All Diabetics Should Take Statins, Say Experts

The European Association for the Study of Diabetes (EASD) has recommended that all people suffering from diabetes should be taking statins, as research showed that the evidence for their effectiveness in reducing cardiovascular risk in diabetics, and even people without diabetes, is incontrovertible.

Professor John Betteridge, of University College London Medical School, pointed out at the EASD annual meeting in September 2010 that all people with diabetes should be taking statins to reduce their chances of having a heart attack or stroke, although he also warned that they should avoid any drug interactions with other medications being taken.

Betteridge has analysed a number of studies into the use of statins, such as the CollaborativeAtoRvastatin Diabetes Study (CARDS), funded by Diabetes UK, the Department of Health and Pfizer, which examined their benefits in people with type 2 diabetes who did not already have evidence ofcardiovascular disease .

In the CARDS study, atorvastatin 10mg/day was shown to reduce major cardiovascular events by 37 per cent and strokes by 48 per cent, reinforcing guidelines issued by the Joint British Society (JBS) regarding targets for low-density lipoprotein cholesterol in this high-risk group.

Betteridge argues that statins are safe if taken appropriately and drug interactions avoided, as they can lead to serious side effects, especially when patients are on a variety of drug treatments. Statins should also not be used by pregnant women at least six weeks before conception.

He realises that statins don’t always get a good press, and that many diabetics will be wary of this advice, but he points out that the evidence shows them to be highly effective in preventing major vascular events in patients with diabetes.

However, the idea of taking statins to offset the effects of junk food has been criticised by diabetes experts. New research had recommended that fast food outlets should give out free statin pills as a way of combating the impact of unhealthy food, as they can reduce the levels of bad cholesterol in the blood, which is why they are normally prescribed to decrease the risk of cardiovascular disease.

There are now worries that using statins could encourage people to lead unhealthier lives, eat more fast food and therefore increase the risk of developing type 2 diabets. Although studies have found that a single, cheap statin pill could offset the increased risk to the heart caused by the fat in a cheeseburger and a small milkshake, there are concerns that it is both irresponsible and dangerous to promote their use as a quick fix to counteract the effects of an unhealthy diet.

Zoe Harrison, Care Advisor at the charity Diabetes UK, said Statins can reduce the risk of cardiovascular disease by lowering the bad cholesterol in our blood which can be raised due to a high-fat diet. However, they don't prevent all the side effects that result from an excessive intake of fatty food.

Statins also have some serious side effects - such as damage to the liver, pancreas and muscles – which is why they should always be prescribed by your doctor who can then closely monitor how you are responding to the medication.

Here's an overview of Diabetes and Statins
Diabetes and statins have a complex relationship and are the focus of intense patient and healthcare debate. Statins are cholesterol-lowering drugs.

Statins are used in diabetes care due to the knowledge that people with diabetes face a greater likelihood of heart attack and stroke.

When used alongside good blood glucose control and other medication, the case for statins argues that they cut cholesterol levels and lower the risk of a cardiovascular event.

Type 2 diabetes in particular is certainly a disease of the circulatory system, and this argument has some weight.

How can I lower my risk of cardiovascular problems without taking statins?
There are many ways to lower your risk of stroke and cholesterol levels. These include stopping smoking and controlling your blood pressure. Diet and exercise can help to lower raised blood pressure, and a healthy lifestyle can cut cholesterol levels. However, some doctors prescribe statins to help reduce cholesterol levels.

What do statins do for people with diabetes?
Statins slow the action of the liver in manufacturing cholesterol, causing blood cholesterol levels to fall.

Do statins work for people with diabetes?
Statins definitely lower cholesterol, and major studies have shown that the risk of heart attack and stroke plummets amongst people with diabetes taking statins. Results indicate that statins can prevent cardiovascular disease by reducing heart attack and stroke risks.

What are the side effects of statins?
Statins are usually well-tolerated by people with diabetes. Side effects can include:

• Headaches

• Affect on liver function

• Stomach problems such as abdominal pain, constipation, flatulence, diarrhoea and vomiting

• Rashes

• Disorder of the muscles (myopathy)

Shouldn’t all people with diabetes therefore take statins?

Statins are the subject of current and ongoing healthcare debate when it comes to diabetes patients. Further research is in progress to make the wider use of statins in diabetes care more clear.

Often, people under 40 may not benefit from taking a statin.

A statin is also just one part of diabetes care and shouldn’t be used instead of good diet, exercise, smoking and excess drinking avoidance.

Source: diabetes.co.uk

How Tiny Nauru Became World's Fattest Nation

The world is facing a "population emergency" as soaring rates of obesity threaten a pandemic ofcardiovascular disease, scientists have warned.

