Great strides have been made in the field of cardiology in recent years. However, according to a new study just out, people with diabetes remain dangerously at risk for heart-related problems like angina and heart attack. The results of the study have been published In the latest issue of the Journal of the American Medical Association (August 2007).

It's quite disturbing to read the numbers on this. Example? For every hundred diabetics who experience severe heart attack, just over eight will die within thirty days. For non-diabetics, that number goes down to around five. I could go on, but you get the picture.

The solution? Says the author of the study, Dr. Elliott M. Antman: "We need aggressive strategies to manage the diabetic population. What we need to do is everything to halt the epidemic of diabetes and find through research what therapies are most helpful for diabetic patients. We've got to do better for those patients." Hear, hear.

But what should those "aggressive strategies" be? And how do you implement them? That's the sticking point. The Washington Post caught the American Diabetes Association's Larry Deeb in a moment of remarkable frankness, saying he really doesn't know what can be done to get cardiologists and endocrinologists working together on this. C'mon, Larry. That's not exactly encouraging news for all the people out there with diabetes!

It's common knowledge that diabetes and heart disease are linked. If you have diabetes, you are much more prone to heart disease than are your non-diabetic counterparts. I've sometimes wondered: why should that be? And here comes the answer, courtesy of a recent Netscape health article.

Scientists at Washington University School of Medicine in St. Louis have been examining the issue. Their conclusion? It all comes down to how the body metabolizes fat. The heart cells of diabetics lose a lipid (cardiolipin) designed to provide the heart with energy to function properly. Says Dr. Richard Gross, "Diabetic hearts run mostly on fats for fuel because glucose isn't readily available to them." Problem is, the absence of cardiolipin screws up the heart's cell membranes, both in terms of structure and function.

It's all downhill after the cardiolipin disappears. For one thing, the heart muscle cells begin to be starved of energy. Second, harmful substances form in the cells. Both these factors contribute to heart problems down the road. Observes Dr. Gross, "The pieces of the puzzle of diabetic heart disease are now rapidly falling into place. We hope that these kinds of studies will enable physicians to diagnose diabetic cardiovascular disease sooner and treat it earlier."

The votes of yesterday's advisory panel on Glaxo's Avandia demonstrate how dysfunctional this government can be. I was just reading up on the details. There were two key votes. On the question: does Avandia increase risk for heart attack, the vote was 20 to 3 in agreement. Yet, incredibly, the same panel also voted overwhelming - 22 to 1 - to keep Avandia on the market.

Coverage on the subject in today's New York Times described the meeting as "extraordinary" in that US Food and Drug Administration officials were openly in disagreement with each other as to what steps to take. As I mentioned yesterday, one of those officials, Dr. David Graham, said the drug should be withdrawn. However, Dr. Robert Meyer, another FDA high-up-official, disagreed.

Let's recap: Glaxo knew Avandia might cause heart trouble and informed the FDA of this. The FDA did nothing. An article in the New England Journal of Medicine (May 2007) stated the drug increased the risk of heart attack. The FDA twiddled its thumbs. Now this? The drug may stay on the market at the behest of the same FDA officials who voted in agreement that it poses a heart risk. Has the world gone mad? The sooner we get some reform at the FDA, the better off we will all be.

Also worth noting: the Times reports that Dr. Steven Nissen, whose NEJM article sparked the controversy, says he would have voted to remove Avandia from the shelves. Also quoted was Dr. Sidney Wolfe of Public Citizen, a drug safety advocacy group. Observed Dr. Wolfe: "If Avandia were up for approval today based on what we know now, it would be rejected."

Earlier today I blogged about the Avandia advisory panel which met today. As of earlier today, the word was an FDA official, David Graham, had issued a written preview of the comments he intended to make. In it, Graham stated his view that GlaxoSmithKline's diabetes drug Avandia is dangerous and should therefore be removed from sale.

Now comes breaking news from the Associated Press that the panel will recommend, against the wishes of many - Dr. Graham included, that Avandia stick around. According to the AP, government health advisers have argued that, hey, sure Avandia may cause increased risk of heart attack, but let's just keep it out there. What?! As of writing, the AP was still waiting for a tally of how the panel voted on the issue, but word is a majority voted against recommending a ban.

The FDA's patient representative for the panel was quoted as saying studies indicating Avandia causes heart trouble "have very significant weaknesses and are inadequate for us to make that kind of decision." In short, the FDA seems to be saying Avandia causes heart damage, but the study-based proof is not strong enough for a ban. Talk about your contradictory messages! Baffled? Disgusted? Join the club.

I was intrigued by a recent Swedish study reporting that people on a so-called "Stone Age" diet had more stable blood sugar levels than those on a Mediterranean diet. An intriguing claim, because it's so often said that Mediterranean-style eating is super-healthful. Let's also admit it is a delicious way to eat: yes, pasta and bread is there, but it's balanced out by tons of fresh fruits, vegetables, fish and olive oil. The Stone Age way is a bit more spare: we're talkin' meat, fish, and lots of whole grains, berries and nuts. Nary a sliver of Parmesan in sight.

