The number of diabetes cases in high-income countries are decreasing despite the steady increase in cases overall, according to the International Diabetes Federation Atlas that was presented at the IDF Congress. The findings, based on data from 221 countries, also showed that 1 in 11 adults aged 20 to 79 and 1 in 5 people aged older than 65 had diabetes, and 11.3% of deaths worldwide were associated with diabetes.
A study published in Diabetologia found that individuals who were born preterm had 21% and 24% greater risk for developing type 1 diabetes before 18 years old and in adulthood, respectively, while type 2 diabetes risk was 26% greater before 18 years old and 49% greater in adulthood, compared with those born at full term. The study, which used data from the Swedish Hospital and Outpatient Registries collected between 1973 and 2014, suggests preterm birth should be seen "as a chronic condition that predisposes to the development of diabetes across the life course," the authors wrote.
Researchers assessed type 1 diabetes disease heterogeneity by HLA- and SNP-genotyping 80 participants to determine HLA-DR-DQ and non-HLA genetic risk score. The study, published in Diabetologia, found that 67 participants had proliferation responses to at least one islet antigen and participants could be stratified into non-, intermediate and high responder groups.
A small study published in Cell Metabolism found that women with metabolic syndrome who had intermittent fasting for 12 weeks lost 3.3 kg of their body weight and also had reductions in body mass index, waist circumference, body fat and visceral fat. Researchers also found time-restricted eating had favorable effects on cardiometabolic parameters, such as reductions in LDL cholesterol, total cholesterol and non-HDL cholesterol, as well as significant reductions in diastolic and systolic blood pressure, and in A1C levels among those with elevated fasting blood glucose levels at baseline.
Average Healthy Eating Index scores for meals eaten by children ages 5 to 7 were 55.3 out of a possible 100 points, but when snacks were included in the analysis, the scores increased to 57.1, researchers reported in The Journal of the Academy of Nutrition and Dietetics. Children averaged just two-thirds of a serving of fruit and just over a half-serving of vegetables daily when looking at just meals, but when snacks were included that increased to 1.08 servings for fruit and 1.29 servings of vegetables.
School meals are getting healthier, but urban school districts have not focused enough time and resources on nutrition education, according to the CDC's 2018 School Health Profiles Report, released this month. The report notes that many cities have poor records when it comes to making nutrition education a requirement, such as Boston, where only 29.4% of schools require it and in San Francisco, where 41.1% of schools have such a rule.
An analysis of data from Medicare beneficiaries with complex chronic health conditions showed those living in rural areas had 23% higher mortality rates and 40% higher rates of preventable hospitalizations than their peers living in urban areas. Poor access to cardiologists, endocrinologists and other specialists was the main reason for the disparity, according to the study in Health Affairs.
Patients expect the health care industry to be as responsive as service providers in other fields and would like to see health care providers offer after-hours appointments and minimize the number of days they must wait to see a physician, according to a survey by DocASAP. Ninety percent of respondents said they would try other options including telemedicine or a phone consultation if they could not get an appointment immediately.
Artificial intelligence can improve health care delivery and patient outcomes if health systems gain the support of patients and health care providers, invest in innovation and develop strong data governance protocols, according to an American Hospital Association report. Physicians are concerned about the usability and accuracy of AI-based software, and patients worry about privacy and safety, according to the report, which recommends ways to increase patient and provider acceptance of AI.
Health IT leaders say cybersecurity and ransomware attacks will remain significant threats to hospitals and health care systems in the coming year, but they warn that new issues are also emerging. NewYork-Presbyterian vice president Leo Bodden cites concerns about market disruptions like the entry of Google, Apple and other technology firms into the health care field, while Memorial Healthcare System CIO Jeffrey Sturman says increased competition from nontraditional players such as CVS and Walgreens is also a cause of concern.
Encourage your patients to listen in to Ask the Experts: It's Personal, a Q&A podcast series featuring real questions from people with type 2 diabetes and answers from diabetes experts. Your patients can learn practical tips on topics such as nutrition, medication management, and physical activity. Find the podcast on iTunes, Spotify and the podcast's landing page.