People with Type 2 Diabetes May Be Overtested

By Amy Norton
HealthDay Reporter

TUESDAY, Dec. 8, 2015 (HealthDay News) — Many Americans with type 2 diabetes may be getting unnecessary blood sugar tests — and, in some cases, needless changes in medication, a new study suggests.

Researchers found that in a large group of U.S. adults with well-controlled type 2 diabetes, 60 percent were undergoing too many hemoglobin A1C tests.

The test, which gauges a person’s average blood sugar control over the past three months, is routinely used to diagnose and monitor type 2 diabetes. But guidelines say it should be done only once or twice a year if a patient has been showing good blood sugar control, according to the study.

All of the patients in the current study fell into that category. Yet nearly 55 percent underwent A1C tests three or four times per year. Another 6 percent had at least five tests per year, according to findings published online Dec. 8 in the journal BMJ.

“I think part of the problem is that we often think more testing is better,” said lead researcher Dr. Rozalina McCoy, a professor of medicine at the Mayo Clinic, in Rochester, Minn.

But, as in other areas of medicine, that is not necessarily true in diabetes care, McCoy explained.

If someone is unlikely to benefit from frequent A1C tests, she said, the downsides — like extra costs and inconvenience — can’t really be justified.

Plus, there are potential risks to patients’ health, McCoy pointed out. In this study, frequent A1C tests raised the odds that patients would be started on additional medications to control their blood sugar.

The worry, McCoy said, is that those more-intense regimens would boost patients’ risk of dangerously low blood sugar.

The study’s findings are based on insurance claims made between 2001 and 2013 for more than 31,000 type 2 diabetes patients age 18 and older.

All of the adults in the study had A1C levels that were consistently below 7 percent within the previous two years — which meant their blood sugar was under good control.

In general, McCoy said, there’s little chance that such patients would benefit from having A1C tests more than once or twice a year. Yet, most patients were tested more often than that over the study period.

Controlling blood sugar is key to preventing long-term diabetes complications, such as damage to the nerves, kidneys and blood vessels, according to the American Diabetes Association (ADA).

But at a certain point, tighter control has “diminishing returns,” said Dr. Rodney Hayward, a professor of medicine at the University of Michigan, in Ann Arbor.

According to Hayward, who wrote an editorial published with the study, clinical trials have found that lowering A1C from 8.5 percent to 7 percent can “modestly” lower heart attack risk. But there’s also evidence that tight blood sugar control can shorten people’s lives, he noted.

And it’s not recommended for elderly adults, who face increased risk of heart attack or stroke if they have a severe blood sugar low, according to the ADA.

So what should people with type 2 diabetes do? McCoy said that when your doctor orders blood work, feel free to ask: “What tests am I having? And how will it improve my care?”

Hayward stressed the importance of asking questions when your doctor wants to add a new diabetes medication. “Discuss what kind of benefit you can expect to get from taking more medication,” he said.

He also cautioned that blood sugar is not the only thing that matters. Getting high blood pressure under control and taking a statin are actually the most effective ways to cut the risk of diabetes complications like heart disease and kidney failure.

“The importance of blood pressure control and statins cannot be overstated,” Hayward said.

The study couldn’t uncover the reasons for overzealous A1C testing. It’s possible, McCoy said, that many doctors, or patients, prefer close monitoring.

“One of the hardest things for doctors is to do less,” she said.

“Fragmented care” could be another reason, McCoy added. Study patients with multiple doctors were more likely to receive three or more tests a year, the research revealed.

Still, the researchers did find a positive trend: After 2009, excessive A1C testing started to decline, the study said.

“That’s encouraging,” McCoy said. “We don’t know what’s driving the change. But it may be related to growing awareness that tight blood sugar control may not benefit patients.”

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more on A1C testing.

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Talk Therapy, Antidepressants Offer Similar Results for Major Depression

By Alan Mozes
HealthDay Reporter

TUESDAY, Dec. 8, 2015 (HealthDay News) — Talk therapy and antidepressants could both be equally effective as stand-alone treatments for major depressive disorder, new research indicates.

A review of 11 previously conducted studies that collectively tracked treatment outcomes for more than 1,500 patients found no difference in how well patients responded to treatment.

“We don’t think this finding is particularly surprising, because each treatment has its own evidence base that shows they’re effective in treating major depressive disorder,” said study lead author Halle Amick, a research associate with the Research Triangle Institute-University of North Carolina in Chapel Hill.

