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News Brief: November 2009
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Sunday, June 15, 2008 Contacts: Contact: Arlyn G. Riskind 1. Glucose Intolerance in Pregnancy Associated with Postpartum Cardiovascular Risk 1. Glucose Intolerance in Pregnancy Associated with Postpartum Cardiovascular Risk Women who have gestational glucose intolerance (a condition less severe than gestational diabetes) exhibit multiple cardiovascular risk factors as early as three months after birth, according to a new study accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM). Researchers in this study sought to evaluate the relationship between gestational glucose intolerance and postpartum risk of metabolic syndrome (defined as the clustering of several cardiometabolic risk factors including obesity, hypertension and low HDL cholesterol). Metabolic syndrome, like gestational diabetes itself, is associated with increased risk of developing type 2 diabetes and cardiovascular disease. Researchers followed 487 women who underwent oral glucose tolerance testing during pregnancy. Each subject was classified as either having normal glucose tolerance, gestational glucose intolerance or gestational diabetes. At three months postpartum, researchers evaluated each subject’s cardiometabolic characteristics, such as blood pressure, weight, waist measurement and lipid levels. Findings support that even mild glucose intolerance during pregnancy predicts an increased likelihood of the metabolic syndrome at 3 months postpartum. The presence of cardiovascular risk factors as early as three months postpartum indicates that these risk factors may be longstanding and contribute to the long-term risk of cardiovascular disease in this patient population. “The study findings raise the important possibility that women with gestational glucose intolerance and subsequent postpartum metabolic syndrome represent a patient population at particularly high risk for the future development of metabolic and vascular disease,“ said Ravi Retnakaran, MD, of Mount Sinai Hospital and the University of Toronto and lead author of the study. ”Further research with long-term follow-up is needed to address this possibility.” “Our data also suggests that glucose tolerance screening in pregnancy, as is currently practiced, may provide previously unrecognized insight into a woman’s postpartum cardiovascular risk-factor profile,” said Retnakaran. “Furthermore, glucose tolerance screening may identify subgroups of young women for whom cardiovascular risk-factor monitoring may be warranted.” Other researchers working on the study include Ying Qi, Bernard Zinman and Mathew Sermer of Mount Sinai Hospital in Toronto, Canada; and Anthony Hanley and Philip Connelly of the University of Toronto in Canada. The article, “Glucose Intolerance in Pregnancy and Postpartum Risk of Metabolic Syndrome in Young Women,” will appear in the February 2010 issue of JCEM. 2. Cardiovascular Risk in Youth with Type 1 Diabetes Linked Primarily to Insulin Resistance According to a new study accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM), youth with type 1 diabetes have now been found to have abnormal insulin resistance. Having abnormal insulin resistance appears to negatively affect heart, blood vessel and exercise function in this population. Type 1 diabetes often begins in childhood. Patients with type 2 diabetes have their insulin resistance measured routinely, but this is currently not common practice in treating patients with type 1 diabetes--especially those with normal weight. Because insulin resistance is known to contribute to cardiovascular disease in type 2 diabetes researchers in this study investigated whether insulin resistance has a similar effect on adolescents with type 1 diabetes. In this study, researchers measured insulin sensitivity and heart, blood and exercise function in 12 adolescents with type 1 diabetes and compared these measurements with measurements from 12 control patients without diabetes, but similar in age, pubertal stage, activity level and body mass index. They found that insulin resistance may affect long-term cardiovascular outcomes in type 1 diabetes as is found in people with type 2 diabetes. Specifically, results indicate that insulin resistance is directly related to decreased heart and vessel function and appears to impair capacity to exercise. “Cardiovascular disease is the major cause of death in adults with diabetes, but until now, little was known about the effects of type 1 diabetes on cardiovascular health in youth,” said Kristen Nadeau, MD, of the University of Colorado Denver, and lead author of the study. “Our data suggests that while youth with type 1 diabetes may not present conditions typical of insulin resistance, such as obesity, insulin resistance is present and may affect long-term cardiovascular outcomes in this population.” “Our study is one of the first definitive studies showing the presence of insulin resistance in youth with type 1 diabetes and this may have significant implications for the cardiovascular health of these patients,” said Nadeau. “Increasing our understanding of the mechanisms underlying insulin resistance in adolescents with type 1 diabetes will direct future research and therapeutic interventions. If insulin resistance is addressed early in the care of patients with type 1 diabetes, it may be possible to decrease cardiovascular morbidity and mortality in this population.” Other researchers working on the study include Judith Regensteiner, Timothy Bauer, Mark Brown, Jennifer Dorosz, Amber Hull, Phil Zeitler, Boris Draznin and Jane Reusch of the University of Colorado Denver School of Medicine. The article, “A Unique Phenotype of Insulin Resistance in Adolescents with Type 1 Diabetes: Implications for Cardiovascular Function,” will appear in the February 2010 issue of JCEM. 3. New Patient Fact Sheet on Type 2 Diabetes and TZDs Available The Hormone Foundation has published a new bilingual (English/Spanish) patient fact sheet, Type 2 Diabetes and TZDs (Thiazolidinediones). The fact sheet defines type 2 diabetes and explains how TZDs work to help keep blood glucose levels on target. It describes the potential benefits and risks of TZDs, and addresses the now-disproven concern that rosiglitazone increases the risk of heart attacks. For more information visit: www.hormone.org.
# # # Founded in 1916, The Endocrine Society is the world's oldest, largest, and most active organization devoted to research on hormones and the clinical practice of endocrinology. Today, The Endocrine Society's membership consists of over 14,000 scientists, physicians, educators, nurses and students in more than 80 countries. Together, these members represent all basic, applied, and clinical interests in endocrinology. The Endocrine Society is based in Chevy Chase, Md. To learn more about the Society, and the field of endocrinology, visit our web site at www.endo-society.org. |