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VIDEO: Dementia risk spikes in older veterans with sleep disorders, PTSD
COPENHAGEN – Older veterans who had sleep disturbances were at a 30% greater risk of developing dementia, according to a retrospective analysis of 200,000 medical records presented at the Alzheimer’s Association International Conference 2014.
And having posttraumatic stress disorder (PTSD) in addition to sleep disturbances put veterans at an 80% greater risk.
"As veterans are turning 65 and older, it’s important for us to understand who in that population is at an increased risk of developing dementia, so when we have that therapy or lifestyle intervention, we can intervene at that point," said Heather M. Snyder, Ph.D., director of medical and scientific operations at the Alzheimer’s Association. Dr. Snyder was not involved in the study.
For the study, researchers studied the records of veterans 55 years and older for 8 years. They found that almost 11% of the veterans with sleep disturbance developed dementia, compared with 9% of those without sleep disturbance, almost a 30% risk increase. The results were similar for veterans who had sleep apnea and nonapnea insomnia.
Meanwhile, researchers found no significant interaction between sleep disturbance and traumatic brain injury or PTSD, with regard to increased risk of dementia. However, veterans who had both PTSD and sleep disturbance had an 80% increased risk of developing dementia.
In a video interview, Dr. Kristine Yaffe, professor of psychiatry and neurology at the University of California, San Francisco, explains the study’s findings, shares practice pearls, and discusses the implications for younger veterans.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
On Twitter @naseemmiller
COPENHAGEN – Older veterans who had sleep disturbances were at a 30% greater risk of developing dementia, according to a retrospective analysis of 200,000 medical records presented at the Alzheimer’s Association International Conference 2014.
And having posttraumatic stress disorder (PTSD) in addition to sleep disturbances put veterans at an 80% greater risk.
"As veterans are turning 65 and older, it’s important for us to understand who in that population is at an increased risk of developing dementia, so when we have that therapy or lifestyle intervention, we can intervene at that point," said Heather M. Snyder, Ph.D., director of medical and scientific operations at the Alzheimer’s Association. Dr. Snyder was not involved in the study.
For the study, researchers studied the records of veterans 55 years and older for 8 years. They found that almost 11% of the veterans with sleep disturbance developed dementia, compared with 9% of those without sleep disturbance, almost a 30% risk increase. The results were similar for veterans who had sleep apnea and nonapnea insomnia.
Meanwhile, researchers found no significant interaction between sleep disturbance and traumatic brain injury or PTSD, with regard to increased risk of dementia. However, veterans who had both PTSD and sleep disturbance had an 80% increased risk of developing dementia.
In a video interview, Dr. Kristine Yaffe, professor of psychiatry and neurology at the University of California, San Francisco, explains the study’s findings, shares practice pearls, and discusses the implications for younger veterans.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
On Twitter @naseemmiller
COPENHAGEN – Older veterans who had sleep disturbances were at a 30% greater risk of developing dementia, according to a retrospective analysis of 200,000 medical records presented at the Alzheimer’s Association International Conference 2014.
And having posttraumatic stress disorder (PTSD) in addition to sleep disturbances put veterans at an 80% greater risk.
"As veterans are turning 65 and older, it’s important for us to understand who in that population is at an increased risk of developing dementia, so when we have that therapy or lifestyle intervention, we can intervene at that point," said Heather M. Snyder, Ph.D., director of medical and scientific operations at the Alzheimer’s Association. Dr. Snyder was not involved in the study.
For the study, researchers studied the records of veterans 55 years and older for 8 years. They found that almost 11% of the veterans with sleep disturbance developed dementia, compared with 9% of those without sleep disturbance, almost a 30% risk increase. The results were similar for veterans who had sleep apnea and nonapnea insomnia.
Meanwhile, researchers found no significant interaction between sleep disturbance and traumatic brain injury or PTSD, with regard to increased risk of dementia. However, veterans who had both PTSD and sleep disturbance had an 80% increased risk of developing dementia.
In a video interview, Dr. Kristine Yaffe, professor of psychiatry and neurology at the University of California, San Francisco, explains the study’s findings, shares practice pearls, and discusses the implications for younger veterans.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
On Twitter @naseemmiller
AT AAIC 2014
VIDEO: Don’t brush off subjective memory decline
COPENHAGEN – Researchers are paying more attention to subjective cognitive decline – a patient’s perceived notion of memory loss – even if the patients complete various cognitive tests with flying colors.
In a video interview at the Alzheimer’s Association International Conference 2014, Wiesje M. van der Flier, Ph.D., head of clinical research for the Alzheimer’s Center at the VU University Medical Center in Amsterdam, explained the issue and how physicians should handle a patient’s perceptions of cognitive decline.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
On Twitter @naseemmiller
COPENHAGEN – Researchers are paying more attention to subjective cognitive decline – a patient’s perceived notion of memory loss – even if the patients complete various cognitive tests with flying colors.
In a video interview at the Alzheimer’s Association International Conference 2014, Wiesje M. van der Flier, Ph.D., head of clinical research for the Alzheimer’s Center at the VU University Medical Center in Amsterdam, explained the issue and how physicians should handle a patient’s perceptions of cognitive decline.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
On Twitter @naseemmiller
COPENHAGEN – Researchers are paying more attention to subjective cognitive decline – a patient’s perceived notion of memory loss – even if the patients complete various cognitive tests with flying colors.
In a video interview at the Alzheimer’s Association International Conference 2014, Wiesje M. van der Flier, Ph.D., head of clinical research for the Alzheimer’s Center at the VU University Medical Center in Amsterdam, explained the issue and how physicians should handle a patient’s perceptions of cognitive decline.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
On Twitter @naseemmiller
At AAIC 2014
New Obesity Algorithm Covers Complications in Addition to BMI
LAS VEGAS– A newly introduced statement proposes to change how obesity is diagnosed and treated.
The American Association of Clinical Endocrinologists and the American College of Endocrinology are suggesting algorithms to determine stages for the disease, each of which comes with a set of therapy recommendations.
"Right now it’s obesity, or overweight/obesity, or Class 1, 2, 3 obesity – it’s all [body mass index]. BMI doesn’t convey actionability. It doesn’t convey a medical meaning," said Dr. W. Timothy Garvey, chair of the AACE Obesity Scientific Committee at the annual meeting of the American Association of Clinical Endocrinologists.
AACE/ACE leaders hope that their new diagnostic algorithm will fill that gap.
"We’re using weight loss therapy to treat the complications of obesity in a medical model," Dr. Garvey said.
