If diabetes was a country, it would be the world’s third largest nation (by population) after China and India, says Monash University, Australia, professor of diabetes Dr Paul Zimmet.
In 2015, China had an estimated population of around 1.37 billion people and India around 1.26 billion, followed by the United States with just over 320 million people.
Meanwhile, the International Diabetes Federation (IDF) estimated that there were 415 million people living with diabetes around the world in the same year.
A further 318 million people had impaired glucose tolerance or pre-diabetes – the stage directly before full-blown type 2 diabetes mellitus.
The umbrella organisation for over 230 national diabetes associations also estimates that there will be 642 million, or one in every 10, people with diabetes by 2030.
More scary is the fact that Prof Zimmet, an IDF honorary president, believes that this number is an underestimation due to the lack of accurate data.
For example, he notes that the standard diagnostic fasting blood glucose test misses up to 25% of diabetes cases, if it is not paired with the oral glucose tolerance test. (See Screening for diabetes on p2)
And for countries that do not record diabetes data, extrapolations from the data of other similar countries are used instead.
For example, Prof Zimmet shares that the diabetes data for Eritrea, one of the world’s poorest nations, is extrapolated from South Africa’s and Tanzania’s diabetic numbers.
Prof Zimmet says that diabetes is an epidemic that is still on the rise, which will result in more and more premature
deaths and disabilities among those of working age.
He compliments Malaysia on the way diabetes data is recorded in the country.
“There aren’t too many countries that actually keep as good data on diabetes as Malaysia,” he says.
“So the Government has got all the information it needs to do something.”
In the July edition of the journal Nature Reviews Endocrinology, Prof Zimmet and his colleagues wrote that accurate and reliable data is necessary in “meeting national and local needs for planning purposes to identify current and future healthcare priorities, to estimate direct and indirect economic and societal costs of the disease, and to allocate appropriate healthcare resources and expenditures for healthcare delivery.
“These data are also very important for identifying groups or populations that might have unique or special needs related to diabetes mellitus, and to help define and set research priorities.
“Ongoing reliable data are also needed not only to project future trends, but to monitor the effects of treatment and to determine the needs, plans, design and effectiveness of prevention activities.”
Diabetes is a simple enough disease in itself; basically, the body is unable to process glucose properly, resulting in high levels of glucose floating around the bloodstream.
The problem is that this excess glucose has wide-ranging effects on multiple body parts.
Common complications of diabetes include retinopathy (eye damage), nephro- pathy (kidney damage), neuropathy (nerve damage) and cardiovascular disease.
Prof Zimmet notes that diabetes is the leading cause of blindness (from retinopathy), kidney disease (from nephropathy) and non-traumatic lower limb amputation (from neuropathy) in the world. It also causes a significant number of heart attacks and strokes.
However, he says that diabetes also has other lesser known complications that simi- larly have a significant effect on people’s lives, as well as economic productivity.
“Data from various countries suggests that people with type 2 diabetes are more likely to have sleep apnoea – 30%-40% will have sleep disturbances.
“And if they go to sleep on the job in a factory, they will lose their fingers. If they are driving a car, they will have car accidents. If they are truck drivers and they go to sleep on the highway, they can clean up about six or seven cars.
“That’s a big public health problem associated with diabetes, quite apart from the complications,” he explains.
Thirty to forty percent of type 2 diabetics suffer from sleep apnoea, which results in sleepiness during the day.
Sleep apnoea is a disorder where the person suffers from either one or more pauses in breathing or shallow breaths during sleep, which can last from a few seconds to mi- nutes.
Each pause or shallow breath disrupts the person’s sleep, resulting in poor quality sleep that causes the person to be tired and sleepy during the day.
Prof Zimmet says however, that the connection between diabetes and sleep apnoea is still unknown; researchers only know that the two are associated.
He adds: “The other thing that is a big problem with diabetes is that, certainly in Western countries, 30%-40% of type 2 diabe- tics have depression – that’s another public health problem.
“And people with poorly-controlled diabetes get a lot of fat in their liver.”
Fatty liver occurs when more than 5%-10% of the liver’s weight is fat. This can eventually led to cirrhosis of the liver, which may result in liver failure or liver cancer.
Says Prof Zimmet: “The commonest cause of cirrhosis at the moment is alcohol, but they are now predicting cirrhosis of the liver, in the next decade or so, is going to be from diabetes.”
He adds: “There is a very simplistic view that it’s just all about high blood sugar and complications that we know about, which are amputations, blindness, heart attacks and kidney disease.
