Research finds link between diabetes and disability risk
A round up of clinical news including new medication for stroke prevention; an online resource for people with rheumatoid arthritis and new research linking blood pressure medication and reduced cognitive decline in people with dementia.
In this story:
- Research finds link between diabetes and disability
- Blood pressure medication may slow down cognitive decline: study
- New anticoagulant on the market
- Launch of online resource for people with rheumatoid arthritis
Diabetes and physical disability risk
Older adults with diabetes are at least 50 per cent more likely to have a physical disability than those without diabetes, according to new study published in The Lancet Diabetes & Endocrinology.
Led by Dr Anna Peeters and Dr Evelyn Wong of the Baker IDI Heart and Diabetes Institute in Melbourne, the results of the systematic review and meta-analysis showed that the risk of physical diabetes in those with diabetes could be as high as 80 per cent.
According to Dr Peeters the reasons why diabetes is associated with physical disability are still unclear, although several mechanisms have been suggested. “It’s possible that the high blood glucose concentrations experienced by people with diabetes might lead to chronic muscle inflammation, eventually resulting in physical disability, and some studies have shown that diabetes is associated with rapid and worsening muscle wasting,” said Dr Peeters.
The complications associated with diabetes, such as heart disease, stroke, and kidney disease, can all result in disability.
In the study disability was defined in terms of both impaired mobility, and functional disability (impaired ability to perform activities of daily living, such as bathing or eating, and instrumental activities of daily living such as using the phone, shopping, and using transport).
Previous studies examining the risk of disability associated with diabetes have produced varying results, ranging from no association, to a doubling of risk. This study is the first meta-analysis to pool those earlier studies to provide a more reliable estimate.
Blood pressure medication may slow down cognitive decline: study
Researchers from Ireland and Canada have identified a link between a class of drugs designed to lower blood pressure and reduced rates of cognitive decline, particularly in the first six months of treatment.
The study of 817 people diagnosed with Alzheimer’s disease and other dementias, published in the British Medical Journal Online, supports the growing body of evidence for the use of anti-hypertensive agents in the management of dementia.
Although the differences in cognitive decline were small and of uncertain clinical significance, the authors said that if sustained over years, the compounding effects may well have significant clinical benefits
Reduced rates of cognitive decline were seen in individuals prescribed centrally acting ACE inhibitors or CACE-Is, irrespective of blood pressure or diagnosis of hypertension.
This is the first study to demonstrate that cognitive scores improve in patients starting on
CACE-Is, compared to those already established on maintenance treatment. This may have been related to better medication compliance, the effects of improved Blood Pressure control or increased cerebrovascular perfusion after initial treatment, the authors said.
Launch of online resource for people with rheumatoid arthritis
A new online resource has been launched to help support Australians living with rheumatoid arthritis (RA) find the information they need to improve their overall health.
People affected by RA can engage directly with specialists online via Healthshare’s Rheumatoid Arthritis Topic Page to help build knowledge about their condition.
Healthshare aims to provide people affected by a health problem, and their family, friends and carers, a way to ask qualified healthcare professionals questions so they can gain more control over their lives.
It is free to ask a question and receive an answer from a registered healthcare professional through Healthshare. You can access the resource here: Rheumatoid Arthritis Topic Page
New anticoagulant on the market
NPS MedicineWise is urging people to talk to their doctor before stopping or making any changes to their anticoagulant medicines as the oral anticoagulant rivaroxaban stroke is added to the Pharmaceutical Benefits Scheme (PBS).
Rivaroxaban (Xarelto) will be subsidised from 1 August for preventing stroke in people with atrial fibrillation, a heart condition which increases the risk of harmful blood clots that cause stroke, and for treating a blood clot in the lung, known as pulmonary embolism.
While the change means more choice for consumers, NPS MedicineWise said people who are already stable on warfarin, which has been the mainstay of anticoagulant therapy for the past 50 years, may not benefit from switching to rivaroxaban.
To find out more about rivaroxaban or warfarin, NPS MedicineWise said to speak to your doctor or pharmacist or visit its website: www.nps.org.au/rivaroxaban and www.nps.org.au/warfarin.