According to the framework, which is not finalized yet, the diagnostic categories of obesity will be:
• Overweight: BMI of 25-29.9 kg/m2, with no obesity-related complications.
• Obesity Stage 0: BMI of at least 30, with no obesity-related complications.
• Obesity Stage 1: BMI of at least 25 and one or more complications that are mild to moderate in severity.
• Obesity stage 2: BMI of greater than or equal to 25 and one or more severe complications.
Also, a four-step diagnosis and treatment approach is recommended for all patients:
1. BMI screening and adjusting for ethnic differences.
2. Clinical evaluation for the presence of obesity-related complications, by using a checklist.
3. Staging for the severity of complications using complication-specific criteria.
4. Selection of prevention and/or intervention strategies targeting specific complications guided by the AACE/ACE obesity management algorithm.
AACE/ACE leaders pointed out that today there are better tools to treat obesity than ever before, including improvements in lifestyle intervention, new medications, and improvements in bariatric surgery, yet there’s limited access and penetrance of these tools in the clinic. They said they hoped the new algorithm would help incorporate available therapies into treating obese patients.
The algorithm emerged from the AACE/ACE 2014 Consensus Conference on Obesity, which included medical professionals, industry representatives, advocacy groups, and regulators. One of the findings that everyone agreed on was that the diagnostic definition of obesity needed to improve.
The current definition of obesity "didn’t give all the stakeholders a reason to buy into a concerted plan." Employers would say, "I bring somebody down from a BMI of 38 to 34. But what does that mean? "How is it benefiting me? How is it benefiting my company? Why would I want to invest in that? But if they’re treating Stage 2, that’s telling them that that person is overweight, has excessive body fat, and it’s impacting their health and they have complications that can be remedied by weight loss and use of more aggressive therapies. All of that is embedded in that simple term," Dr. Garvey said.
The AACE/ACE is not the first to issue a diagnosis or treatment guideline for obesity, which was declared a disease by the American Medical Association in 2013.
There are a lot of commonalities to the guidelines," said Dr. Garvey, professor and chair at the department of Nutrition Sciences at the University of Alabama at Birmingham. They’re all addressing obesity and therapy and attempt to improve patients’ health. "I think we’re more focused on using weight loss as a therapy to treat obesity-related complications," Dr. Garvey said.
AACE/ACE is holding another consensus conference later this year as a step toward finalizing the framework.
Dr. Garvey is a consultant for Daiichi Sankyo, Liposcience, Takeda, Vivus, Boehringer Ingelheim, Janssen, Eisai, and Novo Nordisk. He has received research funding from Merck, Astra Zeneca, Weight Watchers, Eisai, and Sanofi.
On Twitter @naseemmiller
LAS VEGAS– A newly introduced statement proposes to change how obesity is diagnosed and treated.
The American Association of Clinical Endocrinologists and the American College of Endocrinology are suggesting algorithms to determine stages for the disease, each of which comes with a set of therapy recommendations.
"Right now it’s obesity, or overweight/obesity, or Class 1, 2, 3 obesity – it’s all [body mass index]. BMI doesn’t convey actionability. It doesn’t convey a medical meaning," said Dr. W. Timothy Garvey, chair of the AACE Obesity Scientific Committee at the annual meeting of the American Association of Clinical Endocrinologists.
AACE/ACE leaders hope that their new diagnostic algorithm will fill that gap.
"We’re using weight loss therapy to treat the complications of obesity in a medical model," Dr. Garvey said.
According to the framework, which is not finalized yet, the diagnostic categories of obesity will be:
• Overweight: BMI of 25-29.9 kg/m2, with no obesity-related complications.
• Obesity Stage 0: BMI of at least 30, with no obesity-related complications.
• Obesity Stage 1: BMI of at least 25 and one or more complications that are mild to moderate in severity.
• Obesity stage 2: BMI of greater than or equal to 25 and one or more severe complications.
Also, a four-step diagnosis and treatment approach is recommended for all patients:
1. BMI screening and adjusting for ethnic differences.
2. Clinical evaluation for the presence of obesity-related complications, by using a checklist.
3. Staging for the severity of complications using complication-specific criteria.
4. Selection of prevention and/or intervention strategies targeting specific complications guided by the AACE/ACE obesity management algorithm.
AACE/ACE leaders pointed out that today there are better tools to treat obesity than ever before, including improvements in lifestyle intervention, new medications, and improvements in bariatric surgery, yet there’s limited access and penetrance of these tools in the clinic. They said they hoped the new algorithm would help incorporate available therapies into treating obese patients.
The algorithm emerged from the AACE/ACE 2014 Consensus Conference on Obesity, which included medical professionals, industry representatives, advocacy groups, and regulators. One of the findings that everyone agreed on was that the diagnostic definition of obesity needed to improve.
The current definition of obesity "didn’t give all the stakeholders a reason to buy into a concerted plan." Employers would say, "I bring somebody down from a BMI of 38 to 34. But what does that mean? "How is it benefiting me? How is it benefiting my company? Why would I want to invest in that? But if they’re treating Stage 2, that’s telling them that that person is overweight, has excessive body fat, and it’s impacting their health and they have complications that can be remedied by weight loss and use of more aggressive therapies. All of that is embedded in that simple term," Dr. Garvey said.
The AACE/ACE is not the first to issue a diagnosis or treatment guideline for obesity, which was declared a disease by the American Medical Association in 2013.
There are a lot of commonalities to the guidelines," said Dr. Garvey, professor and chair at the department of Nutrition Sciences at the University of Alabama at Birmingham. They’re all addressing obesity and therapy and attempt to improve patients’ health. "I think we’re more focused on using weight loss as a therapy to treat obesity-related complications," Dr. Garvey said.
AACE/ACE is holding another consensus conference later this year as a step toward finalizing the framework.
Dr. Garvey is a consultant for Daiichi Sankyo, Liposcience, Takeda, Vivus, Boehringer Ingelheim, Janssen, Eisai, and Novo Nordisk. He has received research funding from Merck, Astra Zeneca, Weight Watchers, Eisai, and Sanofi.
On Twitter @naseemmiller
LAS VEGAS– A newly introduced statement proposes to change how obesity is diagnosed and treated.
The American Association of Clinical Endocrinologists and the American College of Endocrinology are suggesting algorithms to determine stages for the disease, each of which comes with a set of therapy recommendations.
"Right now it’s obesity, or overweight/obesity, or Class 1, 2, 3 obesity – it’s all [body mass index]. BMI doesn’t convey actionability. It doesn’t convey a medical meaning," said Dr. W. Timothy Garvey, chair of the AACE Obesity Scientific Committee at the annual meeting of the American Association of Clinical Endocrinologists.
