Category Archives: Diabetes

HIV-positive people not on treatment and people with conditions such as hypertension and diabetes could be among the worst affected if cases of the new coronavirus spreads in South Africa.

On Wednesday, 11 March, Health Minister Zweli Mkhize confirmed South Africa now has 13 confirmed cases of the virus, officially named SARS Coronavirus 2 (SARS-CoV-2).

The virus gets its name from its similarity to the virus responsible for the 2003 outbreak of severe acute respiratory syndrome in China. The World Health Organisation (WHO) has called the disease that SARS-CoV-2 causes COVID-19.

So far, eight of the countrys 13 coronavirus cases are among a group of nine people who recently returned from an Italian skiing trip. The group is now in self isolation or quarantine and the health department is tracing anyone who might have been in contact with them.

The other five cases are from people who travelled back to South Africa from Germany, Austria, Portugal, Switzerland and Turkey.All together, 645 tests have been conducted.

Currently, the national health department doesnt think the virus is spreading in South Africa but if, in the future, it does, it may hit people with underlying health conditions such as HIV and TB, and who are not on treatment, the hardest - according to the heads of local HIV and TB research organisations.

Similar risks may hold true for those living with other chronic illnesses.

Then you have no cause for extra concernSalim Abdool Karim is the director of the Durban-based Centre for the Aids Programme of Research in South Africa and a global health professor at Columbia University in the United States.

Abdool Karim says that this coronavirus is too new to know much about its potential impact on people with HIV, but other viruses - such as measles or influenza - can give us a clue.

If those viruses are anything to go by, those with HIV, and who are not on treatment, will be among the most at risk.

If an HIV-positive patient is on antiretrovirals, then their response will be pretty similar to what an HIV-negative patients response would be based on what we know from other infections, he says.

I think what were going to see is that the young people who have HIV and low CD4 counts will have death rates similar to what were seeing in patients who are 60 years old and 70 years old.

CD4 counts are a measure of the immune systems strength. Between 8 and almost 15% of people older than 70 who contracted the virus in Chinas Hubei province died, according to a Chinese Center for Disease Control analysis of more than 44 000 coronavirus cases released in February.

Today, about four out of every 10 people living with HIV in South Africa are still not on antiretrovirals, the latest HIV household survey by the Human Sciences Research Council revealed.

In Johannesburg, the organisation Right to Care provides HIV services. CEO Ian Sanne agrees with Abdool Karim.People on antiretrovirals need to make sure theyre taking their antiretrovirals and then I think theres no reason to worry more than the general population, Sanne told Bhekisisa.

What were worried about are people who are HIV positive and not yet diagnosed.In a statement earlier this week, Sanne explained: Now is the time to know your status and start treatment."

We know very little about what the new virus means for people with TB

South Africa is among 30 high burden countries that account for almost 90% of the worlds TB cases, according to the WHOs 2019 TB report. In 2019, more than half of the countrys 301 000 TB cases were among people infected with HIV.

But Abdool Karim says its not clear how the virus will impact people co-infected with HIV and TB given that both TB and the new coronavirus affect the lungs.

Statistics South Africas 2016 data shows TB was responsible for about 30 000 deaths in 2016 and the condition remains the leading cause of natural death in South Africa.

As of 10 March, 4 012 people had died globally as a result of the new coronavirus, the WHO reported.

The virus death rate continues to be contentious, mostly because countries arent sure theyre catching every case of SARS-CoV-2.

But the WHO and the National Institute for Communicable Diseases have estimated that about 2 to 3.4% of people who reported contracting the virus have died.

Data from the Chinese Centers for Disease Control, however, reveals that your odds of dying from the virus depend on how healthy you are. In its February analysis, the government agency found a death rate of 2.3% among almost 45 000 confirmed cases in the Hubei province.

But this rate rose steeply among those people with weaker immune systems due to, for instance, non-communicable diseases (NCDs).An NCD is a disease that is not passed from person to person.

The agency admitted data on NCDs among coronavirus patients was not routinely collected. But among those infected with the virus who reported having diabetes, the death rate rose to about 7%.

Meanwhile, an estimated 6% of Chinese coronavirus patients with high blood pressure died, the February data shows. This proportion increased to 11% among people with cardiovascular disease.However, its unclear whether patients with NCDs also had any other risk factors, such as an older age, from the data.