“But people don’t link in all the factors, not only sleep apnoea, depression and cirrhosis, but people die younger – we’re now seeing people develop type 2 diabetes in childhood – and the fact that the complications of diabetes can have an economic impact on the country, because we’re seeing type 2 diabetes in the working age group now.
“And so, there’s premature deaths and disabilities from diabetes, it’s not just a simple high blood sugar.”
He concludes: “Diabetes is complicated. It doesn’t just have complications; overall, it is a complicated disease.”
Prof Zimmet was in town recently to give a talk on “Diabesity – The Greatest Epidemic in Human History? Implications for Asia” in Sunway University, Selangor, as part of the Jeffrey Cheah Distinguished Speakers Series.
While men are less likely than women to have generalised anxiety disorder, those who do are more likely to die of cancer than women with the same disorder. — Fotolia
Men over 40 who have anxiety disorders are more than twice as likely to die of cancer than are men who do not have the mental affliction, new research finds.
But for women who suffer from severe anxiety, the research found no increased risk of cancer death.
That finding, presented recently at the European College of Neuropsychopharmacology Congress in Vienna, Austria, emerges from the largest study ever to explore a link between anxiety and cancer.
It tracked 15,938 Britons aged over 40 for 15 years.
Even after researchers took account of factors that boost the risk of cancer, including age, alcohol consumption, smoking and chronic diseases, men with a diagnosis of generalised anxiety disorder were 2.15 times as likely to die of cancer than were those with no such diagnosis.
Generalised anxiety disorder – a condition marked by excessive, uncontrollable worry about many areas of life – affected women more commonly than it did men.
Among women in the large cohort studied, 2.4% suffered from the disorder. Among men in the cohort, 1.8% did.
The authors of the new research acknowledge that the findings do not reveal how cancer and anxiety are related, and do not show that anxiety causes cancer.
Men with anxiety may engage in behaviours that increase cancer risk.
But the two diseases may also spring from common origins, including, possibly, higher rates of systemic inflammation.
Whatever the relationship, said the study’s lead author Olivia Remes of Cambridge University’s Institute of Public Health in Britain, the new findings identify extremely anxious men as a population whose mental and physical health should be closely tracked.
“Society may need to consider anxiety as a warning signal for poor health,” she said. “With this study, we show that anxiety is more than just a personality trait”, but rather, a disorder linked to real and serious health risks.
Imperial College London psychiatrist Dr David Nutt, who was not involved in the new research, said the intense distress suffered by those with anxiety comes with insomnia and widespread physical stress.
“That is bound to have a major impact on many physiological processes, including immune supervision of cancerous cells,” said the former president of the European College of Neuropsychopharmaco-logy.
“As a psychiatrist who used to run one of the very few clinics in the UK specialised in the treatment of people with severe anxiety disorders, these results do not surprise me,” he added. – Los Angeles Times/Tribune News Service
The one thing you should be wearing BEFORE bed to ensure you get a good night's sleep
If you lie on your back, there is a danger you'll end up putting too much pressure on your hips and upper back.
If you prefer to sleep on your front, then this can lead to neck and lower back strain.
Whereas sleeping on your left-hand side can do you the world of good. The body is able to take the pressure off lymph drainage from the heart and spleen, which is crucial for encouraging the natural flow of lymph fluid and preventing lymphatic congestion.
As positions go, it's also better for your breathing - especially if you find yourself congested of a nighttime.
By encouraging them to lie on their left, the volume and frequency of their snoring will be reduced.
There is a best time of day to shave your legs - and it's to do with your body temperature
That's because lying on your side gives optimum air flow to your lungs and prevents the base of your tongue from lolling into the back of your throat, obstructing breathing.
If you suffer from heartburn, sleeping on your left can reduce the uncomfortable symptoms AND reduce acid reflux.
Women expecting a baby are advised to adopt this position when falling asleep to encourage healthy blood flow.
And on a more toilet-related topic , adopting the left-hand side will allow your body to process waste quicker, which in turn helps guard you against constipation.
Because of the route the intestines take, lying on the left means food is able to travel easier towards your colon.
Many parents and caregivers are still placing babies in unsafe sleeping environments, according to a new report from the American Academy of Pediatrics. Photo: TNS
Many parents and caregivers are placing babies in unsafe sleeping environments associated with increased risks of death. That’s according to a new report released by the American Academy of Paediatrics.
“This study points out what many of us fear. Parents are failing to take the necessary steps to prevent sudden infant death syndrome, or SIDS,” says Mayo Clinic paediatrician Dr Robert Jacobson.
