Strength training might help women with type 2 diabetes improve their body's use of insulin, new research suggests.
In a small study of obese, postmenopausal women, investigators found that a regimen of aerobic exercise and strength training was better than aerobic activity alone when it came to improving insulin sensitivity.
Type 2 diabetes arises when the body loses sensitivity to insulin, a hormone that shuttles the sugars from food into body cells to be used for energy. Obesity is a major risk factor for insulin resistance and type 2 diabetes, and diet and exercise modification is one strategy for controlling the condition.
It's been unclear, though, whether there are added benefits from bulking up an exercise regimen with resistance training, which aims to build muscle. Such training could improve insulin sensitivity by boosting muscle mass and cutting fat stores in the body, according to the authors of the new study.
To test this idea, they randomly assigned 28 obese women to one of three groups: one that followed 16 weeks of supervised aerobic exercise and strength training; one that followed an aerobic regimen only; and one that continued with their usual diabetes care.
At the end of the study, women in both exercise groups had less abdominal fat and greater muscle mass. But only the strength-training group, which had a bigger increase in muscle density, showed improved insulin sensitivity in tests.
Darcye J. Cuff, of St. Paul's Hospital in Vancouver, Canada, and her colleagues report the findings in the November issue of Diabetes Care.
According to the researchers, the findings suggest that the changes resistance exercise produced in abdominal fat and muscle mass were behind the improvements in insulin sensitivity. Adding strength training to aerobic workouts, they conclude, might be the best exercise regimen for improving insulin resistance.
Saturday, November 21, 2009
Thursday, November 19, 2009
Cluster Headache Linked to Heart Defect
New research suggests that cluster headache, a severe type of headache that usually begins around one eye, often occurs together with a heart defect called patent foramen ovale (PFO), in which blood can pass through a small hole from the right to the left side of the heart without going through the lungs first.
In the fetus, the hole (foramen ovale) is open, since blood does not need pass through the lungs to pick up oxygen while the baby is in the womb. After birth, the hole normally closes, but quite often this closure is incomplete. Since it is a small defect, people are often unaware that they have an open (patent) foramen ovale.
As reported in the medical journal Neurology, Dr. Cinzia Finocchi and colleagues, from the University of Genoa in Italy, used ultrasound to look for PFO in 40 people with cluster headache and 40 similar subjects without such headaches.
There was evidence of PFO in 17 patients with cluster headache compared with just 7 headache-free subjects. Having a cluster headache more than tripled the odds of having a PFO.
So, why do the two conditions often occur together? The reason is unclear, but it may relate to lower oxygen levels in the blood. With PFO, blood that bypasses lungs carries less oxygen than normal, and previous reports have suggested that poorly oxygenated blood may help induce cluster headaches.
Further studies are needed to better understand the association between cluster headache and PFO, the investigators conclude.
In the fetus, the hole (foramen ovale) is open, since blood does not need pass through the lungs to pick up oxygen while the baby is in the womb. After birth, the hole normally closes, but quite often this closure is incomplete. Since it is a small defect, people are often unaware that they have an open (patent) foramen ovale.
As reported in the medical journal Neurology, Dr. Cinzia Finocchi and colleagues, from the University of Genoa in Italy, used ultrasound to look for PFO in 40 people with cluster headache and 40 similar subjects without such headaches.
There was evidence of PFO in 17 patients with cluster headache compared with just 7 headache-free subjects. Having a cluster headache more than tripled the odds of having a PFO.
So, why do the two conditions often occur together? The reason is unclear, but it may relate to lower oxygen levels in the blood. With PFO, blood that bypasses lungs carries less oxygen than normal, and previous reports have suggested that poorly oxygenated blood may help induce cluster headaches.
Further studies are needed to better understand the association between cluster headache and PFO, the investigators conclude.