Nasheeta Peer is a senior specialist scientist with the South African Medical Research Councils NCD Research Unit.

She says its difficult to predict how people with NCDs such as diabetes, which weaken the immune system, might be impacted by the coronavirus.Peer explains that people with diabetes will be at increased risk compared with the general population, but if their diabetes is uncontrolled, which is possible even when taking medication for diabetes, then the risk may perhaps be greater.

The International Diabetes Federation estimates that about 450-million adults were living with diabetes worldwide in 2017, but almost half these cases were undiagnosed.

Data from Stats SA notes how diabetes is the second leading cause of natural death in South Africa after TB, with about 25 000 people who died in 2016. People with diabetes are three to four times more likely to develop TB, a 2010 research review published in the journal Tropical Medicine & International Health showed. This is why the countrys latest national TB plan recommends increasing TB screening among people with diabetes.

But this may also be true the other way around, according to an article from 2000 published in the Indian Journal of Tuberculosis. TB can temporarily reduce the bodys ability to handle glucose, or sugar, leading to increased blood sugar levels - which is a risk factor for developing diabetes.

Director of the South African NCD Alliance, Vicki Pinkney-Atkinson, says if the new coronavirus begins to spread in South Africa, her main concern is people with NCDs who need medication, but could potentially put themselves at risk of contracting the virus by queuing in long lines at public clinics to do this.

In 2012, the national health department introduced a system to deliver chronic medications to allow patients to pick up their medications at designated pick up points outside of health facilities. About 3.1-million patients are now enrolled in the project, called the Centralised Chronic Medicine Dispensing and Distribution programme, according to presentations made before Parliament earlier this year.

Patients can now pick up medication at more than 800 points around the country despite the programmes challenges with costs and patient tracking.For the moment Im lucky enough that I dont have to go and stand in a long queue [to get my medication] Pinkney-Atkinson says.

What will happen for those people who have to do it and travel on buses to get there and taxis to get there?

READ MORE | Coronavirus in SA: HIV and TB sufferers not on treatment at high risk

READ MORE | Coronavirus: Why the 14-day quarantine period?

READ MORE | Coronavirus 101 - here's what you need to know

This story was produced by the Bhekisisa Centre for Health Journalism, http://bhekisisa.org. Subscribe to the newsletter http://bit.ly/BhekisisaSubscribe.

Sethu Mbuli

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Coronavirus: What you need to know if you're living with HIV, diabetes or TB - Health24

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Friday, February 14, 2020

The longer a woman with gestational, or pregnancy-related, diabetes breastfeeds her infant, the lower her risk for developing type 2 diabetes later in life, suggests an analysis by researchers at the National Institutes of Health and other institutions. The study was conducted by Cuilin Zhang, M.D., Ph.D., of NIHs Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), and colleagues. It appears in Diabetes Care.

In addition to health risks for mothers and babies, gestational diabetes increases the risk for type 2 diabetes 10 to 20 years after pregnancy. Type 2 diabetes increases the risk for heart disease, stroke and other health problems.

The researchers analyzed data from the Nurses Health Study II, a long-term study of risk factors for chronic diseases in women. Of more than 4,000 women in the study who had gestational diabetes, 873 developed type 2 diabetes over the course of 25 years. Compared to women with gestational diabetes who had not breastfed, those who breastfed for six to 12 months were 9% less likely to develop type 2 diabetes, those who breastfed for one to two years were 15% less likely, and those who breastfed for more than two years were 27% less likely.

The researchers suggested that clinicians may want to encourage patients with gestational diabetes to breastfeed if they are able to, to potentially reduce their type 2 diabetes risk.

The analysis was funded by NICHD with additional support from NIHs National Institute of General Medical Sciences.

The studys senior author, Cuilin Zhang, M.D., Ph.D., of the NICHD Epidemiology Branch, is available for comment.

Ley, SH. Lactation duration and long-term risk for incident type 2 diabetes in women with a history of gestational diabetes mellitus. Diabetes Care. 2019. https://doi.org/10.2337/dc19-2237.

About the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD): NICHD leads research and training to understand human development, improve reproductive health, enhance the lives of children and adolescents, and optimize abilities for all. For more information, visit https://www.nichd.nih.gov.

About the National Institutes of Health (NIH):NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov.

