Diabetes Archive

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.

Research we're watching

Could a single blood test one day enable doctors to diagnose Alzheimer's disease? Researchers writing in the March 2 issue of Nature Medicine say they've made advances in this area. The blood test they developed measures the concentration of pTau181 — a form of the tau protein associated with brain changes in Alzheimer's disease — in the body's blood plasma. They used the test on samples collected from more than 400 people who were part of an ongoing -memory study.

The researchers found that the blood test was able to accurately detect which patients had Alzheimer's, which were healthy, and which had a different type of dementia caused by a neurodegenerative disease. Today, doctors typically diagnose Alzheimer's using a series of tests designed to rule out other causes, but the process is time-consuming and costly. The researchers are now aiming to refine the test further, in hopes that it will someday make it easier to detect Alzheimer's at an early stage, when the disease may be easier to treat.

New information may affect your approach to treatment.

Millions of people turn to prescription and over-the-counter medications to cope with heartburn from gastroesophageal reflux disease or other stomach conditions. But navigating the risks of heartburn remedies can leave a sour taste in your mouth, since some have been tied to health concerns. Here's what you need to know about two mainstays of treatment, and how the latest developments may affect you.

H2 blockers

Histamine₂-receptor antagonists, better known as H2 blockers — such as famotidine (Pepcid) and cimetidine (Tagamet) — are available over the counter or by prescription. They block a chemical that signals the stomach to produce acid, and are the go-to drugs when an antacid like calcium carbonate (Tums) or aluminum hydroxide (Maalox) isn't strong enough.

On call

Q. When should I worry about changes in the color of my urine? What color is considered healthy?

A. If a person is well hydrated, the normal color of urine is a pale yellow. Someone who drinks large amounts of fluid or takes diuretics (water pills) can have almost clear-looking urine. A dark yellow color may indicate a need to increase your fluid intake.

News briefs

Struggling with high blood sugar or diabetes? A study published online March 6, 2020, by PLOS Medicine suggests that increasing your daily fiber intake may help. British researchers combed through dozens of studies with about 10,000 participants who had prediabetes, gestational diabetes, type 1 diabetes, or type 2 diabetes. Compared with people who ate low-fiber diets (19 grams of fiber per day), people who ate another 16 grams of fiber per day (a total of 35 grams per day) weighed less and had lower levels of blood sugar, cholesterol, and inflammation. There were also 14 fewer deaths per 1,000 people among those who ate high-fiber diets. If you'd like to increase your fiber intake, try to eat more fiber-rich foods at each meal. Good sources include whole-grain cereals, legumes, and nuts. For example, a cup of bran cereal has up to 47 grams of fiber, depending on the brand; half a cup of white beans has about 10 grams of fiber; and an ounce of almonds has about 13 grams of fiber. Increase fiber intake slowly, to give your digestive tract time to adjust, and remember to increase your water intake as well.

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The guidelines are changing when it comes to screening for hepatitis C, a silent viral infection that attacks the liver and can cause cirrhosis, liver cancer, or liver failure. Back in 2012, the CDC recommended a one-time hepatitis C screening for the so-called baby boomer generation (anyone born between 1945 and 1965), a group that made up about 75% of all hepatitis C cases at that time. The following year, the U.S. Preventive Services Task Force (USPSTF) agreed. Now the USPSTF is expanding the screening age to all adults ages 18 to 79. The move is meant to identify more people in early stages of infection and comes as hepatitis C cases have increased almost fourfold since 2010. The USPSTF also advises screening for people outside of the recommended age range if they have ever used injected drugs. The recommendations were published online March 2, 2020, by JAMA. The CDC is in the process of developing similar recommendations. The screening requires only a simple blood test.

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