Sleep Loss linked to Teens' Suicide Behaviors
Teenagers who usually fall into bed at 2 a.m. each night and get up a few hours later to make their 8 a.m. classes are putting themselves at risk for more than chronic tiredness.
New findings show that adolescents who do not get enough sleep may be more likely to have suicidal thoughts and to attempt suicide than their more well-rested peers. Such suicidal behavior is also evident among those who experience frequent nightmares, according to the study of young Chinese people.
"These findings ... highlight the potential role of sleep intervention in the prevention of adolescent suicide," writes study author Dr. Xianchen Liu of Arizona State University's Prevention Research Center and Shandong University School of Public Health in the People's Republic of China.
While adults need eight hours of sleep on average, experts recommend that adolescents -- whose bodies undergo big growth spurts and hormonal changes -- sleep at least nine hours every night, Liu explained.
Yet many teenagers get far less sleep than they should, which, studies show, affects their thinking, concentration, school performance and behavior. It is also known that suicide risk increases during adolescence.
Two long-term studies of adults have found that completed suicide can be predicted by poor sleep quality and nightmares, but less information is known about the sleep-suicide association among adolescents.
To investigate, Liu analyzed survey responses from 1,362 students from three junior and two senior high schools in a rural area of a province in eastern China. The students were asked about their sleep patterns and problems and their suicidal behavior.
Nearly 20 percent of the students said they had thought about killing themselves, and 10.5 percent admitted attempting suicide at some point during the previous six months, Liu reports in the October issue of the journal Sleep.
About 17 percent reported having insomnia, and a small proportion (2.3 percent) said they had even taken pills to help them go to sleep.
The students generally reported getting about 7.6 hours of sleep each night. And, study findings show, the less sleep the adolescents had, the more likely they were to report having attempted suicide.
Those who slept less than eight hours each night were about three times more likely to attempt suicide than those who slept a minimum of nine hours.
This finding remained true even when Liu took into consideration the teenagers' depressive symptoms and other factors that could potentially skew the results, the report indicates.
In addition, adolescents who said they had experienced frequent nightmares during the past month were more than twice as likely to attempt suicide as those who rarely experienced nightmares.
Further, those who reported having frequent or occasional nightmares - as did almost half of the students - were up to 75 percent more likely to have suicidal thoughts than those who rarely had such frightening dreams.
Various researchers have reported that sleep loss may lead to anxiety, depression, aggressive behavior, decreased brain function and hormonal or immunological changes, Liu told.
"All of these impairments due to sleep loss may directly or indirectly lead to elevated risk for adolescent suicidal behavior," he said.
Parents who know their teen is getting only a few hours of sleep each night need not be alarmed about any potential suicidal behavior, according to the researcher, unless they notice warning signs such as their child giving away prized possessions or making out a will.
If those signs are present, Liu advises that parents "consult a clinical psychologist or psychiatrist, to assess the potential risk... and see a sleep specialist to look for the reasons of sleep loss if short sleep has impacted the child's daytime functioning."
Dr. Rosalind Cartwright, chair of the psychology department at Rush University Medical Center in Chicago, Illinois said that Liu's study shows that sleep deprivation among teens is a "worldwide problem."
Adolescents "need more and get less (sleep) than any other age group," said Cartwright, who was not involved with the study, but has conducted sleep-related research. She added that adolescents, and their parents, should "make sleep a priority."
New findings show that adolescents who do not get enough sleep may be more likely to have suicidal thoughts and to attempt suicide than their more well-rested peers. Such suicidal behavior is also evident among those who experience frequent nightmares, according to the study of young Chinese people.
"These findings ... highlight the potential role of sleep intervention in the prevention of adolescent suicide," writes study author Dr. Xianchen Liu of Arizona State University's Prevention Research Center and Shandong University School of Public Health in the People's Republic of China.
While adults need eight hours of sleep on average, experts recommend that adolescents -- whose bodies undergo big growth spurts and hormonal changes -- sleep at least nine hours every night, Liu explained.