NIHTurning Discovery Into Health

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Breastfeeding may reduce type 2 diabetes risk among women with gestational diabetes - National Institutes of Health

According to the latest statistics from Diabetes UK, 4.8 million individuals may be living with diabetes in the UK. With numbers increasing steadily, the figure is expected to reach 5.3 million by 2025.

Currently, 3.9 million individuals are living with a diagnosis of diabetes in the UK, of which 90% have type 2 diabetes. It is estimated that there are around a million more individuals who have undiagnosed type 2 diabetes, bringing the total figure to more than 4.8 million. The data also show that the number of individuals living with a diagnosis of diabetes has increased by >100,000 since the last year. Furthermore, individuals with type 2 diabetes have a 50% higher risk of premature mortality.

Obesity is the biggest risk factor for diabetes, accounting for 80-85% of a person's risk of developing the condition. The prevalence of obesity in England has increased from 6.9 to 13 million in the past 20 years. Diabetes UK has urged the government to prioritise the fight against childhood obesity and focus on prevention of diabetes complications.

Chris Askew, Chief Executive at Diabetes UK, said: "Type 2 diabetes is an urgent public health crisis, and solving it depends on decisive action thats led by government, supported by industry and delivered across our society."

Adapted from Univadis from Medscape.

Link:
UK May Have 4.8 Million People Living With Diabetes - Medscape

Whether baked, mashed, fried, boiled, or steamed, potatoes are one of the most popular foods in the human diet.

Theyre rich in potassium and B vitamins, and the skin is a great source of fiber.

However, if you have diabetes, you may have heard that you should limit or avoid potatoes.

In fact, there are many misconceptions about what people with diabetes should and shouldnt eat. Many people assume that because potatoes are high in carbs, theyre off-limits if you have diabetes.

The truth is, people with diabetes can eat potatoes in many forms, but its important to understand the effect they have on blood sugar levels and the portion size thats appropriate.

This article tells you everything you need to know about potatoes and diabetes.

Like any other carb-containing food, potatoes increase blood sugar levels.

When you eat them, your body breaks down the carbs into simple sugars that move into your bloodstream. This is whats often called a spike in blood sugar levels (1).

The hormone insulin is then released into your blood to help transport the sugars into your cells so that they can be used for energy (1).

In people with diabetes, this process is not as effective. Instead of sugar moving out of the blood and into your cells, it remains in circulation, keeping blood sugar levels higher for longer.

Therefore, eating high-carb foods and/or large portions can be detrimental to people with diabetes.

In fact, poorly managed diabetes is linked to heart failure, stroke, kidney disease, nerve damage, amputation, and vision loss (2, 3, 4, 5, 6).

Therefore, its usually recommended that people with diabetes limit their digestible carb intake. This can range from a very low carb intake of 2050 grams per day to a moderate restriction of 100150 grams per day (7, 8, 9).

The exact amount varies depending on your dietary preferences and medical goals (9, 10).

Potatoes spike blood sugar levels as carbs are broken down into sugars and move into your bloodstream. In people with diabetes, the sugar isnt cleared properly, leading to higher blood sugar levels and potential health complications.

Potatoes are a high carb food. However, the carb content can vary depending on the cooking method.

Here is the carb count of 1/2 cup (7580 grams) of potatoes prepared in different ways (11):

Keep in mind that an average small potato (weighing 170 grams) contains about 30 grams of carbs and a large potato (weighing 369 grams) approximately 65 grams. Thus, you may eat more than double the number of carbs listed above in a single meal (12).

In comparison, a single piece of white bread contains about 14 grams of carbs, 1 small apple (weighing 149 grams) 20.6 grams, 1 cup (weighing 158 grams) of cooked rice 28 grams, and a 12-ounce (350-ml) can of cola 38.5 grams (13, 14, 15, 16).

The carb content of potatoes varies from 11.8 grams in 1/2 cup (75 grams) of diced raw potato to 36.5 grams in a similar serving size of french fries. However, the actual serving size of this popular root vegetable is often much larger than this.

A low GI diet can be an effective way for people with diabetes to manage blood sugar levels (17, 18, 19).

The glycemic index (GI) is a measure of how much a food raises blood sugar compared with a control, such as 3.5 ounces (100 grams) of white bread (1, 11).

Foods that have a GI greater than 70 are considered high GI, which means they raise blood sugar more quickly. On the other hand, foods with a GI of less than 55 are classed low (1, 11).

