Category Archives: Diabetes

Angela Loucks remembers Dec. 11, 2011, as a day that would change her daughters life forever.

When the doctor at Peninsula Childrens Clinic told her Chloe, then 4-years-old, had Type 1 diabetes and was insulin dependent, Loucks broke down in tears.

Chloe took the news a little better than her mom.

She leaned over and put her hand on me and told me itd be OK, Loucks said.

And it has been OK for the Loucks family, they say.

At first, Loucks said she thought Chloes symptoms of extreme thirst and hunger were part of growing up but the diagnosis that their daughter now had a chronic condition was a culture shock. In time, lifestyle changes came and the Loucks family including dad Larry and sister Emily began to make healthier food choices in support of Chloe.

Being diabetic hasnt taken away her childhood either. Chloe still rides her bike, jumps on the trampoline, goes to birthday parties and trick or treats on Halloween. Treats are just eaten in moderation.

Its just a way of life for her now, Loucks said.

I dont really know anything different, Chloe said.

On and off

Traveling for care is a way of life for many young diabetics, too a functional reality for many local diabetics. The Olympic Peninsula has been without an endocrinologist, a doctor specializing in hormonal imbalances in the endocrine system, for more than a year.

Dr. Josh Jones, chief physician officer for Olympic Medical Physicians, said his group is not recruiting a new endocrinologist for a number reasons, but mainly because of their rarity.

Its difficult to have a solo, lone doctor of any kind of specialty of any kind of coverage, Jones said. There was plenty of need. We werent able to create a program and the clinical infrastructure around the endocrinologist.

Chloe and her family travel to Seattle Childrens every three-four months to see an endocrinologist while others travel to Swedish Pediatrics or Mary Bridge Childrens in Tacoma.

Dr. Jeff Weller, a pediatrician at Peninsula Childrens Clinic, said bringing in a pediatric endocrinologist is even more rare.

Its nearly impossible to have sub-specialists in a rural area, Weller said. All sub-specialists work at a tertiary care center like Mary Bridge.

To offer a local option, Seattle Childrens sends a team including a pediatric endocrinologist to Peninsula Childrens Clinic one day every three months to meet with children with diabetes.

Weller said that interval matches routine appointment schedules in bigger areas.

Waiting

Casey Vass of Sequim has five children and her youngest Kylus, 2, has been a diabetic for about a year. They met with Seattle Childrens endocrinology team in late February in Port Angeles, but Vass said there was such a backlog of patients they waited for more than four hours.

Vass said its easier for her family to travel to Seattle Childrens than wait that long again.

I want him to be monitored and know were doing what we need to be doing, she said.

I cant see putting my family through this every four months.

Shes traveled to Seattle for various diabetes education classes and appointments and since February shes called the clinic twice about filling a prescription and advice on dealing with the stomach flu.

Hes growing so fast that were adjusting his (insulin) numbers every time we go in, she said.

Time is the hardest part of managing her sons diabetes, Vass said.

Its so time-consuming, she said. Its all day with all the food and medical and insurance stuff.

Options

Sadie Crowe of Port Angeles has similar struggles with diabetes on the peninsula.

Crowe, 38, grew up a Type 1 diabetic in Sequim and her daughter Roslyn, 7, has lived with the autoimmune disease for four-plus years, too.

When Roslyn was diagnosed, we really considered whether we should stay here, Crowe said.

They dont provide the level of care we need for Type 1 diabetes here.

Both mother and daughter wear insulin pumps and Roslyn sees a doctor at Mary Bridge Childrens every three months.

It would be life changing for us if we didnt have to drive to Tacoma for care, she said.

Roslyn sees local physicians for immunizations, colds and other basic care but Crowe said when a diabetic is sick you get a little sicker.

Well call the endocrinologist sometimes because if we cant get the diabetes under control, then we cant stop the virus, she said.

On average, Roslyn has traveled about once a year to Tacoma for Mary Bridges pediatric intensive care unit, Crowe said.

Care

The total number of diabetics, Type 1 or 2, isnt known on the Olympic Peninsula, but the Juvenile Diabetes Research Foundation estimates there are more than 1.25 million Americans with Type 1 diabetes.