Yet many teenagers get far less sleep than they should, which, studies show, affects their thinking, concentration, school performance and behavior. It is also known that suicide risk increases during adolescence.
Two long-term studies of adults have found that completed suicide can be predicted by poor sleep quality and nightmares, but less information is known about the sleep-suicide association among adolescents.
To investigate, Liu analyzed survey responses from 1,362 students from three junior and two senior high schools in a rural area of a province in eastern China. The students were asked about their sleep patterns and problems and their suicidal behavior.
Nearly 20 percent of the students said they had thought about killing themselves, and 10.5 percent admitted attempting suicide at some point during the previous six months, Liu reports in the October issue of the journal Sleep.
About 17 percent reported having insomnia, and a small proportion (2.3 percent) said they had even taken pills to help them go to sleep.
The students generally reported getting about 7.6 hours of sleep each night. And, study findings show, the less sleep the adolescents had, the more likely they were to report having attempted suicide.
Those who slept less than eight hours each night were about three times more likely to attempt suicide than those who slept a minimum of nine hours.
This finding remained true even when Liu took into consideration the teenagers' depressive symptoms and other factors that could potentially skew the results, the report indicates.
In addition, adolescents who said they had experienced frequent nightmares during the past month were more than twice as likely to attempt suicide as those who rarely experienced nightmares.
Further, those who reported having frequent or occasional nightmares - as did almost half of the students - were up to 75 percent more likely to have suicidal thoughts than those who rarely had such frightening dreams.
Various researchers have reported that sleep loss may lead to anxiety, depression, aggressive behavior, decreased brain function and hormonal or immunological changes, Liu told.
"All of these impairments due to sleep loss may directly or indirectly lead to elevated risk for adolescent suicidal behavior," he said.
Parents who know their teen is getting only a few hours of sleep each night need not be alarmed about any potential suicidal behavior, according to the researcher, unless they notice warning signs such as their child giving away prized possessions or making out a will.
If those signs are present, Liu advises that parents "consult a clinical psychologist or psychiatrist, to assess the potential risk... and see a sleep specialist to look for the reasons of sleep loss if short sleep has impacted the child's daytime functioning."
Dr. Rosalind Cartwright, chair of the psychology department at Rush University Medical Center in Chicago, Illinois said that Liu's study shows that sleep deprivation among teens is a "worldwide problem."
Adolescents "need more and get less (sleep) than any other age group," said Cartwright, who was not involved with the study, but has conducted sleep-related research. She added that adolescents, and their parents, should "make sleep a priority."
Tuesday, November 17, 2009
Arthritis sufferers 'misusing painkillers'
Thousands of patients with severe arthritis are adding over-the-counter medication to prescrib drugs because GPs are limiting their doses amid safety fears.
The effectiveness of conventional painkillers is being hamstrung by concerns about their side effects, such as bleeding and other severe intestinal problems which can be fatal, according to researchers including Martin Green, chief executive of the charity Counsel and Care for the Elderly.
They report that GPs are not always prescribing to appropriate levels, meaning the drugs are not controlling pain as they should, and that doctors seem reluctant to use a new generation of drugs which have fewer side effects. Patients, therefore, are often turning to other pain-relieving drugs and creams instead.
Work by Mr Green and Brian Crichton, a GP and GP trainer in the West Midlands, suggests that a quarter of patients take over-the-counter medications as well as their prescriptions, and a quarter of doctors order low doses for drugs they prescribe, hoping they can control pain without side effects.
The pair report the findings from an electronic poll of 2,000 doctors and questionnaires returned by more than 3,100 patients with osteoarthritis in the journal Current Medical Research and Opinions. The research was funded by the drug company Merck Sharpe and Dohme.
It is thought that 2,000 people a year might die from complications linked to conventional treatments, still small compared with the millions suffering from osteoarthritis - many of whom are not on prescription drugs at all.
