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April 2008 Briefing - Diabetes & Endocrinology

Here are what the editors at HealthDay consider to be the most important developments in Diabetes & Endocrinology for April 2008. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Exercise Key to Maintaining Weight Loss in Obesity

WEDNESDAY, April 30 (HealthDay News) -- While caloric restriction leads to short-term weight loss, increases in physical activity may be necessary to overcome the body's tendency to re-establish the original body weight and prevent weight regain, according to an article in the May 1 issue of the New England Journal of Medicine.

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Potential Susceptibility Genes for Osteoporosis Identified

WEDNESDAY, April 30 (HealthDay News) -- Genes associated with bone mineral density and low-energy fractures in European populations have been identified, according to a report published online April 29 in the New England Journal of Medicine.

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Inflammation, Albuminuria Predict Heart Failure

WEDNESDAY, April 30 (HealthDay News) -- Markers of inflammation and albuminuria serve as predictors of congestive heart failure, and the association between obesity and the condition may be related to inflammation, according to research published in the May 6 issue of the Journal of the American College of Cardiology.

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New Cushing's Syndrome Guideline Published

WEDNESDAY, April 30 (HealthDay News) -- A new clinical practice guideline will improve physicians' ability to detect and diagnose Cushing's syndrome, according to an article published in the May issue of the Journal of Clinical Endocrinology & Metabolism.

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Receptors Increase in Brain of Mouse Stroke Model

TUESDAY, April 29 (HealthDay News) -- The expression of mineralocorticoid receptors increases in the brain in a mouse model of non-fatal stroke, and a drug that blocks the receptor is neuroprotective, according to study findings published online April 24 in Endocrinology.

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Physicians Lack Feedback on Accuracy of Diagnoses

TUESDAY, April 29 (HealthDay News) -- Clinical diagnosis is a largely open-loop system in which there is no systematic way for clinicians to obtain feedback on the outcome of their diagnoses, according to an article published in a supplement to the May issue of The American Journal of Medicine.

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Insulin-Like Growth Factor I Shown to Help Aging Rats

TUESDAY, April 29 (HealthDay News) -- Treating aging male rats with low doses of insulin-like growth factor I (IGF-I) is associated with increased testosterone levels, improved glucose and lipid metabolism, and reduced oxidative damage in the brain and liver, according to a report published in the May issue of Endocrinology.

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Increasing Incidence of Pre-Pregnancy Diabetes Alarming

TUESDAY, April 29 (HealthDay News) -- The incidence of gestational diabetes has remained stable over time and is similar across different racial and ethnic groups, but the rising number of young, pregnant women with pre-existing diabetes is cause for concern, according to a report published in the May issue of Diabetes Care.

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Phenytoin Accelerates Bone Loss in Premenopausal Women

TUESDAY, April 29 (HealthDay News) -- In premenopausal women with epilepsy, phenytoin monotherapy is associated with a significant loss of bone mineral density over a one-year period, according to the results of a study published in the April 29 issue of Neurology.

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Alendronate May Raise Risk of Atrial Fibrillation

MONDAY, April 28 (HealthDay News) -- Alendronate may increase the risk of developing atrial fibrillation, according to an article published in the April 28 issue of the Archives of Internal Medicine.

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Thiazolidinediones May Raise Risk of Hip, Wrist Fractures

MONDAY, April 28 (HealthDay News) -- Patients with diabetes who take the oral insulin-sensitizing drugs rosiglitazone and pioglitazone may be at an increased risk of suffering hip and wrist fractures, according to an article published in the April 28 issue of the Archives of Internal Medicine.

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Palliative Care Can Improve Patient Care Most, Poll Finds

MONDAY, April 28 (HealthDay News) -- In an international poll conducted by BMJ to determine which area of health care would enable doctors to make the greatest difference to patients, palliative care for non-malignant disease received the most votes, the BMJ Group announced at the International Forum on Quality and Safety in Health Care in Paris this week.

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Extra Estrogen in Utero Leads to Gonadal Defects

MONDAY, April 28 (HealthDay News) -- The male and female offspring of pregnant mice treated with the estrogenic compound diethylstilbestrol have defects in differentiation and cell proliferation in the gonads, according to research published online April 24 in Endocrinology.

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Pre-Pregnancy Diet Choices Linked to Sex of Baby

MONDAY, April 28 (HealthDay News) -- Women with a higher calorie intake before conception are more likely to bear boys, according to research published online April 22 in the Proceedings of the Royal Society B.

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Gene Variants Linked to C-Reactive Protein Levels

FRIDAY, April 25 (HealthDay News) -- Variants of the HNF1A gene encoding hepatocyte nuclear factor 1-alpha are strongly associated with plasma C-reactive protein (CRP) levels, according to two studies published online April 24 in the American Journal of Human Genetics.

