A Ireland health news Blog by Donie

A new study gives more evidence of a diabetes link with Parkinson’s disease

   

People with diabetes may have a heightened risk of developing Parkinson’s disease, especially at a relatively young age, a new study finds.

Published in the journal Diabetes Care, the study adds to recent research linking diabetes to Parkinson’s disease.

But neither this report nor the earlier ones prove that diabetes, itself, raises a person’s risk of Parkinson’s — a disorder in which movement-regulating brain cells gradually become disabled or die.

Instead, researchers suspect that it’s more likely diabetes and Parkinson’s share some common underlying causes.

The new study looked at health insurance claims from more than one million Taiwanese adults — including a little over 600,000 with diabetes.

Researchers found that over nine years, people with diabetes were more likely to be diagnosed with Parkinson’s disease. They were diagnosed at a rate of 3.6 cases per 10,000 people each year, versus 2.1 per 10,000 among people without diabetes.

When the researchers factored in age, sex and certain other health conditions, they found that diabetes was still linked to an increased risk of Parkinson’s — especially at a relatively young age.

Among women in their 40s and 50s, those with diabetes had twice the risk of Parkinson’s that diabetes-free women did.

The same was true among men in their 20s and 30s, though that was based on only a handful of Parkinson’s cases: there were four cases among young men with diabetes, and two among those without diabetes.

Exactly what it all means is unclear, according to Drs. Yu Sun and Chung-Yi Li, who led the study.

But on average, people develop Parkinson’s diagnosis around age 60, the researchers noted in an email to Reuters Health.

“Our findings tend to suggest a relationship between diabetes and early-onset Parkinson’s disease,” said Sun and Li, who are based at En Chu Kong Hospital and National Cheng Kung University in Taiwan.

That’s in line with a study of Danish adults published last year, the researchers noted. (See Reuters Health story of April 15, 2011).

Still, it’s impossible to say for sure that diabetes, itself, is to blame.

One reason is that the current study had limited information, according to Sun and Li.

“Because our study was based on claims data,” they said, “it lacks information on some of the known risk factors for Parkinson’s disease, such as pesticide exposure.”

Researchers have speculated on the potential reasons for the diabetes-Parkinson’s link, and they suspect there might be certain biological mechanisms that contribute to both conditions.

One possibility is chronic, low-level inflammation throughout the body, which is suspected of contributing to a number of chronic diseases by damaging cells. There might also be a common genetic susceptibility to both diabetes and Parkinson’s.

But even if people with diabetes have a relatively elevated risk of Parkinson’s, it’s still a low risk, Sun and Li pointed out.

In this study, there were fewer than four cases per 10,000 diabetic adults each year.

A recent U.S. study found a similar pattern: Of 21,600 older adults with diabetes, 0.8 percent were diagnosed with Parkinson’s over 15 years. That compared with 0.5 percent of people who were diabetes-free at the study’s start.

The researchers on that study said that people with diabetes should simply continue to do the things already recommended for their overall health — like eating a well-balanced diet and getting regular exercise.

Sun and Li agreed with that advice. “There is no need for patients with diabetes to worry too much about the development of Parkinson’s disease,” they said.

More studies are needed, the researchers said, to understand why diabetes is related to a higher Parkinson’s risk — and what, if anything, can be done about it.

Diabetes arises when the body can no longer properly use the blood-sugar-regulating hormone insulin. Parkinson’s occurs when movement-regulating cells in the brain die off or become disabled, leading to symptoms like tremors, rigidity in the joints, slowed movement and balance problems.

Researchers say it’s possible that something about diabetes — like a problem regulating insulin — might somehow contribute to Parkinson’s. But that remains unproven.

HSE warns of more service cuts after 'latest figures released'

The Health services executive has overspent by just over €89 million against their budget by the end of February this year, according to the latest HSE figures.

And the HSE has warned of further cutbacks ahead that will impact on services.

Hospitals accounted for just under €49 million of the deficit and community services €29 million.

The HSE, in its latest performance report, said a review had been carried out on the most financially challenged hospitals. It said cost saving plans are now in place which will require considerable focus and will have an impact on service levels.

The health executive said early indications are that a number of hospitals will have difficulty breaking even this year while maintaining service levels.