The spread of Western fast food was blamed as the tiny Pacific nation of Nauru was named as the fattest in the world. Its average Body Mass Index is between 34 and 35, 70 per cent higher than in some countries in South-east Asia and sub-Saharan Africa.

More than one in 10 of the world's population is obese – more than half a billion adults – and rates have doubled since 1980. The biggest increases are in the richer nations but almost every country has seen rates rise.

Only Bangladesh, the Democratic Republic of Congo and a few countries in sub-Saharan Africa and east and south Asia have escaped the rise. Yet even in these regions neighbouring countries have had widely differeing experiences. The women of Southern Africa are among the fattest in the world.

The rise is being driven by increasing urbanisation, the growth of sedentary, office-based lifestyles and the substitution of Western-style fast foods for traditional diets. Researchers from Imperial CollegeLondon and McMaster University in Canada, writing in The Lancet, describe it as a "tsunami of obesity that will eventually affect all regions of the world".

In its wake comes an epidemic of heart disease and stroke, linked with high blood pressure and raised cholesterol levels. Remarkably, high-income countries such as the US and UK have managed to avoid this, by reducing blood pressure and cholesterol with drugs and dietary changes, such as reducing salt and fats. Smoking too, one of the key causes of heart disease, has fallen. (Japan is an exception where historically low cholesterol levels, associated with the nation's high consumption of fish, have risen to levels seen in western Europe, as the Japanese adopt a Western diet.)

But in middle and low-income countries the outlook is "dismal". "Considering all risk-factor trends together, the forecast for cardiovascular disease burden... comprises a population emergency that will cost tens of millions of preventable deaths, unless rapid and widespread actions are taken by governments and health care systems woldwide," the researchers say.

Treating the consequences of the obesity explosion with drugs will create an "unsustainable financial burden" in these countries and there is an "urgent need" to understand why unhealthy behaviours are adopted by both individuals and communities.

With an increasing trend towards globalisation and urbanisation, the problem is likely to get worse rather than better. "Ironically the economic growth of low-income and middle- income countries is now threated by the projected cardiovascular disease epidemic," they say.

Citing the noted British epidemiologist Geoffrey Rose, the authors say: "Mass disease and mass exposures require mass remedies. Mass remedies require the masses to be part of the solution."

The world obesity map
Fastest growing: US
The US saw the biggest rise in BMI of all developed nations between 1980 and 2008, more than 1kg a decade. Increasingly sedentary occupations, less walking and cycling, more driving in cars and rising consumption of fast foods and sugary drinks are behind the rise which affects all high-income countries.

Slimming down: Italy
Italy is the only high-income country in Europe where BMI declined - for women, from 25.2 to 24.8. Even among men, Italy saw one of the smallest increases. The classic Mediterranean diet - pasta, vegetables and fruit - is one of the healthiest in the world.

Fattening up: UK
The UK has the sixth highest BMI in Europe for women and the ninth highest for men (both around 27). The rate of increase has been second only to the US for men. One in four men and one in three women is overweight and about 12 million are obese.

South America's biggest: Chile
Chile with an average BMI of 27.0 for men and 27.9 for women, was the heaviest country in southern Latin America. The scale of increase in obesity in southern Latin America is second only to the US among men and ranks fifth among women. Rates of obesity soared in Chile with the end of its dictatorship in 1990 and a surge in fast food restaurants and some critics are now calling for a junk food tax to be imposed.

World's thinnest: Bangladesh
Bangladesh is the world's thinnest nation, with an average BMI of 20.5 for women and 20.4 for men. Rice is the staple diet and millions go without enough to eat. More than half of children - more than 9 million - are underweight and have stunted growth.

Fattest on earth: Nauru
Nauru is the world's fattest country, with an average BMI of 34 to 35. Located in the south Pacific it is the smallest island nation, with a population of less than 10,000. Obesity has grown as a result of the importation of Western foods paid for with proceeds from phosphate mining. The most popular dish is fried chicken and cola.

And here are the top ten overweight countries along with the percentages of their populations who are overweight: 

10. Kiribati - 73.6%
9. United States of America- 74.1%
8. Kuwait - 74.2%
7. Palau - 78.4%
6. Samoa - 80.4%
5. Niue - 81.7%
4. Tonga - 90.8%
3. Cook Islands - 90.9%
2. Federated States of Micronesia - 91.1%
1. Nauru - 94.5%

From The Independent

Diabetes Management System Could Be ‘iTunes of Diabetes Care’

With technology increasingly becoming part of diabetes management, here comes news of a development that may make a diabetic's life easier. (Of course, it'll put a further drain on your resources!)