The Centers for Disease Control and Prevention estimates about 26 million Americans have diabetes.

Type 2 diabetes, usually diagnosed in adults, is a metabolic disorder where a person can still produce insulin but cannot use it as well.

Vickie Everrett, supervisor of nutrition counseling and a diabetes educator for Olympic Medical Center, said they see and treat diabetes as an epidemic.

We want to change the mindset of people, she said.

Through her programming, she sees about 600 people annually for diabetes education with about 30 of those Type 1.

It isnt just, Youve got to lose weight and move more, Everrett said. Its really sitting down with them and talking with them about how they fix food, what kind of food access they have and what are their physical abilities in order to get their best medical care.

Some of the things they cover includes diabetes self-management and self-training, counseling services, and they offer a monthly support group from 6:30-7:30 p.m. the fourth Tuesday of each month at Olympic Memorial Hospital.

Everrett said she typically doesnt work with children under 18 and that patients are usually referred by primary care physicians for diabetes assistance.

Weller said when juvenile diabetics are diagnosed they are sent to a tertiary center like Seattle Childrens to be stabilized and work with a diabetes educator.

Everrett said theyve implemented a diabetes prevention program that starts again in August and is covered by Medicare in 2018 for patients who participated in the Center for Disease Controls diabetes program the past three years.

Possibile fixes

While options may be limited, physicians like Jones and Weller want to look for more collaboration.

We can leverage some of our electronic health records to help primary care care doctors provide better care especially around diabetes, Jones said.

Everrett agrees, saying there are a lot of people with diabetes and with early risk factors such as being overweight, a more sedentary lifestyle and those older than 60 who need enhanced support.

That defines a large part of our population, she said. But their providers have to refer them to the (diabetes education) service.

Even though diabetics may prefer to see a specialist, most local diabetes care is not provided by an endocrinologist, Jones said.

For the chronic ongoing care, their care will live in their primary care provider, he said.

Both types of diabetes can be managed by a primary care provider, Jones said, and in more complicated cases theyll consult a specialist.

Weller said tertiary centers are good about having phone access and Olympic Medical Center officials are looking to grow telemedicine offerings through secure, video-to-video in the future.

Peninsula Childrens Clinics recent partnering with Olympic Medical Physicians, also provides a lot of opportunities for growth and opportunity, Jones said, but there are no current plans regarding juvenile diabetes aside from current operations.

Hope

Traveling to Seattle Childrens takes a full day every three months for one of Chloes appointments, Loucks said.

But Chloe looks at the appointment as a fun trip, she says, and only dreads a scheduled arm poke for shots.

For me, whats more important is that she is comfortable and everything is a good fit rather than the cost of gas and traveling for a whole day, Loucks said.

After four-plus years of a strict diet, finger pricks and insulin injections through her pump, Chloe remains hopeful for a cure.

Once a year, she and her family make and sell baked goods at her great-grandmothers garage sale with proceeds benefiting diabetes research.

Im very hopeful, Chloe said.

For more information on Type 1 diabetes and juvenile diabetes, visit http://www.jdrf.org and for more on general diabetes research and information, visit http://www.diabetes.org.

For more information on Olympic Medical Centers Diabetes Prevention Program, call 417-7125.

Reach Matthew Nash at mnash@sequimgazette.com.

Diabetics like Chloe Loucks, left, continue to do everyday things like jump on a trampoline with her sister Emily but in the winter months its been hard to be active, she says. Sequim Gazette photo by Matthew Nash

Eating healthy food is an important part of controlling blood sugars for diabetics. For Chloe Loucks, right, she checks with her mom Angela most of the time before eating snacks like peanut butter crackers, applesauce and yogurt which can bring blood sugar levels up.

Chloe Loucks, left, stands with her family, dad Larry, mom Angela, and sister Emily, on March 8 at the Regional Outreach Luncheon Meeting for Clallam & Jefferson County at Sunland Golf & Country Club. Chloe and Larry spoke about how much Seattle Childrens Hospital has helped her with treatment. The guilds have helped more than 1,400 patients receive $1.2 million in uncompensated care. Sequim Gazette photo by Matthew Nash

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Locals choose out of area diabetes services due to availability - Sequim Gazette

Story Highlights

WASHINGTON, D.C. -- Obese adults between the ages of 25 and 64 are at least four times more likely to have been diagnosed with diabetes than those who are normal weight, according to the Gallup-Healthways Well-Being Index. By their mid-to-late 30s, 9.3% of adults who are obese have been diagnosed with diabetes, compared with 1.8% among those who are normal weight.

