Salt: The Hidden Danger

by Jennifer Bunn, RN

Salt reduction is one of the ways that you can help prevent high blood pressure, one of the risks for heart disease and stroke. Cutting salt in your diet can help, but many people are unaware that only a small amount of their daily intake of salt comes from their salt shaker. Reducing the amount of salt you add to your food is important, but many of the foods we buy contain high amounts of sodium.

Your kidneys do a wonderful job of regulating the sodium in your body, which is needed for essential functions such as regulating fluid in your body, controlling muscle contractions and regulating nerve impulses. When you have too much sodium, your kidneys excrete sodium in your urine; your kidneys conserve sodium when you have too little in your body.

Many of the prepared and processed foods we buy already contain high amounts of sodium, and adding salt to these foods further increases their sodium content. In fact, about 77% of the sodium we consume comes from eating foods that already contain salt. It is important to be aware of foods that contain high levels of sodium if you are trying to control your salt intake. How much salt should you consume? The American Heart Association recommends limiting sodium intake to less than 1,500 milligrams per day. Reading food labels can help you become more aware of those foods that contain high amounts of sodium.

Source: http://www.americanheart.org/presenter.jhtml?identifier=4708

Heredity Plays a Role in Developing Diabetes- Women

by Jennifer Bunn, RN

A new study has shown a definite link between women who have family members with type 2 diabetes and the risk of developing the disease themselves. Previous studies have also supported this hypothesis, but there is no clear genetic link identified.

In a study which spanned 20 years, 73, 227 women from the U.S. were followed to determine their risk of developing type 2 diabetes. Risk factors were taken into consideration, such as weight, height, BMI (body mass index) and lifestyle habits. After controlling for these variables, it was discovered that having a first-degree relative (parent or sibling) with the disease more than doubled the women’s’ risk of developing the disease themselves. Women who had family members with the condition were more prone to being overweight, and this factor accounts for approximately 20% of the heredity factor. Eating red meat and consuming alcoholic beverages and sweetened drinks were also considered to be factors in common. In all, 5,101 of the women developed type 2 diabetes during the course of the study.

Researchers came to the conclusion that being overweight and sharing these dietary habits partially explains the heredity factor in type 2 diabetes. The study was reported in the January issue ofDiabetes Care.

American Heart Month

by Jennifer Bunn, RN

February is designated as American Heart Month, a good time to reflect on our own personal risks for heart disease and how best to prevent the development of heart disease. Although there are some risk factors you can’t change, such as your age, heredity and whether you are male or female, there are several areas that you can work on:

Quitting smoking- this is perhaps one of the best and most important things you can do to decrease your risk for heart disease. Smokers carry a two-to-fourfold risk of developing heart disease when compared to non-smokers.

Lose weight- being overweight forces your heart to work harder. Obesity also contributes to hypertension (high blood pressure) and diabetes. Losing weight, even a small amount, can help in the fight against heart disease.

Exercise- exercising can help you lose weight, avoid diabetes, lower your blood pressure and decrease your cholesterol. The more exercise you do, the healthier your heart will be! Regular, moderate physical activity has been proven to improve heart health, while a sedentary lifestyle is a known risk factor for the development of heart disease.

Watch your blood pressure- high blood pressure increases your risk for heart disease, especially when other risk factors are present, such as diabetes, obesity, and smoking. Monitor your blood pressure regularly, and intervene early.

As well as knowing your risk factors for heart disease, it is important to know the signs of a heart attack, the most obvious of which is chest pain or discomfort. Pain or discomfort may come and go, or may be constant. It may be centered in the mid-sternum and may feel like squeezing, pressure, or tightness. You may also feel light-headed, nauseous, and may feel short of breath.

The Rising Cost of Type 2 Diabetes

by Jennifer Bunn, RN

The rapidly increasing numbers of type 2 diabetics in the US are being blamed for the inflated price tag of $218 billion, which is the estimated cost of pre-diabetes and diabetes for 2007. An analysis spear-headed by the Changing Diabetes Program (NCDP) studied both the direct costs of medical care required for diabetics and the indirect causes, such as absenteeism and lost productivity.