London-based Cellnovo closes $48 million B round to fund commercialization of the first all mobile diabetes management system, which is drawing comparisons to Apple Inc.’s blockbuster iPhone and iPod platforms.

Cellnovo announced its presence as a major player in the diabetes race with $48 million in new funding for what industry observers have called the “iTunes of diabetes care.”

The B round for the London-based company was led by Edmond de Rothschild Investment Partners (EdRIP), with Forbion Capital Partners, Auriga Partners, NBGI Ventures and Credit Agricole Private Equity.

Previous investors Advent Venture Partners, HealthCare Ventures and NESTA also participated in the round, according to a prepared release.

Cellnovo officials said they would use the proceeds to commercialize and expand markets for its diabetes management system, which includes an insulin pump, mobile handset and online management system for diabetics. The pump’s appearance, size and interface have drawn comparisons to Apple Inc.’s iPhone and iTunes products by both industry observers and the company itself.

“If people understand Cellnovo as a device that sends data to a website, they are missing the point,” Cellnovo CEO Bill Mckeon told the medical device publication Invivo last year. “If you had asked Steve Jobs at Apple about his new MP3 player called the iPod, and how it compares to other MP3 players, he might have said, ‘I am not making an MP3 player. I’m bringing entertainment into your life in a number of ways.’”

Mckeon went on to tell the magazine that he puts the Cellnovo system in the same category.

“We believed that the rest of the world was looking at diabetes and the delivery of insulin with a very device-centric mindset. There is a device that pumps insulin, another device that measures blood glucose and another device with continuous sensors,” he said.

David Kliff, an independent diabetes analyst, who publishes the Diabetic Investor, wrote on his web site that Cellnovo’s approach is a “somewhat radical departure from the traditional approach to the market, which is more concerned with building a cheaper version of what’s already on the market while ignoring how patients actually use these systems in a real world setting.”

Kliff added that he believed Cellnovo would be able to attract the attention of the big players in the diabetes market if it’s in search of an exit. Currently, there’s a glut of companies duking it out in the insulin pump and diabetes management market including medical device goliath Medtronic Inc, Johnson & Johnson subsidiary LifeScan and smaller players like Insulet, which makes the OmniPod.

Brazil to Provide Free Hypertension, Diabetes Medicine

Brazilian President Dilma Rousseff said on Thursday that the government will provide free medicine for diabetes and hypertension to Brazilians, starting from mid-February, reports Xinhua.

The measure is part of the Popular Pharmacy Program, which grants discounts to over 100 types of medication for diseases, such as Parkinson, osteoporosis, glaucoma and asthma.

The government will cover 90 percent of the expense of the medicine and the patient pays the rest.

In order to receive the free medicine, patients must show the doctor's prescription and identification at the pharmacy.

The free medicine was one of Rousseff's campaign promises. According to the president, offering free medicine is a step forward to eradicate poverty in Brazil.

The Health Ministry estimated that over 33 million people, or 17 percent of Brazil's population suffer from hypertension and some 7.5 million suffer from diabetes. The two diseases are responsible for 34 percent of the deaths in the country.

Type 2 Diabetes Epidemic in US Linked to Profit-Making Food Industry

According to the 2011 National Diabetes Fact Sheet released by the United States Centers for Disease Control (CDC) on January 26, last year saw an increase in the numbers of people with diabetes in virtually every age category.

The federal agency reports that some 25.8 million Americans, or 8.3 percent of the total population, have diabetes. Fully a third of these individuals do not know that they have the disease and are unaware of the serious risks it creates for their health. In a staggering indictment of the state of public health in the US, the CDC found that a further 79 million people in the country are prediabetic, meaning that their blood sugar levels are elevated, but not yet to the point where they meet the criteria for a full diabetes diagnosis.

Even these stark statistics likely under-report the real situation, with research showing that 35 percent to 40 percent of deceased diabetics did not have the disease listed anywhere on their death certificates.

Ninety percent of diabetics in the US have Type II diabetes, which, as the CDC report points out, is preventable. Once a diagnosis has been made, the severity of the complications can be dramatically reduced with timely and continuing care, including a careful combination of diet, exercise, often oral medication and, not infrequently, insulin administration.

However, what the CDC report fails to note is that such a high level of medical attention is widely unavailable to millions of Americans, who are unable to afford health insurance. With growing poverty, increasing numbers of people cannot buy nutritious food or the glucose test strips needed to monitor sugar levels. For families working multiple jobs and handling the stress of endless financial problems, adequate exercise is also often out of reach.