Jacobson says he supports the study’s recommendations. “Babies need to be placed on the back for every nap and every night until the baby is one year old,” he says.
“No blankets, no bumpers, no pillows, no stuffy animals, but always on a firm, authentic baby crib mattress.”
Other studies have relied on self-reported surveys or police reports after an infant’s death but this report incorporated video recordings which provide a window into parental behaviour during the night.
For the study, “Nocturnal Video Assessment of Infant Sleep Environments,” in the September 2016 Pediatrics (published online Aug 15), researchers video-recorded infants at ages one, three and six months within family homes.
Most parents, even when aware of being recorded, placed the infants in environments with established risk factors for sleep-related infant deaths, including positioning the children on their sides or stomachs; soft sleep surface; loose bedding; or bed-sharing. — Mayo Clinic News Network/Tribune News Service
The test kit, which is now ready for use, costs only a few dollars to produce.ST PHOTO: LIM SIN THAI
SINGAPORE: Scientists in Singapore have developed a kit that can test for the dengue, chikungunya and Zika viruses all at the same time in a matter of two hours.
Now ready for use, the kit costs only a few dollars to produce and has attracted interest from other countries and even the World Health Organisation (WHO), said Dr Masafumi Inoue, a senior research scientist at the Agency for Science, Technology and Research’s (A*Star) Experimental Therapeutics Centre who is part of the team that developed the kit.
The made-in-Singapore kit is among others that the WHO is interested in testing, he said.
He added that he is currently compiling clinical data for the health authority before sending the kit over for testing. If successful, it could be used by the WHO to test for the viruses.
The three mosquito-borne viruses here cause similar symptoms such as rashes and joint pain. Symptoms for the Zika virus are generally mild and go away within a week.
“It is important to quickly distinguish between the three major (and prevalent) mosquito-borne viruses here... This will not only lessen the mental stress on the patient and give the patient peace of mind, but also ensure that he or she can receive the appropriate sort of treatment and care without delay,” said Dr Inoue.
All that is required from the patient is a blood or urine sample. The genetic material of the virus is then extracted to find out what the virus is.
The detection process takes two hours, reducing the time by threefold if each of the viruses were to be tested for individually.
A*Star Experimental Therapeutics Centre's senior research scientist Masafumi Inoue (left) and research associates Gerald Yong and Karen Lee were part of the team behind the kit that can test for dengue, chikungunya and Zika at the same time.ST PHOTO: LIM SIN THAI
Dr Wong Sin Yew, an infectious diseases physician at Gleneagles Medical Centre, said early diagnosis will help in public health control efforts.
“In the case of mosquito-borne infections, it will allow the NEA (National Environment Agency) to focus on intensive vector control measures in new areas and intensify measures in large outbreak areas,” added Dr Wong.
While a similar kit has been developed by the United States Centers for Disease Control and Prevention, it is not readily available here, said Dr Inoue.
The idea to develop the kit came about six months ago when Brazil had been hit badly by the surge in Zika cases. That was when Dr Inoue and Dr Sebastian Maurer-Stroh, senior principal investigator at A*Star’s Bioinformatics Institute, decided to work with Tan Tock Seng Hospital on this project.
“We anticipated that it was a matter of time before the Zika virus would affect Singapore,” said Dr Inoue.
Moving forward, Dr Inoue and his team hope to expand the scope of the kit to include other viruses that, together with Zika, could cause microcephaly - a condition where children are born with abnormally small heads.
An article published by the Nature journal last month cited studies showing it might not be Zika alone that causes the condition. Apart from socio-economic reasons, other factors might be at play.
For instance, a recent paper by Brazilian scientists found a correlation between low vaccination rates for yellow fever and the microcephaly clusters in Brazil.
An overwhelming majority of confirmed cases of microcephaly or birth defects of the central nervous system reported in Brazil since last November were in the north-eastern part of the country. – The Straits Times/Asia News Network
Suicide is a leading cause of death for teens worldwide, and the odds of suicide attempts may be higher when adolescents abuse prescription drugs, a Chinese study suggests.
To explore the connection between suicide risk and misuse of prescription opiates and sedatives, researchers surveyed about 3,300 Chinese teens once when they were about 14 years old and again a year later.
Teens who said they used prescription drugs for non-medical reasons at the start of the study were almost three times as likely to report a suicide attempt a year later, and the risk was more than tripled for youth who abused opiates, researchers report in JAMA Pediatrics.
