Diabetes testing in symptomless adults may not lower risk of death

admin   •   April 15, 2015   •   2718


A person receives a test for diabetes during Care Harbor LA free medical clinic in Los Angeles, California September 11, 2014.

(Reuters Health) – Expanding diabetes screening in adults to catch the disease early does not appear to keep people from dying of cardiovascular causes, according to a report designed to help shape U.S. treatment guidelines.

Earlier detection did seem to slow the progression of so-called prediabetes to full-blown diabetes, but it had no impact on the risk of death from heart or blood vessel disease 10 years later, researchers found when they analyzed studies conducted from 2007 to 2014.

In 2008, the U.S. Preventive Services Task Force recommended testing for diabetes before symptoms emerge in an effort to get millions of undiagnosed adults on medications to lower blood sugar, cholesterol and blood pressure before the disease worsens and complications become harder to treat.

“Many people with early diabetes may not have symptoms, and thus do not seek care,” lead study author Dr. Shelley Selph of Oregon Health and Science University said by email. “It is possible that 10 years of follow-up is insufficient to detect a mortality benefit.”

About 21 million Americans were diagnosed with diabetes in 2010, and an estimated 8 million more were undiagnosed, the researchers note in Annals of Internal Medicine. Most of them have type 2 diabetes, which is linked to obesity and advanced age and happens when the body can’t properly use or make enough of the hormone insulin to convert blood sugar into energy.

Diabetes is the leading cause of kidney failure, non-traumatic lower limb amputations, and blindness. It’s also a major cause of heart disease and stroke and the seventh-leading cause of death in the U.S., the authors note.

Like obesity, hypertension is a risk factor for diabetes, and this link prompted the expansion of U.S. screening guidelines to include people with high blood pressure.

In two trials examined in the report, one of which focused on people at greater risk for diabetes, the risk of death after 10 years was similar whether people were screened or not. This might be due to not enough people getting screened, or improved management of cardiovascular disease contributing to lower mortality, the researchers note.

There’s little harm to screening, though, beyond the potential for short-term anxiety for those who test positive for diabetes, the report authors wrote.

For people with pre-diabetes, with high blood sugar levels but not full-blown disease, both medications and lifestyle changes appear effective at delaying progression of the disease, the researchers said.

The preventive services task force is in the process of updating its diabetes screening guidelines, Dr. Michael Pigone, a task force member, said by email. The group is focusing on “the effectiveness of identifying abnormal blood sugar before it progresses to diabetes, as well as the effectiveness of treating those who have abnormal blood sugar with intensive lifestyle intervention.”

The current report confirms more data is still needed, said Dr. Betul Hatipoglu, an endocrinologist at Cleveland Clinic in Ohio, in an email. “It acknowledges that prevention of diabetes is possible. It would really be a disservice to the population at risk to not give them their second chance to know and prevent diabetes until we can prove that we are not helping but actually harming them by early intervention, which will be impossible in my opinion.”

The study was funded by the Agency for Healthcare Research and Quality and done in consultation with the U.S. Preventive Services Task Force.

SOURCE: bit.ly/1CBZcCg Annals of Internal Medicine, online April 13, 2015.

Apple to re-close more stores in seven states, bringing total to 77

UNTV News   •   July 2, 2020

REUTERS – Apple Inc said on Wednesday (July 1) that it would re-close more than two dozen stores in seven states, including its home state of California, bringing the total closures to 77 as coronavirus cases continue to rise.

Starting Thursday (July 2), stores will close in Alabama, Georgia, Idaho, Louisiana, Nevada, and Oklahoma.

As of Wednesday, additional stores had already closed in Florida, Mississippi, Texas, and Utah.

Apple has taken an city-by-city approach to opening and closing stores, evaluating data for each community.

In cities where stores remain open, Apple requires face coverings for employees and customers while also performing temperature checks and frequent cleaning, the company said.

Apple has said its retail employees will continue to be paid through the closures. (Production: Angela Moore)

Number of Californians with COVID-19 keeps rising; governor declares budget emergency

UNTV News   •   June 26, 2020

California Governor Gavin Newsom on Thursday (June 25) declared a budget emergency in the most populous U.S. state, blaming expenses and the economic downturn caused by the COVID-19 pandemic.

Declaring a budget emergency allows the state to tap into its rainy day fund. California anticipates a $54.3-billion budget deficit due to costs and a drop in revenue linked to the pandemic.

The state’s budget crunch lies in the shadow of coronavirus cases that continue to mount.

Nearly 5,350 people tested positive for the coronavirus in California the past 24 hours, Newsom said. The increase was smaller than Wednesday’s (June 24) record of 7,149 new cases. But the number of Californians becoming very ill continued to rise, using about 34% of the available intensive care beds in the state, up from 29% on Wednesday.

A total of 4,240 patients were hospitalized with COVID-19 on Thursday in the state, using about 9% of total available beds, Newsom said.

The surging cases have prompted the state to put 11 counties, representing about half of California’s population, on a watch list of places that might be required to roll back recent efforts to reopen their economies. (Reuters)

(Production: Jane Ross)

Pilot in Kobe Bryant helicopter crash may have become disoriented in heavy fog – NTSB

UNTV News   •   June 18, 2020

The pilot of a helicopter that crashed in foothills near Los Angeles, killing basketball great Kobe Bryant, his daughter, and all seven others on board, likely became disoriented in the fog, federal investigators said on Wednesday (June 17).

The National Transportation Safety Board report said pilot Ara Zobayan told air traffic controllers that his helicopter was climbing, when in fact it was descending shortly before slamming into a hillside outside the community of Calabasas on Jan. 26.

The NTSB said that pilots can become confused over an aircraft’s attitude and acceleration when they cannot see the sky or landscape around them, causing “spacial disorientation.”

“Without outside references or attention to the helicopter’s attitude display, the actual pitch and bank angles have the potential to be misperceived,” the NTSB said.

The findings came in a “public docket” released by the NTSB as it investigates the crash. The agency has not yet released its final report. (Reuters)

(Production: Omar Younis)


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