drank less water still had higher blood sugar.

One explanation is that individuals who drink more water are more likely to engage in other healthy habits. “Healthier behaviors correlating with higher water drinking could account for the observed association,” said the research team.

Even though the study was unable to prove a direct relationship between drinking more water and lowering one’s blood sugar, Bankir suggested that increasing water intake is always a good idea. “In Western countries, the consumption of sugar is surely too high and contributes to obesity,” she said. “Drinking less of them and more pure water can only be good in my view.”

A new kind of “ultrafast” insulin developed by Halozyme Therapeutics, Inc., has been shown in two clinical trials to work just as well as other insulin replacements in patients with both Type 1 and Type 2 diabetes.

According to Halozyme, the new insulin—called PH20—was as effective as Humalog, an Eli Lilly and Company product, at controlling blood glucose levels. Halozyme stated that PH20 was actually more effective at controlling postprandial glucose levels, or blood sugar levels after a meal. Hypoglycemia rates in PH20 users were similar to those of Humalog users. The two studies were Phase 2, mid-stage clinical trials, each using data from about 110 participants.

One study was conducted on patients with Type 1 diabetes while the other studied participants with Type 2 diabetes. The studies compared effects of PH20 with those of Humalog. PH20 is an insulin analog—a type of insulin that is not produced biologically but synthetically, yet functions the same in the human body as the insulin produced by the beta cells of the pancreas.

PH20 is derived from rHuPH20 (Lispro-PH20 or Aspart-PH20), a recombinant human hyaluronidase enzyme, which “temporarily degrades hyaluronan, a structural protein in the interstitial space,” according to Halozyme. The enzyme allows the delivery of therapeutic medications through subcutaneous injections rather than intravenously. According to Halozyme, subcutaneous injection of pharmaceuticals provides a variety of benefits for patients, including increased convenience and efficiency, extended product life cycle, and decreased costs.

The patients using PH20 insulin demonstrated more than a 50 percent increase in the number of patients who were able to consistently achieve post-mealtime blood glucose targets that are established by the American Association of Clinical Endocrinologists. Patients using PH20 insulin did not demonstrate a significant increase in hypoglycemia or hypoglycemic events; the events that did occur were typically mild and were similar to those experienced by patients using Humalog.

Halozyme stated that it will be pursuing methods of making PH20 available around the world, which means that the company may form a partnership with a larger pharmaceutical manufacturer. Halozyme will present the complete findings of the two studies at a medical conference in 2012. The news boosted Halozyme’s market presence, with shares 49 cents to $8.21 in afternoon trading, a 6.3 percent increase.

Halozyme’s shares also jumped recently by 18.6 percent when the company announced successful clinical trials of a breast cancer drug that Halozyme is developing with Swiss pharmaceutical company Roche. The drug is a variation of Herceptin, which is normally administered with an IV; Halozyme and Roche are working on an injectable version, which was shown in the trial to be just as effective as the IV version. The injectable version will offer more convenience to patients as it can be administered in about five minutes, while the IV version takes about 30 minutes.

According to Halozyme, the company is “dedicated to the development and commercialization of products targeting the area outside the cell known as the extracellular matrix,” a system that provides structural support for tissues and is responsible for directing some important biological activities in humans, such as cell migration, signaling, and survival. The importance of the matrix in biochemical processes allows Halozyme to target the system for treating illnesses. The company was founded in 1998 in San Diego and primarily targets the endocrinology, oncology, dermatology, and drug delivery markets.

A recent study found that phacoemulsification, a process by which the internal lens of the eye is emulsified as a treatment for cataracts, does not affect intraocular pressure (IOP) in individuals who have diabetes. The findings were presented in a poster session at the American Academy of Opthalmology 2011 Annual Meeting, and they contradict previous research on the subject of phacoemulsification’s effects on intraocular pressure.

The poster session detailed the findings of a retrospective chart review which studied the effects of phacoemulsification on patients with diabetes as well as those who had not been diagnosed with the disease. Elevated intraocular pressure in diabetics is a significant issue for doctors since it can precede future loss of vision.

The study was presented by Lisa Park, M.D., and was conducted by a research team at the New York University Langone Medical Center in New York City. Dr. Park’s team analyzed intraocular pressure data from 146 diabetic and non-diabetic patients who underwent cataract phacoemulsification. Measurements of IOP were taken before the procedure, then 1 day, 1 week, and 1 month after the procedure. Patients who did not have diabetes demonstrated significantly lower IOP at the 1 week and 1 month readings after the procedure (1.7mm Hg and 1.8mm Hg, respectively). However, IOP was not significantly different in patients with diabetes at the 1 week or 1 month marks (0.4mm Hg and 0.1mm Hg, respectively). There was a significant difference between diabetics and non-diabetics at the 1 week and 1 month marks (12.7 versus 15.mm Hg at 1 week; 12.6 versus 15.5mm Hg at 1 month).

