Diabetes

Intensive lifestyle intervention (ILI) is more efficient than diabetes support and education (DSE) for the improvement of cardiovascular disease risk factors, as well as for the reduction of medication use and cost, indicate findings from the Look AHEAD trial, a multi-center, randomized controlled trial of 5,145 individuals (aged 45–76 years) with type 2 diabetes mellitus and overweight or obesity. At 1 year, patients in the ILI group had significantly greater improvements in cardiovascular disease risk parameters and reduced medication use and cost compared with individuals in the DSE group. The average number of medications prescribed for the treatment of cardiovascular disease risk factors was 3.1 ± 1.8 for patients in the ILI group, compared with 3.6 ± 1.8 for patients in the DSE group. Estimated total monthly medication costs were US$143 and $173.

Bone

A meta-analysis of 14 prospective studies indicates an association between depression and increased risk of fracture and bone loss, possibly mediated by antidepressants. In six studies where fracture outcomes were reported as hazard ratios (n = 108,157), depression was associated with a 17% increase in fracture risk. Furthermore, depression was associated with a 52% increase in risk in four studies that reported risk ratios as fracture outcomes (n = 33,428). The hazard ratio of three studies (n = 14,777) that did not adjust for antidepressant treatment was higher than that of the three studies (n = 93,380) that did adjust for antidepressant treatment.

Metabolism

Vitamin D insufficiency and hypovitaminosis D are extremely common among Arab Americans, and in men are associated with insulin resistance, components of the metabolic syndrome and glucose intolerance, a study published in Diabetes Care reveals. Serum 25-hydroxyvitamin D levels were measured in a representative, cross-sectional sample of 542 Arab Americans with insulin resistance (46%), metabolic syndrome (33%) and glucose intolerance (42%). Vitamin D insufficiency (12.5 nmol/l to <50.0 nmol/l) was present in 75% and hypovitaminosis D (50 nmol/l to <100 nmol/l) in 24% of participants. In men, but not women, 25-hydroxyvitamin D levels were lower in those with glucose intolerance than normoglycemia.