THURSDAY, May 18, 2023 (HealthDay News) -- Chronic respiratory diseases (CRDs) were the third leading cause of death globally, accounting for 4.0 million deaths in 2019, according to a study published online April 25 in eClinicalMedicine.

Sara Momtazmanesh, M.D., from the Endocrinology and Metabolism Population Sciences Institute in Tehran, Iran, and an international group of chronic respiratory disease collaborators estimated mortality, years lived with disability, years of life lost, disability-adjusted life years (DALYs), prevalence, and incidence of CRDs from 1990 to 2019 by sex, age, region, and sociodemographic index in 204 countries and territories. CRDs included chronic obstructive pulmonary disease (COPD), asthma, pneumoconiosis, interstitial lung disease, pulmonary sarcoidosis, and others.

The researchers found that CRDs were the third leading cause of death in 2019, responsible for 4.0 million deaths with a global prevalence of 454.6 million cases. From 1990 to 2019, total deaths and prevalence of CRDs increased by 28.5 and 39.8 percent, respectively, while age-standardized rates decreased by 41.7 and 16.9 percent, respectively. The primary cause of deaths from CRDs was COPD, with 212.3 million prevalent cases, accounting for 3.3 million deaths. Asthma had the highest prevalence among CRDs, with 262.4 million prevalent cases. From 1990 to 2019, the age-standardized rates of burden measures of COPD, asthma, and pneumoconiosis reduced globally, but throughout the study period, the age-standardized rates of incidence and prevalence of interstitial lung disease and pulmonary sarcoidosis increased. The highest deaths and DALYs from CRDs were due to smoking, followed by air pollution and occupational risks.

"Full global adherence to tobacco control measures and air quality improvement strategies are crucial in reducing the burden attributed to CRD," the authors write. "The high death and DALYs rates in low and low-middle sociodemographic index countries highlights the urgent need for improved preventive, diagnostic, and therapeutic measures."

Several authors disclosed financial ties to the biopharmaceutical industry.

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WEDNESDAY, Feb. 21, 2024 (HealthDay News) -- In an Endocrine Society position statement published online Feb. 21 in the Journal of Clinical Endocrinology and Metabolism, guidelines are presented to help health care providers (HCPs) recognize the perspectives of people with diabetes (PWD) in order to achieve optimal disease management.

Rita R. Kalyani, M.D., from the Johns Hopkins University School of Medicine in Baltimore, and colleagues examined gaps in the management of diabetes and its complications and identified tools needed for HCPs and PWD to address these challenges.

Priority targets for addressing challenges for PWD include effective communication during clinical interactions at diagnosis and through the disease course; addressing the emotional and psychosocial needs of PWD; navigating available therapeutic options and explaining complex regimens to support medication taking; and the use of telehealth in the appropriate clinical setting. The authors describe tools that are available to help HCPs, including guided communication styles for facilitating effective communication; guidance on preferred and nonpreferred language; clinical screening tools for assessing psychosocial conditions and directories to assist in referrals for mental health providers; patient education resources to help navigate aspects of living with diabetes, including pharmacotherapies; and checklists to determine the appropriateness of telehealth use for individual patients.

"In the ever-changing landscape of diabetes and its management, both health care providers and people with diabetes will continue to need new and evolving tools to help address the common challenges they face," Kalyani said in a statement.

Several authors disclosed ties to the biopharmaceutical and other industries.

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FRIDAY, March 31, 2023 (HealthDay News) -- The incidence of type 1 and type 2 diabetes is increasing among children and young people aged 0 to 19 years, according to a study published in the April issue of The Lancet Diabetes & Endocrinology.

Lynne E. Wagenknecht, Dr.P.H., from Wake Forest University School of Medicine in Winston-Salem, North Carolina, and colleagues identified children and young people aged 0 to 19 years with a physician diagnosis of type 1 or type 2 diabetes at five U.S. centers between 2002 and 2018 to describe the incidence during a 17-year period.

