Diabetes Archive

The latest recommendations focus on newer medications, lifestyle changes, and procedures.

If you have heart disease, following a healthy diet and getting regular exercise should be a top priority. Both habits can help you reach and stay at a healthy weight and lower your blood pressure and cholesterol level. Chances are you'll also need to take medications to further improve those common heart-related risk factors. But if you also have diabetes, you may need even more aggressive treatment, according to new advice from the American Heart Association.

The recommendations, published May 12, 2020, in the journal Circulation, detail the latest evidence about treatments for people with both heart disease and diabetes. Diabetes, which affects about one in 10 adults, doubles the odds of having a heart attack or stroke (see "Why is diabetes hard on your heart?").

Are artificial sweeteners benign or a threat to your long-term health? A recent study adds a new element to the debate.

Artificial sweeteners seem to offer a tantalizing free pass to dessert. These low- or no-calorie additives taste like sugar, but your body can't absorb them the same way it does natural sugars. You get the taste without the calories, which should mean that you can eat them guilt-free. Right?

Over the years, experts have increasingly questioned whether artificial sweeteners are too good to be true. Are they really your ticket to a ­low-calorie treat — or will you wind up getting your just desserts for trying to outsmart Mother Nature?

Ask the doctor

Q. Will we have a vaccine to prevent COVID-19 and, if so, when?

A. I'm optimistic because never in human history has so much scientific time and effort been spent trying to make a vaccine. But it won't it be easy. As fast as possible, the vaccine scientists need to prove, first, that a vaccine is safe (minimal side effects) and, second, that it works to reduce a person's risk of getting the disease. Then they need to produce enough of it to immunize most of the 7.6 billion people on earth. Doing all of this within two to three years of a new virus being discovered would be an unprecedented achievement.

Many lifestyle factors can influence the development of atrial fibrillation, and doctors now better understand the importance of these factors in treating afib. Those who are at risk of developing afib can take action to improve their health, and in some cases they may be able to reduce their symptoms.

How maintaining a healthy weight and other lifestyle habits can help prevent this common heart rhythm disorder.

During a bout of atrial fibrillation, your heart may beat so rapidly, it may feel as though it's going to explode out of your chest. Commonly known as afib, this heart rhythm problem can leave you breathless and lightheaded—or cause no symptoms at all. About 9% of people ages 65 and older have afib, which raises the risk of stroke and other heart-related problems. But there are ways to lower your odds of developing afib—or to reduce its impact if you already have the condition.

Lessen your load

By far, the most important step you can take is to attain and stay at a healthy weight. "We have good evidence from multiple studies showing that people who are overweight have a higher risk of afib than people who are at a healthy weight," says Harvard professor of medicine Dr. Christine Albert, former director of the Center for Arrhythmia Prevention at Brigham and Women's Hospital. And the more you weigh, the higher your risk: people who are overweight have a 20% to 25% higher risk, whereas those who are obese (a body mass index, or BMI, of 30 or higher) have a 60% higher risk.

Tennis elbow is the common term for lateral epicondylitis, an inflammatory condition of the tendon that connects the extensor muscles of the lower arm to a bony prominence on the outside of the elbow called the lateral epicondyle. The condition causes pain at the point where the tendon attaches to the epicondyle. The pain may radiate to the forearm and wrist, and in severe cases, grip strength may lessen. It can become difficult to perform simple actions like lifting a cup, turning a key, or shaking hands.

As many as half of all people who play racket sports have the condition, but most people who have tennis elbow didn't acquire it by playing tennis, squash, or racquetball. It can result from any activity that involves twisting or gripping motions in which the forearm muscles are repeatedly contracted against resistance, such as pruning bushes or pulling weeds, using a screwdriver, or playing a violin. Tennis elbow is an occupational hazard for professional gardeners, dentists, and carpenters.

Research we're watching

An increasing number of Americans have a blood abnormality that indicates autoimmunity, which means their immune system has created antibodies that could work against the body's own cells, according to a study published April 7, 2020, in Arthritis and Rheumatology. Autoimmunity can lead to autoimmune diseases such as rheumatoid arthritis or lupus, although the study authors said they didn't look to see whether the prevalence of diagnosed autoimmune diseases also rose during the same period of time.

The researchers found a rise over two decades in the number of people who had positive antinuclear antibody (ANA) blood tests, a signal of autoimmunity. They used blood samples taken from 14,211 people ages 12 and older, as part of the U.S. National Health and Nutrition Examination Survey. In samples taken in the period 1988 to 1991, ANA prevalence was 11%. It rose slightly to 11.5% for the 1999–2004 time period, and to 15.9% in the 2011–2012 period. Comparing differences in gender, race and age, the largest increases in positive ANA tests occurred in men, non-Hispanic whites, adolescents, and adults ages 50 and older.

On call

Q. I occasionally get an excruciating leg cramp that wakes me from sleep. What causes leg cramps, and how can I prevent them?

A. Although nocturnal leg cramps can strike people at any time of life, they become more frequent with age. Among people older than age 50, about half report having leg cramps, a third say they are awakened at night by them, and 15% report having cramps about once per week.

Men need to manage their bone health as much as women do.

Most people think of osteoporosis as a women-only health problem, but older men also need protection from this bone-weakening disease.

About one in four men older than 50 will break a bone because of osteoporosis during his lifetime, according to the National Osteoporosis Foundation. And research has found that compared with women, older men are more likely to die following a fracture related to osteoporosis.

Ask the doctor

Q. I know doctors and scientists are very busy dealing with COVID-19. Is the need to care for, and do research on, COVID-19 affecting the care of and research on other important diseases?

A. You're right: the COVID-19 pandemic has consumed and disrupted medical care and medical research in the United States and around the world.