Search
Diabetes News

Archive - 07 - 2011

Does Menopause Matter When It Comes to Diabetes?

Posted by dlife on Tue, Jul 26, 11, 09:57 AM 0 Comment

July 26, 2011 (Newswise) Menopause has little to no impact on whether women become more susceptible to diabetes, according to a one-of-a-kind study.Postmenopausal women had no higher risk for diabetes whether they experienced natural menopause or had their ovaries removed, according to the national clinical trial of 1,237 women at high risk for diabetes, ages 40 to 65.In our study, menopause had no additional effect on risk for diabetes, says study lead author Catherine Kim, M.D., M.P.H., an associate professor of internal medicine and obstetrics and gynecology at the University of Michigan Health System. Menopause is one of many small steps in aging and it doesnt mean womens health will be worse after going through this transition.Kim and colleagues in the Diabetes Prevention Program Research Group will publish their results in the August issue of Menopause.The findings also shed light on the impact of diet and exercise and hormone replacement therapy on the health of postmenopausal women.Previous evidence has suggested that menopause would speed the progression to diabetes because postmenopausal women have relatively higher levels of the hormone testosterone, which is considered a risk factor for diabetes. But the recent study shows healthy outcomes for postmenopausal women.The women in the study were enrolled in the Diabetes Prevention Program, a clinical trial of adults with glucose intolerance, meaning tests show their bodys struggle to process glucose, or blood sugar, into energy.Glucose intolerance is often a pre-stage to diabetes, a condition common later in life and is diagnosed when the body has abnormally high levels of blood sugar. Age, weight, physical activity and family history can contribute to type 2 diabetes.But Diabetes Prevention Program researchers have shown lifestyle intervention and the blood sugar-lowering drug metformin can prevent diabetes in those with glucose intolerance. The interventions work well in women who have gone through menopause.Menopause is the end of monthly periods and chance for pregnancy and estrogen production by the ovaries stops. In the United States, menopause happens around age 51 or 52.The research is considered the only menopause study that specifically analyzed the impact of diabetes on women who had natural menopause and those who had their ovaries removed. Most other studies mixed them together or excluded one group.According to the new study, for every year 100 women were observed, 11.8 premenopausal women developed diabetes, compared to 10.5 among women in natural menopause and 12.9 cases among women who had their ovaries removed.However for women whose estrogen production ended as a result of having their ovaries removed, and engaged in lifestyle changes, cases of diabetes were extremely low. For every year 100 of these women were observed, only 1.1 women developed diabetes.Lifestyle changes included losing 7 percent of their body weight and exercising for at least 150 minutes a week. For instance, a 180-pound postmenopausal woman would see benefits from losing 12.6 pounds.The results among this group were surprising considering almost all of the women who had their ovaries removed were on hormone replacement therapy, a regime that women and doctors fear puts them at risk for a host of health issues. Study authors say more research is needed on the role of hormone therapy and diabetes risk.Physicians can be empowered to tell women that lifestyle changes can be very effective, and that menopause does not mean that they have a higher risk of diabetes, Kim says.

In Pregnancy, Diabetes-Obesity Combo a Major Red Flag

Posted by dlife on Tue, Jul 26, 11, 09:30 AM 0 Comment

July 26, 2011 (University of Rochester) Type 2 diabetes and obesity in pregnancy is a daunting duo, according to new research published this month in The Journal of Maternal-Fetal and Neonatal Medicine. The study shows that both conditions independently contribute to higher risks, opening the door to a wide range of pregnancy, delivery and newborn complications.Study authors say the findings are important because obesity and type 2 diabetes are skyrocketing in women of childbearing age. A study in The Journal of the American Medical Association reports that between 2007 and 2008 the prevalence of obesity among adult women in the United States was more than 35 percent. A report from the Centers for Disease Control and Prevention states that approximately 11 percent of women above the age of 20 had diabetes in 2010.Loralei Thornburg, M.D., senior study author and a high-risk pregnancy expert at the University of Rochester Medical Center, emphasizes that the research is needed now more than ever. Weve never seen the degree of obesity and type 2 diabetes in women that we are seeing right now, because for a very long time diabetes was a disease of an older population, so we rarely dealt with it in prenatal care. We hope this new knowledge will help physicians better understand and care for this rapidly expanding group of high-risk women.Kristin Knight, M.D.While numerous studies have established that obesity, in the absence of diabetes, is associated with problems in pregnancy preterm birth, birth trauma, blood loss and a prolonged hospital stay, to name a few less is known about type 2 diabetes and what causes difficulties when the two conditions coexist. Researchers from Rochester wanted to determine if obesity alone accounts for the increased risks in this dual-diagnosis group, or if diabetes plays a role as well. To determine the influence of obesity and type 2 diabetes when the conditions coexist in pregnancy, Thornburg and lead study author Kristin Knight, M.D., used clinical records and the hospitals birth certificate database to identify 213 pairs of women who delivered babies at the Medical Center between 2000 and 2008. Each pair included a diabetic and a non-diabetic patient with approximately the same pre-pregnancy body mass index (BMI). The majority of women in the study were overweight, obese or morbidly obese.Loralei Thornburg, M.D.We matched the pairs pound for pound, because if obesity was the main problem, wed see similar outcomes between women, whether they had diabetes or not. But if we saw different outcomes between pairs, wed know the diabetes was impacting outcomes as well, said Thornburg.Using mathematical models and controlling for outside factors, such as age and tobacco use, researchers found that the patients with type 2 diabetes had overall worse pregnancy, delivery and newborn outcomes than their BMI-matched counterparts. Specifically, diabetic patients had higher rates of preeclampsia, cesarean delivery, shoulder dystocia, preterm delivery, large for gestational age infant, fetal anomaly and admission to the neonatal intensive care unit. Women and their physicians need to be aware that each condition on its own increases risk in pregnancy, so when they coexist the situation is even more worrisome, said Knight, a maternal fetal medicine fellow at Rochester. Pregnancy is a time of great change, and fortunately many women are very open to making modifications during this period in their life. Anything a woman can do to improve her condition, from controlling blood sugar and exercising, to eating nutritious foods and maintaining an optimal weight, will help her deliver a healthier baby. Knight originally focused her research on the effects of type 1 and type 2 diabetes on pregnancy. In a previous study, she found that women with type 2 diabetes, most of whom were also obese, had poorer outcomes. Consequently, her research turned to obese, type 2 diabetics and their experiences in pregnancy.If a woman enters pregnancy obese, but hasnt developed type 2 diabetes, she is in a better place than if she had both, concluded Thornburg.In addition to Knight and Thornburg, Eva K. Pressman, M.D., and David N. Hackney, M.D., from the Medical Center, also participated in the research.

Sign up for FREE dLife Newsletters

dLife Membership is FREE! Get exclusive access, free recipes, newsletters, savings, and much more! FPO

Congratulations!
You are subscribed!
Congratulations!
You are subscribed!
Congratulations!
You are subscribed!
Sponsor Specials

dLife Weekly Poll

What about diabetes frustrates you the most?