The researchers identified 18,169 individuals aged 0 to 19 years with type 1 diabetes in 85 million person-years and 5,293 individuals aged 10 to 19 years with type 2 diabetes in 44 million person-years. The annual incidence of types 1 and 2 diabetes was 22.2 and 17.9 per 100,000, respectively, in 2017 to 2018. A linear effect and a moving-average effect were captured in the model for trend, with a significant increasing linear effect observed for types 1 and 2 diabetes (2.02 and 5.31 percent, respectively). Greater increases in the incidence of both types of diabetes were seen for children and youth from racial and ethnic-minority groups such as non-Hispanic Blacks and Hispanics. The peak age at diagnosis was 10 and 16 years for type 1 and type 2 diabetes, respectively. Diagnoses of type 1 diabetes peaked in January, while type 2 diabetes diagnoses peaked in August.

"These findings will help guide focused prevention efforts," Wagenknecht said in a statement. "Now that we have a better understanding of risk factors, our next phase of research will be studying the underlying pathophysiology of youth-onset diabetes."

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A behavioral intervention designed to support weight loss can yield remission of type 2 diabetes, according to a study published online Aug. 5 in The Lancet Diabetes & Endocrinology.

Jonathan Valabhji, M.D., from NHS England in the United Kingdom, and colleagues assessed remission of type 2 diabetes among participants in the NHS Type 2 Diabetes Path to Remission program, a 12-month behavioral intervention to support weight loss, which included a three-month period of total diet replacement (composed of nutritionally formulated products such as soups, shakes, and bars and a total daily calorie intake of 800 to 900 kcal). A total of 1,740 participants started total diet replacement before January 2022 and had 12 months to complete the program by the time of data extraction in December 2022; 55 percent completed the program and had weight recorded at 12 months.

The researchers found that the mean weight loss for the 1,710 participants who started the program before January 2022 and had no missing data was 8.3 percent or 9.4 kg, and the mean weight loss was 9.3 percent or 10.3 kg for the 945 participants who completed the program and had no missing data. Overall, 27 percent of a subgroup of 710 participants who started the program before January 2022 and had two hemoglobin A1c (HbA1c) measurements recorded had remission, with mean weight loss of 13.4 percent or 14.8 kg. Among 450 participants who completed the program and had two HbA1c measurements recorded, 32 percent had remission, with mean weight loss of 14.4 percent or 15.9 kg.

"Remission is possible outside of research settings through at-scale delivery, although the rate of remission is less than those reported in randomized controlled trial settings," the authors write.

Several authors disclosed ties to the pharmaceutical industry.

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Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) reduce the risk for clinically important kidney and cardiovascular disease outcomes in individuals with type 2 diabetes, according to research published online Nov. 25 in The Lancet Diabetes & Endocrinology.

Sunil V. Badve, Ph.D., from the University of New South Wales in Sydney, and colleagues conducted a meta-analysis of randomized controlled trials that compared a GLP-1 RA to placebo among participants with type 2 diabetes. Post hoc, the SELECT trial, which enrolled participants with cardiovascular disease and a body mass index of 27 kg/m2 or greayer without diabetes, was included. The meta-analysis included 11 trials with 85,373 participants (67,769 with type 2 diabetes).

The researchers found that GLP-1 RAs reduced the composite kidney outcome, kidney failure, major adverse cardiovascular events (MACE), and all-cause death compared with placebo (hazard ratios, 0.82, 0.84, 0.87, and 0.88, respectively) in participants with type 2 diabetes. On inclusion of the SELECT trial, the effect on the composite kidney outcome, kidney failure, MACE, and all-cause death was similar (hazard ratios, 0.81, 0.84, 0.86, and 0.87, respectively), with no evidence of heterogeneity between the trials. The GLP-1 RA and placebo groups had no differences in the risk for serious adverse events, including acute pancreatitis and severe hypoglycemia.

"Taken together, these results and the breadth of the benefits observed support an important role for GLP-1 receptor agonists as kidney-protective and heart-protective medications that could play an important role in addressing the global burden of noncommunicable diseases," the authors write.

Several authors disclosed ties to the pharmaceutical industry.

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TUESDAY, Jan. 30, 2024 (HealthDay News) -- For women approaching the final menstrual period (FMP), heavy metals may diminish ovarian reserve, according to a study published online Jan. 25 in the Journal of Clinical Endocrinology & Metabolism.

Ning Ding, Ph.D., M.P.H., from the University of Michigan in Ann Arbor, and colleagues examined the associations of heavy metals with anti-Müllerian hormone (AMH), a marker of ovarian reserve, among 549 women from the Study of Women's Health Across the Nation with 2,252 repeated AMH measurements taken from 10 to 0 years before the FMP. High-resolution inductively coupled plasma mass spectrometry was used to measure urinary concentrations of arsenic, cadmium, mercury, and lead.

