In the News This Week

High Blood Sugar Tied to Pregnancy Complications

Women with elevated blood sugar levels face an increased rate of pregnancy complications, even if their blood sugar levels don’t qualify for gestational diabetes. In a study of more than 23,000 pregnant women, none of whom had diabetes, for each standard deviation increase in blood sugar, the risk of complications was found to increase. Complications caused by high blood sugar included a large birth weight baby, the need to deliver by Caesarean section, developing preeclampsia, delivering prematurely, and having a delivery complication known as shoulder dystocia. The babies born to women with high blood sugar levels had a higher risk of having high insulin levels and low blood sugar. The relationship between blood glucose levels of the mother and the risk of complications was found to be continuous, thus researchers involved in the study reported that they were unable to determine at what point pregnant women should begin treatment for hyperglycemia. Further research is needed to determine treatment guidelines. A second study that investigated treatment options for hyperglycemic pregnant women who did not have gestational diabetes found that metformin, an oral diabetes medication, was well-tolerated by the women and easier to administer than shots of insulin.
Read the full story on healthday.com

More than Half of US Diabetics Have Arthritis

A survey of almost 800,000 Americans found that more than half of diabetes patients in the US also have arthritis. Diabetics are generally urged by their doctors to exercise, which can help control blood sugar and lower risk of heart disease complications. However, arthritis can be a painful obstacle to physical activity, and it is preventing many diabetes patients from getting the proper amount of exercise. Of the patients surveyed, those with both diabetes and arthritis were 30% to 40% less likely to be physically active than those who had only diabetes. Although the pain of arthritis can be a deterrent, exercise is an important part of managing arthritis. Walking, biking, aquatics, and other forms of exercise that do not put excessive stress on joints are highly recommended for arthritis patients. Diabetics who suffer from arthritis should strive to incorporate these activities into their lifestyle, as it will positively impact the management of both conditions with which they are afflicted.
Read the full story on washingtonpost.com

Group Urges FDA to Take Contraceptive Off Market

The consumer advocacy group Public Citizen is urging the US FDA to take the birth control patch off the market after studies revealed patch users have a higher rate of life-threatening blood clots than women who take birth control pills. The weekly birth control patch, marketed by a Johnson & Johnson subsidiary as Ortho-Evra, releases estrogen through the skin to prevent pregnancy. Patients absorb up to 60% more estrogen with the birth control patch than the pill, and can have up to double the risk of blood clots in the legs and lungs. The risk of accidental pregnancy is equal for the two forms of contraception. The FDA mandated an update of the patch’s label in 2005, 2006, and early 2008 with warnings about the risk of blood clots. Public Citizen’s petition, which was filed with the FDA last week, calls for a gradual phasing out of sales of the patch, to give women who are current users time to explore other contraception options.
Read the full story on nytimes.com

When Breast Biopsies Aren’t Necessary

Finding a benign lesion on a mammogram can be unsettling for doctors, and scary for patients. However, new data shows that immediately having a biopsy may not be the best course of action in such cases. Instead, waiting 6 months and having a follow-up mammogram may be a safe option for patients. In a study of more than 45,000 women who had lesions that were most likely benign found on mammograms and then waited 6 months for a follow-up mammogram, in about 99% of the cases, the lesions were still found to be benign after 6 months. Only roughly 1 out of every 100 women were eventually diagnosed with cancer within the ensuing 12 months. Biopsies are invasive procedures that are painful, anxiety-inducing, and expensive. Ideally, doctors will be able to save their patients from the pain and expense of biopsies without jeopardizing their health. Patients who opt to wait for a 6-month follow-up mammogram should be closely monitored for any changes in their lesions, as such changes could be indicative of cancer.
Read the full story on nytimes.com