However, the results of yet another study, this time from Australia, indicates Mediterranean-style eating is a good choice, especially for diabetics. Researchers from the University of Melbourne say Mediterranean-born immigrants in Australia are less likely to die from heart disease than other Australians. The researchers have concluded it's all down to dietary patterns. More than forty thousand people participated in the study over a period of ten years. The numbers revealed those who ate the most Mediterranean-style foods had a thirty percent lower risk of dying from heart disease. For diabetics, the researchers speculate, the benefits could be even higher, reducing the risk of death due to ischemic heart disease.

Results have been published in The American Journal of Clinical Nutrition. Visit Reuters for a discussion of the study.

A new report says physical activity is critical for kids with type 1 diabetes because it helps prevent heart trouble later in life. The German and Austrian researchers behind the study reached this conclusion after crunching the numbers for more than 23,000 kids between ages three and eighteen, comparing their health with activity levels. As you would expect, the most active kids had the healthiest hearts and lower levels of cholesterol and triglycerides. By comparison, thirty-six percent of children who were active only once or twice a week had high cholesterol and triglycerides.

For type 1 kids, activity levels relate to HbA1c levels: fit children had lower HbA1c levels. High HbA1c levels in childhood practically guarantee your child will experience heart problems down the road. Says lead researcher Antje Herbst: "Clearly, getting off the couch and out of doors, where they can be more physically active, is good for all kids. But for children with type 1 diabetes, the need to stay physically active is even greater due to the increased risk for heart disease."

Parents: you don't have to sign your little ones up for triathlon training, boot camp or anything like that. Vigorous exercise is not necessary to reap the benefits. Regular periods of normal play are adequate. Even half an hour a day can make a difference, the researchers say. Common sense, however, suggests this is a case where more is definitely better.

The results of this study appear in the latest Diabetes Care (August 2007).

Ever noticed that people tend to be around the same weight as spouses and friends? Well, it's not your imagination. A study just out in the New England Journal of Medicine reports that obesity, a major risk factor for type 2 diabetes, acts somewhat like a contagious disease - so when one person puts on weight, others around them follow suit. This, the researchers say, helps explain why Americans have gotten so fat in recent decades.

The study, a summary and discussion of which is featured in The New York Times, involved the analysis of a social network of 12,067 people over a period of thirty-two years (from 1971 to 2003). Researchers tracked not only the health and weight loss/gain of these people, but also who knew whom, who was friends with whom, and who was related to whom. Over time, it became clear that those whose friends became obese were much more likely to grow obese themselves. The likelihood, in fact, tripled in the case of close friends. Interestingly, friendship mattered more as a determining factor than did being related or being neighbors with someone.

It works like this: people tend to share the lifestyle habits of their family and friends. Folks who consider salads delightful and who enjoy frequent jogs around the park generally surround themselves with similarly-minded folks, and it shows in their trim physiques. Likewise, fast-food munchers who enjoy lots of TV tend to hang out with a similar crowd...and their thighs - not to mention waistlines, hearts, blood sugar levels etc. - suffer the consequences. Another factor, says researcher Nicholas Christakis, is the perception of the self in relation to others: "You change your idea of what is an acceptable body type by looking at the people around you."

A study shows that men with type 2 diabetes experience pronounced risk of erectile dysfunction (ED) when they have symptoms of depression.

Depression appears to be a vicious cycle that may instigate the development of ED, while the ED symptoms perpetuate the symptoms of depression. Effectively deducing that ED in diabetic patients is not related entirely to organic factors. The study evaluated men with type 2 diabetes who completed questionnaires every 6 months for 3 years. Five hundred men reported ED at the start of the study, and an additional 192 developed the disorder during follow-up. The investigators noted higher prevalence of high blood pressure (46% versus 32%) and lipid abnormalities (23% versus 13%) among men who complained of ED. The researchers also observed higher incidence of retinopathy, neuropathy or heart and vascular disease in ED sufferers. Those with ED were more likely to be treated with insulin or diuretics. Depression and ED was found more often in those with poor physical and psychological health.

The researchers surmised that erectile problems are not necessarily an inevitable outcome of the aging process. The risk factors for ED are modifiable and can be changed to reduce the likelihood of the outcome (or lack thereof). The results should serve as uplifting news for suffers of ED, no pun intended.

Does this sound familiar? Weight Gain? Memory Lapses? Mood Swings? Fatigue? The Sugar Solution is an easy-to-follow, drug-free program that can bring blood sugar into balance in just one month. Weight gain, fatigue, depression, and poor concentration are symptoms that could potentially lead to diabetes, heart disease and cancer.

The book points out that high blood sugar and depression often go hand in hand. In fact, depression may lead to increased sugar consumption and ultimately depression. The Sugar Solution helps readers determine whether they're at risk for blood sugar problems and shows them how to keep their blood sugar levels in range without drugs or injections. The exclusive 30-day lifestyle makeover guides them every step of the way, with complete daily menus, exercise strategies, and stress-reduction techniques. Pounds will melt away, energy will soar, and mental sharpness will return as blood sugar stabilizes.

The book will be helpful for people looking for an exercise and eating plan to help stabilize blood sugar levels and lose weight. Kick-off the New Year with a new approach to a better lifestyle!