The researchers found that women in the highest versus the lowest tertile of urinary arsenic or mercury concentrations had lower AMH concentrations at the FMP after adjustment for confounders (percentage change, −32.1 and −40.7 percent for arsenic and mercury, respectively). Accelerated rates of decline in AMH over time were seen in association with higher cadmium and mercury (percent change per year, −9.0 and −7.3 percent, respectively).

"This information may enable researchers to address adverse health outcomes known to be associated with metals and with reproductive hormone changes (e.g., premature menopause, bone loss and osteoporosis, increased risks of cardiovascular disease, cognitive decline, vasomotor symptoms)," the authors write.

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Physicians are reevaluating the use of body mass index (BMI) as a measure of weight status. During the American Medical Association's annual meeting, concerns were raised about BMI's limitations and its impact on patient care. The reliance on BMI, influenced by insurance reimbursement, was criticized for hindering access to treatment options. Experts highlighted that BMI fails to accurately measure body fat and overlooks variations among different racial/ethnic groups, sexes, and age ranges. In response, the American Medical Association's Council on Science and Public Health recommended combining BMI with other valid measures like visceral fat, body adiposity index, body composition, relative fat mass, waist circumference, and genetic/metabolic factors to assess risk more effectively.

The shift in thinking reflects a growing recognition that BMI alone is insufficient for assessing health and that its use may perpetuate inequities in healthcare. Certain races and ethnicities had a greater chance of obesity misclassification with BMI than others, the researchers added. Specifically, Asian and Hispanic adults were more likely to have a normal BMI, but have DEXA-confirmed obesity according to their body fat percentage, compared with white adults. Asian and Hispanic adults were also more likely to have a greater proportion of abdominal fat. On the other hand, Black adults with a normal BMI were far less likely to have high body fat percentages and tended to have less abdominal fat...Read more

How do you think we should be cost-effectively measuring healthy weight?

“Pointless” bureaucracy is helping hospitals grind to a halt, a leading doctor has warned. Dr Gordon Caldwell, who has just retired after 40 years as an NHS hospital consultant, said “horribly inefficient” paperwork around patients moving in and out of wards is fuelling record delays. The senior doctor took a photograph of all the forms required for one medical admission to an NHS hospital, laid against his 5ft 10in frame.

Dr Caldwell said promises by the NHS to “digitise” the health service had simply seen needless bureaucracy transferred on to poor computer systems that were often incompatible with each other.  The specialist in general medicine and diabetes endocrinology said: “A few years ago there were estimates that nurses were spending around 50 per cent of their time on paperwork;  now I’d say it’s closer to 70 per cent.” “It’s bureaucratic and it’s very slow and horribly inefficient,” he said.

Dr Caldwell said the rise of unthinking officialdom was one of the factors that led to his recent retirement. Too often, dozens of forms were produced with little thought given to duplication, or how to obtain the key information quickly. He said the issue is one of the reasons why whole days are lost to admission and discharge of patients...Read more

Have you felt that needless bureaucracy affects you from treating patients properly?

Polycystic ovary syndrome (PCOS) is associated with an increased likelihood of any eating disorder, according to a review published online Aug. 8 in the Journal of Clinical Endocrinology & Metabolism.

Laura G. Cooney, M.D., from the University of Wisconsin in Madison, and colleagues conducted a systematic review and meta-analysis to examine the prevalence of disordered eating/eating disorders among women with and without PCOS. Data were obtained from 20 articles, including 28,922 women with PCOS and 258,619 controls.

The researchers found that the odds of any eating disorder were increased for individuals with PCOS (odds ratio, 1.53), which persisted in studies in which PCOS was diagnosed by Rotterdam criteria (odds ratio, 2.88). Increased odds of bulimia nervosa, binge eating disorder, and disordered eating were seen in PCOS, but not anorexia nervosa. Higher mean disordered eating scores were seen in PCOS, including on stratification by normal- and higher-weight body mass index. Most of the studies were of moderate quality, and no evidence of publication bias was seen.

"Care for women with PCOS should be individualized and contextualized with the knowledge of the negative impact of weight stigma or weight management in the setting of eating disorders," the authors write.