AACE/ACE leaders hope that their new diagnostic algorithm will fill that gap.
"We’re using weight loss therapy to treat the complications of obesity in a medical model," Dr. Garvey said.
According to the framework, which is not finalized yet, the diagnostic categories of obesity will be:
• Overweight: BMI of 25-29.9 kg/m2, with no obesity-related complications.
• Obesity Stage 0: BMI of at least 30, with no obesity-related complications.
• Obesity Stage 1: BMI of at least 25 and one or more complications that are mild to moderate in severity.
• Obesity stage 2: BMI of greater than or equal to 25 and one or more severe complications.
Also, a four-step diagnosis and treatment approach is recommended for all patients:
1. BMI screening and adjusting for ethnic differences.
2. Clinical evaluation for the presence of obesity-related complications, by using a checklist.
3. Staging for the severity of complications using complication-specific criteria.
4. Selection of prevention and/or intervention strategies targeting specific complications guided by the AACE/ACE obesity management algorithm.
AACE/ACE leaders pointed out that today there are better tools to treat obesity than ever before, including improvements in lifestyle intervention, new medications, and improvements in bariatric surgery, yet there’s limited access and penetrance of these tools in the clinic. They said they hoped the new algorithm would help incorporate available therapies into treating obese patients.
The algorithm emerged from the AACE/ACE 2014 Consensus Conference on Obesity, which included medical professionals, industry representatives, advocacy groups, and regulators. One of the findings that everyone agreed on was that the diagnostic definition of obesity needed to improve.
The current definition of obesity "didn’t give all the stakeholders a reason to buy into a concerted plan." Employers would say, "I bring somebody down from a BMI of 38 to 34. But what does that mean? "How is it benefiting me? How is it benefiting my company? Why would I want to invest in that? But if they’re treating Stage 2, that’s telling them that that person is overweight, has excessive body fat, and it’s impacting their health and they have complications that can be remedied by weight loss and use of more aggressive therapies. All of that is embedded in that simple term," Dr. Garvey said.
The AACE/ACE is not the first to issue a diagnosis or treatment guideline for obesity, which was declared a disease by the American Medical Association in 2013.
There are a lot of commonalities to the guidelines," said Dr. Garvey, professor and chair at the department of Nutrition Sciences at the University of Alabama at Birmingham. They’re all addressing obesity and therapy and attempt to improve patients’ health. "I think we’re more focused on using weight loss as a therapy to treat obesity-related complications," Dr. Garvey said.
AACE/ACE is holding another consensus conference later this year as a step toward finalizing the framework.
Dr. Garvey is a consultant for Daiichi Sankyo, Liposcience, Takeda, Vivus, Boehringer Ingelheim, Janssen, Eisai, and Novo Nordisk. He has received research funding from Merck, Astra Zeneca, Weight Watchers, Eisai, and Sanofi.
On Twitter @naseemmiller
ADA Unifies All Pediatric HbA1c Targets to Less Than 7.5%
SAN FRANCISCO – The American Diabetes Association has unified the pediatric hemoglobin A1c target values to less than 7.5% for all pediatric age groups, moving away from breaking down glycemic control targets by age. This will also harmonize the HbA1c goals with those of international groups such as the International Society of Pediatric and Adolescent Diabetes (ISPAD).
The change is part of a new position statement released on June 16 during the annual scientific sessions of the American Diabetes Association (Diabetes Care 2014;37:2034-54). The document also for the first time brings together recommendations for care of individuals with type 1 diabetes across all age groups.
In a video interview, Dr. Lori M.B. Laffel, one of the statement’s coauthors and chief of the pediatric, adolescent, and young adult section at Joslin Diabetes Center, Boston, explains the rationale behind this decision. Dr. David Maahs of the University of Colorado, Aurora, discusses the potential concern regarding the risk of hypoglycemia.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
On Twitter @naseemmiller
SAN FRANCISCO – The American Diabetes Association has unified the pediatric hemoglobin A1c target values to less than 7.5% for all pediatric age groups, moving away from breaking down glycemic control targets by age. This will also harmonize the HbA1c goals with those of international groups such as the International Society of Pediatric and Adolescent Diabetes (ISPAD).
The change is part of a new position statement released on June 16 during the annual scientific sessions of the American Diabetes Association (Diabetes Care 2014;37:2034-54). The document also for the first time brings together recommendations for care of individuals with type 1 diabetes across all age groups.
In a video interview, Dr. Lori M.B. Laffel, one of the statement’s coauthors and chief of the pediatric, adolescent, and young adult section at Joslin Diabetes Center, Boston, explains the rationale behind this decision. Dr. David Maahs of the University of Colorado, Aurora, discusses the potential concern regarding the risk of hypoglycemia.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
On Twitter @naseemmiller
SAN FRANCISCO – The American Diabetes Association has unified the pediatric hemoglobin A1c target values to less than 7.5% for all pediatric age groups, moving away from breaking down glycemic control targets by age. This will also harmonize the HbA1c goals with those of international groups such as the International Society of Pediatric and Adolescent Diabetes (ISPAD).
The change is part of a new position statement released on June 16 during the annual scientific sessions of the American Diabetes Association (Diabetes Care 2014;37:2034-54). The document also for the first time brings together recommendations for care of individuals with type 1 diabetes across all age groups.
In a video interview, Dr. Lori M.B. Laffel, one of the statement’s coauthors and chief of the pediatric, adolescent, and young adult section at Joslin Diabetes Center, Boston, explains the rationale behind this decision. Dr. David Maahs of the University of Colorado, Aurora, discusses the potential concern regarding the risk of hypoglycemia.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
On Twitter @naseemmiller
AT THE ADA ANNUAL SCIENTIFIC SESSIONS
VIDEO: ADA unifies all pediatric HbA1c targets to less than 7.5%
SAN FRANCISCO – The American Diabetes Association has unified the pediatric hemoglobin A1c target values to less than 7.5% for all pediatric age groups, moving away from breaking down glycemic control targets by age. This will also harmonize the HbA1c goals with those of international groups such as the International Society of Pediatric and Adolescent Diabetes (ISPAD).
The change is part of a new position statement released on June 16 during the annual scientific sessions of the American Diabetes Association (Diabetes Care 2014;37:2034-54). The document also for the first time brings together recommendations for care of individuals with type 1 diabetes across all age groups.