These results are based on nearly 500,000 interviews conducted in the U.S. from 2014 through 2016 as part of the Gallup-Healthways Well-Being Index.

Unlike some government estimates of obesity, the Gallup-Healthways Well-Being Index uses respondents' self-reported height and weight to calculate body mass index (BMI) and subsequent weight classes. It does not involve clinical measurements that typically result in higher obesity estimates. A BMI of 30 or higher results in an obese classification. Additionally, the Well-Being Index does not discern between Type 1 and Type 2 diabetes, but rather asks: "Has a doctor or nurse ever told you that you have diabetes?"

In 2016, 28.4% of all U.S. adults were classified as obese, and 11.6% reported having been diagnosed with diabetes. Researchers from the Centers for Disease Control and Prevention (CDC) have estimated that about one in three Americans born in the year 2000 will be diagnosed with diabetes in their lifetime, and that the percentage of Americans with the disease will at least double from current levels by the year 2050.

Not all individuals who are obese will develop diabetes, and some who are normal weight will get the disease. Factors other than obesity status or age could increase the risk of developing diabetes, including physical inactivity, race and ethnicity, and genetic predisposition.

Still, the odds of having been diagnosed with diabetes are substantially higher among those who are obese than among those who are overweight or normal weight, and remain elevated between the ages of 25 and 64. The peak years of elevated risk are between ages 35 and 39. At this stage in life, obese individuals are over five times more likely than their normal weight counterparts to have been diagnosed with diabetes.

Women Have Higher Diabetes Risk Because of Obesity

In 2016, women were only slightly more likely than men to report having been diagnosed with diabetes -- 11.7% to 11.4%, respectively. Women who are obese, however, are more likely than obese men to have diabetes across all age groups up to age 60, at which point both groups converge.

The increased diabetes risk is considerably higher for obese women than for obese men across most age groups. For example, obese women aged 50 to 54 are six times more likely than women who are normal weight to have diabetes, while obese men of the same age are only about three times more likely than their normal weight counterparts to have diabetes.

The results of this analysis cannot establish a causal relationship between obesity and diabetes, as individuals are not asked to confirm the age at which they were diagnosed with diabetes and their height and weight at the time of the diagnosis. Some who were obese when interviewed may have been normal weight at an earlier age when they were diagnosed with diabetes, and some who were normal weight (or overweight) at the time of the interview may have been obese at the point of their diagnosis.

The results do, however, add to a significant body of research that demonstrates the unambiguous link between the two diseases: Those who are obese carry a significantly higher risk of developing diabetes.

Implications

Obesity has climbed steadily in the U.S. since 2008, increasing nearly three percentage points to 28.4% in 2016. This means there are now 7 million more U.S. adults who are obese than would have been the case if the rate had held steady at the 2008 level.

Diabetes, in turn, has climbed by one point since 2008, to 11.6%. Every three-point increase in the U.S. obesity rate is associated with a roughly one-point increase in the diabetes rate.

The findings from this analysis show the strength of the relationship between obesity and diabetes, even for young adults. By their mid-to-late 20s, obese individuals are already four times more likely than their normal weight counterparts to have been diagnosed with diabetes. This increased risk only grows over the next decade before peaking between the ages of 35 and 39. As such, communities, businesses and healthcare providers should pursue efforts to curtail obesity at the earliest possible time and with increased urgency.

The costs of obesity are substantial. In unplanned absenteeism alone, obesity and associated chronic conditions have been estimated to cost the U.S. economy $153 billion annually. This economic impact is likely exacerbated given that the obesity-diabetes link is greatest among adults in their prime working years.

Curtailing the relentless climb of obesity and associated chronic conditions such as diabetes can be accomplished. Hospitals can put in place diabetes management programs to help people who have already been diagnosed, as well as diabetes prevention programs for those who are at risk.