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Markers of diabetes are positively associated with overactive bladder (OAB), according to a study published online April 28 in Frontiers in Endocrinology.

Qingliu He, from Jinjiang Municipal Hospital in Quanzhou, China, and colleagues used data from six cycles of the U.S. National Health and Nutrition Examination Survey (23,863 participants) to examine the relationship between diabetes and OAB.

The researchers found that diabetes mellitus participants' OAB prevalence was 77 percent higher versus those without diabetes. With increasing quartiles of diabetes-related markers, the odds of OAB monotonically increased in three models. There was a linear association between glycohemoglobin and OAB. The associations between diabetes-related markers (glycohemoglobin, fasting glucose, and insulin) with OAB were significantly mediated by white blood cells (7.23, 8.08, and 17.74 percent, respectively) and partly mediated by neutrophils (6.58, 9.64, and 17.93 percent, respectively). Machine learning of the XGBoost model predicted glycohemoglobin is the most important indicator of OAB.

"Our hypothesis based on the analysis results of the association between OAB, diabetes, and systemic inflammation is that diabetes mellitus may increase OAB risk by promoting systemic inflammation," the authors write.

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FRIDAY, March 31, 2023 (HealthDay News) -- There is a strong association between the fat mass of mothers and their daughters, according to a study published online March 21 in the Journal of Clinical Endocrinology & Metabolism.

Rebecca J. Moon, Ph.D., from the University of Southampton in the United Kingdom, and colleagues examined mother-offspring and father-offspring associations in body composition in early childhood among 240 mother-father-offspring trios from a prospective prebirth cohort. Anthropometry and dual-energy X-ray absorptiometry assessment of whole-body-less-head body composition was assessed in offspring at ages 4, 6 to 7, and 8 to 9 years and in the mother and father at the 8- to 9-year offspring visit.

The researchers identified positive associations between mother-daughter body mass index (BMI) and fat mass at ages 6 to 7 and 8 to 9 years, with similar associations seen at age 4 years, bounding the 95 percent confidence intervals. At each of the ages studied, mother-son, father-son, and father-daughter associations for BMI and fat mass were weaker.

"Further studies are needed to understand why this is happening, but our findings suggest that approaches to addressing body weight and composition should start very early in life, particularly in girls born to mothers with obesity and overweight," Moon said in a statement.

Several authors disclosed financial ties to the pharmaceutical industry.

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THURSDAY, Feb. 1, 2024 (HealthDay News) -- COVID-19 pandemic disruptions had a fairly negative impact on diabetes outcomes, according to a study published in the February issue of The Lancet Diabetes & Endocrinology.

Jamie Hartmann-Boyce, D.Phil., from University of Massachusetts Amherst, and colleagues conducted a systematic literature review to determine whether COVID-19-related disruptions to health care and lifestyles impacted diabetes management.

Based on 138 included studies (Jan. 1, 2020, to June 7, 2023), the researchers found that all-cause mortality (six studies) and diabetes-related mortality (13 studies) showed consistent increases, and most studies indicated increases in sight loss (six studies). Data for studies with an adult or mixed sample generally suggested no difference in diabetic ketoacidosis frequency or severity, while studies of children and adolescents showed increases with some due to new-onset diabetes (69 studies). In adults, data suggested decreases in hospital admissions, while there were increases in diabetes-related admissions to pediatric intensive care units (35 studies). For diabetic foot ulcer presentations (nine studies), emergency department admissions (nine studies), and overall amputation rates (20 studies), data were ambiguous. Impacts were most pronounced for females, younger people, and racial and ethnic minority groups, when evaluated.

"The review also points to the importance of ensuring all people with diabetes, but particularly those from less advantaged groups, have consistent access to diabetes medication and care," Hartmann-Boyce said in a statement.

Two authors disclosed ties to the pharmaceutical industry.

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For individuals with type 1 diabetes, intraindividual body weight variability, or body weight cycling, is associated with an increased risk for renal events, according to a study published online Feb. 4 in the Journal of Clinical Endocrinology & Metabolism.

Marion Camoin, M.D., from the Assistance Publique–Hôpitaux de Paris, and colleagues conducted a retrospective analysis of data from the Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications (EDIC) studies to examine the association between body weight cycling and risk for renal events among patients with type 1 diabetes. Four indices of intraindividual body weight variability were calculated for 1,432 participants of the DCCT/EDIC studies; variability independent of the mean (VIM) was the main index. During follow-up (21 ± four years), six criteria of progression of chronic kidney disease (CKD) were studied.

