Life changes 'can save millions from diabetes'

A major review of scientific evidence concluded that diet and exercise are vital for staving off the illness, which affects 3.8 million people in Britain.

Combined with stopping smoking and regular checks on blood pressure and glucose levels, Type 2 diabetes can be prevented altogether, the team from the University of Alberta, Canada, said.

Last month, Diabetes UK said losing weight, eating more fruit and vegetables and taking regular exercise is all people need to do to significantly slash their chance of developing Type 2.

Type 2 diabetes mortality risk declining

Death rates from Type 2 diabetes have fallen sharply in Canada and the United Kingdom since the mid-1990s, researchers say.

The excess mortality risk among those with diabetes compared with those without the condition decreased over time in both Canada and the U.K., Dr. Lorraine Lipscombe, an endocrinologist at Women’s College Hospital in Toronto, said in Thursday’s issue of Diabetologia, the Journal of the European Association for the Study of Diabetes.

Nearly 2.4 million Canadians were living with diagnosed diabetes in 2008-09, according to federal statistics. (Steve Yeater/Associated Press)

The excess risk of mortality estimated during 2009 was 51 per cent in Ontario compared with 90 per cent in 1996.

“The hypothesis is that the mortality rates for diabetes have gone down in part because we’re taking better care of our diabetes patients,” Lipscombe said.

The risk declined by a similar degree for men and women over the study period.

In 2008-09, nearly 2.4 million Canadians aged one year and older were living with diagnosed diabetes, either Type 1 or Type 2, according to the Public Health Agency of Canada.

The researchers cautioned it’s possible there are now more newly diagnosed patients who have had diabetes for a shorter period, since recent guidelines focus on screening high-risk groups.

In the last 10 years, guidelines have stressed aggressive control of blood pressure, cholesterol and hyperglycemia in people with diabetes, so patients may now be receiving more intensive care.

The prevalence of diabetes was higher in Ontario than in the U.K., where the risk fell to 65 per cent in 2009 compared with 114 per cent in 1996.

It’s not clear why, but factors such as screening programs, ethnicity, eating habits or physical activity patterns could be contributing, the researchers speculated. Ontario’s population was also relatively constant over time while the U.K. group increased.

Factors that influence death rates, such as cardiovascular disease and smoking, were not explored. Lipscombe hopes to check if there is a similar trend for cardiovascular disease in the province.

The study was funded by Ontario’s Ministry of Health and Long-Term Care and an unrestricted grant from AstraZeneca and Novo Dordisk Scandinavia.

People taking statins face an increased risk of developing diabetes: Researchers

People taking statins face an increased risk of developing diabetes, researchers have warned.

Treatment with high potency statins, especially atorvastatin and simvastatin, may increase the risk of developing diabetes, according to the study published in British Medical Journal (BMJ).

Statins are among the most widely prescribed medications for the prevention of cardiovascular events. Although tolerated well, an association with new-onset diabetes has recently been suggested.

One trial suggested a 27 per cent increased risk of diabetes with rosuvastatin whereas another suggested patients taking pravastatin benefitted from a 30 per cent lower risk.

Researchers from Canada carried out a population-based study on 1.5 million residents in Ontario, Canada to examine the association between individual statin use and new-onset diabetes.

All patients were aged 66 and over and started statin therapy between 1997 and 2010. The median age was 73 years. Follow up ended either at the end of 2010 or a maximum of five years following the initiation of statins, whichever came first. The primary outcome was incident diabetes.

Statins included in the study were: fluvastatin, lovastatin, pravastatin, simvastatin, atorvastatin and rosuvastatin.

All studies used pravastatin-treated patients as the comparison group as this has been shown to have favourable effects on newly diagnosed diabetes in animal models and clinical trials.

As many as 471,250 patients were identified with no history of diabetes and who were newly treated with a statin. 54 per cent were women. Atorvastatin accounted for more than half of all new statin prescriptions followed by rosuvastatin, simvastatin, pravastatin, lovastatin and fluvastatin.

The overall risk of developing diabetes was low but this risk was increased among some patients taking statins. Between 162 and 407 patients would have to be treated with the various statins for one extra patient to develop diabetes.

Patients treated with atorvastatin were found to have a 22 per cent increased risk of new-onset diabetes, rosuvastatin an 18 per cent increased risk and simvastatin a 10 per cent increased risk, relative to pravastatin. In contrast, patients treated with fluvastatin were at a 5 per cent decreased risk and lovastatin a 1 per cent decreased risk.

… contd.


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