“But this is one of the few studies to actually compare them head to head. And the finding is important because many doctors don’t have an understanding of cognitive behavioral therapy, and often don’t feel fully comfortable prescribing it,” Amick added.

The take-away message from this study may be that if a doctor doesn’t talk about psychotherapy as a treatment option, patients really should be encouraged to ask about it, she said.

The study findings are in the Dec. 8 issue of BMJ.

Major depression is a mood disorder where feelings of sadness, loss or frustration may be severe enough to interfere with daily life, according to the U.S. National Library of Medicine. The study team points out that major depressive disorder now affects more than 32 million Americans, making it the most common form of depression in the United States.

Still, only about one-fifth of patients actually get appropriate care, the study authors said. Appropriate care can either take the form of two months of prescription antidepressants (coupled with four-plus visits to a physician), or a minimum of eight half-hour psychotherapy sessions, the researchers said.

To see if one approach bested the other, the current study looked at research done between 1990 and 2015. All included patients 18 years or older. The studies looked at the benefits of talk therapy alone versus drug treatment, or a combination of the two versus drugs alone.

The talk therapy used in the study was cognitive behavioral therapy (CBT). CBT is a psychologist-led intervention designed to help patients identify, and ultimately change, harmful ways of thinking and behaving, the researchers said. Medications used in the study were known as second-generation antidepressants. This class of medications includes drugs such as Lexapro, Paxil, Prozac, Zoloft, Effexor and Wellbutrin, the study said.

Many of the studies turned out to have methodology problems, and the study authors said many findings were “low strength” in terms of reliability. They also noted that drugs were reviewed as a class of medications, not by individual drug.

Nevertheless, Amick said there was “no statistical or clinical difference between the two treatments.”

“We’re not saying that one treatment is better than the other. All we can say is that both seem to be equally effective,” she stressed.

She also pointed out that there are generally more costs involved with CBT, including the costs of the sessions that aren’t covered by insurance and time away from work.

“On the other hand, medications might have a higher risk for adverse side effects. Our data didn’t explore these issues, though they need to be considered when choosing between the two,” Amick added.

Dr. Mark Sinyor, a psychiatrist at the Sunnybrook Health Sciences Centre in Toronto, Canada, said, “This study certainly adds to a body of work showing that both are good treatments.” He co-authored an editorial accompanying the study.

“However, there may be circumstances where a patient would benefit more from one intervention than another,” said Sinyor, who is also an assistant professor of psychiatry at the University of Toronto.

“For example, CBT is a treatment optimally delivered to people who are able to notice and name their thoughts and are open to running behavioral experiments. For some people this is much more attractive than the idea of taking a medication,” he explained.

“For others, particularly those unable or unwilling to make the time commitment and wishing for relatively rapid relief of symptoms, antidepressants may be a better option,” Sinyor said.

More information

Learn more about depression from the U.S. National Institute of Mental Health.

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3-D Video Games May Boost Brainpower, Study Finds

TUESDAY, Dec. 8, 2015 (HealthDay News) — Playing 3-D video games can improve your ability to form memories and may benefit your brain as you age, researchers report.

“It’s often suggested that an active, engaged lifestyle can be a real factor in stemming cognitive [mental] aging. While we can’t all travel the world on vacation, we can do many other things to keep us cognitively engaged and active. Video games may be a nice, viable route,” study co-author Craig Stark, from the Center for the Neurobiology of Learning and Memory at the University of California, Irvine, said in a university news release.

The researchers tracked non-gamer college students who played either a 2-D or 3-D video game 30 minutes a day for two weeks.

Before and after the two-week period, the students were given a memory test designed to engage the hippocampus, the region of the brain associated with complex learning and memory. Those who played the 3-D game showed improvement on the memory test, while those who played the 2-D game did not, the investigators found.

Memory performance among those who played the 3-D game improved about 12 percent, the same amount it normally declines between ages 45 and 70, according to the study authors.

The study was funded by the U.S. National Institute on Aging and the James S. McDonnell Foundation, and published Dec. 9 in The Journal of Neuroscience.

“First, the 3-D games have a few things the 2-D ones do not,” Stark said.

“They’ve got a lot more spatial information in there to explore. Second, they’re much more complex, with a lot more information to learn. Either way, we know this kind of learning and memory not only stimulates but requires the hippocampus,” he explained.

