Gender disparities in care
Research on disparities between how women and men are treated in medical settings is growing – and it is concerning for any woman seeking care, reports The New York Times. Research shows that both doctors and nurses prescribe less pain medication to women than men after surgery, even though women report more frequent and severe pain levels. And a University of Pennsylvania study found that women waited 16 minutes longer than men to receive pain medication when they visited an emergency room. Women are also more likely to be told their pain is “psychosomatic,” or influenced by emotional distress. And in a survey of more than 2,400 women with chronic pain, 83 percent said they felt they had experienced gender discrimination from their healthcare providers.
Eye care advances
“Today’s clinical technologies to image the eye are pretty amazing, but they are undergoing tremendous advances,” Dr. Donald Miller, an expert in eye imaging technology at Indiana University, says in a recent National Institutes of Health newsletter. With new tools, eye health professionals may be able to catch disease even earlier. For example, Miller and his research team created a type of microscope to improve the diagnosis and treatment of glaucoma, which causes blindness by damaging nerve cells at the back of the eye. “The cells that get damaged by glaucoma are hard to see in the early stages of the disease,” Miller says. “With current technology, thousands of cells must die before it’s detected.” His team’s new method would allow eye doctors to see the damage earlier. In glaucoma, early treatment can often protect you against serious vision loss. Other eye imaging technologies are being developed to better detect age-related macular degeneration (AMD), the leading cause of vision loss and blindness nationwide among people age 50 and older.
Low-carb diets and diabetes
Most diabetes experts advise against low-carb diets for people with Type 1 diabetes, especially children, reports The New York Times. Some worry that restricting carbs can lead to dangerously low blood sugar levels, a condition known as hypoglycemia, and potentially stunt a child’s growth. But a study published this spring in the journal Pediatrics suggests otherwise. It found that children and adults with Type 1 diabetes who followed a very low-carb, high-protein diet for an average of just over two years – combined with the diabetes drug insulin at smaller doses than typically required on a normal diet – had “exceptional” blood sugar control. The new study comes with a caveat: It was an observational study, not a randomized trial with a control group.
The risks of gestational diabetes
Gestational diabetes may predispose women to early-stage kidney damage, a precursor to chronic kidney disease, according to a study by researchers at the National Institutes of Health and other institutions. The study appears in the journal Diabetes Care. The researchers found that women who had gestational diabetes were more likely to have a high glomerular filtration rate (GFR), an estimate of how much blood per minute passes through the glomeruli, the tiny filters within kidneys that extract waste from the blood. Many researchers think that a very high GFR can precede the early kidney damage that accompanies pre-diabetes. “Our findings suggest that women who have had gestational diabetes may benefit from periodic checkups to detect early-stage kidney damage and receive subsequent treatment,” said the study’s senior author, Cuilin Zhang, M.D., M.P.H., Ph.D., of the Epidemiology Branch at the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).
Apps for diabetes self-management
Hundreds of apps for diabetes self-management are commercially available. The National Institutes of Health recently identified health outcomes studies on 11 of them. Of the 11, studies showed only five were associated with clinically significant improvements in HbA1c, an important clinical test for monitoring diabetes. For Type 1 diabetes, they are Glucose Buddy and Diabeo Telesage. For Type 2 diabetes, they are Blue Star, WellTang and Gather Health. None of the studies showed patient improvements in quality of life, blood pressure, weight, or body mass index. More rigorous and longer-term research studies could determine whether apps help people manage their diabetes and reduce complications. Approximately 29 million Americans have some form of diabetes mellitus, which includes Type 1 diabetes, Type 2 diabetes, and gestational diabetes, reports the Agency for Healthcare Research and Quality.
Do you need a hearing aid?
Close to 29 million adults could benefit from hearing aids, yet only one in four has ever used one, reports the National Institutes of Health. Some people don’t want to try hearing aids because of how they think it might look to others. “Hearing loss is far more obvious than a hearing aid,” says Dr. Kelly King, an NIH hearing health expert. “The hard work people do to compensate for their hearing loss, and the mistakes they sometimes make when communicating, make the loss more noticeable to those around them than a hearing aid.” If you answer “yes” to several of these questions, you may need a hearing test:
- Is it hard to hear or understand others?
- Do you get frustrated trying to hear things?
- Do people get frustrated because they need to repeat what they say to you?
- Do you turn up the TV or radio louder than those around you would like?
- Do you have trouble hearing what people are saying in restaurants or at the movies?
- Is your social life, school, or job limited by your problem with hearing?
The discomfort zone
High-intensity interval training – which involves bursts of all-out exercise followed by brief periods of rest – is one of the biggest trends in fitness, reports The New York Times. Chris Jordan, director of exercise physiology at the Johnson & Johnson Human Performance Institute in Orlando, suggests this three-question test to determine whether you’re on the right path, that is, experiencing just the right amount of discomfort:
- Perceived exertion. Rate your effort on a scale of 0 to 10, with 0 being rest and 10 being maximum effort. A 5 or 6 suggests moderate exercise, and a 7 or 8 is the vigorous exercise zone you’re aiming for.
- Talk and sing test. If you still can talk while exercising, but can’t sing, you’re in a moderate zone — the pace you should use during recovery intervals. If you can speak only a few words (gasp) before pausing (gasp) for breath, then that’s the high-intensity zone. That’s good.
- Fatigue test. If, after the workout, you feel spent but not totally exhausted or nauseated, you’re probably in the “discomfort zone.” That’s where you want to be.
Vitamin D and pregnancy
Among women planning to conceive after a pregnancy loss, those who had sufficient levels of vitamin D were more likely to become pregnant and have a live birth, compared to women with insufficient levels of the vitamin, according to an analysis by researchers at the National Institutes of Health. This study appears in the journal The Lancet Diabetes & Endocrinology. “Our findings suggest that vitamin D may play a protective role in pregnancy,” said the study’s principal investigator Sunni L. Mumford, Ph.D., in the Epidemiology Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. The authors note that a few studies have shown that women who have higher levels of vitamin D before undergoing in vitro fertilization have higher pregnancy rates than those with lower levels. However, little research has been done on pregnancy rates and pregnancy loss in women attempting to conceive without assisted reproductive technologies. Additional studies are needed to determine whether providing vitamin D to women at risk for pregnancy loss could increase their chances for pregnancy and live birth.
Sleep deprivation increases Alzheimer’s protein
A small study by NIH’s National Institute on Alcohol Abuse and Alcoholism demonstrated that losing just one night of sleep led to an increase in beta-amyloid, a protein in the brain associated with impaired brain function and Alzheimer’s disease. The results suggest that sleep deprivation may increase the risk for beta-amyloid build-up. Beta-amyloid is a metabolic waste product that is found in the fluid between brain cells (neurons). A build-up of beta amyloid is linked to impaired brain function and Alzheimer’s disease. In Alzheimer’s disease, beta-amyloid clumps together to form amyloid plaques, which hinder communication between neurons. More studies are needed to identify the precise biological mechanism underlying the observed increase in beta-amyloid. It is also important to note that the link between sleep disorders and Alzheimer’s risk is thought to go both ways – that is to say, elevated beta-amyloid may also lead to trouble sleeping.