In a video interview, Dr. Lori M.B. Laffel, one of the statement’s coauthors and chief of the pediatric, adolescent, and young adult section at Joslin Diabetes Center, Boston, explains the rationale behind this decision. Dr. David Maahs of the University of Colorado, Aurora, discusses the potential concern regarding the risk of hypoglycemia.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
On Twitter @naseemmiller
SAN FRANCISCO – The American Diabetes Association has unified the pediatric hemoglobin A1c target values to less than 7.5% for all pediatric age groups, moving away from breaking down glycemic control targets by age. This will also harmonize the HbA1c goals with those of international groups such as the International Society of Pediatric and Adolescent Diabetes (ISPAD).
The change is part of a new position statement released on June 16 during the annual scientific sessions of the American Diabetes Association (Diabetes Care 2014;37:2034-54). The document also for the first time brings together recommendations for care of individuals with type 1 diabetes across all age groups.
In a video interview, Dr. Lori M.B. Laffel, one of the statement’s coauthors and chief of the pediatric, adolescent, and young adult section at Joslin Diabetes Center, Boston, explains the rationale behind this decision. Dr. David Maahs of the University of Colorado, Aurora, discusses the potential concern regarding the risk of hypoglycemia.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
On Twitter @naseemmiller
SAN FRANCISCO – The American Diabetes Association has unified the pediatric hemoglobin A1c target values to less than 7.5% for all pediatric age groups, moving away from breaking down glycemic control targets by age. This will also harmonize the HbA1c goals with those of international groups such as the International Society of Pediatric and Adolescent Diabetes (ISPAD).
The change is part of a new position statement released on June 16 during the annual scientific sessions of the American Diabetes Association (Diabetes Care 2014;37:2034-54). The document also for the first time brings together recommendations for care of individuals with type 1 diabetes across all age groups.
In a video interview, Dr. Lori M.B. Laffel, one of the statement’s coauthors and chief of the pediatric, adolescent, and young adult section at Joslin Diabetes Center, Boston, explains the rationale behind this decision. Dr. David Maahs of the University of Colorado, Aurora, discusses the potential concern regarding the risk of hypoglycemia.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
On Twitter @naseemmiller
AT THE ADA ANNUAL SCIENTIFIC SESSIONS
Glucose lights up the adolescent brain
SAN FRANCISCO – The developing adolescent brain may be responding differently to sugary drinks, leading to higher consumption of sugars and feeding the childhood obesity epidemic, according to researchers.
The findings come from a small, preliminary study that compared cerebral blood flow in 14 lean adolescents and 20 lean adults brains after the study subjects ingested 75 g of glucose.
Functional MRI scans revealed that glucose ingestion increased cerebral blood flow in the reward and executive function areas of the teens’ brains.
"This study is the first step in understanding what is occurring in the developing adolescent brain in response to drinking sugar," said Dr. Ania M. Jastreboff of Yale University, New Haven, Conn.
Several areas of the brain regulate food intake. They include the hypothalamus; the striatal region, which includes the putamen and caudate and is in charge of motivation and reward; the limbic region, where emotion and memory reside; and the cortical region, which includes the prefrontal cortex, insula, and the anterior cingulate cortex and handles the integration and processing of the brain.
In a previous study, Dr. Jastreboff and colleagues showed that "obese, but not lean, individuals exhibited increased activation in striatal, insular, and hypothalamic regions during exposure to favorite-food" (Diabetes Care 2013;36:394-402).
The group also has shown that glucose ingestion in lean adults reduced cerebral blood flow in appetite-regulation and reward-processing regions of the brain, Dr. Jastreboff said at the annual scientific sessions of the American Diabetes Association.
Subsequently, they wanted to find out if lean adolescent brains, compared with brains of lean adults, responded differently to glucose.
Among the subjects, the average body mass index was 22 kg/m2, and the mean age was 16 years for adolescents and 31 years for adults.
They came in at 8 a.m. after overnight fasting. They had a baseline MRI, drank 75 g of glucose, and had a functional MRI scan. Their labs were drawn every 10 minutes throughout the 1-hour scanning procedures.
Results showed that in lean adolescents, glucose ingestion increased cerebral blood flow in the striatum, insula, anterior cingulate cortex and the prefrontal cortex, all of which are regions of the brain that reside in the corticostriatal-limbic circuitry undergoing significant developmental changes during adolescence, said Dr. Jastreboff. There were no changes in hypothalamus and thalamus blood flow.
In contrast, consumption of the sugary drink in lean adults decreased cerebral blood flow in the hypothalamus, thalamus, striatum, insula, and the anterior cingulate cortex. There was no change in the prefrontal cortex.
"We hypothesize that these striking differences in brain response to glucose ingestion might contribute to adolescents’ higher consumption of added sugars," said Dr. Jastreboff.
She said that her group also conducted the study in obese adolescents and the results should be published soon. "What I can say is that the responses were different," she said.
The findings are far from definitive.
"I’m always skeptical that any test, if repeated the next day, will show the same thing," said Dr. Silva Arslanian, professor of pediatrics at the University of Pittsburgh. "The question is, is it an innate difference, or is it an environmental-driven difference?"
"But it’s definitely new data that needs to be pursued further to see what its translation is," said Dr. Arslanian, who was not involved in the study.
Dr. Jastreboff and Dr. Arslanian had no relevant disclosures.
On Twitter @naseemmiller
SAN FRANCISCO – The developing adolescent brain may be responding differently to sugary drinks, leading to higher consumption of sugars and feeding the childhood obesity epidemic, according to researchers.
The findings come from a small, preliminary study that compared cerebral blood flow in 14 lean adolescents and 20 lean adults brains after the study subjects ingested 75 g of glucose.
Functional MRI scans revealed that glucose ingestion increased cerebral blood flow in the reward and executive function areas of the teens’ brains.
"This study is the first step in understanding what is occurring in the developing adolescent brain in response to drinking sugar," said Dr. Ania M. Jastreboff of Yale University, New Haven, Conn.
Several areas of the brain regulate food intake. They include the hypothalamus; the striatal region, which includes the putamen and caudate and is in charge of motivation and reward; the limbic region, where emotion and memory reside; and the cortical region, which includes the prefrontal cortex, insula, and the anterior cingulate cortex and handles the integration and processing of the brain.
In a previous study, Dr. Jastreboff and colleagues showed that "obese, but not lean, individuals exhibited increased activation in striatal, insular, and hypothalamic regions during exposure to favorite-food" (Diabetes Care 2013;36:394-402).