“Baseline opioids misuse, sedatives misuse, and nonmedical use of… prescription drugs were positively associated with later suicidal ideation,” said lead study author Dr Lan Guo of Sun Yat-sen University in Guangzhou.
Those thoughts were more likely to turn into suicide attempts with “baseline opioids misuse and nonmedical use of any prescription drugs,” Guo added.
Less than 3 per cent of the teens reported misuse of any prescription drugs, with 1.8 per cent saying they used opiates or stimulants for nonmedical reasons and about 1 percent reporting abuse of sedatives.
it’s possible that prescription drugs may alter teens’ moods or lower inhibitions.
Overall, 17 per cent of the participants reported suicidal thoughts, and 3 percent reported suicide attempts in the survey at the end of the study.
The link between drug abuse and suicide persisted even after researchers accounted for teens who reported experiencing depression at the start of the study.
While the study doesn’t examine why abuse of prescriptions and other drugs might be linked to a greater suicide risk, it’s possible that these drugs might alter teens’ moods or lower inhibitions in a way that allows suicidal impulses to flourish, the authors conclude.
Limitations of the study include its reliance on teens to accurately report and recall both drug use and suicidal thoughts or suicide attempts, the authors note.
It’s not surprising, however, that the same teens who are prone to abusing drugs would also be susceptible to suicidal thoughts, said Dr Bernard Biermann, an adolescent psychiatry researcher at the University of Michigan’s C.S. Mott Children’s Hospital in Ann Arbor.
“Substance abuse can be associated with causing depression and distress, but it’s also a means of self-medicating,” Biermann, who wasn’t involved in the study, said in a phone interview.
It’s essential that parents keep an eye on teens for changes in behavior that go beyond temporary moodiness to suggest a bigger problem, said Dr Benjamin Shain, a researcher at the University of Chicago and head of child and adolescent psychiatry at NorthShore University HealthSystem.
“Growing up has always been difficult and life now is even more complicated,” Shain, who wasn’t involved in the study, said by email. “Parents should take seriously severe or persistent distress and changes in behavior, such as isolation or falling grades, and bring their teen to their primary care physician or a mental health professional with any signs.”
Parents should also try to make it harder for teens to get their hands on things to harm themselves, said Dr Yolanda Evans, an adolescent medicine specialist at Seattle Children’s Hospital who wasn’t involved in the study.
“When possible, avoid having things readily available that teens may impulsively use to end their life,” Evans said by email. “Old narcotics or medications should be discarded (look for pharmacy take back options).” – Reuters/Lisa Rapaport
Scientists believe that the game Pokemon Go can get people to be more active and may help fight type 2 diabetes and obesity.
A specialist diabetes researcher sees Pokemon Go – the virtual character-hunting game with millions of players worldwide – as an excellent means of tackling rising levels of obesity and type 2 diabetes.
Pokemon Go has now piqued the interest of the medical world. The smartphone-based character-hunting craze that’s sweeping the world has caught the attention of a researcher at the University of Leicester, in Britain, specialising in international diabetes research.
In fact, Dr Tom Yates sees the application as a potential means of tackling sedentary lifestyles and obesity, which can lead to type 2 diabetes.
The augmented reality mobile game has so far been downloaded 75 million times worldwide, and sees users chase Pokemon characters through the streets. The famous little “Pocket Monsters” who sprung up in the 1990s appear on users’ smartphone screens superimposed on real-world locations.
One of the main recommendations in the prevention and treatment of diabetes is regular physical exercise, totalling at least two and a half hours per week.
The breaks were used to introduce five minutes of walking or other forms of movement. Pokemon Go is an interesting solution since players can cover several kilometres without even realising.
Pokemon Go may be able to make people more active and avoid a sedentary lifestyle.
According to Dr Tom Yates, “If there is something out there which is getting people off the sofa and pounding the streets then this game could be an innovative solution for rising obesity levels. Walking is hugely underrated yet it is man’s best and the cheapest form of exercise. It’s an easy and accessible way to get active and help maintain a healthy body.”
Experts suggest this fun and non-violent game can be a good form of exercise and can be played by the whole family. However, users should take care not to let their Pokemon hunt lead to dangerous behaviour – avoiding playing while driving or crossing roads, for example, and steering clear of venturing into dark, isolated areas.
Risk factors for diabetes include genetic predisposition and family history, but above all obesity, lack of physical exercise and sedentary lifestyles.
Type 2 diabetes accounts for 90% of diabetes cases worldwide. – AFP Relaxnews