Further research is required to determine whether the hippocampus is stimulated by the large amount of information and complexity, or the spatial relationships and exploration in the 3-D video game, said Stark, a professor of neurobiology and behavior.

He and his colleagues will examine if environmental enrichment through 3-D video games or real-world exploration experiences can reverse age-related declines in hippocampus function. The research is funded by a $300,000 Dana Foundation grant.

More information

The U.S. National Institute on Aging has more about healthy brain aging.

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Doctors Rally in Support of Fibroid Device Curbed by FDA

By Dennis Thompson
HealthDay Reporter

TUESDAY, Dec. 8, 2015 (HealthDay News) — Dozens of gynecologists, cancer doctors and women’s health experts are challenging a U.S. Food and Drug Administration warning on a power device used to remove fibroid growths from a woman’s uterus.

The tool — a laparoscopic power morcellator — grinds up fibroid growths during minimally invasive surgery. The group of experts claim that curbing its use may force patients to undergo riskier, more invasive procedures.

The FDA issued a “boxed warning” label on the devices last year. The agency had concluded that in about one out of every 458 cases, the morcellator chews up an undiagnosed cancerous growth and floods the woman’s abdomen with cancer cells.

But a review group of 46 experts says the FDA got its facts wrong. The likelihood that power morcellation would grind up a cancerous growth is actually much lower, they contend.

“The best case scenario would be for the FDA to recalculate the prevalence estimates to make them more accurate, because they did an absolutely horrible job with them,” said Dr. William Parker, director of minimally invasive gynecologic surgery at University of California, Los Angeles Medical Center in Santa Monica.

Parker is the lead author of a new paper published Dec. 8 in the journal Obstetrics & Gynecology that criticizes the FDA’s action. The authors have also issued an open letter to the FDA asking it to change course.

Benign fibroids, also called leiomyomas, can be found in about 75 percent of all women in their lifetime, the article says. These fibroids result in an estimated 210,000 hysterectomies and 50,000 surgical fibroid removals each year in the United States.

Because of the FDA warning, doctors and women have turned from minimally invasive laparoscopic surgery to full-fledged abdominal surgery to remove fibroids, the review authors contend.

Major surgery entails longer hospital stays and drastically increases risk of complication and death. A group of 100,0000 women undergoing laparoscopic surgery to remove uterine fibroids would be expected to experience 20 fewer deaths, 150 fewer dangerous blood clots in their blood vessels and 4,800 fewer wound infections than an equal number of women having abdominal surgery, the report states.

“Doctors are taking the FDA at their word, and patients take the FDA at their word,” Parker said. “So I think the FDA needs to reconsider what they’ve done and do it better.”

The FDA stands by its decision, the agency said in a statement responding to the new paper.

“At this time, the agency’s recommendations have not changed. We continue to believe that inclusion of a boxed warning and contraindications to the use of power morcellation for uterine fibroid removal in the majority of women is both appropriate and necessary,” the statement reads.

“We welcome the continued scientific dialogue concerning the available evidence about benefits and risks associated with power morcellation and will notify the public if our recommendations change,” it concludes.

The review group contends that the FDA’s data is flawed because the agency only included studies that evaluated cases of fibrous growths that turned out to be cancerous. Using those strict guidelines, the FDA found only seven studies upon which to make its analysis, Parker said.

However, an independent analysis that included all uterine growths, cancerous or not, uncovered 133 studies that were relevant, Parker said. That larger study revealed the risk of coming across a cancerous growth was actually one in 1,960, much lower than the FDA’s estimate of one in 458.

Another recently published large study found two cancerous growths among 8,720 women having surgery for fibroids, the report adds.

Dr. Hal Lawrence III, executive vice president and CEO of the American Congress of Obstetricians and Gynecologists, said that the new article is a “well-timed, thoughtful document” that “really sheds some light” on concerns that gynecologists have had since the FDA raised the issue.

“If the FDA called and asked me, I would say let’s step back and re-look at all of this data and make sure you made the right decision,” Lawrence said. “Maybe you want to modify that decision.”

In the paper, Parker and his colleagues argue there are ways to reduce the risk of spreading cancer while using a morcellator.

Certain ultrasound or MRI findings should increase a doctor’s suspicion of cancerous fibroids in a woman’s uterus, they said.

Also, surgeons should take the time to carefully remove all tissue fragments and then thoroughly irrigate the pelvic and abdominal cavities to wash away loose material, the report states.