The group also has shown that glucose ingestion in lean adults reduced cerebral blood flow in appetite-regulation and reward-processing regions of the brain, Dr. Jastreboff said at the annual scientific sessions of the American Diabetes Association.
Subsequently, they wanted to find out if lean adolescent brains, compared with brains of lean adults, responded differently to glucose.
Among the subjects, the average body mass index was 22 kg/m2, and the mean age was 16 years for adolescents and 31 years for adults.
They came in at 8 a.m. after overnight fasting. They had a baseline MRI, drank 75 g of glucose, and had a functional MRI scan. Their labs were drawn every 10 minutes throughout the 1-hour scanning procedures.
Results showed that in lean adolescents, glucose ingestion increased cerebral blood flow in the striatum, insula, anterior cingulate cortex and the prefrontal cortex, all of which are regions of the brain that reside in the corticostriatal-limbic circuitry undergoing significant developmental changes during adolescence, said Dr. Jastreboff. There were no changes in hypothalamus and thalamus blood flow.
In contrast, consumption of the sugary drink in lean adults decreased cerebral blood flow in the hypothalamus, thalamus, striatum, insula, and the anterior cingulate cortex. There was no change in the prefrontal cortex.
"We hypothesize that these striking differences in brain response to glucose ingestion might contribute to adolescents’ higher consumption of added sugars," said Dr. Jastreboff.
She said that her group also conducted the study in obese adolescents and the results should be published soon. "What I can say is that the responses were different," she said.
The findings are far from definitive.
"I’m always skeptical that any test, if repeated the next day, will show the same thing," said Dr. Silva Arslanian, professor of pediatrics at the University of Pittsburgh. "The question is, is it an innate difference, or is it an environmental-driven difference?"
"But it’s definitely new data that needs to be pursued further to see what its translation is," said Dr. Arslanian, who was not involved in the study.
Dr. Jastreboff and Dr. Arslanian had no relevant disclosures.
On Twitter @naseemmiller
SAN FRANCISCO – The developing adolescent brain may be responding differently to sugary drinks, leading to higher consumption of sugars and feeding the childhood obesity epidemic, according to researchers.
The findings come from a small, preliminary study that compared cerebral blood flow in 14 lean adolescents and 20 lean adults brains after the study subjects ingested 75 g of glucose.
Functional MRI scans revealed that glucose ingestion increased cerebral blood flow in the reward and executive function areas of the teens’ brains.
"This study is the first step in understanding what is occurring in the developing adolescent brain in response to drinking sugar," said Dr. Ania M. Jastreboff of Yale University, New Haven, Conn.
Several areas of the brain regulate food intake. They include the hypothalamus; the striatal region, which includes the putamen and caudate and is in charge of motivation and reward; the limbic region, where emotion and memory reside; and the cortical region, which includes the prefrontal cortex, insula, and the anterior cingulate cortex and handles the integration and processing of the brain.
In a previous study, Dr. Jastreboff and colleagues showed that "obese, but not lean, individuals exhibited increased activation in striatal, insular, and hypothalamic regions during exposure to favorite-food" (Diabetes Care 2013;36:394-402).
The group also has shown that glucose ingestion in lean adults reduced cerebral blood flow in appetite-regulation and reward-processing regions of the brain, Dr. Jastreboff said at the annual scientific sessions of the American Diabetes Association.
Subsequently, they wanted to find out if lean adolescent brains, compared with brains of lean adults, responded differently to glucose.
Among the subjects, the average body mass index was 22 kg/m2, and the mean age was 16 years for adolescents and 31 years for adults.
They came in at 8 a.m. after overnight fasting. They had a baseline MRI, drank 75 g of glucose, and had a functional MRI scan. Their labs were drawn every 10 minutes throughout the 1-hour scanning procedures.
Results showed that in lean adolescents, glucose ingestion increased cerebral blood flow in the striatum, insula, anterior cingulate cortex and the prefrontal cortex, all of which are regions of the brain that reside in the corticostriatal-limbic circuitry undergoing significant developmental changes during adolescence, said Dr. Jastreboff. There were no changes in hypothalamus and thalamus blood flow.
In contrast, consumption of the sugary drink in lean adults decreased cerebral blood flow in the hypothalamus, thalamus, striatum, insula, and the anterior cingulate cortex. There was no change in the prefrontal cortex.
"We hypothesize that these striking differences in brain response to glucose ingestion might contribute to adolescents’ higher consumption of added sugars," said Dr. Jastreboff.
She said that her group also conducted the study in obese adolescents and the results should be published soon. "What I can say is that the responses were different," she said.
The findings are far from definitive.
"I’m always skeptical that any test, if repeated the next day, will show the same thing," said Dr. Silva Arslanian, professor of pediatrics at the University of Pittsburgh. "The question is, is it an innate difference, or is it an environmental-driven difference?"
"But it’s definitely new data that needs to be pursued further to see what its translation is," said Dr. Arslanian, who was not involved in the study.
Dr. Jastreboff and Dr. Arslanian had no relevant disclosures.
On Twitter @naseemmiller
AT THE ADA ANNUAL SCIENTIFIC SESSIONS
Key clinical point: Reward centers of the adolescent brain may be susceptible to sugar.
Major finding: Glucose ingestion increased cerebral blood flow in the reward and executive function areas of the adolescent brain, in contrast to adults.
Data source: Functional MRI brain scans of 14 lean adolescents and 20 lean adults after ingestion of glucose.
Disclosures: Dr. Jastreboff and Dr. Arslanian had no relevant disclosures.
Novel combination drug IDegLira boosts glycemic control
SAN FRANCISCO – The fixed-ratio combination of insulin degludec and the glucagonlike peptide-1 receptor agonist liraglutide improved glycemic control with a low risk of hypoglycemia across different weight groups, according to a post-hoc analysis of two phase III trials.
The investigational drug IDegLira also effectively reduced hemoglobin A1c (HbA1c) in both insulin-naive patients and in patients who were previously uncontrolled on basal insulin, Dr. John B. Buse reported at the annual scientific sessions of the American Diabetes Association.
Dr. Buse and his colleagues analyzed the phase III DUAL I and DUAL II trials to find the efficacy and safety of IDegLira across four body mass index (BMI) categories: less than 25 kg/m2; 25-30 kg/m2; 30-35 kg/m2; and more than 35 kg/m2.
DUAL I, a large open-label study of 1,600 insulin-naive patients with type 2 diabetes, compared IDegLira with insulin degludec (IDeg) and with liraglutide (Lira).
The DUAL II trial involved 400 patients and was designed to specifically study the contribution of liraglutide in IDegLira, compared with IDeg alone. Study participants had been on modest doses of insulin and had relatively uncontrolled diabetes.