The cost of type 2 diabetes was found to be $10,000.00 per person (annual), while the cost of pre-diabetes was only $443.00 annually. The message here is that it is important to prevent those with pre-diabetes from advancing to full-blown type 2 diabetes, with its attendant costs and complications. How can this be done? The answer is to focus on prevention, particularly weight loss and moderate exercise, which may reduce the risk of developing type 2 diabetes by almost 60%.

The cost of pre-diabetes and diabetes is borne by all citizens in the form of higher health care premiums. Furthermore, it is estimated that in the US, the diabetes population will double in the next 25 years, and that the cost of this increase will reach $336 billion by 2034 (American Diabetes Association). These figures make it that much more imperative that we all work together to develop programs to prevent diabetes.

Source: Diabetes And Pre-Diabetes Accounted For $218 Billion In Costs In 2007, Health Affairs Paper Demonstrates

Source: National Diabetes Fact Sheet, 2007

Increased Cost Sharing Means Fewer Doctor Visits Among Elderly

by Jennifer Bunn, RN

A study published in the New England Journal of Medicine showed that increasing Medicare co-payments resulted in fewer doctor visits and more frequent and lengthy hospitalizations among seniors.

In tough economic times, insurance companies may see the benefit in raising co-payments to help defer rising costs, but this strategy is likely to backfire on them, as evidenced by this study. The study included almost 900,000 seniors enrolled in 36 different Medicare plans. The results? Those seniors who saw a raise in their co-pay rates saw a doctor less often and were hospitalized more often and for longer periods of time. Good medicine? This would not seem to be the case. The populations most affected by a rise in co-payments were those who could least afford it- those living in low-income neighborhoods and those who already had diagnosed health problems, such as diabetes, hypertension and heart disease.

The study illustrated what many intuitively know: raising co-payments leads to less preventative care, which means sicker patients who need to be cared for at a higher cost, not to mention an increase in patient dissatisfaction.

Source: Increased Ambulatory Care Copayments and Hospitalizations among the Elderly

FDA Requests Stronger Warning Label for Weight Loss Drug

by Jennifer Bunn, RN

Meridia, a popular weight loss drug, must now come with a stronger warning on its label, following the results of the Scout trial, a study of 10,000 individuals taking Meridia (sibutramine) to manage their weight. The participants of the study all had type 2 diabetes or cardiovascular disease. The results of the Scout trial showed an increase in the risk of myocardial infarction (heart attack), stroke, and other cardiovascular problems.

Following the release of the results of the trial, Europe has banned the sales of medication containing sibutramine, including Meridia, one of the most popular. In the US, however, it has only been recommended that the drug be labeled with the stronger warning. Patients who have a history of the following conditions should not take Meridia or any other drugs containing sibutramine:

  • Previous heart attack
  • Previous stroke
  • Heart arrhythmia
  • Coronary artery disease
  • Peripheral artery disease
  • Uncontrolled hypertension (high blood pressure)

Meridia is prescribed for patients with a BMI of 30 or more, or a BMI of 27 with risk factors for cardiovascular disease.

Source: Europe Bans Meridia Diet Pill; FDA Strengthens Warning

Opioids Increase Risk of Bone Fracture in Older Adults

by Jennifer Bunn, RN

A study that examined the risk of bone fracture in 2,300 older adults found that taking prescription opioids increased their risk of bone fracture substantially. Furthermore, larger dosages of opioids conveyed a higher risk than lower doses.

What are opioids? Opioids are narcotic analgesics (painkillers) prescribed to treat moderate to severe pain. They may be used as a one-time treatment or may be prescribed for continuous use in certain chronic conditions. Although they are very potent painkillers, they are not without risk, including the risk of becoming addicted. Other side effects may include drowsiness, itching, gastrointestinal upset, constipation and dry mouth. Taking too much of this type of drug can result in respiratory depression, where the rate of breathing slows, low blood pressure, and other dangerous effects.