The rise in the incidence of Type 2 diabetes has come alongside a decline in the overall quality of nutrition in US society and a sharp growth in obesity. These processes are bound up with subordination of the food industry to the profit motive, a fact that has even garnered attention in the mainstream press. In May 2009, the news magazine Businessweek observed that “evidence is mounting that the obesity crisis is not the result of a lack of personal responsibility,” going on to note that “the processed food industry’s practices may be just as much, if not more, to blame.”

The omnipresence in the food industry of federally subsidized corn carbohydrates and dairy fats, coupled with advertising campaigns aimed at the most vulnerable segments of the population—the young and the working poor—have been cited in studies as chief reasons behind the enormous weight gains of the American people over the last 40 years.

At the 2009 European Congress on Obesity in Amsterdam, Dr. Boyd Swinburn of Deakin University in Melbourne, Australia, pointed out to Heartwire that the food industry has been targeting the most impressionable layers of society. “They’ve worked their marketing out to the nth degree,” he noted.

In 2009, Kelly D. Brownell from the Rudd Center for Food Policy and Obesity at Yale University and Kenneth E. Warner from the University of Michigan published an article entitled, “The Perils of Ignoring History: Big Tobacco Played Dirty and Millions Died. How Similar is Big Food?” The authors noted:

“To protect profits, the food industry must avoid perceptions that it is uncaring and insensitive, ignores public health, preys on children, intentionally manipulates addictive substances, and knowingly, even cynically, contributes to death, disability, and billions in health care costs every year. Stated another way, it cannot afford to look like tobacco.”

As Brownell and Warner point out, the food industry buys access to key associations, including the professional organization for US nutritionists, the American Dietetic Association. The Association regularly publishes “fact sheets” on nutritional advice for the public. The food industry pays $20,000 per sheet, which industry lobbyists then write for the association.

According to Brownell and Warner, the food industry’s strategy for deflecting attention from its practices for the poor state of nutrition in the US includes the following:

“Focus on personal responsibility as the cause of the nation’s unhealthy diet; raise fears that government action usurps personal freedom; vilify critics with totalitarian language, characterizing them as the food police, leaders of a nanny state, and even ‘food fascists,’ and accuse them of desiring to strip people of their civil liberties; criticize studies that hurt industry as ‘junk science’; emphasize physical activity over diet; state there are not good or bad foods, hence no food or food type (soft drinks, fast foods, etc.) should be targeted for change; plant doubts when concerns are raised about the industry.”

On the very day of the CDC’s 2011 Fact Sheet release, Robert Langreth of Forbes noted that sections of the pharmaceutical and health care industry were pleased with the latest report.

“What’s bad news for Americans is good news for companies that make diabetes treatments. One company that has ridden the obesity and diabetes epidemic like no other is the Danish company Novo Nordisk…. Other companies helped by the bad news include Merck (of the popular diabetic pill Januvia), Allergan (obesity surgery supplies), Orexigen Therapeutics (new obesity drug pending FDA approval).”

Good News! Even Telephonic Intervention Improves Diabetes Control

A health educator-implemented telephonic intervention is more effective than a print intervention in helping low-income adults in an urban population control their diabetes, according to research published in the January issue ofDiabetes Care.

Elizabeth A. Walker, Ph.D., R.N., of the Albert Einstein College of Medicine in Bronx, N.Y., and colleagues randomized 526 low-income, urban, minority individuals with an A1C of 7.5 percent or higher to telephonic intervention or print intervention to compare the effectiveness of the two approaches in improving diabetes control over one year in this patient population.

The researchers note that the telephone group experienced a mean decline in A1C of 0.23, while the print group experienced a rise of 0.13. Medication adherence among those not taking insulin was associated with the telephone intervention.

"A one-year tailored telephonic intervention implemented by health educators was successful in significantly, albeit modestly, improving diabetes control compared with a print intervention in a low-income, insured, minority population," the authors write.

The full study published in the January 2011 issue of the journal Diabetes Care can be found here.

Why Do Diabetics Find It Difficult To Exercise, Researchers Wonder

Research being carried out by scientists at the University of Colorado School of Medicine is investigating why exercise feels more difficult for people suffering from type 2 diabetes than it does for people without the disease.

With a recent study showing that under half of all people with type 2 diabetes take any regular exercise, and that people who do not have diabetes are actually more likely to take exercise, the team hope to pinpoint the reasons why this is.

The new study is examining 50 women aged between 50 and 75, with each being questioned about their level of comfort with exercise, and the findings for those with diabetes being compared to that of women without the disease of a similar age, weight and physical ability.

If this study is able to confirm findings from previous research that revealed that exercise felt harder for those people with diabetes, then it is hoped it will be possible to design specific exercise programmes for people with type 2 diabetes.