"The best diabetes management programs are comprehensive -- delivering professional education, inpatient glycemic management, outpatient prevention, and self-management education and support -- and they engage multidisciplinary teams for coordinated care," said Sheila Holcomb, vice president, Sharecare Diabetes Solutions. "They focus on metrics such as achieving glycemic targets and reducing average length of inpatient stays."

Additionally, at the community level, initiatives like the Blue Zones Project -- an organization that specializes in transforming communities across the U.S. into higher well-being places -- has compiled many success stories.

For example, between 2010 and 2015 the California Beach Cities (Redondo Beach, Manhattan Beach and Hermosa Beach) had a 9.2-point decline in adults who were either overweight or obese, coupled with a 1.1-point decline in diabetes. This was done in part through close planning and cooperation with the Beach Cities Health District to transform both the physical structure of each community and the culture itself, resulting in a population that is healthier and better informed about what is needed to best pursue a life well-lived.

See the Gallup-Healthways report on U.S. diabetes prevalence across states and communities here.

These data are available in Gallup Analytics.

Results are based on telephone interviews conducted Jan. 2, 2014-Dec. 30, 2016, as part of the Gallup-Healthways Well-Being Index, with a random sample of 484,350 adults aged 18 and older, living in all 50 U.S. states and the District of Columbia. The smallest sample size for all adults is for those who were classified as obese and aged 25 to 29 (n=5,789); the largest sample size is for those classified as normal weight and aged 18 to 24 (n=21,372). These sample sizes were reduced by roughly half when parsed by gender. The margin of sampling error for each reported BMI class within each age group is no more than 0.2 percentage points in most cases. All reported margins of sampling error include computed design effects for weighting.

Each sample of national adults since Sept. 1, 2015, included a minimum quota of 60% cellphone respondents and 40% landline respondents, with additional minimum quotas by time zone within region. Prior sampling dating back to Jan. 2, 2014, involved a 50% split between cellphone and landline interviews. Landline and cellular telephone numbers are selected using random-digit-dial methods.

Learn more about how the Gallup-Healthways Well-Being Index works.

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Obesity Quadruples Diabetes Risk for Most US Adults - Gallup

06-Apr-2017

Fond du Lac County Public Health Officer Kim Mueller says six week courses on Living Well with Diabetes will be offered this spring. She says whether you have been living with it a long time or were just diagnosed it will help you manage it. She says 475,000 residents in Wisconsin have diabetes and another 1.4 million people are pre-diabetic. The course will be offered on Thursdays from 9:30 a.m. to Noon from April 27th through June 1st, and Fridays from 1 to 3:30 p.m. from May 19th through June 23rd at Agnesian Health Shoppe on Camelot Drive in Fond du Lac. She says they will have more sessions in the future at a variety of locations and times. The course is free, but registration is required. That can be done online at Agnesian.com. Mueller says the course will teach you what you need to know about physical activity, food choices, and medications associated with diabetes. She says its hoped it will help reduce emergency room visits.

Thursdays

Fridays

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Living Well With Diabetes - Kfiz

Justin Green was diagnosed with type two diabetes in 2016. At the time, he weighed nearly 400 lbs (WKEF/WRGT)

KEEPING FAMILIES SAFE: Weight loss can be very difficult, especially if you have a lot of pounds to lose, but the payoff is worth it. A young man FOX 45s Deborah Linz spoke to for her Keeping Families Safe report proves exactly that.

Justin Green was diagnosed with type two diabetes in 2016. At the time, he weighed nearly 400 lbs. Since then hes lost 120 lbs, with his doctor recommending being more active and changing his diet. But, Justin's lifestyle changes didn't come easily.

"I probably eat less than a quarter of what I used to. Nothing fried, raw vegetables, Justin said.

We always encourage diabetics to reduce calories and carb intake, Dr Omotayo Akinmad said, but also only eat when they have to when they're hungry. It's overeating that leads to an uncontrolled blood sugar."

Justin said his weight loss has improved his overall health, and he no longer has to take medication or check his blood sugar.

"The diagnosis was technically reversed but I consider myself a non-practicing diabetic," Dr. Akinmad said. "It's not uncommon for patients who are very well motivated who have lost significant weight and have change their lifestyle to have a reversal in their blood sugar."

