Posts Tagged: diabetes
Newly Published Research Provides New Insight Into How Diabetes Leads to Retinopathy
Embargo lifts at 10 a.m., Pacific Time An international team of scientists led by Professor Ingrid...
Diabetic retinopathy is the most common diabetic eye disease and a leading cause of adult blindness. Chronically high blood sugar from diabetes damages the tiny blood vessels in the retina, leading to diabetic retinopathy, according to the National Eye Institute of the National Institutes of Health. (Photo by Kathy Keatley Garvey)
Language may impact diabetes care for Latinos with limited English
When researchers studied 31,000 patients with diabetes who received insurance and healthcare through Kaiser Permanente in Northern California, they found that about 60 percent of Spanish-speaking Latino patients skipped filling prescriptions at least 20 percent of the time in the two years after they were told they needed the drugs to help control the disease.
That rate was only about 52 percent among English-speaking Latino patients and 38 percent among white patients.
"Latino patients with diabetes, even when insured and facing relatively low barriers to healthcare, are much more likely to have poor medication adherence than their white counterparts," said lead study author Dr. Alicia Fernandez, a researcher at San Francisco General Hospital and the University of California, San Francisco.
The study didn't find any difference in medication adherence for diabetics with limited English based on whether they saw Spanish-speaking doctors.
This suggests factors beyond just language and communication may come into play, researchers conclude in JAMA Internal Medicine.
"Physicians who care for Latino patients with diabetes should focus on medication adherence and explore individual barriers to adherence," Fernandez added by email. "These may include lack of 'buy-in' to medication treatment, concern regarding side effects, concerns regarding costs, and competing life demands on medication use and self-care."
But while this study didn't find that having Spanish-speaking doctors improved medication adherence, a separate study of Latino diabetics published in the same journal did see some benefit.
The researchers on the second study also looked at data from Kaiser Permanente, in this case to see whether patients with limited English proficiency might have better blood sugar control when they switched from English-speaking to Spanish-speaking primary care physicians.
This study included about 1,600 Latino patients who preferred speaking Spanish to English.
At the start of the study, 54 percent of these patients saw a primary care provider who didn't speak Spanish. During the study, 48 percent of this group of patients switched to a Spanish-speaking doctor.
After this switch to Spanish-speaking doctors, 74 percent of these patients had blood sugar in a healthy range, up from 63 percent when they saw English-speaking doctors. This increase was 10 percent more than the patients who just switched from one English-speaking doctor to another.
"Having a primary care provider that speaks your language appears to be important for several reasons; it improves lines of communication, may reduce the risk of misunderstandings, increases patient satisfaction and now there is evidence that it may also improve management of diabetes," said lead study author Melissa Parker, a researcher at Kaiser Permanente in Oakland, California.
Both studies have some limitations, including the lack of data on some factors that can influence how much patients take their medicine or follow advice from doctors, such as health literacy or the degree of spoken or written abilities in English and Spanish for physicians and patients.
Still, the results from these studies suggest that it would make sense to prioritize access to Spanish-speaking doctors for Latinos with limited English who are newly diagnosed with diabetes, Dr. Eliseo Perez-Stable, director of the National Institute on Minority Health and Health Disparities, writes in an accompanying editorial.
That's because seeing a doctor who speaks Spanish may be more important for establishing a treatment regimen than maintaining one, Perez-Stable writes.
"Communication between clinicians and patients is essential in most aspects of medicine but it is especially true in management of a chronic disease such as diabetes," Perez-Stable said by email.
Ideally, there would be more Spanish-speaking and bilingual doctors, Perez-Stable added by email. Absent that, patients should make sure there's a professional interpreter available and also bring someone to clinic visits who is bilingual and can help support the treatment plan after patients go home.
Source: Published originally on foxnews.com, Language may impact diabetes care for Latinos with limited English,, January 24, 2017.
Latinos age slower than other ethnicities, UCLA study shows
“Latinos live longer than Caucasians, despite experiencing higher rates of diabetes and other diseases. Scientists refer to this as the ‘Hispanic paradox,'” said lead author Steve Horvath, a professor of human genetics at the David Geffen School of Medicine at UCLA. “Our study helps explain this by demonstrating that Latinos age more slowly at the molecular level.”
According to the Centers for Disease Control and Prevention, Latinos in the United States live an average of three years longer than Caucasians, with a life expectancy of 82 versus 79. At any age, healthy Latino adults face a 30 percent lower risk of death than other racial groups, according to a 2013 study in the American Journal of Public Health.
The UCLA team used several biomarkers, including an “epigenetic clock” developed by Horvath in 2013, to track an epigenetic shift in the genome that's linked to aging. Epigenetics is the study of changes to the DNA molecule that influence which genes are active but don't alter the DNA sequence.
Horvath and his colleagues analyzed 18 sets of data on DNA samples from nearly 6,000 people. The participants represented seven ethnicities: two African groups, African-Americans, Caucasians, East Asians, Latinos and an indigenous people called the Tsimane, who are genetically related to Latinos. The Tsimane live in Bolivia.
When the scientists examined the DNA from blood — which reveals the health of a person's immune system — they were struck by differences linked to ethnicity. In particular, the scientists noticed that, after accounting for differences in cell composition, the blood of Latinos and the Tsimane aged more slowly than other groups.
According to Horvath, the UCLA research points to an epigenetic explanation for Latinos' longer life spans. For example, the biological clock measured Latino women's age as 2.4 years younger than non-Latino women of the same age after menopause.
“We suspect that Latinos' slower aging rate helps neutralize their higher health risks, particularly those related to obesity and inflammation,” said Horvath, who is also a professor of biostatistics at the UCLA Fielding School of Public Health. “Our findings strongly suggest that genetic or environmental factors linked to ethnicity may influence how quickly a person ages and how long they live.”
The Tsimane aged even more slowly than Latinos. The biological clock calculated the age of their blood as two years younger than Latinos and four years younger than Caucasians. This reflects the group's minimal signs of heart disease, diabetes, hypertension, obesity or clogged arteries, the researchers said.
“Despite frequent infections, the Tsimane people show very little evidence of the chronic diseases that commonly afflict modern society,” said coauthor Michael Gurven, a professor of anthropology at UC Santa Barbara. “Our findings provide an interesting molecular explanation for their robust health.”
In another finding, the researchers learned that men's blood and brain tissue ages faster than women's from the same ethnic groups. The discovery could explain why women have a higher life expectancy than men.
Horvath and his colleagues next plan to study the aging rate of other human tissues and to identify the molecular mechanism that protects Latinos from aging.
The research was supported by grants from the National Heart, Lung and Blood Institute and the National Institute on Aging.
Source: Published originally on newsroom.ucla.edu as Latinos age slower than other ethnicities, UCLA study shows by Elaine Schmidt, August 16, 2016
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Researchers (from left) Bora Inceoglu, Fawaz Haj and Bruce Hammock (Photo by Kathy Keatley Garvey)
How an Entomologist Switched from Insects to Humans to Target Chronic Pain
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Distinguished professor Bruce Hammock in his office at Briggs Hall, UC Davis Department of Entomology and Nematology. (Photo by Kathy Keatley Garvey)