In general, potatoes have a medium to high GI (20).

However, the GI alone isnt the best representation of a foods effect on blood sugar levels, as it doesnt take into account portion size or cooking method. Instead, you can use the glycemic load (GL).

This is the GI multiplied by the actual number of carbs in a portion, divided by 100. A GL of less than 10 is low, while a GL greater than 20 is considered high. Generally, a low GI diet aims to keep the daily GL under 100 (11).

Both the GI and GL can vary by potato variety and cooking method.

For example, a 1 cup (150 gram) serving of potato may be high, medium, or low GL depending on the variety (11, 20):

If you have diabetes, choosing varieties like Carisma and Nicola is a better option to slow the rise of blood sugar levels after eating potatoes.

You can check the GI and GL of different types of potatoes through this website.

The way a potato is prepared also affects the GI and GL. This is because cooking changes the structure of the starches and thus how fast theyre absorbed into your bloodstream.

In general, the longer a potato is cooked the higher the GI. Therefore, boiling or baking for long periods tends to increase the GI.

Yet, cooling potatoes after cooking can increases the amount of resistant starch, which is a less digestible form of carbs. This helps lower the GI by 2528% (21, 22).

This means that a side of potato salad may be slightly better than french fries or hot baked potatoes if you have diabetes. French fries also pack more calories and fat due to their cooking method.

Additionally, you can lower the GI and GL of a meal by leaving the skins on for extra fiber, adding lemon juice or vinegar, or eating mixed meals with protein and fats as this helps slow the digestion of carbs and the rise in blood sugar levels (23).

For example, adding 4.2 ounces (120 grams) of cheese to a 10.2 ounce (290 gram) baked potato lowers the GL from 93 to 39 (24).

Keep in mind that this much cheese also contains 42 grams of fat and will add nearly 400 calories to the meal.

As such, its still necessary to consider the overall number of carbs and the quality of the diet, not just the GI or GL. If controlling weight is one of your goals, your total calorie intake is also important.

A low GI and GL diet can be beneficial for people with diabetes. Potatoes tend to have a medium to high GI and GL, but cooled cooked potatoes, as well as varieties like Carisma and Nicola, are lower and make a better choice for people with diabetes.

Although its safe for most people with diabetes to eat potatoes, its important to consider the amount and types you consume.

Eating potatoes both increases your risk of type 2 diabetes and may have negative effects on people with existing diabetes.

One study in 70,773 people found that for every 3 servings per week of boiled, mashed, or baked potatoes, there was a 4% increase in the risk of type 2 diabetes and for french fries, the risk increased to 19% (25).

Additionally, fried potatoes and potato chips contain high amounts of unhealthy fats that may increase blood pressure, lower HDL (good) cholesterol, and lead to weight gain and obesity all of which are associated with heart disease (26, 27, 28, 29).

This is particularly dangerous for people with diabetes, who often already have an increased risk of heart disease (30).

Fried potatoes are also higher in calories, which can contribute to unwanted weight gain (27, 29, 31).

People with type 2 diabetes are often encouraged to maintain a healthy weight or lose weight to help manage blood sugar and reduce the risk of complications (32).

Therefore, french fries, potato chips, and other potato dishes that use large amounts of fats are best avoided.

If youre having trouble managing your blood sugar levels and diet, speak with a healthcare provider, dietitian, or diabetes educator.

Eating unhealthy potato foods, such as chips and french fries, increases your risk of type 2 diabetes and complications, such as heart disease and obesity.

Although you can eat potatoes if you have diabetes, you may still want to limit them or replace them with healthier options.

Look for high fiber, lower carb, and low GI and GL foods like the following (33):

Another good way to avoid large portions of high carb foods is to fill at least half of your plate with non-starchy vegetables, such as broccoli, leafy greens, cauliflower, peppers, green beans, tomatoes, asparagus, cabbage, Brussels sprouts, cucumbers, and lettuce.

Lower carb replacements for potato include carrots, pumpkin, squash, parsnip, and taro. High carb but lower GI and GL options include sweet potato, legumes, and lentils.

Potatoes are a versatile and delicious vegetable that can be enjoyed by everyone, including people with diabetes.

However, because of their high carb content, you should limit portion sizes, always eat the skin, and choose low GI varieties, such as Carisma and Nicola.

In addition, its best to stick with boiling, baking, or steaming and avoid fried potatoes or potato chips, which are high in calories and unhealthy fats.