Justin's advice for anyone trying to manage their diabetes is to never give up.

Read more:
KEEPING FAMILIES SAFE: Weight loss and diabetes - WKEF ABC 22

Newser

Researchers Developing Contact Lens to Help People With Diabetes Newser (Newser) People with diabetes can monitor their blood glucose levels continuously by using electrodes implanted under their skin, but that method can be painful and can even lead to infections. Researchers think they have a more elegant solution: a ... Researchers develop contact lens that tells people with diabetes when they need to take medicationThe Independent all 6 news articles »

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Researchers Developing Contact Lens to Help People With Diabetes - Newser

Dear Doctor: A recent study found that air pollution increases the risk of Type 2 diabetes. How can that be? Air pollution cant possibly raise blood sugar levels.

Dear Reader: I can understand your disbelief. My first thought when I saw this study was that it was correlative, not causative. In other words, air quality is simply worse in cities, which are more likely to have large numbers of people with lower socioeconomic status, who, in turn, tend to have greater rates of obesity and diabetes. Then I looked more closely.

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Air pollutants assessed in the studies include nitrogen dioxide and particulate matter between 0.1 to 2.5 microns in size (PM 2.5). Early epidemiologic studies showed a correlation between areas of greater pollution and diabetes but did not control for socioeconomic status. Then came a 2010 study that used census data from three counties in the United States, and assessed rates of diabetes and Environmental Protection Agency data regarding PM 2.5 pollution.

The authors took into account such socioeconomic variables as median income, high school completion, male sex and ethnicity all markers for diabetes risk. The authors found a 16 percent to 20 percent increase in the prevalence of diabetes in the areas that had the highest amounts of PM 2.5 versus those areas with the lowest amounts, even with all other factors being equal.

Then came this years study published in the journal Diabetes that included 314 obese Latino children in Los Angeles. The authors analyzed where the children lived; the amount of pollution to which they were exposed, measured by nitrogen dioxide and PM 2.5; and their parents socioeconomic data. The children were followed for 3.4 years, during which time they underwent tests of blood sugar, two-hour glucose tolerance, insulin and insulin response to glucose. The authors found that the markers for future diabetes were much greater in those exposed to greater amounts of pollutants. This was independent of socioeconomic status and even independent of the level of obesity.

The cause isnt completely clear yet. Studies in rodents exposed to pollutants have shown increased inflammation within fat cells, accumulation of cholesterol in the liver and decreased ability of muscles to use sugar. This leads to metabolic dysfunction and obesity. Further, pollutants can lead to systemic inflammation that in turn leads to insulin resistance, and thus the inability to bring sugar into the cells of the body, leaving it to sit in the bloodstream.

What is clear is that there does appear to be an association between pollution and diabetes, but more studies are needed to evaluate the degree of the association. Regardless, pollution is obviously unhealthy and needs to be controlled within society. The measurements of pollution provided in these studies come from the Environmental Protection Agency, whose existence is to safeguard the health of current and future societies.

Robert Ashley, M.D., is an internist and assistant professor of medicine at the University of California, Los Angeles. Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.

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Ask the Doctors: Studies show surprising link between diabetes and pollution - Tulsa World

Catch News

Urine metabolites may help predict which obese teens will develop diabetes Science Daily Researchers have discovered a unique metabolic "signature" in the urine of diabetic, obese black teenagers that they say may become a way to predict the development of type 2 diabetes in people at risk. They will present their results Tuesday at the ... Children at risk of diabetes should be screened by HbA1C, oral glucose tolerance testsMedical Xpress Diabetes control is more difficult for night-shift workers The Endocrine SocietyEurekAlert (press release) all 5 news articles »

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Urine metabolites may help predict which obese teens will develop diabetes - Science Daily

Ventura 9:04 a.m. PT April 4, 2017

Betty Berry (Photo: Contributed photo)

QUESTION:I am looking for information about living with diabetes.Someone told me about a six-week workshop being offered do you have any information about where and when?

ANSWER:Yes, I do and I would be more than glad to share it with you.

You are asking about a self-management diabetes workshop called Everyone with Diabetes Counts. It is a program that encourages lifestyle changes while teaching about diabetes and how it affects overall health.