The research suggests patients are four times more likely to be dissatisfied with the poor pain relief caused by the drugs than by side effects such as stomach upsets.
The government's national institute for clinical excellence, which monitors the cost-effectiveness of treatments, last year endorsed the new generation of drugs only in those patients who might be at high risk of developing stomach side effects.
These included people over 65, those with gastrointestinal problems, and those already taking other medicines that could cause ulcers. The drugs themselves cost more money, but their supporters argue they more than make up for that by preventing return visits to GPs, hospital treatment and the need for other drugs to counter side effects.
Dr Crichton said: "If you are on a prescription painkiller and it is not working for you don't add another painkiller you have bought yourself. Always ask the advice of your doctor or local pharmacist."
The effectiveness of conventional painkillers is being hamstrung by concerns about their side effects, such as bleeding and other severe intestinal problems which can be fatal, according to researchers including Martin Green, chief executive of the charity Counsel and Care for the Elderly.
They report that GPs are not always prescribing to appropriate levels, meaning the drugs are not controlling pain as they should, and that doctors seem reluctant to use a new generation of drugs which have fewer side effects. Patients, therefore, are often turning to other pain-relieving drugs and creams instead.
Work by Mr Green and Brian Crichton, a GP and GP trainer in the West Midlands, suggests that a quarter of patients take over-the-counter medications as well as their prescriptions, and a quarter of doctors order low doses for drugs they prescribe, hoping they can control pain without side effects.
The pair report the findings from an electronic poll of 2,000 doctors and questionnaires returned by more than 3,100 patients with osteoarthritis in the journal Current Medical Research and Opinions. The research was funded by the drug company Merck Sharpe and Dohme.
It is thought that 2,000 people a year might die from complications linked to conventional treatments, still small compared with the millions suffering from osteoarthritis - many of whom are not on prescription drugs at all.
The research suggests patients are four times more likely to be dissatisfied with the poor pain relief caused by the drugs than by side effects such as stomach upsets.
The government's national institute for clinical excellence, which monitors the cost-effectiveness of treatments, last year endorsed the new generation of drugs only in those patients who might be at high risk of developing stomach side effects.
These included people over 65, those with gastrointestinal problems, and those already taking other medicines that could cause ulcers. The drugs themselves cost more money, but their supporters argue they more than make up for that by preventing return visits to GPs, hospital treatment and the need for other drugs to counter side effects.
Dr Crichton said: "If you are on a prescription painkiller and it is not working for you don't add another painkiller you have bought yourself. Always ask the advice of your doctor or local pharmacist."
The Better You Sleep, the Better You Work
Practice alone isn't quite enough to make you perfect. You need to get enough sleep, too.
A study by Harvard Medical School researchers that appears in the July 3 issue of the journal Neuron says your ability to learn motor skills is maximized when you get a full night's sleep.
The study involved teaching groups of people to type a sequence of keys on a computer keyboard as quickly and accurately as they could. One group was trained in the morning and then re-tested 12 hours later. They were able to improve their typing ability by about 2 percent in the re-test.
Another group was trained in the evening and then re-tested 12 hours later, after they'd had a full night's sleep. They had an average 20 percent improvement in their performance when they were re-tested.
The study also found that the amount of performance improvement was linked to the amount of Stage 2 sleep, called non-rapid eye movement (NREM), experienced by the participants, particularly late in the night.
"This is the part of a good night's sleep that many people will cut short by getting up early in the morning," says the study's senior author, Matter Walker, a clinical fellow in psychiatry at Harvard Medical School.
"In order for an individual to learn new things, they may require a good night's sleep before the maximum benefit of the time they spend practicing is realized," Walker adds in the Harvard press release.
A study by Harvard Medical School researchers that appears in the July 3 issue of the journal Neuron says your ability to learn motor skills is maximized when you get a full night's sleep.