If youre struggling to make healthy choices to manage your diabetes, consult your healthcare provider, dietitian, or diabetes educator.

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Potatoes and Diabetes: Safety, Risks, and Alternatives - Healthline

According to the World Health Organization, diabetes was directly related to the deaths of around 1.6 million people around the world in the year 2016 alone. In addition to family history, sedentary lifestyle, and diet, there is increasing evidence that micro-organisms in the gut (microbiota) play an important role in the development of type 2 diabetes. However, despite the growing evidence for the role of gut bacteria in type 2 diabetes, consensus on the role of different families of bacteria in the development of this disease is lacking. To address this problem, researchers from Oregon State University, USA have published a systematic review of 42 human studies on the associations between microbial families and type 2 diabetes. This review was published in the journal EBioMedicine.

While the researchers were unable to find any consensus on specific microbial communities being implicated in the development of diabetes, some groups of bacteria show an association with either presence or absence of the disease. For example, a decrease in at least one of these five distinct families of bacteria that include Bacteroides, Roseburia, Faecalibacterium, Akkermansia and Bifidobacterium families of bacteria is consistently associated with protection from type 2 diabetes. In contrast, the Lactobacillus family of bacteria shows divergent associations with type 2 diabetes and the specific effects of the bacteria on diabetes appear to be species-specific. For example, L.acidophilus, L.gasseri, L.salivarius were increased and L. amylovorus was decreased in diabetes patients.

Gut bacteria can influence the development and progression of type 2 diabetes in several ways. Certain species of bacteria can cause changes in glucose metabolism either directly by affecting the digestion of sugars or indirectly by affecting the production of hormones that control the process of digestion. For instance, Bifidobacterium lactis can cause an increase in glycogen synthesis the main storage form of glucose in the body while also increasing glucose uptake, thus reducing blood sugar levels.

Gut bacteria can also affect intestinal barrier functions. Type 2 diabetes causes an increase in intestinal permeability, resulting in leakage of gut microbial products such as lipopolysaccharides into the blood. Floating lipopolysaccharides in the blood can create chronic long-term inflammation in the body. Two bacterial species, B. vulgatus and B.dorei, upregulate the genes involved in maintaining the intestinal barrier, thus reducing intestinal permeability.

Gut bacteria can also affect the activity of drugs. A recent study showed that a probiotic- B.animalis along with prebiotic polydextrose and sitagliptin (a diabetes drug) was effective in reducing several diabetes parameters. There are also indications that combining prebiotic polysaccharide with metformin and sitagliptin reduced high blood sugar levels to a larger extent than using the drugs alone.

The systematic literature review described here concludes that while there is greater understanding in the role of certain microbial families in the pathophysiology of type 2 diabetes, simple interpretations and solutions are still elusive due to the high degree of variation in both the disease manifestation and the impact of gut microbes on the disease.

Written by Bhavana Achary, Ph.D

References:

Gurung M, Li Z, You H, Rodrigues R, Jump DB, Morgun A, Shulzhenko N. Role of gut microbiota in type 2 diabetes pathophysiology. EBioMedicine. 2020 Jan;51:102590.

Prevalence of diabetes in the US https://www.cdc.gov/diabetes/basics/type2.html

Global prevalence of diabetes https://www.who.int/news-room/fact-sheets/detail/diabetes

Image byArek SochafromPixabay

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The role of gut microbiota in the development and progress of type 2 diabetes - Medical News Bulletin

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Monsters are everywhere in this world. Nobodys safe. On March 11th, Action Lab: Danger Zone brings you the ComixCentrals 2018 Peoples Choice award-winning Sweet Heart,a new horror comic series by up-and-coming writer, Dillon Gilbertson, with art by Ghastly Award-winner, Francesco Iaquinta (Croak), and colors by Marco Pagnotta (Phantom Squad, Captain Canuck). Variant cover by Christian DiBari.Follow the tale of Sweet Heart and you may learn that things are not so sweet after all

Being hunted is an everyday risk in Ellicott City and the town itself is designed to make life comfortable for its citizens while being actively stalked by the eerie, insatiable creatures that live among them. But when Ben is chosen by one of the creatures near his home, his mother struggles to cope with the certainty of her sons death.

