PHARMACY

American Dietetic Association journal article emphasizes diabetes nutrition therapy

BY Alaric DeArment

ST. LOUIS — The Journal of the American Dietetic Association has published a list of nutritional practice guidelines for people with Type 1 and Type 2 diabetes in its December issue.

Researchers reviewed research literature to create recommendations and practice guidelines centered on carbohydrates, protein intake, cardiovascular disease and weight management. Dietitians, according to the article, can encourage lifestyle changes and select appropriate interventions based on recommendations that include balancing nutritional intake with insulin doses, physical activity, weight management strategies and use of blood-glucose data.

“This publication has reviewed the process for developing the guidelines; identified major and contributing factors for diabetes nutrition therapy; reviewed and summarized research; and stated the nutrition practice recommendations that are to be integrated into the nutrition care process,” lead author and nutrition consultant Marion Franz said. “The nutrition practice guidelines provide recommendations for assessing client [and] patient needs and for selecting interventions, monitoring and evaluating outcomes.”

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Antiviral drugs could cause insulin resistance, study finds

BY Alaric DeArment

ST. LOUIS — Since the beginning of the HIV/AIDS epidemic in the early 1980s, one of the greatest advances has been antiviral drugs that have helped extend the lives of patients with viral infections.

But the drugs also cause insulin resistance, which can put people taking them at risk for diabetes and cardiovascular disease. According to a new study conducted by researchers at Washington University in St. Louis and published in the Journal of Biological Chemistry, compounds in the drugs known as protease inhibitors interfere with the body’s ability to control blood-sugar levels.

“Our lab has established that one of the effects of these drugs is blocking glucose transport, one of the most important steps in how insulin works,” WUSTL medical professor and lead study author Paul Hruz said. “Now that we’ve identified the main mechanism, we will look to develop new drugs that treat HIV but don’t cause diabetes.”

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Study: Depression may be both a risk factor and consequence of diabetes

BY Allison Cerra

NEW YORK — A new study published in the Nov. 22 issue of Archives of Internal Medicine suggested there is a two-way relationship between depression and diabetes.

An Pan of the Harvard School of Public Health and colleagues assessed the relationship between the two diseases among 65,381 women who were ages 50 years to 75 years in 1996. After completing an initial questionnaire about their medical history and health practices, participants completed follow-up questionnaires every two years through 2006. The study subjects were classified as having depression if they reported symptoms of depression, using antidepressant medication or being given a diagnosis of depression by a physician. Women who reported a new diagnosis of diabetes completed a supplementary questionnaire about symptoms, diagnostic tests and treatments, the authors said.

During the 10-year follow-up, 2,844 women were diagnosed with Type 2 diabetes, and 7,415 developed depression. Women with depression were about 17% more likely to develop diabetes after controlling for other risk factors, such as physical activity and body mass index. Those who were taking antidepressants had a 25% higher risk of developing diabetes than those who did not have depression.

After controlling for other risk factors for mood disorders, women with diabetes were 29% more likely to develop depression. Women who took insulin for diabetes had a further increased risk — 53% higher than women without diabetes.

"The findings from this well-characterized cohort of more than 55,000 U.S. women with 10 years’ follow-up add to the growing evidence that depression and diabetes are closely related to each other, and this reciprocal association also depends on the severity or treatment of each condition," the authors wrote. "All the associations were independent of sociodemographic, diet and lifestyle factors."

The study was supported by a National Institutes of Health grant.

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