The study involved teaching groups of people to type a sequence of keys on a computer keyboard as quickly and accurately as they could. One group was trained in the morning and then re-tested 12 hours later. They were able to improve their typing ability by about 2 percent in the re-test.
Another group was trained in the evening and then re-tested 12 hours later, after they'd had a full night's sleep. They had an average 20 percent improvement in their performance when they were re-tested.
The study also found that the amount of performance improvement was linked to the amount of Stage 2 sleep, called non-rapid eye movement (NREM), experienced by the participants, particularly late in the night.
"This is the part of a good night's sleep that many people will cut short by getting up early in the morning," says the study's senior author, Matter Walker, a clinical fellow in psychiatry at Harvard Medical School.
"In order for an individual to learn new things, they may require a good night's sleep before the maximum benefit of the time they spend practicing is realized," Walker adds in the Harvard press release.
Herbal medicines linked to liver inflammation
Some types of herbal medicines have been linked to liver inflammation in patients, suggesting the need for these products to be regulated to reduce further risks to consumers, UK researchers report.
"The preparation and prescribing of these medications urgently needs tighter control, as evidence of their potential toxicity has been recognized for some years and is a growing problem," according to Dr. Margaret F. Bassendine of the Center for Liver Research in Newcastle Upon Tyne and her colleagues.
In the latest issue of the European Journal of Gastroenterology and Hepatology, the researchers present the stories of two patients who experienced extensive liver inflammation after taking a mixture of Chinese herbal roots, one of whom died following a liver transplant.
Bassendine and her co-authors also conducted a review of medical literature written in English and identified 29 more patients with liver inflammation linked to herbal treatments.
Why certain herbal medicines can cause inflammation of the liver is, at present, unknown, the authors note. "It is difficult to provide conclusive evidence of what caused (liver inflammation) since traditional Chinese herbal medicines are sold in Europe as food supplements and therefore evade the controls that apply to conventional medicines," Bassendine's team writes. Some products are mixtures that contain adulterants.
However, certain herbal products are mentioned more frequently than others by people who experienced liver complications, the authors add. One product that was taken by 11 patients, called Jin bu huan, is an extract of a plant that behaves like an opiate. Six patients also reported taking Dictamnus dasycarpus, which is sometimes used to treat eczema.
In the first case the authors present, a 31-year-old woman who was given an infusion of Chinese herbal roots to help alleviate joint pain. The woman soon became jaundiced and developed dark urine. She stopped taking the medications 5 weeks after she began. She was not on any other medications, and tests found no signs of hepatitis virus in her blood, which can cause liver damage.
Nevertheless, her condition worsened. After doctors gave her an infusion of an antibody that improved the functioning of her liver, she fully recovered.
In the second case, a 32-year-old man began taking Chinese herb roots to treat benign tumors in his fatty tissue, and finished the entire nine doses of the treatment even after he began to feel unwell. After the treatment ended, he became jaundiced and also developed dark urine, and his condition began to deteriorate rapidly. He received a liver transplant, but died from an infection 13 days after the operation.
"Physicians and the general public should remain alert to the possibility of adverse effects from all herbal remedies, which are being used widely without definite evidence in common conditions such as asthma," Bassendine and her team conclude.
"The preparation and prescribing of these medications urgently needs tighter control, as evidence of their potential toxicity has been recognized for some years and is a growing problem," according to Dr. Margaret F. Bassendine of the Center for Liver Research in Newcastle Upon Tyne and her colleagues.
In the latest issue of the European Journal of Gastroenterology and Hepatology, the researchers present the stories of two patients who experienced extensive liver inflammation after taking a mixture of Chinese herbal roots, one of whom died following a liver transplant.
Bassendine and her co-authors also conducted a review of medical literature written in English and identified 29 more patients with liver inflammation linked to herbal treatments.
