Patient Care Endocrinology & Cardiology - October 2007 - (Page 19)

Research Digest Continued from page 5 Continued from page 9 Medicine in the News I (apo) B-apo A-I ratio predicted coronary heart disease per standard deviation increment in both men (hazard ratio [HR], 1.39) and women (HR, 1.40). But they found that these risk ratios were comparable to, but not better than, those for total cholesterol to HDL-C ratios in men (HR, 1.35) and women (HR, 1.36). “These data do not support measurement of apo B or apo A-I in clinical practice when total cholesterol and HDL-C measurements are available,” the authors conclude. Ingelsson E, Schaefer EJ, Contois JH, et al. Clinical utility of different lipid measures for prediction of coronary heart disease in men and women. JAMA. 2007;298:776-785. Nonfasting plasma glucose testing alone appears to be at least as accurate as fullscale metabolic syndrome testing, and it is cheaper, too. In a study of 1155 adults not known to have diabetes, the simpler, faster screen turned out to be just as accurate in detecting glucose intolerance as the metabolic syndrome workup.3 Measuring A new, internationally tested HbA1c standard has been developed that can be translated for patients into an easy-to-understand, average blood glucose number. The change does not affect diabetes management but provides patients with helpful information on how well blood glucose is controlled on a day-to-day basis.4 Screening 1. Nissen SE, Wolski K. Effect of rosiglitazone on the risk of myocardial infarction and death from cardiovascular causes. N Engl J Med. 2007;356(24):2457-2471. 2. Farmer AJ, Wade AN, Goyder E, et al, for the DiGEM Trial Group. The DiGEM trial: an open parallel group randomized trial of blood glucose self-monitoring in non-insulin treated diabetes. Presented at: 67th Annual Scientific Sessions of the American Diabetes Association; June 26, 2007; Chicago, Ill. 3. Bassuoni EA, et al. Metabolic syndrome is no better than random plasma glucose to screen for unrecognized glucose intolerance. Poster presented at: 67th Annual Scientific Sessions of the American Diabetes Association; June 22-26, 2007; Chicago, Ill. Abstract 916-P. 4. Nathan DM. Relationship between average blood glucose and A1c. Symposium at: 67th Annual Scientific Sessions of the American Diabetes Association; June 25, 2007; Chicago, Ill. Patients who have lived with type 1 diabetes for 50 years or more do well Patients who have lived with type 1 diabetes for 50 years or more demonstrate fewer microvascular complications than expected. Researchers at the Joslin Diabetes Center in Boston, Mass, evaluated questionnaires completed by 326 subjects living in the United States. More than half of the patients were female (54.7%), their median age was 69.5 years, and their median age at diagnosis was 12.6 years. Microvascular complications were reported by 53.4% (164 cases of neuropathy, 139 of retinopathy, 22 of nephropathy). Patients with complications had higher triglyceride levels and insulin dosages than those who did not, and lower HDL cholesterol (HDL-C). Physical activity was associated with a lower risk of complications in those whose HDL-C was below the median (65 mg/dL), but not in those above the median. The subjects’ parents had a longer life expectancy than their peers, suggesting a possible genetic component. Keenan HA, Costacou T, Sun JK, et al. Clinical factors associated with resistance to microvascular complications in diabetic patients of extreme disease duration: the 50-year Medalist Study. Diabetes Care. 2007;30:1995-1997. WRITTEN BY JUDITH ASCH-GOODKIN OCTOBER 2007 PATIENT CARE ENDOCRINOLOGY & CARDIOLOGY 19

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Patient Care - Endocrinology & Cardiology - October 2007 Research Digest Contents Medicine in the News Recognizing and Managing Patients with the Metabolic Syndrome and Prediabetes Using Troponins to Evaluate Cardiac Injury The 15-Minute Visit Classified Advertising Clinical Clips

Patient Care Endocrinology & Cardiology - October 2007

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