The analysis showed that there was a consistent and significant HbA1c reduction across all baseline BMI categories in the DUAL I and DUAL II trials.
In DUAL I, IDegLira reduced HbA1c by 1.8%-1.9%. IDeg lowered HbA1c levels between 1.1% and 1.4%, and Lira reduced those levels between 1.1% and 1.3%.
The DUAL II results also showed similar significant reductions when IDegLira was compared with IDeg. "Relatively great efficacy of combination is maintained across the BMI categories," said Dr. Buse, professor of medicine, chief of the division of endocrinology and metabolism, and executive associate dean for clinical research at the University of North Carolina, Chapel Hill.
With IDegLira, there also were low rates of hypoglycemia across the four BMI categories in both trials.
The combination also reduced insulin requirement across BMI categories in DUAL I when IDegLira was compared with IDeg. In DUAL II, the insulin doses were equivalent for IDegLira and IDeg across the BMI categories, since titration was capped at 50 units to achieve identical exposure.
Previous studies on the combination of insulin with GLP-1 agonists have had uniformly encouraging results, showing less weight gain and in some cases better overall glucose control, said Dr. Matthew C. Riddle, professor of medicine at Oregon Health and Science University in Portland, who was not involved in the study.
Combination therapies do have some disadvantages, he said, and "you get potential side effects from GLP-1 agonists that you don’t get from insulin. But overall, the balance looks very favorable. So this is one in a series of studies that shows this is an attractive option for the future."
Dr. Buse is a consultant to Novo Nordisk and more than 30 other pharmaceutical companies. Dr. Riddle said that he is a consultant for several companies, including Novo Nordisk.
On Twitter @naseemmiller
phase III DUAL I and DUAL II trials, insulin-naive patients with type 2 diabetes, insulin degludec, IDeg, liraglutide, Lira, HbA1c reduction,
SAN FRANCISCO – The fixed-ratio combination of insulin degludec and the glucagonlike peptide-1 receptor agonist liraglutide improved glycemic control with a low risk of hypoglycemia across different weight groups, according to a post-hoc analysis of two phase III trials.
The investigational drug IDegLira also effectively reduced hemoglobin A1c (HbA1c) in both insulin-naive patients and in patients who were previously uncontrolled on basal insulin, Dr. John B. Buse reported at the annual scientific sessions of the American Diabetes Association.
Dr. Buse and his colleagues analyzed the phase III DUAL I and DUAL II trials to find the efficacy and safety of IDegLira across four body mass index (BMI) categories: less than 25 kg/m2; 25-30 kg/m2; 30-35 kg/m2; and more than 35 kg/m2.
DUAL I, a large open-label study of 1,600 insulin-naive patients with type 2 diabetes, compared IDegLira with insulin degludec (IDeg) and with liraglutide (Lira).
The DUAL II trial involved 400 patients and was designed to specifically study the contribution of liraglutide in IDegLira, compared with IDeg alone. Study participants had been on modest doses of insulin and had relatively uncontrolled diabetes.
The analysis showed that there was a consistent and significant HbA1c reduction across all baseline BMI categories in the DUAL I and DUAL II trials.
In DUAL I, IDegLira reduced HbA1c by 1.8%-1.9%. IDeg lowered HbA1c levels between 1.1% and 1.4%, and Lira reduced those levels between 1.1% and 1.3%.
The DUAL II results also showed similar significant reductions when IDegLira was compared with IDeg. "Relatively great efficacy of combination is maintained across the BMI categories," said Dr. Buse, professor of medicine, chief of the division of endocrinology and metabolism, and executive associate dean for clinical research at the University of North Carolina, Chapel Hill.
With IDegLira, there also were low rates of hypoglycemia across the four BMI categories in both trials.
The combination also reduced insulin requirement across BMI categories in DUAL I when IDegLira was compared with IDeg. In DUAL II, the insulin doses were equivalent for IDegLira and IDeg across the BMI categories, since titration was capped at 50 units to achieve identical exposure.
Previous studies on the combination of insulin with GLP-1 agonists have had uniformly encouraging results, showing less weight gain and in some cases better overall glucose control, said Dr. Matthew C. Riddle, professor of medicine at Oregon Health and Science University in Portland, who was not involved in the study.
Combination therapies do have some disadvantages, he said, and "you get potential side effects from GLP-1 agonists that you don’t get from insulin. But overall, the balance looks very favorable. So this is one in a series of studies that shows this is an attractive option for the future."
Dr. Buse is a consultant to Novo Nordisk and more than 30 other pharmaceutical companies. Dr. Riddle said that he is a consultant for several companies, including Novo Nordisk.
On Twitter @naseemmiller
SAN FRANCISCO – The fixed-ratio combination of insulin degludec and the glucagonlike peptide-1 receptor agonist liraglutide improved glycemic control with a low risk of hypoglycemia across different weight groups, according to a post-hoc analysis of two phase III trials.
The investigational drug IDegLira also effectively reduced hemoglobin A1c (HbA1c) in both insulin-naive patients and in patients who were previously uncontrolled on basal insulin, Dr. John B. Buse reported at the annual scientific sessions of the American Diabetes Association.
Dr. Buse and his colleagues analyzed the phase III DUAL I and DUAL II trials to find the efficacy and safety of IDegLira across four body mass index (BMI) categories: less than 25 kg/m2; 25-30 kg/m2; 30-35 kg/m2; and more than 35 kg/m2.
DUAL I, a large open-label study of 1,600 insulin-naive patients with type 2 diabetes, compared IDegLira with insulin degludec (IDeg) and with liraglutide (Lira).
The DUAL II trial involved 400 patients and was designed to specifically study the contribution of liraglutide in IDegLira, compared with IDeg alone. Study participants had been on modest doses of insulin and had relatively uncontrolled diabetes.
The analysis showed that there was a consistent and significant HbA1c reduction across all baseline BMI categories in the DUAL I and DUAL II trials.
In DUAL I, IDegLira reduced HbA1c by 1.8%-1.9%. IDeg lowered HbA1c levels between 1.1% and 1.4%, and Lira reduced those levels between 1.1% and 1.3%.
The DUAL II results also showed similar significant reductions when IDegLira was compared with IDeg. "Relatively great efficacy of combination is maintained across the BMI categories," said Dr. Buse, professor of medicine, chief of the division of endocrinology and metabolism, and executive associate dean for clinical research at the University of North Carolina, Chapel Hill.