Such a process should only take 15 to 20 minutes, Parker said.

“It should be done, and it should be done carefully,” he said. “There should essentially be no tissue left behind.”

More information

For more on uterine fibroids, visit Womenshealth.gov.

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3 Conditions That Make Your Joints Hurt

 

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You know how it goes: a creaky hip here, a popped knee there. Though you may have thought that your joints wouldn’t ache until you reached old age, the truth is, a woman who has been active most of her life may feel the first twinge in her 30s. And if you’re one of the 300,000 unlucky people to contract lyme disease annually, that may also affect your joint health. Figure out what may be causing your aches by spotting your symptoms on this chart.

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Shopping Is Like Playing A Sport, Researchers Say

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There are 10 minutes left on the clock. Time to quicken your pace. You narrow in on your goal: a pair of running shoes. Red slash marks cover the price tag of this double-discounted item. You swiftly snag the sneakers and head to the finish line. After the cashier rings up your purchase, you get a thrill of excitement and proudly carry your bag out of the store—a trophy for your triumph.

If this experience sounds familiar, you may be a “sport shopper”—a new type of individual researchers identified in the recent study “The Thrill of Victory: Women and Sport Shopping.”

“This isn’t a ‘shop til you drop’ or ‘retail therapy’ situation,” says one author of the study, Kathleen O’Donnell, PhD, Associate Dean of Marketing at San Francisco State University. “These shoppers look at bargain hunting as an achievement domain, similar to how athletes look at sports.”

RELATED: The 8 Germiest Places in the Mall

Unlike the classic “bargain hunter,” these sport shoppers can often afford to pay full price. “But it’s no fun for them to do so,” says O’Donnell. Instead, they scour stores looking for the best deal, proving they’re clever enough to outsmart the system.

O’Donnell explains: “They pride themselves on this skill and talk about the good deals they found, almost like trophies for all of their hard work.”

And sport shoppers’ “trophies” aren’t the only parallel to competitive athletes. For instance, they’re always training and conditioning their skills. Each shopping trip is an opportunity to gather information on merchandising patterns: they observe when new items come in, when things get marked down, the latest prices, and current products. So even if they walk away from one trip without any purchases, they feel totally fine, says O’Donnell. They file the newfound information away, and develop extensive strategies to find a better deal on their next shopping excursion.

RELATED: 7 Gifts for Women Who Love to Work Out

But when they do find total steals, those triumphs become a part of sport shopper’s identity. Finding a great deal is about more than just feeling good in that instant, says O’Donnell. “It’s a positive aspect of their self-concept.”

In fact, they can recall their most successful purchases in vivid detail the same way professional athletes can recite every stat of their best game. And sport shoppers love the opportunity to tell anyone who will listen about the deals they got, says O’Donnell. “Telling people reinforces it for them. They re-live the positive feeling by talking about it.”

O’Donnell plans to continue this line of research along with her co-authors Judi Strebel and Gary Mortimer. One new aspect she hopes to look into is these shoppers’ physiological response when they walk into a store (Does their heart race? Adrenaline kick in? And so on). She’s also working on developing a simple “sport shopper scale” and questionnaire. With this scale, she’ll be able to survey a much larger sample size and get a better idea of just how many sport shoppers exist. So if you think you might actually be one of these retail-mavens there will soon be a way to know for sure.

But even if you are a sport shopper, don’t kid yourself—“sport” may be in the title, but these shopping habits are NOT an excuse to skip your workouts. (Sorry!)

RELATED: 17 Ways to Lose Weight When You Have No Time

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The 10 Health.com Stories You Shared Most in 2015

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We don’t mean to toot our own horn, but we we’re pretty popular on social media in 2015. Our editors worked hard to seek out content that you wanted and gave you realistic advice that you could apply to your life. We talked to the experts to get the best tips on everything from finally kicking your bad soda habit to stealing the routine that Jillian Michael’s uses to get her killer bod and we’re so glad that you couldn’t resist sharing our tips with your followers. Check out 10 of our most-shared articles from 2015.

10 Reasons Your Belly Fat Isn’t Going Away

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We rounded up research-backed ways to get rid of your gut for good. With easy-to-do tips like incorporating monounsaturated fatty acids and magnesium-rich foods into your diet, it’s no surprise that our guide was a hit among followers

30-Day Weight Loss Challenge

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Weight loss, made easy. This interactive 30-day challenge was our most-shared story on Facebook in 2015, and for good reason. Each day offers expert tips, meal plans, or workouts to make shedding pounds a no-brainer.