It is a Diabetes Empowerment Education Program and is being presented by the Braille Institute.The workshops are interactive and involve demonstrations, role play, games and other engaging activities for group learning.

The class you are asking about is six short, weekly workshops from 10 a.m. to noon Thursdays from April 20 through May 25 at theGoebel Adult Community Center, 1385 E. Janss Road in Thousand Oaks.

The program will be facilitated by Brenda Birdwell from the Braille Institute.To register, call886-6025.

QUESTION:I just heard about an organization called Long-Term Care Ombudsman.Can you shed any light on what this organization does?

ANSWER:To understand what this organization does, you need to mark your calendar to attend a seminar at the Goebel Adult Community Center in Thousand Oaks from 2-2:45 p.m. April 27.

Ventura County Ombudsman Daniel Uhlar will explain What Is An Ombudsman? and What Does an Ombudsman Do? He will answer these questions as well as provide the history and current perspective of the program.

Come and learn how these federally mandated volunteer advocates fight for the rights and needs of the elderly and disabled residents living in nursing homes and other long-term care facilities.

The Long-Term Care Ombudsman Program of Ventura is a nonprofit organization.Services are free and confidential.They can be reached Mondays through Fridays at 656-1986.

To make a reservation for this very informative presentation, call 381-2744.

Happenings

April 9, 8 a.m. to 1 p.m.:9th annual Community Garage Sale at Goebel Adult Community Center, 1385 E. Janss Road in Thousand Oaks.Call 381-2744 for information.

April 11, 9-11a.m.:FOOD Share Distribution of Senior Kitsat Goebel Adult Community Center, 1385 E. Janss Road in Thousand Oaks.Flyers and applications are available at the center.For more information, call 381-2744.

April 13, 12:30 p.m.:Transportation Expo will offer information on local transportation choices at the Goebel Adult Community Center, 1385 E. Janss Road in Thousand Oaks. Seating is limited. For reservations, call 381-2744.

April 19, 8 a.m. to noon:Simi Valley Wellness Expo 2017 at Simi Valley Senior Center, 3900 Avenida Simi.For more information, call 583-6363.

April 14, 1:30-3p.m.:Lets Look at Volunteering in a Different Way seminar at Westlake Civic Center, 31200 E. Oak Crest Drive in Westlake Village.For more information, call 495-6250.

April 20, 1-3 p.m.:Will You Pass Your Next Driving Test? seminar at Goebel Adult Community Center, 1385 E. Janss Road in Thousand Oaks.For reservations, call 381-2744.

Betty Berry is a senior advocate for Senior Concerns.The advocates are at the Goebel Adult Community Center, 1385 E. Janss Road in Thousand Oaks. Call 495-6250 or e-mail bberry@seniorconcerns.org. Please include your telephone number.You are invited to submit questions on senior issues.

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Six-week workshop to cover living with diabetes - Ventura County Star

Diabetes and fatigue Look to the causes of fatigue to overcome this common side effect of diabetes.

Posted on April 3, 2017 by Diana Hassan, Michigan State University Extension

Fatigue is a common side effect of diabetes. But what causes fatigue and how can you overcome it?

Managing diabetes can be challenging with all the tasks that you have to track such as glucose levels, carbohydrates, food portions, medication and many other tasks. This daily management of the disease can cause a person to experience fatigue. However, there could be other underlying causes of fatigue.

Diabetes itself can also cause fatigue due to high or low blood glucose (sugar). High levels of glucose in the blood can slow circulation. As a result, oxygen and nutrients do not get transported efficiently to the cells and this can cause fatigue. Additionally, since glucose is a fuel for the cells, low blood sugar can also cause fatigue simply because there isnt enough glucose or fuel for the cells.

There could be other medical conditions causing fatigue such as anemia, hypothyroidism (low thyroid), and depression, to name a few. Please check with your doctor if you think that your fatigue is caused by a condition other than diabetes.

To prevent diabetes-related fatigue, try to keep blood sugar levels in control, get enough sleep and try to limit stress in your life. Caffeinated beverages and energy drinks may help you deal with fatigue temporarily, but this approach is not a long-term solution and can also mask the root causes of fatigue.