The researchers found that a high VIM was significantly associated with the incidence of a 40 percent decline in estimated glomerular filtration rate (eGFR) from baseline values, doubling of baseline serum creatinine, CKD stage 3, and a decline in eGFR >3 mL/min/m2 per year after adjustment for CKD risk factors at baseline and follow-up and use of nephroprotective drugs. There was also an association seen for VIM with incidence of moderately and severely increased albuminuria, but after adjustment for follow-up covariates, the associations were no longer significant. For the other indices of body weight cycling, similar results were observed.

"Strategies aimed at weight reduction in people with type 1 diabetes should focus on promoting long-term weight maintenance, as weight stability may have a positive impact on health outcomes," the authors write.

Several authors disclosed ties to the pharmaceutical industry.

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Even individuals with a high genetic risk for type 2 diabetes (T2D) benefit from a low-cost, group-based intervention focused on healthy diet and physical activity, according to a study recently published online in the Journal of Clinical Endocrinology & Metabolism.

Maria Anneli Lankinen, Ph.D., from the University of Eastern Finland in Kuopio, and colleagues investigated whether a low or high genetic risk has effects on incident T2D in a group-based lifestyle intervention study. The analysis included men (aged 50 to 75 years) participating in the Metabolic Syndrome in Men cohort, with 315 characterized as having low genetic risk and 313 as having high genetic risk for T2D, as well as controls (196 low and 149 high genetic risk).

The researchers found that the three-year intervention significantly lowered the risk for T2D among the participants with a high genetic risk for T2D (hazard ratio, 0.30; 95 percent confidence interval, 0.16 to 0.56; P < 0.001). However, in the low genetic risk group, the effect was not significant (hazard ratio, 0.69; 95 percent confidence interval, 0.36 to 1.32; P = 0.262). Between the high and low genetic risk groups, the intervention effect was not significantly different. In both the low and high genetic risk groups, the intervention significantly ameliorated the worsening of glycemia and decreased weight.

"All individuals at risk of T2D should be encouraged to make lifestyle changes regardless of genetic risk," the authors write.

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TUESDAY, May 14, 2024 (HealthDay News) -- Among slow responders to tirzepatide treatment at week 12, 90 percent went on to achieve clinically meaningful weight reduction (≥5 percent) by week 72, according to a study presented at the annual meeting of the American Association of Clinical Endocrinology, held from May 9 to 11 in New Orleans.

Kimberly Gudzune, M.D., from Johns Hopkins University in Baltimore, and colleagues assessed the baseline characteristics and weight reduction achieved at 24 and 72 weeks in tirzepatide-treated participants by early response (≥5 percent weight reduction at week 12) and slow response status (<5 percent weight reduction at week 12). The analysis included 278 slow responders and 1,267 early responders participating in the SURMOUNT-1 trial.

The researchers found that at baseline, slow responders were more likely to be male (45 versus 30 percent) and had higher body weight (110.2 versus 103.6 kg), body mass index (39.1 versus 37.7 kg/m2), and waist circumference (117.5 versus 113.4 cm). At the end of dose titration at week 24, 70 percent of the slow responders achieved ≥5 percent weight reduction, while 90 percent achieved ≥5 percent weight reduction at week 72. Additionally, at week 72, 31 percent of the slow responders achieved ≥5 to <10 percent weight loss, 29 percent achieved ≥10 to <15 percent weight loss, 13 percent achieved ≥15 to <20 percent weight loss, 10 percent achieved ≥20 to <25 percent weight loss, 4 percent achieved ≥25 to <30 percent weight loss, and 3 percent achieved ≥30 percent weight loss. For slow responders who went on to achieve ≥5 percent weight loss, the mean time to reach 5 percent was 24.8 weeks. Overall, 1.8 percent of participants were nonresponders (lost <5 percent body weight) at week 72.

"It is reasonable to consider treatment for longer than 12 weeks to determine weight loss response to tirzepatide, which takes at least 20 weeks to reach the highest dose," the authors write.

The SURMOUNT-1 trial is supported by Eli Lilly, the manufacturer of tirzepatide.

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Overdiagnosis of thyroid cancer in the United States remains a persistent problem, according to a study published online Feb. 5 in The Lancet Diabetes & Endocrinology.