Watch What Happens When Women Choose Between Doors Marked ‘Average’ and ‘Beautiful’

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Back in April, Dove released an inspirational video that sent a strong message about how we view ourselves as women. A camera crew filmed women choosing to walk through two doors—one marked “Beautiful” and one marked “Average.” Many of the women, who were located in out five different cities around the world, went through the door marked average, as that’s how they would describe themselves. The clip ended by encouraging women to celebrate themselves as they are, a message we should all get behind.

13 Ways to Stop Drinking Soda for Good

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We all know a soda habit isn’t the healthiest, but it can be hard to kick the carbonation. Cutting back, whether you consume diet or regular, can be good for your weight and your overall health. Our guide makes weaning off soda seem less daunting.

21-Day Challenge: Power Up Your Veggies

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Looking to add a little green to your life? Our 21-day challenge helps to seamlessly incorporate veggies into your diet. Our easy recipes and expert strategies will have you eating 30 grams of fiber by the end of week three.

Jillian Michaels: This 7-Move Circuit Will Change Your Body

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Jillian Michaels is the definition of #abgoals, so no wonder her fat-blasting circuit was our biggest hit of the year on Pinterest. With just 7 moves, this calorie-torching series promises to transform your body in 4 weeks.

14 Lifestyle Changes That Make You Look Younger

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Age-defying hair, skin, and hands can be yours—no expensive spa treatments required. Eating well, exercising often, and heading off stress are the real foundation for a youthful glow.

This 50 Push-Up Challenge Will Transform Your Body in 30 Days

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Does the thought of doing 50 push-ups seem daunting? One of our editors proved that it’s totally do-able with this 30-day plan by New York City-based Master Trainer Shaun Zetlin. With our day-by-day guide you’ll be half way to 100 in just 4 weeks.

12 Surprising Beauty Uses for Baking Soda

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You’re probably used baking soda to make homemade baked goods, but who knew that this kitchen staple had so many beauty uses? Turns out the product can be used as an alternative to many expensive spa treatments used to smooth hair, brighten skin, whiten teeth, and more.

8 Ways Sex Affects Your Brain

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Your brain on sex can have interesting effects on your overall health. Doing the deed can act like an antidepressant, relieve pain, and boost your memory. Now that scientists are unraveling the mystery, it’s hard not to wonder the role that getting frisky plays on our mind.

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Optimistic Outlook May Boost Recovery After Heart Attack

By Steven Reinberg
HealthDay Reporter

TUESDAY, Dec. 8, 2015 (HealthDay News) — Having an optimistic attitude after a heart attack may be good for your health, Harvard researchers report.

Two weeks after a heart attack, patients who had a positive attitude were less likely to be readmitted to the hospital. After six months, these patients were more physically active than less optimistic patients, the study found.

“In contrast, gratitude, assessed right after the heart attack, actually had no effect on readmissions or increasing physical activity,” said lead researcher Dr. Jeff Huffman, an assistant professor of psychiatry at Harvard, in Boston.

For the study, Huffman and colleagues studied 164 patients. The researchers assessed a patient’s optimism and gratitude two weeks after the heart attack and again six months later.

These findings suggest that all positive emotional experiences may not be alike when it comes to their potential effects on heart health, he said.

“It may be that optimism, as a forward-looking expectation, may help people to feel that they can make healthy changes and thrive,” Huffman said.

Gratitude, however, often focuses on immediate or past events, and while it may have benefits, these may be less connected to taking active steps in managing one’s health, he said.

This connection between optimism and positive health outcomes was independent of patients’ age, sex, health or level of activity before the heart attack, Huffman said.

Huffman said these findings may make it worthwhile to find ways to make patients more optimistic after a heart attack as a way of improving their recovery.

“Finding ways to cultivate optimism after a major health event may lead to substantially better recovery, though there have not yet been rigorous studies to test whether it is possible to make less optimistic people more hopeful and whether that improves health,” he said. This particular study was not designed to prove a cause-and-effect relationship between optimism and recovery from a heart attack.

The report was published online Dec. 8 in the journal Circulation.