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Triglycerides May Explain Cognition Problems in Obesity

FRIDAY, April 25 (HealthDay News) -- Experiments with mice suggest that triglycerides play a major role in obesity-related cognitive disturbance and that lowering triglycerides can improve such impairment, according to research published in the May issue of Endocrinology.

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Treatment of Hirsutism Addressed in Guideline

THURSDAY, April 24 (HealthDay News) -- Testing for elevated androgen levels should be considered in premenopausal women who have moderate to severe hirsutism and in those with milder hirsutism accompanied by menstrual dysfunction, obesity or clitoromegaly, according to a clinical practice guideline published in the Journal of Clinical Endocrinology & Metabolism in April.

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Risedronate Protects Bone Mass in Breast Cancer Patients

THURSDAY, April 24 (HealthDay News) -- Once-weekly risedronate protects against chemotherapy-related bone loss in women with breast cancer, according to an article published online April 21 in The Journal of Clinical Oncology.

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Gene Mutations Found in Hypothyroid Patients

WEDNESDAY, April 23 (HealthDay News) -- Research published in the April 24 New England Journal of Medicine reports on mutations found in DEHAL1 -- the gene encoding a thyroid enzyme that controls the reuse of iodide for thyroid hormone synthesis -- that resulted in problems including hypothyroidism, goiter and mental deficits in four patients.

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Drug Reduces Biomarkers in Coronary Heart Disease

WEDNESDAY, April 23 (HealthDay News) -- Darapladib reduces lipoprotein-associated phospholipase A2 (Lp-PLA2) activity and other inflammatory markers in patients with coronary heart disease who are receiving statins, according to a study in the April 29 issue of the Journal of the American College of Cardiology. A related study found that statins have variable effects on oxidative stress markers in patients with high cholesterol.

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Link Between Obesity and Renal Dysfunction Explored

WEDNESDAY, April 23 (HealthDay News) -- New research suggests that adiponectin may protect the kidney against oxidant stress, and the lower levels of adiponectin seen in obese individuals may predispose them to kidney dysfunction and the development of albuminuria, according to an article published online April 22 in The Journal of Clinical Investigation.

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Skim Milk Linked to Acne in Teenage Boys

WEDNESDAY, April 23 (HealthDay News) -- In teenage boys, high consumption of skim milk is positively associated with acne, according to a study published in the May issue of the Journal of the American Academy of Dermatology.

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Bivalirudin Improves Cardiac Outcomes for Diabetics

TUESDAY, April 22 (HealthDay News) -- Diabetic patients with acute coronary syndromes have higher rates of adverse clinical outcomes than nondiabetics, and treatment with bivalirudin results in a lower rate of adverse outcomes than treatment with heparin plus glycoprotein IIb/IIIa inhibition (GPI), according to a study in the April 29 issue of the Journal of the American College of Cardiology.

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Insulin Resistance Differs Among Teenage Boys and Girls

TUESDAY, April 22 (HealthDay News) -- Insulin resistance develops differently in boys and girls as they transition from late childhood through adolescence, according to a study published online April 21 in Circulation.

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Adiponectin Linked to Left Ventricular Dysfunction

MONDAY, April 21 (HealthDay News) -- High serum levels of adiponectin -- a protein hormone exclusively secreted by fat cells -- may independently predict moderate to severe left ventricular systolic dysfunction in patients who have been referred for coronary angiography, according to a study published in the April 15 issue of The American Journal of Cardiology.

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Serum Creatinine Higher in Blacks Than Others on Dialysis

FRIDAY, April 18 (HealthDay News) -- Among patients with chronic kidney disease using hemodialysis, black individuals had significantly higher serum creatinine concentrations, which are associated with a lower risk of death in dialysis patients, according to research published online April 16 in the Clinical Journal of the American Society of Nephrology.

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No Benefit to Self-Monitoring Glucose in Early Diabetes

FRIDAY, April 18 (HealthDay News) -- Self-monitoring of blood glucose in individuals with non-insulin-treated type 2 diabetes is associated with higher costs, worsened quality of life and little or no improvement in glycemic control, according to two articles published online April 17 in BMJ.

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Obese Mice Have Impaired Brain Insulin Transport

FRIDAY, April 18 (HealthDay News) -- Obese mice have impaired transport of insulin into the brain, which regulates weight, and which is reversed by starvation or triglycerides, according to research published online April 10 in Endocrinology.

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Thyrotropin Receptor Antibody Binding Site Identified

FRIDAY, April 18 (HealthDay News) -- Key amino acid residues in the human thyrotropin receptor (TSHR) are crucial for its binding by a monoclonal antibody, according to the results of a study published online April 3 in Endocrinology.