Michelle M. Chen, M.D., from Stanford University in Palo Alto, California, and colleagues examined whether U.S. thyroid cancer incidence has truly decreased or merely plateaued and to understand some of the underlying factors driving these trends. The analysis included 91,968 patients with thyroid cancer identified from the National Cancer Institute Surveillance, Epidemiology, and End Results database and the National Center for Health Statistics database (1975 to 2019).

The researchers found that the rise and subsequent plateau in the incidence of thyroid cancer have been primarily driven by time period effects, likely due to changing patterns in diagnostic pressure. The incidence of thyroid cancer by age increased during the study period and was driven predominantly by overdiagnosis. Although the incidence of thyroid cancer has plateaued, it remains at peak levels, suggesting that overdiagnosis remains a crucial unresolved public health issue.

"Further work is needed to help limit the current drivers of overdiagnosis and to implement novel solutions aimed at ... physicians, patients, and policy makers," the authors write.

Several authors disclosed ties to relevant organizations.

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WEDNSDAY, May 15, 2024 (HealthDay News) -- Use of an artificial intelligence (AI)-informed health app aids diabetes outcomes and cuts atherosclerotic cardiovascular disease (ASCVD) risk, according to a study presented at the annual meeting of the American Association of Clinical Endocrinology, held from May 9 to 11 in New Orleans.

Paramesh Shamanna, M.D., from the Bangalore Diabetes Centre in India, and colleagues evaluated the effectiveness of the digital twin (DT) technology to improve hemoglobin A1C (HbA1c) and 10-year ASCVD risk. The analysis included 208 individuals assigned to the DT intervention (a mobile app that uses AI and Internet of Things to integrate multidimensional data to give precision nutrition and health recommendations) and 81 assigned to standard of care.

The researchers found that overall, 72.5 percent sustained diabetes remission in one year. There was a significantly larger difference in the change in HbA1c in the DT group versus standard of care (−3 versus −0.2). Further, the DT group had a marked decrease in the ASCVD risk profile at 360 days, with 76.6 percent of participants categorized as low-risk versus 49.1 percent at baseline. By comparison, the standard-care group showed a marginal increase in the low-risk category from 43.2 to 45.7 percent. In the DT group, reductions in the high-risk category were more pronounced, while the standard-care group remained unchanged. There was a significant positive correlation between the change in ASCVD risk in the DT group versus the standard-care group (−4.3 versus −0.97).

"Digital twin technology significantly enhanced HbA1c reduction and reduced 10-year ASCVD risk in type 2 diabetes mellitus patients, outperforming standard care and demonstrating its potential in precision diabetes management," the authors write.

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Empiric vitamin D supplementation is suggested for those aged 1 to 18 years, those older than 75 years, those who are pregnant, and those with high-risk prediabetes, according to an Endocrine Society clinical practice guideline published online June 3 in the Journal of Clinical Endocrinology & Metabolism.

Marie B. Demay, M.D., from Massachusetts General Hospital and Harvard Medical School in Boston, and colleagues developed clinical guidelines for use of vitamin D to lower the risk for disease among individuals without indications for vitamin D treatment.

The researchers suggest empiric vitamin D supplementation for children aged 1 to 18 years to prevent nutritional rickets and for the potential to reduce the risk for respiratory tract infections; for adults aged 75 years and older due to the potential for reducing mortality risk; for pregnant women due to the potential for reducing the risk for preeclampsia, intrauterine mortality, preterm birth, small-for-gestational-age birth, and neonatal mortality; and for those with high-risk prediabetes due to the potential reduction in the risk for progression to diabetes. The optimal doses for empiric vitamin D supplementation remain unclear. The panel suggests supplementation via daily administration of vitamin D for nonpregnant people older than 50 years for whom vitamin D is indicated, and suggests against empiric vitamin D supplementation above the current dietary reference intake to reduce risk among healthy adults younger than 75 years. There was no evidence found to support routine 25-hydroxyvitamin D screening in the general population.

"Healthy populations who may benefit from higher dose vitamin D supplements are those 75 and older, pregnant people, adults with prediabetes, and children and adolescents 18 and younger, but we do not recommend routine testing for vitamin D levels in any of these groups," Demay said in a statement.

Authors disclosed ties to Amgen and Dexcom.

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