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People with type 2 diabetes were 83 percent more likely to get Parkinson's. As people with obesity-linked type 2 diabetes
age, their risk of getting Parkinson's disease climbs, a new study warns.  
In fact, excess weight may explain why diabetics are at increased risk of getting the neurological disorder, a Finnish study
suggests.

"These findings are important from a clinical and public health point of view," said study author Dr Gang Hu, senior
researcher at the National Public Health Institute in Helsinki. "Type 2 diabetes is increasing rapidly in all populations, and its
impact on various health outcomes are not fully known or even explored."
Two-thirds of diabetics will die from heart attack or stroke, researchers warn. Yet, just 30 minutes of physical activity
reduced the risk by 58%!  
As the number of Americans with type 2 diabetes has soared over the past 50 years, so, too, has heart disease linked to the
blood sugar illness, researchers report.

"The proportion of heart disease due to diabetes has increased about 60 percent over time," said lead author Dr. Caroline S.
Fox, a medical officer at the National Heart, Lung, and Blood Institute's Framingham Heart Study. "Compared with other risk
factors for heart disease, diabetes is becoming more of an issue," she said.
African-Americans who have family members with diabetes are more aware of the disease, risk factors ? but that
awareness may not lead to a healthier lifestyle.  
The type 2 diabetes epidemic disproportionately affects African-Americans, so researchers wanted to see whether having a
family member with the disease had any influence on a person’s awareness or behavior.

The study evaluated 1,122 African-American adults, living in Raleigh and Greensboro, N.C. None of the participants were
diagnosed with diabetes; however, 36 percent reported that an immediate family member had the disease.

Participants where shown a seven-item list and asked whether any of the factors increase a person’s risk of developing
diabetes. All seven items on the list are risk factors for diabetes — minority race or ethnicity, overweight, family history of
diabetes, sedentary lifestyle, older age, high-calorie diet and diabetes during pregnancy.

Among the participants with a family history of diabetes, nearly 60 percent had a better- than-average awareness of the
diabetes risk factors. About 47 percent of the participants with no family history demonstrated such awareness.

Yet, this awareness didn’t necessarily translate into healthy behavior.

“We hypothesized that persons with a family history would be more aware of risk factors for diabetes, however, we were
surprised that they were not more likely to engage in more of the healthy behaviors compared to persons without a family a
history,” said study co-author Tiffany Gary, Ph.D., of the Johns Hopkins Bloomberg School of Public Health.
Frequency of blood glucose monitoring in relation to glycaemic control: observational study with diabetes database
Josie M M Evans, Wellcome postdoctoral research fellow in health services research,a Ray W Newton, consultant
diabetologist,b Danny A Ruta, senior lecturer,c Thomas M MacDonald, professor of pharmacoepidemiology,a Richard J
Stevenson, medical student,d and Andrew D Morris, senior lecturerd

Key messages

Several studies have indicated the importance of self monitoring of blood glucose concentration for prevention of
complications in patients with diabetes:

Uptake of reagent strips for self monitoring of blood glucose among diabetic patients who used insulin was low, with only
20% of patients with type 1 diabetes and 17% of those with type 2 diabetes obtaining enough strips to test blood glucose
concentration once daily

Reagent strip uptake depends on characteristics such as age and social deprivation category, and patient groups with low
uptake should be identified and targeted

There was a direct association between strip uptake in the previous 6 months and glycaemic control in patients with type 1
diabetes but not in those with type 2 diabetes
J Gen Intern Med. 2000 Aug;15(8):551-5.   Links
Revisiting the oral glucose tolerance test criterion for the diagnosis of diabetes.Davidson MB, Schriger DL, Peters AL,
Lorber B.
Charles R. Drew University of Medicine and Science, Los Angeles, Calif, USA. mdavids@cdrewu.edu

OBJECTIVE: The Expert Committee on the Diagnosis and Classification of Diabetes retained the 2-hour glucose
concentration on an oral glucose tolerance test of >/=11.1 mmol/L (200 mg/dL) as a criterion to diagnose diabetes. Since
glycated hemoglobin levels have emerged as the best measure of long-term glycemia and an important predictor of
microvascular and neuropathic complications, we evaluated the distribution of hemoglobin A1C (Hb A1C) levels in
individuals who had undergone an oral glucose tolerance test to determine how well 2-hour values could identify those
with normal versus increased Hb A1C levels. DESIGN: A cross-sectional analysis of 2 large data sets was performed. We
cross-tabulated 2-hour glucose concentrations on an oral glucose tolerance test separated into 4 intervals (<7.8 mmol/L
[140 mg/dL], 7.8-11.0 mmol/L [140-199 mg/dL], 11.1-13.3 mmol/L [200-239 mg/dL], and >/=13.3 mmol/L [240 mg/dL]) with
Hb A1C levels separated into 3 intervals (normal; <1% above the upper limit of normal; and greater than or equal to the
upper limit of normal + 1%). RESULTS: Approximately two thirds of patients in both data sets with 2-hour glucose
concentrations of 11.1 to 13.3 mmol/L (200-239 mg/dL) had normal Hb A1C levels. In contrast, 60% to 80% of patients in
both data sets with 2-hour glucose concentrations >/=13.3 mmol/L (240 mg/dL) had elevated Hb A1C levels.
CONCLUSION: Since Hb A1C levels are the best measures presently available that reflect long-term glycemia, we
conclude that the 2-hour glucose concentration criterion on an oral glucose tolerance test for the diagnosis of
diabetes should be raised from >/= 11.1 mmol/L (200 mg/dL) to >/= 13.3 mmol/L (240 mg/dL) to remain faithful to the
concept that diagnostic concentrations of glucose should predict the subsequent development of specific diabetic
complications (e.g., retinopathy).
Relationship between fasting plasma glucose and glycosylated hemoglobin: potential for false-positive diagnoses of
type 2 diabetes using new diagnostic criteria.Davidson MB, Schriger DL, Peters AL, Lorber B.
Clinical Trials Unit, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA.