The study outlining the increased rate of bone fractures in older patients taking opioids serves as a reminder that opioids should be prescribed and taken with caution. Aside from their addictive potential, opioids can cause drowsiness and low blood pressure, increasing the risk for falls. The potential for these side effects combined with an increased risk of bone fracture in older adults using opioids means that older people may need to be particularly cautious when using opioids to control pain.

Source: Prescription Painkillers Increase Risk of Bone Fractures, Study Finds

Study Shows Vitamin D Plays Role in Preventing Heart Disease

by Jennifer Bunn, RN

More and more studies are pointing to the fact that vitamin D is important in disease prevention. Scientists studied the genetic material of 617 people stored in a DNA data bank. They divided the people into three groups: those who were healthy, those who had hypertension, and those who had both hypertension and CHF (congestive heart failure).

What they discovered is that those who suffered from both conditions, high blood pressure and congestive heart failure, had an abnormality in the CYP27B1 gene. This gene is associated with a reduction in the rate at which the body converts vitamin D which has been stored into active vitamin D that the body can readily use. Researchers point out that this means that, in future, they may be able to screen people for this an abnormality in this gene earlier. Knowing that someone has this gene may mean that that person requires more vitamin D from their diet and more daily exposure to UVB rays present in sunlight, although researchers point out that more studies will need to be done to confirm their findings.

Vitamin D has been researched extensively in recent times, and is thought to have a protective effect against certain cancers, autoimmune disorders, insulin sensitivity, depression and hypertension.

Source: American Heart Association (2008). Lack Of Vitamin D May Increase Heart Disease Risk. ScienceDaily.

The Relationship Between Obstructive Sleep Apnea and Diabetes

by Jennifer Bunn, RN

A new study has found that having obstructive sleep apnea can mean poorer glucose control for type 2 diabetics. Obstructive sleep apnea is estimated to affect more than 18 million people in the US. In obstructive sleep apnea, the sufferer quits breathing during their sleep for sometimes as long as a minute at a time. This may happen hundreds of times in a night. The person who has obstructive sleep apnea is often unaware they have a problem, but may report feeling tired all the time.

The study included 60 participants, only a few of whom had been diagnosed with obstructive sleep apnea. After testing, 77% of the sample were found to be suffering from obstructive sleep apnea. After testing the participants and measuring a  blood value sensitive for glucose control (Hgb A1C), it was determined that those participants with obstructive sleep apnea had higher numbers, leading the researchers to conclude that obstructive sleep apnea has a detrimental effect on glycemic control.

What is meaningful about this research is that treating obstructive sleep apnea could improve control for those who have concurrent type 2 diabetes. This could mean fewer complications for diabetics and less dependency on medication to control blood sugar levels. Obstructive sleep apnea can be treated with weight loss, oral appliances, positional therapy, or continuous positive airway pressure (CPAP). Losing weight will often cure sleep apnea and will often improve glycemic control in type 2 diabetes.

Source: The Relationship Between Obstructive Sleep Apnea and Diabetes

The Risks of Obesity During Pregnancy

by Jennifer Bunn, RN

Women who are an unhealthy weight during pregnancy may be putting themselves and their unborn babies at risk. More than half of non-pregnant women of childbearing age are considered overweight or obese. Gaining too much weight during pregnancy can lead to complications for both mother and baby.

Complications for babies can include neural tube defects, such as spina bifida, heart defects and the risk of having more than one health problem at birth, or multiple anomalies. In addition, babies born to overweight mothers are more likely to be obese when they grow up.

For overweight pregnant mothers, health risks can run the gamut from high blood pressure to preeclampsia, increasing the risk of a cesarean birth, the necessity of inducing labor, and hemorrhage. In addition, being overweight or obese during pregnancy increases the risk of gestational diabetes. Having diabetes during pregnancy is one of the risk factors for the development of type 2 diabetes later on.

There is a definite relationship between obesity in pregnancy and obesity in the offspring of overweight women. By entering pregnancy at a healthy weight, women can reduce the risk of their children becoming obese, lowering their future risk of diseases related to obesity, such as heart disease and diabetes.

Source: Overweight Pregnant Women May Be Putting Their Infants At Risk