In an interview with But Why Tho?, Gilbertson explained how the series began as a thinly veiled analogy for his life with diabetes that grew to represent ta number of chronic health, psychological, and personal issues many people deal with every day.

Sweet Heartfinds the monster in all of us, and maybejust maybeyoull get the courage to face yours. Dillon will be signing at The Comic Bug in Manhattan Beach, CA on March 11th, from 5-8 pm, and will also be attending Emerald City Comic Con (ECCC) in Seattle, WA, March 12-15th. The book will be available in comic book stores and online through ComiXology using our affiliate link.

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'Sweet Heart' is Based on One Writer's Struggle With Diabetes - But Why Tho? A Geek Community

MORGANTOWN, W.Va. Mon Health hosted the first of 24 diabetes prevention classes where participants learned life skills to avoid Type 2 diabetes (T2D).

People gathered at the Mon Health Conference Center where they were weighed to get a baseline. Andre McCarty, a dietitian, who is the diabetes coordinator, led the first hour-long class. McCarty said they have been running the program for almost seven years, and this class is their 19th.

With one in three adults at risk of developing diabetesone in three adults have pre-diabetes most of them dont know it, McCarty said. Type 2 diabetes can be prevented and thats the goal of this programits to help with making modest behavior changes that promote some weight loss that result in decreasing the risk of developing Type 2.

By modest behavioral changes, McCarty means participants watching how much they eat, what they eat and exercising more. One strategy they employ is to have patients write down everything they eat, so that they are aware of what exactly theyre consuming.

Another important aspect of preventing Type 2 she explained, was stress management. The goal is to teach participants strategies of prevention but to also get them to lose weight, hence the weigh-in.

The program goal is five to sevent percent weight loss, because that moderate amount of weight loss has been shown to decrease the risk of Type 2, McCarty said.

The group is already full, however, McCarty said there are always two or three classes throughout the year, so interested participants can sign up for those as they become available later in the year.

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Mon Health diabetes prevention class aims to teach strategies on avoiding type 2 diabetes - WBOY.com

With the use of age-adjusted thresholds for noninvasive markers of liver steatosis and fibrosis, patients with type 2 diabetes (T2D) may be referred more efficiently to specialists, according to study results published in BMJ Open Diabetes Research & Care. Furthermore, the researchers found a consistent association between these markers and chronic complications of T2D.

Current guidelines for T2D care recommend routine screening for the presence of nonalcoholic fatty liver disease (NAFLD), as well as assessment of advanced liver fibrosis in high-risk patients, using ultrasound and serum biomarkers. Patients with T2D are at increased risk of progressing from NAFLD to steatohepatitis and liver-related mortality. The goal of the current study was to examine changes in specialist referrals after the use of suggested noninvasive biomarkers of steatosis and fibrosis in patients with T2D. In addition, the association between these biomarkers and cardiovascular and kidney morbidity was investigated.

The retrospective study included adults with T2D who were treated at the diabetes clinic at Policlinico di Monza in Monza, Italy, between 2013 and 2018.

Liver steatosis assessment was based on the Fatty Liver Index, Hepatic Steatosis Index, and NAFLD Ridge Score. Risk for advanced fibrosis was assessed by using the Fibrosis-4 (FIB-4) score, NAFLD Fibrosis Score, aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio, and the AST to platelet ratio index.

Of 2770 patients with T2D included in the study, data on liver steatosis markers were available in 1519, 2076, and 1082 for Fatty Liver Index, Hepatic Steatosis Index, and NAFLD Ridge Score, respectively. Data needed to calculate liver fibrosis scores were available for 2096, 1429, 1421, and 370 patients for AST/ALT ratio, AST/platelet ratio index, FIB-4, and NAFLD Fibrosis Score, respectively.

High probability of liver steatosis was evident in most patients based on each of the 3 steatosis scores (65%-88%). However, there was a wide variation in the high probability of advanced fibrosis according to different noninvasive markers, ranging from 1% with the use of the AST/platelet ratio index to 33% using the NAFLD Fibrosis Score. A significant number of patients were classified as having indeterminate risk, ranging from 23.1% using the AST/platelet ratio index to 55.8% using the AST/ALT ratio.

With a sequential combination of 2 noninvasive markers of steatosis (Fatty Liver Index) and fibrosis (FIB-4) with standard cutoffs, 28.3% of patients would require referrals to specialized hepatologists because of either intermediate (253 patients) or high risk (36 patients). With the use of age-adjusted cutoffs, this rate significantly decreased to 13.4% of the entire population (102 patients with intermediate risk, 35 with high risk).

