Diabetes Archive

As we reported in March, sleep apnea and other sleep breathing problems are associated with the development of dementia. Now a study published online April 15, 2015, by Neurology finds that sleep breathing problems are associated with an earlier onset of the decline in thinking skills.

Researchers analyzed the medical histories of about 2,500 people ages 55 to 90 and found that people with sleep breathing problems were diagnosed with mild cognitive impairment (a decline in thinking skills) an average of 10 years earlier than people who didn't have those problems. The encouraging news: people who treated their sleep breathing problems with a continuous positive airway pressure (CPAP) machine were diagnosed with mild cognitive impairment about 10 years later than people whose problems were not treated. The study doesn't prove a cause-and-effect relationship, but it does offer hope. "CPAP improves the quality of sleep in people with sleep-disordered breathing. Healthy sleep is an important time for our brains to accomplish critical 'housekeeping' tasks. One of these tasks is clearing beta-amyloid, one of the main proteins associated with Alzheimer's disease," says Dr. Scott McGinnis, an instructor in neurology at Harvard Medical School.

Controlling blood pressure and blood sugar will help both your heart and your kidneys.

On the surface, it's difficult to see how coronary artery disease and kidney damage might be related. But on the cellular level, the two conditions often go hand in hand. A closer look reveals the key. Underlying both conditions are two powerful risk factors: high blood pressure and diabetes, each of which damages the heart and kidneys independently.

Diabetes damages every part of the body, from the brain to the feet. High blood sugar, the hallmark of diabetes, wreaks havoc on blood vessels. It makes sense that keeping blood sugar under control should prevent diabetes-related damage — but how low to push blood sugar is an open question. A study published in The New England Journal of Medicine (NEJM) provides reassuring evidence that so-called tight blood sugar control is good for the heart and circulatory system. A 10-year follow-up of the Veterans Affairs Diabetes Trial showed that participants who aimed for tight blood sugar control had lower blood sugar and fewer heart attacks and strokes than participants whose blood sugar was allowed to float a bit higher. Although tight blood sugar control can help prevent diabetes-related damage, it can have drawbacks such as bouts of low blood sugar (hypoglycemia), which can be dangerous. Current guidelines from the American Diabetes Association recommend tight blood sugar control, but also recognize there’s no one-size-fits-all rule.

I had shingles in 2005 and haven?t had a shingles shot. I haven?t been able to find any studies that indicate whether a shot is feasible for people who have already had shingles. What do you recommend?

People with high blood pressure could benefit from a B vitamin known as folate if they are not getting enough from their diets, according to a study in The Journal of the American Medical Association (JAMA).

The study included more than 20,000 adults in China with high blood pressure who had never had a stroke or heart attack. Participants who took folate supplements along with a blood pressure medication had fewer strokes over the four-and-one-half-year trial than those who only took the medication.

Many different medications can potentially harm the liver, so doctors sometimes do liver function tests to ensure safety. The worst-case scenario is liver failure, but when this happens, the cause is usually not prescription medications, but rather the over-the-counter painkiller acetaminophen (Tylenol) or herbal supplements, according to a study in Gastroenterology.

Researchers scrutinized 5.4 million records of patients in the Kaiser Permanente Northern California system from 2004 to 2010. They identified only 62 cases of liver failure, 32 of which were linked to medications. This may not precisely reflect national rates, but it does suggest that liver failure from medications is relatively uncommon.

A fainting spell can be inconsequential, or it can signal a serious health issue. It's important to learn why you faint.

Many procedures require anesthesia, and which of the four types you have can affect your recovery.

If you've ever had a tooth filled without Novocaine, you know the difference anesthesia can make. Anesthesia—whether it numbs your mouth or puts you into a full sleep—is designed to keep you comfortable during a procedure that otherwise might be hard to tolerate physically, emotionally, or both. "We have four goals: to see that you have no pain, that you're drowsy or unconscious, that your body is still so that the surgeon can work on it, and that you aren't left with bad memories of the procedure," says Dr. Kristin Schreiber, an anesthesiologist at Harvard-affiliated Brigham and Women's Hospital.

There are four basic kinds of anesthesia—local, which is typically administered to numb a small area; regional, which numbs a larger area, like your hand, arm, or foot; neuraxial (spinal or epidural), which is injected near the spine and numbs the lower half of your body; and general, which works in the brain to render you completely unconscious and unable to sense pain. The type used depends upon the procedure you're having, your state of health, and, often, your preferences.

Researchers from the biotechnology company Biogen have reported that a new drug reduced the amount of amyloid plaques—the brain deposits associated with dementia—and slowed cognitive decline in people with early Alzheimer's disease. They presented the report March 20, 2015, at the International Conference on Alzheimer's and Parkinson's Diseases in Nice, France.

The researchers studied 166 people ages 50 to 90 who had been diagnosed with mild Alzheimer's. The participants were randomly assigned to receive either a placebo or one of four different doses of the drug aducanumab—an antibody that attaches to amyloid deposits and turns the immune system on them.

Q. I just got diagnosed with diabetes and my doctor said I am at risk for heart disease. Why?

A. Diabetes is considered to be an extremely strong risk factor for heart disease. One reason is that people with diabetes are also more likely to have other conditions that raise their odds of heart disease, such as obesity, high blood pressure, or elevated LDL cholesterol. Also, those factors seem to have more of a detrimental effect on people who have diabetes compared with those who don't.