With IDegLira, there also were low rates of hypoglycemia across the four BMI categories in both trials.
The combination also reduced insulin requirement across BMI categories in DUAL I when IDegLira was compared with IDeg. In DUAL II, the insulin doses were equivalent for IDegLira and IDeg across the BMI categories, since titration was capped at 50 units to achieve identical exposure.
Previous studies on the combination of insulin with GLP-1 agonists have had uniformly encouraging results, showing less weight gain and in some cases better overall glucose control, said Dr. Matthew C. Riddle, professor of medicine at Oregon Health and Science University in Portland, who was not involved in the study.
Combination therapies do have some disadvantages, he said, and "you get potential side effects from GLP-1 agonists that you don’t get from insulin. But overall, the balance looks very favorable. So this is one in a series of studies that shows this is an attractive option for the future."
Dr. Buse is a consultant to Novo Nordisk and more than 30 other pharmaceutical companies. Dr. Riddle said that he is a consultant for several companies, including Novo Nordisk.
On Twitter @naseemmiller
phase III DUAL I and DUAL II trials, insulin-naive patients with type 2 diabetes, insulin degludec, IDeg, liraglutide, Lira, HbA1c reduction,
phase III DUAL I and DUAL II trials, insulin-naive patients with type 2 diabetes, insulin degludec, IDeg, liraglutide, Lira, HbA1c reduction,
AT THE ADA ANNUAL SCIENTIFIC SESSIONS
Key clinical point: Combining insulin with GLP-1 receptor agonists continues to be an attractive therapeutic option for patients across BMI categories with uncontrolled diabetes.
Major finding: The investigational drug IDegLira effectively reduced HbA1c in both insulin-naive patients and in patients who previously were uncontrolled on basal insulin.
Data source: Post-hoc analysis of phase III DUAL I and DUAL II trials.
Disclosures: Dr. Buse is a consultant to Novo Nordisk and more than 30 other pharmaceutical companies. Dr. Riddle said that he is a consultant for several companies, including Novo Nordisk.
VIDEO: Teen brain reacts to sugar differently
SAN FRANCISCO — When it comes to glucose ingestion, the adolescent brain reacts differently than the adult brain. That’s according to functional MRI scans comparing the cerebral blood flow of lean adolescents with lean adults, Dr. Ania M. Jastreboff reported June 15 at the annual scientific sessions of the American Diabetes Association.
Researchers found that lean adolescents showed increased cerebral blood flow in several regions, including the reward-motivation region (striatum), the impulse control region (anterior cingulate cortex), and the prefrontal cortex, which is in charge of executive function regulation. All these regions undergo marked developmental changes during adolescence.
In a video interview, Dr. Jastreboff, assistant professor of internal medicine and pediatrics at Yale University, New Haven, Conn., further explains the study’s findings and its implications.
On Twitter @naseemmiller
SAN FRANCISCO — When it comes to glucose ingestion, the adolescent brain reacts differently than the adult brain. That’s according to functional MRI scans comparing the cerebral blood flow of lean adolescents with lean adults, Dr. Ania M. Jastreboff reported June 15 at the annual scientific sessions of the American Diabetes Association.
Researchers found that lean adolescents showed increased cerebral blood flow in several regions, including the reward-motivation region (striatum), the impulse control region (anterior cingulate cortex), and the prefrontal cortex, which is in charge of executive function regulation. All these regions undergo marked developmental changes during adolescence.
In a video interview, Dr. Jastreboff, assistant professor of internal medicine and pediatrics at Yale University, New Haven, Conn., further explains the study’s findings and its implications.
On Twitter @naseemmiller
SAN FRANCISCO — When it comes to glucose ingestion, the adolescent brain reacts differently than the adult brain. That’s according to functional MRI scans comparing the cerebral blood flow of lean adolescents with lean adults, Dr. Ania M. Jastreboff reported June 15 at the annual scientific sessions of the American Diabetes Association.
Researchers found that lean adolescents showed increased cerebral blood flow in several regions, including the reward-motivation region (striatum), the impulse control region (anterior cingulate cortex), and the prefrontal cortex, which is in charge of executive function regulation. All these regions undergo marked developmental changes during adolescence.
In a video interview, Dr. Jastreboff, assistant professor of internal medicine and pediatrics at Yale University, New Haven, Conn., further explains the study’s findings and its implications.
On Twitter @naseemmiller
AT THE ADA ANNUAL SCIENTIFIC SESSIONS
VIDEO: ACC/AHA lipid guidelines and diabetes
SAN FRANCISCO – Those looking for guidance from the American Diabetes Association regarding the guidelines released last fall from the American College of Cardiology and the American Heart Association dropping cholesterol treatment goals will have to wait until next year.
That’s when the ADA’s Clinical Practice Recommendations, released each year in January, will incorporate the Professional Practice Committee’s review of the ACC/AHA guidelines and the evidence behind it. The new recommendations caused some controversy and raised some questions about treatment of certain patient groups, most notably those with diabetes.
The ADA hasn’t recommended any changes to its current guidelines, which still incorporate treatment to target. But it has been reviewing the guidelines to see if it would recommend any changes for its 2015 guidelines.
Dr. Robert E. Ratner, chief scientific and medical officer for the American Diabetes Association, further explained the organization’s position on treatment of lipids in patients with diabetes in a video interview at the annual scientific sessions of the ADA.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
The association is also holding a debate at this year’s meeting to discuss the pros and cons of the new lipid guidelines for patients with diabetes.
In a press conference, Dr. Robert Eckel, professor of medicine and Charles A. Boettcher chair in atherosclerosis at University of Colorado, Anschutz Medical Campus, Aurora, said he was in support of the ACC/AHA guidelines, having served on the Task Force on Practice Guidelines, and that he believed that almost all patients with diabetes should be on a statin. He stressed that the new guidelines are evidence based.
But Dr. Henry Ginsberg, Irving Professor of Medicine and Director of the Irving Institute for Clinical and Translational Research at Columbia University, New York, argued that the guidelines’ evidence-based construct was too narrow.
In a video interview, Dr. Ginsberg further discussed his position and his practice tips for physicians.
Both physicians agreed that patients should be treated on an individual basis. For instance, patients who are statin intolerant won’t meet the guidelines’ criteria and "we’ll have to go beyond the guidelines," said Dr. Eckel.
On Twitter @naseemmiller
SAN FRANCISCO – Those looking for guidance from the American Diabetes Association regarding the guidelines released last fall from the American College of Cardiology and the American Heart Association dropping cholesterol treatment goals will have to wait until next year.
