Tag Archives: diabetes

You Can Take Steps to Lower Your Breast Cancer Risk

Fear of breast cancer is widespread, yet many women don’t realize that adopting protective living habits may help keep it at bay. The habits described below may also help to ward off other life-threatening ills, like heart disease and diabetes.

Certainly, women have ample reason to worry about breast cancer. The disease is very common. One woman in eight in the United States will develop it in the course of a lifetime. The American Cancer Society estimates that this year 252,710 new cases of invasive breast cancer will be diagnosed, and 40,610 women will die from the disease.

Regular screening is touted as the most effective way to reduce breast cancer deaths, although experts continue to debate who should be screened, how often and at what ages. But not nearly enough is said about what women can do on their own to lower their risk of getting breast cancer in the first place.

One of the most important actions is an inaction: not smoking. The incidence of smoking has fallen significantly in the last half century, yet every day on the streets of New York I still see young women and teenage girls smoking. A decades-long study conducted among 102,098 women in Norway and Sweden found that, compared with nonsmokers, those who smoked 10 or more cigarettes a day for 20 or more years had a third higher risk of developing invasive breast cancer, and girls who started smoking before age 15 were nearly 50 percent more likely to get breast cancer.

An editorial in The Journal of Clinical Oncology last year stated that as many as 20,000 women in the United States continue to smoke even after a diagnosis of breast cancer. The authors, Dr. Barbara A. Parker and John P. Pierce of the University of California, San Diego, said breast cancer patients who quit smoking can add significantly to the benefits of postoperative chemotherapy and radiation.

Another important factor under personal control is weight. As body mass index, or B.M.I., rises, so does a woman’s risk of developing breast cancer, especially if she carries much of her excess weight around her waist. That’s because abdominal fat is particularly metabolically active, producing growth factors and hormones, including estrogen, that can stimulate the growth of breast cancer cells.

To read the full story, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

 

‘Weekend Warriors’ Show Survival Benefits

Working out only on the weekends or otherwise compressing your total physical activity into one or two prolonged runs or a single vigorous basketball or soccer game each week could lessen your risks of dying prematurely almost as effectively as more frequent, shorter workouts spread throughout the week, according to an interesting new study of the so-called weekend warrior phenomenon.

As most of us have heard by now, the standard recommendation about how much exercise we should complete each week for health purposes is 150 minutes of moderate or 75 minutes of vigorous physical activity. Moderate exercise consists of activities like brisk walking or easy cycling that raise heart rates while still allowing us to talk to training partners, and vigorous activities are those like running, fast-paced cycling, and many team sports, including basketball and soccer, that raise heart rates into a zone where speaking is difficult.

Meeting these guidelines is associated with a substantially reduced risk of developing a wide range of diseases and dying too young.

The guidelines also suggest that, for practical purposes, people consider breaking the 150 minutes into five moderate 30-minute sessions each week or a comparable number of shorter, more vigorous workouts.

But many people apparently do not have the time or inclination to exercise five times per week. About a third of American adults engage in zero weekly exercise and others pack their workouts into one or two sessions on Saturday or Sunday, when they have more free time.

There has been little information, though, about whether the weekend warrior pattern of exercise lowers the risk for premature death as effectively as more frequent and generally shorter workouts.

So for the new study, which was published on Monday in JAMA Internal Medicine, researchers at Loughborough University in England and other institutions decided to delve into the exercise routines of tens of thousands of men and women already participating in the Health Survey for England and the Scottish Health Survey.

To read the full story, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Fasting Diets Are Gaining Acceptance

Mark Mattson, a neuroscientist at the National Institute on Aging in Maryland, has not had breakfast in 35 years. Most days he practices a form of fasting — skipping lunch, taking a midafternoon run, and then eating all of his daily calories (about 2,000) in a six-hour window starting in the afternoon.

“Once you get used to it, it’s not a big deal,” said Dr. Mattson, chief of the institute’s laboratory of neurosciences. “I’m not hungry at all in the morning, and this is other people’s experience as well. It’s just a matter of getting adapted to it.”

In a culture in which it’s customary to eat three large meals a day while snacking from morning to midnight, the idea of regularly skipping meals may sound extreme. But in recent years intermittent fasting has been gaining popular attention and scientific endorsement.

It has been promoted in best-selling books and endorsed by celebrities like the actors Hugh Jackman and Benedict Cumberbatch. The late-night talk show host Jimmy Kimmel claims that for the past two years he has followed an intermittent fasting program known as the 5:2 diet, which entails normal eating for five days and fasting for two — a practice Mr. Kimmel credits for his significant weight loss.

To read the full story, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

 

New Diabetes Cases, at Long Last, Begin to Fall in the United States

After decades of relentless rise, the number of new cases of diabetes in the United States has finally started to decline.

The rate of new cases fell by about a fifth from 2008 to 2014, according to researchers at the Centers for Disease Control and Prevention, the first sustained decline since the disease started to explode in this country about 25 years ago.

The drop has been gradual and for a number of years was not big enough to be statistically meaningful. But new data for 2014 released on Tuesday serves as a robust confirmation that the decline is real, officials said. There were 1.4 million new cases of diabetes in 2014, down from 1.7 million in 2008.

“It seems pretty clear that incidence rates have now actually started to drop,” said Edward Gregg, one of the C.D.C.’s top diabetes researchers. “Initially it was a little surprising because I had become so used to seeing increases everywhere we looked.”

Experts say they do not know whether efforts to prevent diabetes have finally started to work, or if the disease has simply peaked in the population. But they say the shift tracks with the nascent progress that has been reported recently in the health of Americans.