Why certain herbal medicines can cause inflammation of the liver is, at present, unknown, the authors note. "It is difficult to provide conclusive evidence of what caused (liver inflammation) since traditional Chinese herbal medicines are sold in Europe as food supplements and therefore evade the controls that apply to conventional medicines," Bassendine's team writes. Some products are mixtures that contain adulterants.
However, certain herbal products are mentioned more frequently than others by people who experienced liver complications, the authors add. One product that was taken by 11 patients, called Jin bu huan, is an extract of a plant that behaves like an opiate. Six patients also reported taking Dictamnus dasycarpus, which is sometimes used to treat eczema.
In the first case the authors present, a 31-year-old woman who was given an infusion of Chinese herbal roots to help alleviate joint pain. The woman soon became jaundiced and developed dark urine. She stopped taking the medications 5 weeks after she began. She was not on any other medications, and tests found no signs of hepatitis virus in her blood, which can cause liver damage.
Nevertheless, her condition worsened. After doctors gave her an infusion of an antibody that improved the functioning of her liver, she fully recovered.
In the second case, a 32-year-old man began taking Chinese herb roots to treat benign tumors in his fatty tissue, and finished the entire nine doses of the treatment even after he began to feel unwell. After the treatment ended, he became jaundiced and also developed dark urine, and his condition began to deteriorate rapidly. He received a liver transplant, but died from an infection 13 days after the operation.
"Physicians and the general public should remain alert to the possibility of adverse effects from all herbal remedies, which are being used widely without definite evidence in common conditions such as asthma," Bassendine and her team conclude.
Child Vaccinations Do Not Cause Diabetes
Routine childhood vaccinations do not increase the risk of developing diabetes, according to a study of more than 700,000 Danish children.
The study, led by Anders Hviid of the Statens Serum Institute in Copenhagen, looked at all Danish children born from 1990 through 2000 and found that diabetes rates were not higher regardless of what types of vaccines were administered.
"The study will, one hopes, be the last one that is necessary to disprove an association between immunization and diabetes," said Dr. Lynne Levitsky of Massachusetts General Hospital.
In an editorial in the New England Journal of Medicine, where the study appears, Levitsky said researchers "should now move on to the most important tasks" of finding what actually causes the blood sugar disease and, perhaps, a way to prevent it.
In addition, the study found siblings of children who had diabetes -- and were therefore more likely to develop the condition themselves -- were not more likely to become diabetics if they were vaccinated.
The Hviid team also looked to see if the vaccinations increased the risk of diabetes two, three or four years later in life. They found it did not.
The fact that doctors are doing a better job of getting children immunized against a dozen often-serious diseases had prompted speculation vaccines might contribute to the growing incidence of childhood diabetes.
But there is already evidence from previous studies that a yet-to-be-discovered environmental factor makes the body stop producing the insulin it needs to process blood sugar.
The study, led by Anders Hviid of the Statens Serum Institute in Copenhagen, looked at all Danish children born from 1990 through 2000 and found that diabetes rates were not higher regardless of what types of vaccines were administered.
"The study will, one hopes, be the last one that is necessary to disprove an association between immunization and diabetes," said Dr. Lynne Levitsky of Massachusetts General Hospital.
In an editorial in the New England Journal of Medicine, where the study appears, Levitsky said researchers "should now move on to the most important tasks" of finding what actually causes the blood sugar disease and, perhaps, a way to prevent it.
In addition, the study found siblings of children who had diabetes -- and were therefore more likely to develop the condition themselves -- were not more likely to become diabetics if they were vaccinated.
The Hviid team also looked to see if the vaccinations increased the risk of diabetes two, three or four years later in life. They found it did not.
The fact that doctors are doing a better job of getting children immunized against a dozen often-serious diseases had prompted speculation vaccines might contribute to the growing incidence of childhood diabetes.
But there is already evidence from previous studies that a yet-to-be-discovered environmental factor makes the body stop producing the insulin it needs to process blood sugar.