According to the researchers, the findings demonstrate that diabetics do not benefit from the lowering of intraocular pressure as a result of the phacoemulsification procedure that non-diabetics do.

“Our results show that postoperative IOP is significantly different between diabetic and nondiabetic patients, and that the pressure-lowering effect [seen in previous studies] is not demonstrable in the diabetic population,” they wrote.

According to Dr. Park, the findings may demonstrate that the effects of phacoemulsification on intraocular pressure have simply not received much research.

“Not a lot has been known about postoperative IOP in diabetics. Information has been more anecdotal. A number of factors can be involved in IOP. Our study is different, in that we focused exclusively on IOP and diabetes,” said Dr. Park.

If further research proves demonstrably that cataract surgery does not lower intraocular pressure in diabetics, it could point to difficulties related to vision that extend beyond cataracts. Dr. Park stated that the growing number of individuals with diabetes warrants additional research into methods of reducing intraocular pressure.

“With the population aging and diabetes growing to epidemic proportions, we are going to need to focus more on this segment of the population. Management to reduce IOP after surgery along with management of inflammatory reactions could be done,” she said.

Patients with diabetes are advised to schedule regular visits with an ophthalmologist, as the high blood glucose levels associated with diabetes can cause swelling in the eyes that affect vision. Cataracts, or clouding of the eye, are especially common in individuals with diabetes: they form earlier in life for diabetics and they progress more quickly, causing impaired vision. The lens is unable to focus light and vision is reduced. Common treatments for cataracts include surgery and glasses or contact lens to correct vision.

A new study conducted in Canada suggests that women who have been recently diagnosed with diabetes are more likely to also be diagnosed with breast cancer.

Research has previously linked breast cancer and diabetes. However, this new study also suggests that doctors may be discovering more cases of breast cancer in diabetics partly because they’re checking more, and not just because diabetes increases a woman’s risk of developing breast cancer. The findings of the study were published in the journal “Diabetes Care.”

Jeffrey Johnson of the University of Alberta in Edmonton was one of the researchers involved with the study. “The relationship that we see (between diabetes and cancer), we wondered if it was something about the fact that people with diabetes go to the doctor’s office more often,” said Johnson.

“When a new diagnosis of diabetes is made, people undergo a lot of tests and general health exams,” which often includes breast cancer screenings through mammograms.

Scientists have previously demonstrated in research that individuals who have been diagnosed with diabetes are also at an increased risk of several types of cancer, from colorectal and pancreatic cancer to breast cancer. Some hypothesized that certain risk factors, such as a sedentary lifestyle, poor diet, and smoking could be risk factors for both diabetes and cancer—explaining why the disease seem to accompany each other so often.

The metabolic changes that occur in diabetics, including blood sugar and insulin levels, could also provide a more favorable environment for the growth of tumors, said Johnson.

The study analyzed data from approximately 170,000 women living in British Columba, half of which had been recently diagnosed with Type 2 diabetes; the other half did not have the disease. The researchers tracked study participants for four to five years, and over that time period, about 2,400 of the women were diagnosed with breast cancer.

The chances of getting breast cancer were similar across the diabetes and non-diabetes groups. However, a deeper analysis revealed that age and time of diabetes diagnosis seemed to have an effect on breast cancer rates. Women who were older and post-menopausal with diabetes had a slightly higher chance of being diagnosed with breast cancer than women without diabetes.

Additionally, among women 55 and older, those who had been diagnosed with diabetes within the last three months were about 30 percent more likely to also be diagnosed with breast cancer than women without diabetes. Still, doctors couldn’t determine whether those results were due to random chance.

A few months after the researchers began following the participants—around the time when checkups and appointments would slow down following a diagnosis of diabetes—breast cancer diagnosis rates were the same among women with and without diabetes.

According to Johnson, the results don’t eliminate explanations such as common risk factors for the two diseases or increased chances of cancer due to hormonal changes.

“I think there are so many things going on in the relationship that this is maybe only one part of it,” said Johnson. “We’re really early on in understanding this relationship.”

According to Dr. Christos Mantzoros, an expert on with Harvard Medical School, the findings of the study might mean that the increased diagnoses of breast cancer in women with diabetes was due to the increased frequency of check-ups following diabetes. However, it could also mean that the risk factors common to both diseases could cause them to develop close to each other.

“Women with diabetes need to be more vigilant and their doctors need to be screening them for malignancies associated with diabetes including, but not limited to breast cancer,” said Mantzoros.