According to the report, emergency admissions to hospitals were up 3.7% on the same period last year and planned admissions are up by 5% compared to this time last year.

The February figures also show that fewer patients were being treated within set targets in hospital emergency departments (EDs) in February compared to January.

The percentage of all ED attendees either treated and discharged or admitted within six hours of ED registration in February was 64.3%, compared to 65.2% in January.

The percentage of patients in February who needed admission who were admitted to a bed through EDs within nine hours of registration was 56.4%, compared to 58.7% in January.

The figures show there were 59,584 people on treatment waiting lists at the end of February, including around 1,200 waiting more than 12 months for treatment. However, according to the Department of Health, this number has reduced in recent weeks to around 550.

The total number on waiting lists at the end of January was 59,387.

Would you like your teeth with 'Wireless decay sensors'

    

We’re getting that much closer to the merging of man with machine. Princeton University researcher Michael McAlpine has developed a technique wherein a graphene sensor like above left can be attached to a human tooth, detecting bacteria in the area and sending that signal to a wireless receiver as above right.

Before you start reaching for your tinfoil hat, realize that this research is still quite early and even McAlpine himself isn’t sure what the ultimate commercial application will be. The demonstration is with a human tooth and it’s the first time that the sensor has been “interfaced directly with biological tissue,” but it could just as easily be applied to other surfaces too.

A silk-graphene “tattoo” is attached to the tooth and then it is rinsed with water to dissolve the silk support. The ultra-thin circuitry remains and it is then ammended with bifunctional peptides and naturally occurring antimicrobial proteins (AMPs). A small electric field is modulated in the presence of bacteria and an RFID reader can then pick up on these signals and the bacterial concentration can then be determined.

I imagine there are some interesting medical applications that could come out of this research, but as always, further study is required.

Meanwhile researchers say:

Dentists should check their patient’s drinking habits

Dentists should screen patients for signs that they drink too much alcohol, researchers have said.

Questionnaires could be handed out at the start of consultations to identify those with hazardous drinking levels.

Dentists have a duty to promote the general health and wellbeing of the public as well as looking out for specific signs of mouth problems linked to drinking, the experts said.

Writing in the Royal College of Surgeon's Dental Journal, they added: "Alcohol misuse can impact on the oral health of patients attending primary care services in numerous ways.

"Excessive alcohol consumption is not only a risk factor for sustaining orofacial injury (either through falls, road traffic accidents or interpersonal violence) but also implicated in the aetiology of potentially fatal oral disease, including cancers of the mouth, larynx, pharynx and oesophagus."

They said patients who drink lots also suffer tooth decay and erosion of the tooth surface.

Alcoholic drinks high in sugar may also contribute to the development of cavities.

"After screening, the individuals identified as misusing alcohol could then be offered treatment, including brief motivational advice sessions delivered by hygienists or dental nurses," said experts, including from the University of Cardiff.

"Liaison with the patients' medical practitioner could also result in referral for specialist care should the patient demonstrate alcohol dependence or depression, for example."

The team said patients tend to go to their GP because they are ill but often visit a dentist as a preventative measure for a routine check-up.

"This provides the primary dental healthcare team with unique opportunities to intervene, particularly as asking patients about their levels of alcohol consumption is a routine component of medical history taking."

Jonathan Shepherd, professor of oral and maxillofacial surgery from the University of Cardiff's School of Dentistry, and lead author of the paper, said: "Excessive alcohol consumption can lead to cancer of the mouth, larynx and oesophagus and dentists may be the first to notice these conditions.

"So we need to introduce an alcohol screening tool that reliably detects hazardous and harmful drinking alongside effective treatment."

"The dental team has a responsibility to promote overall health and not just dental health," he added.

"Dentists and the Government must work together to develop and deliver screening and treatment by intervening early."

British Dental Association chief executive Peter Ward said: "We agree that the dental examination is an ideal time to promote oral and general health messages.

"It is well recognised that excessive alcohol consumption, alongside smoking, increases the risk of developing oral cancer and gum disease so the dentist has always had an important role to play in reinforcing these health messages and detecting such cancers.

"The opportunity for dentists to concentrate more on preventive messages is currently being tested in dental pilots in England."