Patient Care Endocrinology & Cardiology - October 2007 - (Page 2)

Research Digest A quick summary of recent reports from leading medical journals Frequent awakenings during hypoglycemia in late sleep Hormonal changes may explain the frequent awakenings during hypoglycemic episodes in late sleep in people with diabetes. Investigators in Germany induced hypoglycemia with an insulin injection immediately after sleep onset or after about 3.5 hours of sleep in 16 healthy subjects. Hypoglycemia was not induced on control nights. The researchers found that 10 subjects spontaneously awoke when hypoglycemia was induced during early sleep while no subjects awoke during the same period of the control night. All subjects awoke when hypoglycemia was induced during late sleep compared with 4 subjects during the same period of the control night. Increases in hormones such as epinephrine were significantly weaker during late hypoglycemia. “The pattern indicates that the frequency of awakenings caused by hypoglycemia is similar for early and late sleep,” the authors conclude. They suggest that “diminished hormonal counter-regulation during late sleep could be one factor contributing to the clinically observed accumulation of hypoglycemic episodes in the later part of the night in patients with diabetes.” Jauch-Chara K, Hallschmid M, Gais S, et al. Awakening and counterregulatory response to hypoglycemia during early and late sleep. Diabetes. 2007;56(7):1938-1942. Benefits of drug-eluting stents may outweigh risks The benefit of drug-eluting stents, a reduction in the risk of clinically necessary target lesion revascularization, appears to outweigh the slightly increased risk of later stent thrombosis and MI. Researchers in Denmark analyzed 2002-2005 data from the Western Denmark Heart Registry on 12,395 patients, including 3548 who received drug-eluting stents and 8847 who received bare-metal stents. During the 12 to 15 months after implantation, the researchers found that patients who received drug-eluting stents were more likely than those who received bare-metal stents to experience late definite stent thrombosis (hazard ratio [HR], 10.93) or MI (HR, 4.0). Use of drug-eluting stents reduced the risk of target lesion revascularization by 43%. “The minor risk of stent thrombosis and MI within 15 months after implantation of drug-eluting stents seems unlikely to outweigh the benefit of these stents,” the authors write. Jensen LO, Maeng M, Kaltoft A, et al. Stent thrombosis, myocardial infarction, and death after drug-eluting and bare-metal stent coronary interventions. J Am Coll Cardiol. 2007;50(5):463-470. Elevated cystatin C levels predict prediabetes Elevated levels of cystatin C are associated with a 3fold higher risk of developing prediabetes. Researchers reexamined 1455 men and women (aged 39-79 years) from the Western New York Health Study who did not have type 2 diabetes or cardiovascular disease. Of these, 91 progressed from a fasting glucose level of less than 100 mg/dL at baseline (1996-2001) to between 101 and 125 mg/dL at the follow-up examination (2002-2004), which was defined as incident prediabetes. After matching the patients with 273 controls and adjusting for confounding factors, an elevated baseline concentration of cystatin C was found to be a “highly statistically significant” predictor of prediabetes (odds ratio, 3.28). The association For more medical news that matters to primary care, please see Medicine in the News, page 9, and Clinical Clips, page 28. Research Digest is prepared by the editors of Patient Care and HealthDay’s Physician’s Briefing (http://www.physiciansbriefing.com). 2 PATIENT CARE ENDOCRINOLOGY & CARDIOLOGY www.patientcareonline.com http://www.physiciansbriefing.com http://www.patientcareonline.com

Table of Contents Feed for the Digital Edition of Patient Care Endocrinology & Cardiology - October 2007

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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