Call for diabetes screening in adults with asthma or COPD

A respiratory expert has called for patients with chronic airway inflammation to be screened for type 2 diabetes following a study which showed they are at increased risk of the disease.

Thoracic physician, Professor Christine Jenkins, Clinical Professor of Medicine at the University of Sydney, also warned doctors to be cautious about prescribing unnecessary doses of corticosteroids when managing patients with asthma or chronic obstructive pulmonary disease (COPD).

She was commenting on the results of a study, published in Diabetes Research and Clinical Practice involving a cohort of 38,570 women from the Women’s Health Study.

The women, aged 45 years or more, were free of cardiovascular disease and cancer at baseline, and free of diabetes at baseline and in the first 12 months.

However, during a median follow-up of 12.2 years, 2,472 cases of type 2 diabetes were reported.

Women with asthma had a 37% increased risk of diabetes, and those with COPD, including emphysema, chronic bronchitis and bronchiectasis, without asthma had a 38% increased risk.

The risks were independent of traditional diabetes risk factors including age, smoking, physical activity, BMI, alcohol intake, hormone replacement therapy and menopausal status.

The authors said their results indicated chronic airway inflammation might contribute to the pathogenesis of diabetes.

Professor Jenkins said given the prevalence of asthma and COPD in Australia, a 38% increased risk of diabetes meant such patients should be screened.

She said this would maximise the chances of the patient maintaining good quality of life and being free of exacerbations without the need for oral corticosteroids.

Professor Jenkins said up to 20% of adults in Australia were thought to have an obstructive airways disease of some type.

The increased risk appeared to be independent of other known risk factors for diabetes, she said.

Diabetes expert, Professor Stephen Colagiuri, Professor of Metabolic Health at the University of Sydney, said it was important for clinicians to be aware of the link.

Such patients should be advised to take more care with activities such as diet, physical activity and other lifestyle changes that minimised their risk of diabetes.

A drawback of the study was that it did not assess the use of corticosteroids, Professor Colagiuri said.

Diabetes research shows results
After three years of collaborative research involving patients from the Busselton Health Study in Wetsern Australia, drug discovery company, Proteomics International, announced the identification and analytical validation of 13 protein biomarkers for a significant complication of diabetes – diabetic nephropathy (kidney disease).

In a presentation at the Human Proteome Organisation’s World Congress in Sydney, Dr Richard Lipscombe, managing director of Proteomics International, revealed the findings that could benefit many of the 250 million people worldwide who have diabetes.

“Applying our uniquely accredited proteomics biomarker expertise to patient samples (plasma) from the Busselton Health Study and the Fremantle Diabetes Study allowed us to analyse three well characterized clinical cohorts of selected disease groups (adults who had Type 2 diabetes and diabetic nephropathy),” said Dr Lipscombe.

“The protein biomarkers that we found could now allow for the prediction of those patients who would progress to the development of kidney disease and provide new targets for drug therapies that prevent the onset of this serious complication,” he said.

Mediterranean eating helps combat diabetes
A 60-year-old diet from the other side of the world is having an impact in the fight against a 21st century Australian health problem, a University of Canberra researcher has found.

Associate Professor Catherine Itsiopoulos, head of nutrition and dietetics at the University of Canberra, found switching to a diet modelled on the food eaten in post-war Crete (Greece) had significant health benefits for Australians with type 2 diabetes.

Switching to a Mediterranean menu for every meal for the duration of the three-month study was effective in mitigating two of the main symptoms of type-two diabetes: elevated glucose levels and reduced levels of antioxidants, which help prevent heart disease and some cancers.