Few people heading for ‘diabetes’ know it

NEW YORK, June 30, (RTRS): Only about one in eight people with so-called pre-diabetes, often a precursor to full-blown disease, know they have a problem, a US study found.

Lacking awareness, people with the elevated blood sugar levels were also less likely to make lifestyle changes such as getting more exercise or eating less sugary food that might prevent them from ultimately becoming diabetic.

“People with pre-diabetes who lose a modest amount of weight and increase their physical activity are less likely to develop diabetes,” lead study author Dr Anjali Gopalan, a researcher at the Philadelphia VA Medical Center, said by email. “Our study importantly shows that individuals with pre-diabetes who were aware of this diagnosis were more likely to engage in some of these effective and recommended healthy lifestyle changes.”

Globally, about one in nine adults have diabetes, and the disease will be the seventh leading cause of death by 2030, according to the World Health Organization.

Most of these people have Type 2, or adult-onset, diabetes, which happens when the body can’t properly use or make enough of the hormone insulin to convert blood sugar into energy.

Average blood sugar levels over the course of several months can be estimated by measuring changes to the hemoglobin molecule in red blood cells. The hemoglobin A1c test measures the percentage of hemoglobin ñ the protein in red blood cells that carries oxygen ñ that is coated with sugar, with readings of 6.5 percent or above signaling diabetes.

But A1C levels between 5.7 percent and 6.4 percent are considered elevated, though not yet diabetic.

More than one third of US adults have such elevated blood sugar levels and each year about 11 percent of them progress to having full-blown diabetes, Gopalan and colleagues note in the American Journal of Preventive Medicine.

Diabetes

To gauge awareness of this heightened diabetes risk among people with the condition, researchers weeded out people who said they already had the disease. Then, they reviewed A1c test results for the rest.

Out of 2,694 adults with test results showing elevated A1c, only 288 people were aware of their status.

People who were aware of their condition were about 30 percent more likely to exercise and get at least 150 minutes of moderate activity each week.

They were also about 80 percent more likely to attempt weight loss and to have shed at least 7 percent of their body weight in the past year.

In 2014, the US Preventive Services Task Force, a governmentbacked independent panel that reviews medical evidence, said that screening for diabetes risk does help to identify people headed for fullblown disease and can help some of them to avert it with medication and lifestyle changes.

It’s possible that some patients in the current study had been told about their status but didn’t recall or didn’t understand the specific way researchers asked about the condition, said Dr Laura Rosella, a public health researcher at the University of Toronto.

“The health care provider has to tell the patient that they don’t meet the criteria for diabetes but they aren’t quite out of the woods, which can be a challenging concept to get across,” Rosella, who wasn’t involved in the study, said by email. “This challenge could explain the low awareness.”

Some patients may also have been tested for diabetes using another measurement known as an oral glucose tolerance test, which can get different results than screening for A1c, said Dr Robert Cohen, a diabetes specialist at the University of Cincinnati College of Medicine.

Confusion

“People can pass by one and miss by the other and it is confusion,” Cohen, who wasn’t involved in the study, said by email. “Many labeled as pre-diabetes by A1c would have diabetes if tested by the gold standard oral glucose tolerance test.”

Meanwhile, Vitae Pharmaceuticals Inc said its diabetes drug failed to significantly reduce blood sugar levels of patients when used as an addon therapy, raising questions about the drug’s potential.

Vitae’s shares fell as much as 34 percent on Monday, before paring some losses to trade down 12 percent in morning trading.

VTP-34072, being co-developed with German drugmaker Boehringer Ingelheim, was tested as an add-on to a common diabetes drug, metformin, to treat type 2 diabetes in overweight patients.

Results from a trial testing VTP34072 as a monotherapy are expected later this year and Boehringer Ingelheim said it will review data from both trials to decide on the next steps for the drug.

However, analysts said they did not have much hope for the drug.

Wedbush analyst Liana Moussatos said she did not expect the drug to continue being tested unless the monotherapy trial had “spectacular results”. The drug works by targeting an enzyme that produces a hormone called cortisol, which increases blood sugar and helps in breaking down fat.

Stifel analyst Thomas Shrader said he did not have much hope for the drug as a monotherapy either, drawing a parallel with Incyte Corp’s failed diabetes drug, which had a NEW YORK, June 30, (RTRS): Phone-based surveys show that nearly four of every 10 kids and teens in the US were exposed to violence or abuse over the previous year, researchers have found.

“Children are the most victimized segment of the population,”said study leader David Finkelhor of the Crimes Against Children Research Center at the University of New Hampshire in Durham.

“The full burden of this tends to be missed because many national crime indicators either do not include the experience of all children or don’t look at the big picture and include all the kinds of violence to which children are exposed,”Finkelhor told Reuters Health by email.

Compared to 2011, the violence rates appear to be stable, and certain kinds of violence exposure may be decreasing, he said.

While the rates are not going up, “the problem is that there is still way too much,”he said.

The National Survey of Children’s Exposure to Violence includes phone interviews with contacts at a representative sample of US numbers in 2013 and 2014. Overall, researchers collected information on 4,000 kids age 17 and younger.

If the child was between age 10 and 17, he or she was interviewed over the phone. An adult caregiver answered questions for younger children.

The interviewers asked about conventional crime, child maltreatment, peer and sibling abuse, sexual assault, indirect exposure to violence and witnessing violence to others, and Internet violence. If the child had been exposed to any of these events over the previous year, the interviewers also asked about who committed the violence, weapons and injuries.

About 37 percent of kids had been physically assaulted over the previous year, and almost 10 percent were injured as a result, the researchers found. Two percent of girls had been sexually assaulted or abused, including more than 4 percent of girls age 14 to 17.

About 15 percent had experienced maltreatment by a caregiver. Almost 6 percent had witnessed violence between their parents.

These numbers are similar to what’s been found in previous studies in the US and elsewhere, Dr Andreas Jud of Lucerne University of Applied Sciences and Arts in Switzerland told Reuters Health by email. Jud was not part of the new study.

Most maltreatment incidents occur within the family, according to John Fluke, a child welfare scholar-in-residence at the University of Denver in Colorado.

In the social service population and in his own study, neglect is the predominant form of maltreatment, Fluke told Reuters Health by email.

“This is really complex and what is needed is some considerable effort to use surveillance data in targeted ways to help determine what prevention and treatment approaches are most effective for specific populations,”Fluke said.

The researchers called land lines as well as cellphone-only households, but people are increasingly reluctant to participate in surveys, which is a limitation of this kind of study, Finkelhor said.

“Violence and abuse in childhood are big drivers behind many of our most serious health and social problems,”he said. “They are associated with later drug abuse, suicide, criminal behavior, mental illness and chronic disease like diabetes.”

similar target as VTP-34072.

“Incyte did a trial on the same target,” Shrader said. “The data looked pretty good, but they stopped the program. A chemistry company will always be at the mercy of the targets it uses.”

The failure of the diabetes drug is the second blow to Vitae this year after trails for its Alzheimer’s drug were placed on hold in February.

Vitae is also developing drugs for auto-immune diseases.

The stock was down 12 percent at $13.36 in morning trading on the Nasdaq. Through Friday, the shares had almost doubled since the company went public in September.