CONTEXT: New criteria for the diagnosis of type 2 diabetes mellitus have recently been introduced that lowered the
diagnostic fasting plasma glucose (FPG) concentration from 7.8 to 7.0 mmol/L (140 to 126 mg/dL). OBJECTIVE: To
determine if individuals with diabetes diagnosed by the new FPG concentration criterion would have excessive
glycosylation (elevated hemoglobin [HbA1c] levels). DEFINITIONS: We determined the distribution of HbA1c levels in
individuals using 4 classifications: (1) normal by the new criterion (FPG concentration <6.1 mmol/L [110 mg/dL]); (2)
impaired fasting glucose by the new criterion (FPG concentration of 6.1-6.9 mmol/L [110-125 mg/dL]); (3) diabetes
diagnosed solely by the new FPG concentration criterion of 7.0 through 7.7 mmol/L (126-139 mg/dL); and (4) diabetes
diagnosed by the previous FPG concentration criterion of 7.8 mmol/L (140 mg/dL) or higher. DESIGN: Cross-sectional
analysis of 2 large data sets (NHANES III and Meta-Analysis Research Group [MRG] on the Diagnosis of Diabetes Using
Glycated Hemoglobin) that contained individuals in whom FPG concentrations, 2-hour glucose concentrations using an
oral glucose tolerance test, and an HbA1c level were simultaneously measured. We cross-tabulated FPG concentrations
(<6.1 mmol/L [110 mg/dL], 6.1-6.9 mmol/L [110-125 mg/dL], 7.0-7.7 mmol/L [126-139 mg/dL], and > or =7.8 mmol/L [140
mg/dL]) and HbA1c levels separated into 3 intervals: normal, less than the upper limit of normal (ULN); slightly elevated,
ULN to ULN plus 1%; and high, higher than ULN plus 1%. RESULTS: Among subjects with normal FPG concentrations,
HbA1c levels in the NHANES III (and the MRG) data sets were normal in 97.3% (96.2%), slightly elevated in 2.7% (3.6%),
and high in 0.1% (0.2%). Among individuals with impaired fasting glucose, HbA1c concentrations were normal in 86.7%
(81.4%), slightly elevated in 13.1% (16.4%), and high in 0.2% (2.2%). Among diabetic patients diagnosed by the new FPG
criterion only, HbA1c levels were normal in 60.9% (59.6%), slightly elevated in 35.8% (32.8%), and high in 3.4% (7.6%). In
diabetic patients diagnosed by the former FPG criterion, HbA1c levels were normal in 18.6% (16.7%), slightly elevated in
32.5% (21.0%), and high in 48.9% (62.3%). CONCLUSIONS: About 60% of the new cohort of diabetic patients in both
data sets have normal HbA1c levels. We believe that diabetes should not be diagnosed in those with FPG
concentrations less than 7.8 mmol/L (140 mg/dL) unless excessive glycosylation is evident. Individuals without
excessive glycosylation but with moderate elevations of FPG concentrations (6.1-7.7 mmol/L [110-139 mg/dL]) should
be diagnosed as having impaired fasting glucose and treated with an appropriate diet and exercise. This diagnostic
labeling achieves the goal of early intervention without subjecting these persons to the potentially negative insurance,
employment, social, and psychological consequences of a diagnosis of diabetes mellitus.

































Boxplots of HbA1c by various diagnostic criteria. Subdivisions in each of these groups are depicted by different coloured
boxes (red-diabetes, green-impaired, blue-normal). The box encloses the middle 50 percent of patients, and the median
is represented as a horizontal line inside the box. The whiskers are lines that extend from the box to the highest and
lowest values excluding outliers. The left and right plots depict 2-hour and FPG subdivisions respectively while the upper
and lower plots depict comparisons against single and combined criteria clusters respectively (CC = combined criteria).
There were two outliers (shown in the plots as circles with the patient number) and they were selected based on being
more than 1.5 box lengths from the ends of the box, but were included in the analysis in tables 1 & 2. Diabetes was
diagnosed in the same percentage (63%) of patient's according to either of the single criteria or the combined criteria. One
quarter of the diabetics by each single criterion were not diabetic by the other single criterion.
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ST. LOUIS, Jan. 26 (UPI) -- About half the U.S. population has the gene that puts them at greater risk of developing
diabetes, a study from Saint Louis University said.

The gene causes people to metabolize fat differently and may hurt their ability to remove sugar from the blood, said
Edward Weiss, an assistant professor of nutrition and dietetics at Doisy College of Health Sciences at Saint Louis
University.

"This study adds to what was previously known about this gene variant by showing that after consuming a very rich
milkshake, people with the variant gene process the fat from the drink differently than other people," said Weiss.

His research doesn't mean that half the U.S. population is destined to get diabetes.

"Many other genes, some known and some unknown, are involved in a person's overall risk of developing diabetes.
Those are things a person can't control," Weiss said. "But there are risk factors for diabetes that a person can change --
lifestyle factors, such as diet and exercise."

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