Biomarkers of steatosis were significantly associated with risk for albuminuria. Among patients with Fatty Liver Index scores in the intermediate- or high-risk category, prevalence of microalbuminuria was significantly higher (odds ratio [OR], 3.49; 95% CI, 2.05-5.94).

Cardiovascular disease was more common in patients within the intermediate- (OR, 2.0; 95% CI, 1.6-2.5) and high-risk (OR, 2.6; 95% CI, 1.7-4.0) categories for FIB-4 score and within the intermediate (OR, 1.73; 95% CI, 1.4-2.1) and high (OR, 1.86; 95% CI, 1.4-2.5) categories of the AST/ALT ratio. For patients within the lower-risk category for fibrosis, risks for coronary heart disease and stroke were significantly lower.

The researchers acknowledged the results may be limited given that other etiologies of liver disease were not examined.

While the use of different non-invasive fibrosis scores among patients with type 2 diabetes identify different proportion of patients with advanced fibrosis, the use of age-adjusted FIB-4 cut-offs leads to a drop in gray-zone results, making referrals to hepatologists more sustainable for the healthcare system, the researchers wrote.

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Reference

Ciardullo S, Muraca E, Perra S, et al. Screening for non-alcoholic fatty liver disease in type 2 diabetes using non-invasive scores and association with diabetic complications. BMJ Open Diabetes Res Care. 2020;8:e000904.

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Noninvasive Markers of Liver Disease May Improve Referrals, Predict Complications in Diabetes - Endocrinology Advisor

Trending News: Ophthalmic Condition Linked to Blindness in Diabetes May Indicate Stroke Risk

A new phase 1 trial has demonstrated that a PRIMVAC placental malaria vaccine candidate is safe, immunogenic, and induced functional antibodies in volunteers, according to Contagion Live. The study, which marked the first in-human trial of the vaccine candidate, involved a randomized, double-blind trial in 2 staggered phase taking place between April 2016 and July 2017. Antibody titers increased with each successive dose and seroconversion was observed in all women who received the vaccination.

An ophthalmic condition linked to blindness in diabetes could serve as an additional indicator of increased stroke risk, according to HCP Live. An analysis of more than 2500 patients revealed that those who had diabetic retinopathy had an increased risk of stroke compared with patients without diabetes. The study also showed that having diabetic retinopathy was associated with a 60% higher risk of stroke compared with patients with diabetes without the ophthalmic condition. The study authors feel that more aggressive treatment for patients with a risk of stroke and who have been diagnosed with diabetic retinopathy may be warranted to reduce risk.

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Trending News: Ophthalmic Condition Linked to Blindness in Diabetes May Indicate Stroke Risk - Pharmacy Times

Investors in Tandem Diabetes Care, Inc. TNDM need to pay close attention to the stock based on moves in the options market lately. That is because the Mar 20, 2020 $60 Put had some of the highest implied volatility of all equity options today.

What is Implied Volatility?

Implied volatility shows how much movement the market is expecting in the future. Options with high levels of implied volatility suggest that investors in the underlying stocks are expecting a big move in one direction or the other. It could also mean there is an event coming up soon that may cause a big rally or a huge sell-off. However, implied volatility is only one piece of the puzzle when putting together an options trading strategy.

What do the Analysts Think?

Clearly, options traders are pricing in a big move for Tandem Diabetes shares, but what is the fundamental picture for the company? Currently, Tandem Diabetes is a Zacks Rank #2 (Buy) in the Medical Instruments industry that ranks in the Top 43% of our Zacks Industry Rank. Over the last 60 days, no analysts have increased their earnings estimates for the current quarter, while one analyst has revised the estimate downward. The net effect has taken our Zacks Consensus Estimate for the current quarter from a loss of 8 cents per share to a loss of 7 cents in that period.

Given the way analysts feel about Tandem Diabetes right now, this huge implied volatility could mean theres a trade developing. Oftentimes, options traders look for options with high levels of implied volatility to sell premium. This is a strategy many seasoned traders use because it captures decay. At expiration, the hope for these traders is that the underlying stock does not move as much as originally expected.

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Are Options Traders Betting on a Big Move in Tandem Diabetes (TNDM) Stock? - Yahoo Finance