Health scan: A warning for women with gestational diabetes

Tel Aviv University research is important to note.

By JUDY SIEGEL-ITZKOVICH
Patient (photo credit: Courtesy)
Patient
(photo credit: Courtesy)
A common test to diagnose gestational diabetes – a temporary condition during pregnancy that can harm both mother and child if left untreated – also has predictive power for Type II adult-onset diabetes, according to a new Tel Aviv University study.
Dr. Gabriel Chodick of TAU Medical Faculty’s epidemiology and preventive medicine department has proven that women who “fail” the glucose challenge test – a series of four blood tests conducted over a single four-hour period – have a higher chance of developing adult-onset diabetes later in life.
In his latest research, published recently in the journal Diabetic Medicine, Chodick found that nearly half the women who fail all four of the tests, demonstrating an elevated blood sugar level, developed Type II diabetes within a decade.
Gestational diabetes currently affects 3 percent to 5% of all pregnant women in the US and other Western countries, and rates are continuing to rise, Chodick says. “It’s an epidemic that can be stopped with information and action.” His study proves statistically what has been anecdotally believed by health care practitioners in the past.
“While doctors take this into consideration, there usually isn’t close follow-up in the clinical setting,” says Chodick. He adds that women in the highest risk group (those who fail all four of the tests) should be given special counselling and intervention to prevent the onset of diabetes, which can greatly diminish quality of life and lead to adverse effects if blood sugar is not controlled, including heart disease, stroke, loss of limbs, blindness and liver disease.
In the retrospective study, Chodick, Dr.
Varda Shalev and colleagues collected data on more than 185,000 Israeli women who took the glucose challenge test and then then obtained data from the health registry on what percentage contracted diabetes later in life. They found that women who failed all four glucose challenge blood tests had a nearly 50% risk of developing Type II diabetes within the next 10 years. Those who failed three of the four tests had a 20% overall chance of developing the disease within the same period. “This is the firstever study to show the long-term health of those who failed the glucose challenge test,” says Chodick.
While doctors commonly advise that women with gestational diabetes exercise and supplement their diet with fiber (and, in the most extreme circumstances, take insulin injections), women who take the advice usually have the health of their child in mind, not themselves. After giving birth, they often resume adverse eating and lifestyle habits. Now Chodick hopes to change attitudes and policies through his new study. In the US, Israel and Europe, he concludes, health maintenance organizations are thinking about eliminating the glucose battery test from their coverage, potentially putting fetal health in danger and preventing women from receiving invaluable predictive information.
OUTPATIENT EATING DISORDERS CENTER The first center outside the center of the country for day treatment of teenagers with eating disorders has been opened at Ziv Medical Center in Safed. Half of the cost has been supplied by a Dutch family and the rest by the Health Ministry. The center allows the youngsters to live at home while receiving psychological and other treatment in the hospital. The one-stop, multidisciplinary center represents a new approach in treating anorexia, bulimia and other eating disorders; until now, victims have been hospitalized as psychiatric department inpatients. The new facility provides individual and group therapy and guidance to the parents as well.
OMEGA 3 LINKED WITH LOWER BREAST CANCER RISK There is growing evidence that fish oil supplements (omega 3) may play a role in preventing breast cancer, in addition to heart disease and others, according to a recent report in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.
Researchers at the Fred Hutchinson Cancer Research Center in Seattle, led by Dr. Emily White, asked 35,016 postmenopausal women who did not have a history of breast cancer to complete a 24-page questionnaire about their use of non-vitamin, non-mineral “specialty” supplements in the Vitamins and Lifestyle (VITAL) cohort study.
After six years of follow-up by the retrospective study, 880 cases of breast cancer were identified. The team found that regular use of fish oil supplements was linked with a 32% lower risk of invasive ductal breast cancer, the most common type of the disease. The use of other specialty supplements, many of which are commonly taken by women to treat symptoms of menopause, was not associated with breast cancer risk.
This research is the first to demonstrate a link between the use of fish oil supplements and a reduction in breast cancer. However, more studies are needed to confirm the conclusions, White said. Harvard researchers are currently enrolling 20,000 patients for the prospective randomized Vitamin D and Omega-3 Trial (also called VITAL), which will assess the impact of fish oil supplements and vitamin D on cancer, heart disease and stroke.
Meanwhile, research at the Mayo Clinic has found that Ixempra (ixabepilone), the Bristol-Myers-Squibb drug for “triple negative” breast cancer, offers hope to patients.
This is a very aggressive type of tumor that results from a specific genetic profile and has not responded well to Herceptin and other breast cancer drugs. The therapy can increase the likelihood that the tumor is a chronic illness that can be handled, the study found, rather than a disease that kills.