Diabetes

Poll Watch: American Diabetes Rate Levels Off and Obesity Rate Declines Slightly

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According to the latest Gallup Poll.

In the third quarter of 2011, 11% of Americans reported having ever been diagnosed with diabetes. This measurement and the 10.6% that Gallup and Healthways measured in the second quarter of this year are among the lowest levels recorded since 2009. The diabetes rate was below 11% throughout 2008, but then began to increase in 2009 and 2010.

Gallup and Healthways measure the diabetes rate in the United States by asking Americans: “Have you ever been told by a physician or nurse that you have diabetes?” The question does not discern between Type 1 and Type 2 diabetes.

And, the United States obesity rate has decreased slightly.

The graph:

Good news and since type 2 diabetes (the most common form of diabetes) is preventable with diet and exercise, it only makes sense that when the obesity rate declines so will diabetes.
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Health

Will Moving Out of a Poor Neighborhood Bring Down the Levels of Obesity and Diabetes?

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Evidently so, according to a new study.

Helping people move out of poor neighborhoods into those that are better off may help reduce levels of obesity and diabetes, researchers found.

In a large social experiment, people who used vouchers to move to an area with better socioeconomic conditions were significantly less likely to have a high body mass index (BMI) and elevated glycated hemoglobin (HbA1c) levels than those who remained in poor neighborhoods, Jens Ludwig, PhD, of the University of Chicago, and colleagues reported in the Oct. 20 issue of the New England Journal of Medicine.

Moving from high-poverty to low-poverty areas is associated “with modest but potentially important reductions in the prevalence of extreme obesity and diabetes,” Ludwig and colleagues wrote.

Researchers have long questioned whether a person’s neighborhood directly contributes to the development of obesity and diabetes. Observational studies have shown that neighborhood factors such as poverty or racial separation are associated with greater risks of these conditions.

To look more closely at the association, Ludwig and colleagues looked at data from a Department of Housing and Urban Development (HUD) program conducted between 1994 and 1998.

The department randomly assigned 4,498 women with children who were living in public housing in high-poverty urban areas to one of three groups:

    1,788 received rent-subsidy housing vouchers earmarked for a move to a low-poverty area, as well as counseling ‘to help with their housing search’
    1,312 got rent-subsidy vouchers with no requirement as to where they could live and no special counseling
    1,398 were assigned to a control group that wasn’t offered either opportunity

The researchers then looked at participants’ health outcomes — including height, weight, and HbA1c levels — between 2008 and 2010.

Overall, 48% of the families given the vouchers to move to a low-poverty area used them; 63% used the no-restriction vouchers.

Ludwig and colleagues found that using a voucher to move to a low-poverty area was associated with a decreased risk of extreme obesity and diabetes among the female heads-of-households.

Well, we are the product of our genes and our environment.

Will public health physicians be able to identify the specific factors which affect obesity and diabetes and devise interventions for those who cannot or will not move?

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Alzheimer's Disease

Does Diabetes Increase Alzheimer’s Disease Risk?

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Yes, and other forms of dementia as well.

People with diabetes are at increased risk of having a heart attack or stroke at an early age, but that’s not the only worry. Diabetes appears to dramatically increase a person’s risk of developing Alzheimer’s disease or other types of dementia later in life, according to a new study conducted in Japan.

In the study, which included more than 1,000 men and women over age 60, researchers found that people with diabetes were twice as likely as the other study participants to develop Alzheimer’s disease within 15 years. They were also 1.75 times more likely to develop dementia of any kind.

“It’s really important for the [public’s] health to understand that diabetes is a significant risk factor for all of these types of dementia,” says Rachel Whitmer, Ph.D., an epidemiologist in the research division of Kaiser Permanente Northern California, a nonprofit health-care organization based in Oakland, California.

Whitmer, who studies risk factors for Alzheimer’s but wasn’t involved in the new research, stresses that many questions remain about the link between diabetes and dementia. The new study was “well done” and provides “really good evidence that people with diabetes are at greater risk,” she says, “but we really need to look at other studies to find out why.”

More studies are needed and it makes sense that the longer you live, the more of a chance you will develop some sort of dementia. But, it also makes sense that via diet and exercise, you should avoid diabetes in the first place.

Diabetes could contribute to dementia in several ways, which researchers are still sorting out. Insulin resistance, which causes high blood sugar and in some cases leads to type 2 diabetes, may interfere with the body’s ability to break down a protein (amyloid) that forms brain plaques that have been linked to Alzheimer’s. High blood sugar (glucose) also produces certain oxygen-containing molecules that can damage cells, in a process known as oxidative stress.

In addition, high blood sugar — along with high cholesterol — plays a role in the hardening and narrowing of arteries in the brain. This condition, known as atherosclerosis, can bring about vascular dementia, which occurs when artery blockages (including strokes) kill brain tissue.

“Having high glucose is a stressor to the nervous system and to the blood vessels,” says David Geldmacher, M.D., a professor of neurology at the University of Alabama at Birmingham. “The emerging information on Alzheimer’s disease and glucose shows us that we do need to remain vigilant on blood sugar levels as we get older.”

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