HEALTH

Expectant mothers at risk for gestational diabetes if they snore, study finds

BY Michael Johnsen

CHICAGO A new study from researchers at the Northwestern University Feinberg School of Medicine released Friday found that women who reported frequent snoring during their pregnancy were more likely to develop gestational diabetes.

The study also found pregnancy increases the likelihood that a woman will snore.

This is the first study to report a link between snoring and gestational diabetes. Pregnant women who were frequent snorers had a 14.3% chance of developing gestational diabetes, while women who did not snore had a 3.3% chance. Even when researchers controlled for other factors that could contribute to gestational diabetes, such as body mass index, age and race and ethnicity, frequent snoring still was associated with the disease.

Principal investigator Francesca Facco, a fellow at the Feinberg School, presented her findings at the SLEEP 2009 23rd Annual Meeting of the Associated Professional Sleep Societies on June 11.

“Sleep disturbances during pregnancy may negatively affect your cardiovascular system or metabolism,” said Facco. “Snoring may be a sign of poor air flow and diminished oxygenation during sleep, which can cause a cascade of events in your body. This may activate your sympathetic nervous system, so your blood pressure rises at night. This can also provoke inflammatory and metabolic changes, increasing the risk of diabetes or poor sugar tolerance.”

The study also showed more women became frequent snorers as their pregnancies progressed. Early in pregnancy, 11% of women in the study reported frequent snoring; by the third trimester, the number rose to 16.5%. Frequent snoring was defined as snoring three or more nights a week.

Facco said snoring during pregnancy may be triggered by weight gain and edema (a buildup of fluid), which can increase airway resistance. Exactly how the snoring is linked to gestational diabetes is not yet known.

About 4% of pregnant women develop gestational diabetes, a condition in which women without previously diagnosed diabetes develop high blood sugar levels during pregnancy. Babies born to mothers with gestational diabetes are at increased risk of such problems as being large for gestational age, which may lead to delivery complications. These babies also may have low blood sugar levels and are at increased risk of becoming obese or developing impaired sugar tolerance or metabolic syndrome later in life.

While gestational diabetes usually resolves after pregnancy, women who develop it are at higher risk for Type 2 diabetes later in life.

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Pharmacy groups brief Congress on health, cost benefits of MTM

BY DSN STAFF

NEW YORK Making sure that medication therapy management is a part of any new healthcare reform legislation is a major priority for this industry, but it may be even more critical to the U.S. healthcare system.

 

Here’s why: according to Centers for Medicare and Medicaid estimates, $2.5 trillion will be spent on health care this year. Approximately 54% of that spend was assumed by private insurers and out-of-pocket costs. By 2018, the majority of that spend is expected to shift toward the government, CMS predicts, with an assumption of some 51% of the $4.4 trillion projected spend then.

 

Meanwhile, pharmacists do a lot more than just fill prescriptions, such as work with physicians to optimize therapeutic choices, and help patients understand their medications and how to take them. These types of services already help save billions each year in unnecessary hospitalizations and emergency room visits by preventing dangerous interactions and adverse effects.

Then there’s MTM.

Using diabetes as just one example, such programs as the Diabetes Ten City Challenge, a national program launched by the APhA Foundation in 2005 that today is saving up to $1,000 per year per patient through a pharmacist-driven patient intervention.

Walgreens Health Initiatives in 2006 determined that its MTM program netted a 2.5:1 return on investment, saving some $408,000 annually for each 100,000 covered.

Take either one of those studies and extrapolate those savings across the ever-growing Medicare population, and you have some real  potential to take a significant bite out of that $2.2 trillion in projected government healthcare costs within the next 10 years.

What’s real telling, however, is that Congress is listening to what pharmacy might be able to offer. This Tuesday, the National Association of Chain Drug Stores is hosting its first RxIMPACT Day on Capital Hill. Already, 60 leaders from over 20 states have committed to attend.

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CDC director: Get traditional flu vaccine and H1N1 vaccine next season

BY Michael Johnsen

ATLANTA Should consumers later this year be more concerned about getting a vaccine shot for the novel H1N1 strain, should one be developed in time, in place of maybe the seasonal influenza vaccine?

According to the Centers for Disease Control and Prevention, the answer is both — consumers should at least get the seasonal vaccine that’s being produced currently, as well as the novel H1N1 strain that was officially raised to pandemic status earlier this week, should one be available.

“We are continuing to expect to be administering the seasonal influenza vaccine and making sure people get it,” Anne Schuchat, CDC’s director, National Center for Immunization and Respiratory Diseases, told reporters in a press briefing Thursday. “Seasonal influenza can be a bad thing. About 36,000 people die from that every year, and it’s disproportionately a problem in the elderly and the vaccines that are available can really reduce illness as well as some of the complications,” she said.

The importance around inoculating the population against seasonal flu is in the danger of strain mutation, she said. “Seasonal H1N1 virus that we’ve had this past year is resistant to Tamiflu. And we really don’t want this novel H1N1 virus to become resistant to Tamiflu as well so there can be some benefit from trying to reduce these other infections even in the circumstance of a novel strain,” she advised. “I think it’s really premature for us to make any definitive conclusions about the seasonal influenza vaccine, but based on what I know today, I’m not expecting us to change our recommendations about that.”

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