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Roundup: Diabetes Screening, Caffeine and Statin Use

Screening Guidelines May Miss Half of Diabetic, Prediabetic Patients, Study Says

A national government panel of healthcare experts recommends that physicians screen patients for dysglycemia (prediabetes or type 2 diabetes) when they are 40 to 70 years old and are overweight or obese.

By following this recommendation by the United States Preventive Service Task Force (USPSTF), 53 percent of patients who had prediabetes or type 2 diabetes would not be screened, according to a new study. The study also found that screening patients using an expanded set of risk factors, which the USPSTF suggests but does not formally recommend, would identify most cases of prediabetes and type 2 diabetes.

But screening patients for diabetes based solely on their age and weight could miss more than half of high-risk patients, according to the new study from Northwestern University’s Feinberg School of Medicine in Chicago. An estimated 1 in 3 U.S. adults has prediabetes, but most do not know it. Prediabetic people are much likelier to develop full-blown diabetes — unless they make key lifestyle changes.

If expanded screening criteria were used, the amount of missed patients with prediabetes or diabetes would drop to 23 percent, the study found. The expanded criteria includes a family history of diabetes, history of gestational diabetes or polycystic ovarian syndrome, or non-white race or ethnicity, researchers found.

“By demonstrating how well these expanded criteria work in identifying patients with prediabetes and diabetes, we’re proposing a better path for the USPSTF to strengthen its screening guidelines,” said lead author Dr. Matthew O’Brien, assistant professor of medicine at Northwestern University Feinberg School of Medicine.

The study was published in the Journal of General Internal Medicine [1].

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FDA Acts to Protect Consumers from Highly Concentrated or Pure Caffeine Supplements

Just one teaspoon of some pure caffeine powders currently on the market amount to 16 times the limit of what the U.S. Food and Drug Administration (FDA) considers a safe single dose of caffeine (200 mg).

In response, the FDA says that selling “dietary supplements containing pure or highly concentrated caffeine in powder or liquid forms” is considered unlawful when sold in bulk quantities directly to consumers. The agency calls such forms of pure caffeine a public health threat.

“We know these products are sometimes being used in potentially dangerous ways,” said Scott Gottlieb, M.D., FDA commissioner. “For example, teenagers, for a perceived energy kick, sometimes mix dangerously high amounts of super-concentrated caffeine into workout cocktails.”

One half cup of a highly concentrated liquid caffeine can contain about 2,000 mg of caffeine, and just a single teaspoon of a powdered pure caffeine product can contain approximately 3,200 mg of caffeine. This is equivalent to about 20 to 28 cups of coffee, a potentially toxic dose, said the FDA.

In 2015 and 2016, the FDA sent warning letters to seven distributors of pure powdered caffeine, noting the products were dangerous and presented a “significant or unreasonable risk of illness or injury to consumers.” Since that time, the FDA has continued to see a proliferation of similar products being sold online.

The FDA on April 13 issued guidance [4] for providers of dietary supplements containing caffeine.

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Women Less Likely Than Men to Get Statins After Heart Attack, Research Shows

Women who survive a heart attack are less likely than men to receive cholesterol-lowering statin drugs , a new study finds.

Statins, which have been found to reduce cardiovascular disease and mortality in those who are at high risk, are among the best-selling drugs in the United States. They can reduce the risk of another heart attack or stroke.

Researchers analyzed data of more than 88,000 U.S. adults who filled a statin prescription after a heart attack in the years 2014 and 2015. Of those, 56 percent of men and 47 percent of women picked up a high-intensity statin drug.

“Prior studies have found that women are less likely than men to receive treatment with statins following a heart attack. Our study shows that even when women are prescribed statins, these continue to be in lower intensities than the guidelines recommend,” said study leader Sanne Peters, who is a research fellow in epidemiology at Oxford University’s George Institute in the United Kingdom.

The discrepancy in statin use may explain, at least partially, why death rates for women with a history of heart disease and stroke are higher than for men, researchers said. The study concluded that some deaths could be prevented if the guidelines for treatment with high-intensity statins were followed.

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