To understand the benefits of diabetes self-management and to enroll in a diabetes self-management workshop near you visitMichigan State University Extension.

This article was published by Michigan State University Extension. For more information, visit http://www.msue.msu.edu. To have a digest of information delivered straight to your email inbox, visit http://www.msue.msu.edu/newsletters. To contact an expert in your area, visit http://expert.msue.msu.edu, or call 888-MSUE4MI (888-678-3464).

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Diabetes and fatigue - Michigan State University Extension

Americans of South Asian descent are twice as likely as whites to have risks for heart disease, stroke and diabetes, when their weight is in the normal range, according to a study headed by Emory University and UC San Francisco.

Similarly, Americans of Hispanic descent were 80 percent more likely than whites to suffer from so-called cardio-metabolic abnormalities that give rise to heart disease, stroke and diabetes, compared with 50 percent more likely for those who were Chinese and African-American.

These risks include high blood pressure (hypertension), elevated glucose, low HDL, the good cholesterol, and high triglycerides, a fat found in blood. In the study, participants who were aged between 45 and 84, were classified as having cardio-metabolic abnormalities if they had two or more of these four risk factors.

The study, publishing April 3, 2017, in Annals of Internal Medicine, included 803 South Asian residents of San Francisco Bay and Chicago areas, who traced their ancestry to India, Pakistan, Nepal, Bangladesh or Sri Lanka. Also enrolled in a parallel study were approximately 6,000 residents of New York, Baltimore, Chicago, Los Angeles, Minneapolis-St. Paul and Winston-Salem areas, who identified as Chinese, white, Hispanic or African-American.

For whites, Hispanics and African-Americans, normal weight was categorized as having a body mass index (BMI) between18. 5 and 24.9 kg/m2. For Chinese and South Asians, the range was narrower: from 18.5 to 22.9 kg/m2.

Questionnaires were given to assess participants activity levels and eating habits.

While other studies have looked at race and cardio-metabolic risk, this is the first that looks at the relative differences between five races, said senior author Alka Kanaya, MD, professor of medicine, epidemiology and biostatistics in the Division of Internal Medicine at UCSF. Its also the first that compared risk between two different Asian populations.

The researchers found that for non-whites to have the same number of cardio-metabolic risk factors as whites with a BMI of 25 kg/m2 the equivalent of 150 pounds for a woman measuring 5-foot-5 they had to have much lower BMI levels. These were 22.9 kg/m2 for African-Americans, 21.5 kg/m2 for Hispanics, 20.9 kg/m2 for Chinese and 19.6 kg/m2 for South Asians the equivalent of 118 pounds for a woman measuring 5-foot-5.

These differences are not explained by differences in demographic, health behaviors or body fat location, said first author Unjali Gujral, PhD, a postdoctoral fellow at the Global Diabetes Research Center at Emory University in Atlanta. Clinicians using overweight/obesity as the main criteria for cardio-metabolic screening, as currently recommended by the U.S. Preventive Services Task Force, may fail to identify cardio-metabolic abnormalities in many patients from racial/ethnic minority groups.

Kanaya, who is also the principal investigator of the MASALA study (Mediators of Atherosclerosis in South Asians Living in America), which enrolled the South Asians, said that the results of the study should not be interpreted as a call to those with normal BMI to lose weight.

We hope the results will enable patients and their health care providers to see that race/ethnicity alone may be a risk factor for cardio-metabolic health in minority Americans, she said.

The study was funded by the National Institutes of Health and the National Heart, Lung and Blood Institute.

Co-authors are Eric Vittinghoff, PhD, of UCSF; Morgana Mongraw-Chaffin, PhD, of Wake Forest School of Medicine in Winston-Salem, N.C.; Dhananjay Vaidya, PhD, of Johns Hopkins University School of Medicine in Baltimore; Namratha Kandula, MD, MPH, and Kiang Liu, PhD, both of Northwestern University in Chicago; Matthew Allison, MD, MPH, of UC San Diego; Jeffrey Carr, MD, of Vanderbilt University in Nashville, Tenn.; and KM Venkat Narayan, MD, of Emory University.

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Race Ranks Higher than Pounds in Diabetes, Heart-Health Risks - ScienceBlog.com (blog)