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Anemia Predicts Cardiac Events After Vascular Surgery

THURSDAY, April 17 (HealthDay News) -- In patients who undergo elective vascular surgery, preoperative anemia is a significant predictor of perioperative and long-term cardiac events, researchers report in the April 15 issue of the American Journal of Cardiology.

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Diabetic Retinopathy a Risk Factor for Heart Failure

THURSDAY, April 17 (HealthDay News) -- Diabetic retinopathy is an independent risk factor for heart failure in patients with type 2 diabetes, according to a report published in the April 22 issue of the Journal of the American College of Cardiology.

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Electronic Medical Records Improve Elderly Patient Care

WEDNESDAY, April 16 (HealthDay News) -- Elderly and diabetic patients are better served by the use of electronic medical and health records, according to two studies published in the April issue of the Journal of General Internal Medicine.

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Jury Still Out on Testosterone for Low Libido in Women

TUESDAY, April 15 (HealthDay News) -- Although intermediate-dose testosterone supplementation modestly improves measures of sexual function in premenopasual women with low libido, more robust evidence of efficacy is needed before the treatment can be recommended, report the authors of an article published in the April 15 issue of the Annals of Internal Medicine.

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Complex Relationship Between Estrogen, Eye Disease Risk

TUESDAY, April 15 (HealthDay News) -- Postmenopausal hormone use is associated with an increased risk of early signs of age-related macular degeneration (AMD) but a reduced risk of neovascular AMD, the late stage of the disease, according to an article published in the Archives of Ophthalmology in April.

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Drug Resistance Threatens Gonorrhea Control

TUESDAY, April 15 (HealthDay News) -- The emerging resistance of Neisseria gonorrhoeae to multiple antimicrobial agents is a major public health challenge, and heightened surveillance of antimicrobial resistance patterns and improved screening practices are necessary for adequate prevention and control of gonorrhea, according to an article published in the April 15 issue of the Annals of Internal Medicine.

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Statins Reduce Blood Pressure in Normotensive Subjects

MONDAY, April 14 (HealthDay News) -- Statins modestly reduce blood pressure in men and women with normal blood pressure, according to a report in the April 14 issue of the Archives of Internal Medicine. A related study in the same issue notes that a diet high in fruits, vegetables, low in dairy products, and low in animal proteins is associated with a lower risk of coronary heart disease and stroke in women.

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Loop Diuretics Linked to Bone Loss in Older Men

MONDAY, April 14 (HealthDay News) -- Loop diuretics may lead to accelerated hip bone loss in older men, researchers report in the April 14 issue of the Archives of Internal Medicine.

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Acupuncture, Exercise May Help Insulin Sensitivity in PCOS

MONDAY, April 14 (HealthDay News) -- Low-frequency electro-acupuncture and exercise both improve insulin sensitivity and correct defects in adipose tissue gene expression in a rat model of polycystic ovary syndrome (PCOS), according to study findings published online April 3 in Endocrinology.

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Glitazones Not Superior to Older Diabetes Drugs

MONDAY, April 14 (HealthDay News) -- There is no convincing evidence that glitazones are superior as a monotherapy compared to older type 2 diabetes treatments, according to a review published in the April issue of the Drug and Therapeutics Bulletin.

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Hyperthyroidism in Mice Linked to Lower HDL Cholesterol

FRIDAY, April 11 (HealthDay News) -- Severe hyperthyroidism is associated with a 40 percent drop in high-density lipoprotein cholesterol (HDL-C) levels in mice, according to study findings published online April 3 in Endocrinology.

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Individualized Health Care Budgets Improve Care

FRIDAY, April 11 (HealthDay News) -- The U.K.'s National Health Service (NHS) should allow patients individual control of their health care budgets, an approach that has been shown in pilot studies to improve outcomes and patient satisfaction in a cost-effective manner, according to an analysis published April 12 in BMJ.

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Raloxifene Effectiveness Unaffected by Kidney Disease

THURSDAY, April 10 (HealthDay News) -- Raloxifene increases bone mineral density at the hip and spine better than placebo in postmenopausal women with osteoporosis and chronic kidney disease, and also reduces vertebral fractures, according to study findings published online April 9 in the Journal of the American Society of Nephrology.

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Impaired Insulin Secretion Increases Alzheimer's Risk

THURSDAY, April 10 (HealthDay News) -- An impaired insulin response at 50 years of age is associated with an increased risk of developing Alzheimer's disease, according to research published online April 9 in Neurology.

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Intake of Eggs Has No Impact on Cardiovascular Risk

THURSDAY, April 10 (HealthDay News) -- Although eggs are a significant source of dietary cholesterol, altering intake of eggs does not seem to have any impact on the risk of cardiovascular disease, according to the results of a study published in the April issue of the American Journal of Clinical Nutrition.

