Diabetes Archive

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.

Ask the doctors

Q. A friend told me that I should be screened for hepatitis C. I'm not in a high-risk group. Is this really necessary?

A. If you're an adult younger than 80 years old, the answer is yes. In March, a government health advisory group, the U.S. Preventive Services Task Force (USPSTF), revised its earlier position and now recommends that all people ages 18 to 79 be screened for this "silent" virus. Prior to this change, the USPSTF recommended only that only high-risk individuals or adults born between the years 1945 and 1965 be screened. Hepatitis C can attack the liver and lead to serious liver damage and liver cancer. The condition is curable if detected. But people often don't consider themselves at risk and are unaware that they are infected, because they typically don't have symptoms.

News briefs

Drinking coffee is linked to many health benefits, such as less weight gain, lower average daily blood pressure, and a reduced risk for diabetes and cardiovascular disease. But which brewing method will help you get the most from your cup? A study published online April 22, 2020, by the European Journal of Preventive Cardiology found that filtering coffee (for example, with a paper filter) — not just boiling ground coffee beans and drinking the water — was better for health, particularly for older people. Researchers analyzed the survey responses of more than 500,000 healthy coffee drinkers (ages 20 to 79) who were followed for about 20 years. People younger than 60 who drank one to four cups of coffee, particularly filtered coffee, had lower rates of artery disease and death. The lower rate of death with filtered coffee drinkers persisted in people ages 60 or older, but was lost in people who drank five or more cups per day. The study is observational and doesn't prove that filtered coffee is healthier than unfiltered coffee, but it makes sense. Unfiltered coffee contains diterpenes, compounds that can raise cholesterol, and researchers say a cup of unfiltered coffee contains 30 times more diterpenes than a cup of filtered coffee. So use that coffee filter, save the French press or Turkish unfiltered coffee for rare occasions, and consider limiting your coffee intake to less than five cups per day, on average.

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The easiest way to protect your eyes from the sun's hazardous radiation is to wear sunglasses, not only in the summer months, but year-round. Ultraviolet (UV) light can damage the iris, retina, lens, and cornea, leading to permanent vision loss. It's a good idea to request UV protection (an invisible coating) on all of your prescription glasses.

UV light has three wavelengths:

UVA is long, looks almost blue in the visible spectrum, and is responsible for skin tanning and aging. It may also contribute to skin cancer risk.

Obstructive sleep apnea affects an estimated 20% of the population, and if untreated it has negative effects on cardiac and metabolic health as well as quality of life. If the condition is moderate or severe, a CPAP machine is the first-line treatment, but there is less consensus about treatment of mild OSA.

Research we're watching

People with clogged arteries in their hearts (coronary artery disease) or legs (peripheral artery disease) face a high risk of having a heart attack or stroke, particularly if they also have diabetes. For such people, a combination of clot-preventing drugs lowers the risk of those dangerous outcomes, according to a study published online March 28 by the journal Circulation.

The study included just over 18,300 people with coronary or peripheral artery disease; about 38% also had diabetes. They all took low-dose aspirin daily, but half also took 2.5 milligrams of rivaroxaban (Xarelto) twice daily while the others took a placebo. Like aspirin, rivaroxaban helps discourage blood clots, but through a different mechanism.