To read the full story, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Cutting Sugar Improves Children’s Health in Just 10 Days

Obese children who cut back on their sugar intake see improvements in their blood pressure, cholesterol readings and other markers of health after just 10 days, a rigorous new study found.

The new research may help shed light on a question scientists have long debated: Is sugar itself harming health, or is the weight gain that comes from consuming sugary drinks and foods mainly what contributes to illness over the long term?

In the new study, which was financed by the National Institutes of Health and published Tuesday in the journal Obesity, scientists designed a clinical experiment to attempt to answer this question. They removed foods with added sugar from a group of children’s diets and replaced them with other types of carbohydrates so that the subjects’ weight and overall calorie intake remained roughly the same.

After 10 days, the children showed dramatic improvements, despite losing little or no weight. The findings add to the argument that all calories are not created equal, and they suggest that those from sugar are especially likely to contribute to Type 2 diabetes and other metabolic diseases, which are on the rise in children, said the study’s lead author, Dr. Robert Lustig, a pediatric endocrinologist at the Benioff Children’s Hospital of the University of California, San Francisco.

To read the full story, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Possible Discrimination Practices Being Investigated

The New York Times   (12/23, A19, Pear, Subscription Publication) reports that the Obama Administration “said Monday that it would investigate prescription drug coverage and other benefits offered by health insurance companies to see if they discriminated against people with AIDS, mental illness, diabetes or other costly chronic conditions.” Officials said they had become aware of “discriminatory benefit designs” that discourage people from enrolling because of age or medical condition. In a letter to health insurers, “administration officials said that a health plan could be engaging in unlawful discrimination if its list of approved drugs excluded all medicines needed to treat a particular condition, or if it restricted access to such drugs by charging large co-payments or requiring prior authorization.” The Times notes the Affordable Care Act mandates that insurers accept all applicants for coverage and cannot charge higher premiums based on a person’s pre-existing conditions.

To read more, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Cost Effectiveness a Taboo Conversation

If I had a pill that would extend your life by one day, but it cost a billion dollars, it’s unlikely that many people would argue that health insurance should pay for it. We all understand that while the benefit might be real and quantifiable, it’s not worth the expense. But what if the pill cost a million dollars? And what if it extended your life by 10 years?

Such discussions are about cost effectiveness. For the most part, we’re avoiding them when we talk about health care in the United States.

Some think that discussing cost effectiveness puts us on the slippery slope to rationing, or even “death panels.” After all, if we decide that the billion-dollar-for-a-day-of-life pill isn’t worth it, then what’s to stop us from deciding that spending a couple hundred thousand dollars to extend grandma’s life for a year isn’t worth it either?

In fact, we in the United States are so averse to the idea of cost effectiveness that when the Patient Centered Outcomes Research Institute, the body specifically set up to do comparative effectiveness research, was founded, the law explicitly prohibited it from funding any cost-effectiveness research at all. As it says on its website, “We don’t consider cost effectiveness to be an outcome of direct importance to patients.”

As a physician, a health services researcher and a patient, I have to disagree. I think understanding how much bang for the buck I, my patients and the public are getting from our health care spending is of great importance.

Research in this area can be difficult to perform. One of the reasons is that it’s not always easy to measure health outcomes. Some things, like death, can be relatively easy to define, but how do you quantify having diabetes, asthma or a seizure disorder?

To read more, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

 

Google Contact Lenses a Reality

Remember Google’s smart contact lenses? Well, now the giant Swiss pharmaceutical company Novartis is turning them into a commercial reality.

The two companies have announced that Novartis is licensing Google’s technology to create special contact lenses for diabetic patients. The new lenses will analyze tear fluid in the eye and provide real-time, constant measurement of an individual’s glucose levels. That data will then be transmitted wirelessly to a mobile, enabling users to monitor their condition easily.

Novartis appears to have plans beyond simple glucose level monitoring, though. It plans to use them to treat people with presbyopia, who can no longer read without glasses, and is even considering the possibility of implanting the lens directly into the eye. Which, is great but… ouch?

The technology is still very much in its infancy—you can be sure it’ll take a while to get FDA approval—but this is a big step forwards. This is one Google X project that is definitely becoming a commercial reality.

To read more, click here.

Jeffrey R. Ungvary President

Jeffrey R. Ungvary

Organization of Economic Research and Development to Measure the ACA

Research by the Organization of Economic Research and Development has gathered 15 years of data on diseases to measure the effectiveness of the Affordable Care Act.

Charting the numbers number of deaths from diseases that could have been prevented if the patient had access to appropriate health care, called the “amenable mortality” rate, shows that the United States is far behind European nations.

These diseases — like heart disease, diabetes and certain cancers — are tracked because early treatment significantly increases the likelihood of survival.

Nearly 20 years ago, the United States was closer to the middle of the pack, but other countries, like Ireland and South Korea, sharply improved their rates by 2007, according to the most recent data available from the Organization for Economic Research and Development.

The rate of improvement in the United States was 14 percent, the lowest of all countries surveyed.

In the Organization of Economic Research and Development survey, some countries that started with high amenable mortality, like the Czech Republic and Poland, had great improvement in their rates. Seven countries improved their rates to pass the United States, which is now on par with countries like Chile and Portugal.

The rate of uninsured Americans has crept up since 1999, a trend that may change with more than eight million people enrolled in health care plans under the Affordable Care Act by mid-April. Researchers will use these mortality rates as one measure of the success of this expansion in health care.

To read more, click here.

Jeffrey R. Ungvary

President

Jeffrey R. Ungvary