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Consider Health Literacy Level When Writing for Patients

THURSDAY, April 10 (HealthDay News) -- Giving patients clearly written educational materials that convey key messages without resorting to jargon is an important part of engaging patient compliance with treatment and can contribute to health literacy, according to an article published in the April issue of Chest.

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Paternal Obesity Linked to Liver Injury

WEDNESDAY, April 9 (HealthDay News) -- Early-onset paternal, but not maternal, obesity is associated with a higher risk of having high levels of alanine aminotransferase (ALT), a marker of liver injury associated with obesity, researchers report in the April issue of Gastroenterology.

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Doctors Vote on the Ways to Make Biggest Difference

WEDNESDAY, April 9 (HealthDay News) -- The BMJ has begun accepting votes on which areas of health care allow doctors to make the biggest difference to patient care, with a shortlist of six areas each being championed by eminent doctors and researchers. The winning topic will gain special coverage in the BMJ and the BMJ Group's 24 other specialist journals and online education products.

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Lower Lipid and Blood Pressure Goals May Help Heart

TUESDAY, April 8 (HealthDay News) -- Reducing low-density lipoprotein cholesterol (LDL-C) and systolic blood pressure beyond traditional targets resulted in regression of atherosclerosis in individuals with type 2 diabetes, according to research published in the April 9 issue of the Journal of the American Medical Association.

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Childhood Abuse May Raise Adult Inflammation Levels

TUESDAY, April 8 (HealthDay News) -- Depressed adults with a history of maltreatment in childhood tend to have higher levels of C-reactive protein than their counterparts without a history of abuse, putting them at increased risk of cardiovascular disease, according to a report published in the April issue of the Archives of General Psychiatry.

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Short Sleep in Infancy Linked to Childhood Overweight

TUESDAY, April 8 (HealthDay News) -- Infants who sleep less than 12 hours per day may have an increased risk of becoming overweight when they reach preschool age, according to research published in the April issue of the Archives of Pediatrics and Adolescent Medicine.

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Presence of Varicocele May Be Hereditary

FRIDAY, April 4 (HealthDay News) -- Varicocele, the most common correctable cause of male infertility, may be a hereditary condition as it is more prevalent among first-degree relatives, particularly brothers, of men with known varicocele, researchers report in the April issue of Urology.

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Allopurinol Does Not Halt Procedure-Related Pancreatitis

FRIDAY, April 4 (HealthDay News) -- Pre-procedure treatment with allopurinol does not appear to reduce the risk of pancreatitis caused by endoscopic retrograde cholangiopancreatography (ERCP) but may be of benefit in patients at highest risk of the complication, according to research published in Clinical Gastroenterology and Hepatology in April.

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Tai Chi Beneficial in Diabetes, Metabolic Syndrome

THURSDAY, April 3 (HealthDay News) -- A Tai Chi exercise program may help reduce HbA1c and improve immune function in adults with diabetes, and also may improve indicators of metabolic syndrome in adults, according to two small studies published online April 2 in the British Journal of Sports Medicine.

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Obesity Boosts Use of Health Care Services in Pregnancy

WEDNESDAY, April 2 (HealthDay News) -- Women who are overweight or obese before pregnancy or early in pregnancy use more health care services and have longer hospital stays for delivery, researchers report in the April 3 issue of the New England Journal of Medicine.

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Researchers Identify Gene Behind Vitamin B12 Defect

WEDNESDAY, April 2 (HealthDay News) -- Mutations responsible for the cblD defect, one of nine defects of intracellular cobalamin (vitamin B12) metabolism, have been found in the MMADHC gene on chromosome 2, according to a report published in the April 3 issue of the New England Journal of Medicine.

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Adverse Effects of Shock Waves for Kidney Stones Studied

WEDNESDAY, April 2 (HealthDay News) -- Shock wave lithotripsy treatment of renal or ureteral stones does not appear to increase the rate of new-onset hypertension or diabetes mellitus, according to research published in the April issue of Urology.

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Psoriasis Linked to Multiple Comorbidities

WEDNESDAY, April 2 (HealthDay News) -- Patients with psoriasis are likely to have comorbidities that should be assessed by their primary health care providers and addressed with health screening tests, preventative exams and referrals, according to a clinical consensus statement from the National Psoriasis Foundation published in April in the Journal of the American Academy of Dermatology.

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Kidney Damage May Lead to Hypertension

TUESDAY, April 1 (HealthDay News) -- Hypertension and kidney disease commonly co-exist, and new research published in the April 1 issue of the Annals of Internal Medicine points to kidney damage as a risk factor for subsequent hypertension.

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Diabetics Should Receive Cardiovascular Prophylaxis

TUESDAY, April 1 (HealthDay News) -- Diabetics aged 30 and older are at similar risk of cardiovascular disease as non-diabetics with a history of myocardial infarction, according to a report released online March 31 in advance of publication in the April 15 issue of Circulation: Journal of the American Heart Association.

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