That’s when the ADA’s Clinical Practice Recommendations, released each year in January, will incorporate the Professional Practice Committee’s review of the ACC/AHA guidelines and the evidence behind it. The new recommendations caused some controversy and raised some questions about treatment of certain patient groups, most notably those with diabetes.
The ADA hasn’t recommended any changes to its current guidelines, which still incorporate treatment to target. But it has been reviewing the guidelines to see if it would recommend any changes for its 2015 guidelines.
Dr. Robert E. Ratner, chief scientific and medical officer for the American Diabetes Association, further explained the organization’s position on treatment of lipids in patients with diabetes in a video interview at the annual scientific sessions of the ADA.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
The association is also holding a debate at this year’s meeting to discuss the pros and cons of the new lipid guidelines for patients with diabetes.
In a press conference, Dr. Robert Eckel, professor of medicine and Charles A. Boettcher chair in atherosclerosis at University of Colorado, Anschutz Medical Campus, Aurora, said he was in support of the ACC/AHA guidelines, having served on the Task Force on Practice Guidelines, and that he believed that almost all patients with diabetes should be on a statin. He stressed that the new guidelines are evidence based.
But Dr. Henry Ginsberg, Irving Professor of Medicine and Director of the Irving Institute for Clinical and Translational Research at Columbia University, New York, argued that the guidelines’ evidence-based construct was too narrow.
In a video interview, Dr. Ginsberg further discussed his position and his practice tips for physicians.
Both physicians agreed that patients should be treated on an individual basis. For instance, patients who are statin intolerant won’t meet the guidelines’ criteria and "we’ll have to go beyond the guidelines," said Dr. Eckel.
On Twitter @naseemmiller
SAN FRANCISCO – Those looking for guidance from the American Diabetes Association regarding the guidelines released last fall from the American College of Cardiology and the American Heart Association dropping cholesterol treatment goals will have to wait until next year.
That’s when the ADA’s Clinical Practice Recommendations, released each year in January, will incorporate the Professional Practice Committee’s review of the ACC/AHA guidelines and the evidence behind it. The new recommendations caused some controversy and raised some questions about treatment of certain patient groups, most notably those with diabetes.
The ADA hasn’t recommended any changes to its current guidelines, which still incorporate treatment to target. But it has been reviewing the guidelines to see if it would recommend any changes for its 2015 guidelines.
Dr. Robert E. Ratner, chief scientific and medical officer for the American Diabetes Association, further explained the organization’s position on treatment of lipids in patients with diabetes in a video interview at the annual scientific sessions of the ADA.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
The association is also holding a debate at this year’s meeting to discuss the pros and cons of the new lipid guidelines for patients with diabetes.
In a press conference, Dr. Robert Eckel, professor of medicine and Charles A. Boettcher chair in atherosclerosis at University of Colorado, Anschutz Medical Campus, Aurora, said he was in support of the ACC/AHA guidelines, having served on the Task Force on Practice Guidelines, and that he believed that almost all patients with diabetes should be on a statin. He stressed that the new guidelines are evidence based.
But Dr. Henry Ginsberg, Irving Professor of Medicine and Director of the Irving Institute for Clinical and Translational Research at Columbia University, New York, argued that the guidelines’ evidence-based construct was too narrow.
In a video interview, Dr. Ginsberg further discussed his position and his practice tips for physicians.
Both physicians agreed that patients should be treated on an individual basis. For instance, patients who are statin intolerant won’t meet the guidelines’ criteria and "we’ll have to go beyond the guidelines," said Dr. Eckel.
On Twitter @naseemmiller
AT THE ADA ANNUAL SCIENTIFIC SESSIONS
Bottom Line on Maternal Infections and Cerebral Palsy
VANCOUVER, B.C. – Intra- or extra-amniotic fluid infections during pregnancy elevate the risk of having a child with cerebral palsy, according to analysis of 6 million California birth records – although the findings shows an association, not causality.
Researchers showed that pregnant women who were hospitalized with a diagnosis of chorioamnionitis had a fourfold increase in the risk of having a child with cerebral palsy (CP), while genitourinary and respiratory infections increased that risk twofold.
"I think this is a very important study, and it took us a step further in trying to understand what could cause cerebral palsy," said Dr. Lee M. Sanders, associate professor of pediatrics and codirector of the Center for Policy, Outcomes, and Prevention at Stanford (Calif.) University.
Because the study shows an association only, however, "it’s important not to cause alarm," cautioned Dr. Sanders, who was not involved in the study.
In a video interview, Dr. Sanders explains what’s known so far about this association, the implications of the study’s findings, and the research that’s already underway.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
On Twitter @naseemmiller
VANCOUVER, B.C. – Intra- or extra-amniotic fluid infections during pregnancy elevate the risk of having a child with cerebral palsy, according to analysis of 6 million California birth records – although the findings shows an association, not causality.
Researchers showed that pregnant women who were hospitalized with a diagnosis of chorioamnionitis had a fourfold increase in the risk of having a child with cerebral palsy (CP), while genitourinary and respiratory infections increased that risk twofold.
"I think this is a very important study, and it took us a step further in trying to understand what could cause cerebral palsy," said Dr. Lee M. Sanders, associate professor of pediatrics and codirector of the Center for Policy, Outcomes, and Prevention at Stanford (Calif.) University.
Because the study shows an association only, however, "it’s important not to cause alarm," cautioned Dr. Sanders, who was not involved in the study.
In a video interview, Dr. Sanders explains what’s known so far about this association, the implications of the study’s findings, and the research that’s already underway.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
On Twitter @naseemmiller
VANCOUVER, B.C. – Intra- or extra-amniotic fluid infections during pregnancy elevate the risk of having a child with cerebral palsy, according to analysis of 6 million California birth records – although the findings shows an association, not causality.
Researchers showed that pregnant women who were hospitalized with a diagnosis of chorioamnionitis had a fourfold increase in the risk of having a child with cerebral palsy (CP), while genitourinary and respiratory infections increased that risk twofold.
"I think this is a very important study, and it took us a step further in trying to understand what could cause cerebral palsy," said Dr. Lee M. Sanders, associate professor of pediatrics and codirector of the Center for Policy, Outcomes, and Prevention at Stanford (Calif.) University.
Because the study shows an association only, however, "it’s important not to cause alarm," cautioned Dr. Sanders, who was not involved in the study.
In a video interview, Dr. Sanders explains what’s known so far about this association, the implications of the study’s findings, and the research that’s already underway.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
On Twitter @naseemmiller
AT THE PAS ANNUAL MEETING