Another study, published last spring in the journal Psychosomatic Medicine, found that among nearly 400 heart attack patients the most pessimistic patients were twice as likely to suffer from serious complications such as a second heart attack, heart surgery or death in the four years following their initial heart attack, compared with the most optimistic patients.

Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, said, “There has been great interest as to whether psychological factors, including having a positive outlook and feeling gratitude, can impact cardiovascular outcomes.”

However, this latest study is too small to provide enough information to really tell if trying to get patients to be more optimistic can improve outcomes, he said.

“Further analyses will be necessary to replicate these findings, as well as determine whether interventions that focus on patients’ level of optimism can have a favorable impact on cardiovascular outcomes,” Fonarow said.

More information

Visit the American Heart Association for more on heart attacks.

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ADHD Diagnoses Rising Among U.S. Kids, Study Finds

By Amy Norton
HealthDay Reporter

TUESDAY, Dec. 8, 2015 (HealthDay News) — A growing number of U.S. children have been diagnosed with attention-deficit/hyperactivity disorder (ADHD) — with girls and Hispanic children showing the biggest increases of all, a new study shows.

Researchers found that in 2011, an estimated 12 percent of U.S. kids aged 5 to 17 had ever been diagnosed with ADHD. That was up 43 percent from 2003.

“But what struck us the most were the increases among girls and Hispanic children,” said senior researcher Sean Cleary, an associate professor of epidemiology and biostatistics at George Washington University, in Washington, D.C.

Historically, ADHD has been most often diagnosed in boys, particularly white boys. But Cleary’s team found that the trends are shifting.

ADHD is still almost twice as common among white kids compared with their Hispanic peers — 14 percent versus less than 8 percent. But between 2003 and 2011, the prevalence among Hispanic children rose by 83 percent, compared with a 46 percent increase among white children, the study found.

Similarly, boys still have more than double the rate of ADHD compared to girls. But the prevalence among girls increased by 55 percent during the study period: By 2011, slightly more than 7 percent of girls had ever been diagnosed with the disorder, Cleary’s team reported in the Dec. 8 online issue of the Journal of Clinical Psychiatry.

The question is why, Cleary said.

“Have doctors been traditionally underdiagnosing this in girls and Hispanic children?” he said. “Or is this a true increase in the incidence of ADHD? Or is this overdiagnosis? We can’t say.”

It’s possible, according to Cleary, that the increase among Hispanic children reflects a growing cultural acceptance of ADHD — or the wider availability of mental health resources in Spanish.

As for the increase among girls, Cleary noted that ADHD symptoms can be different for girls and boys. Boys’ symptoms are often more overt, and they may stand out as “troublemakers.” With girls, attention issues seem more common — so they may have problems with daydreaming, Cleary said, or with getting schoolwork done.

“It’s possible there’s been a growing awareness of that over time,” he said.

But Dr. Andrew Adesman, a behavioral pediatrics specialist who was not involved in the study, agreed that the reasons for the findings remain unclear.

The analysis, which is based on federal government data, seems to “convincingly show that ADHD is on the rise,” he said.

“But it does not help us understand why these increases are being observed,” said Adesman, chief of developmental and behavioral pediatrics at Cohen Children’s Medical Center of New York, in New Hyde Park, N.Y.

There has long been controversy surrounding ADHD, with critics charging that some children are being labeled as having a “disease” and treated with drugs they do not need. Ritalin and other so-called stimulant medications are often prescribed for the disorder, and some parents balk at the idea of having their child on a drug long-term.

Cleary said that if parents think their child is having significant problems with attention and behavior, they should talk to their pediatrician: The cause may be ADHD or something different, such as sleep problems.

And Adesman pointed out that this study looked at kids’ lifetime prevalence of ADHD.

“Although that 12 percent figure is concerning and definitely reflects an increase in recent years, it does not mean that 12 percent of children at any one point in time have ADHD,” Adesman said.

More information

The U.S. Centers for Disease Control and Prevention has more on ADHD.

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Blood Thinner, Certain Diabetes Drugs Are a Bad Combo

TUESDAY, Dec. 8, 2015 (HealthDay News) — Taking the blood thinner warfarin at the same time as certain diabetes drugs increases the risk of hospitalization, a new study warns.

Researchers analyzed data from nearly 466,000 Medicare patients. They found that those who took warfarin along with the diabetes drugs glipizide or glimepiride — also known as sulfonylureas — had a 22 percent increased risk of making an emergency room visit or being hospitalized for low blood sugar (hypoglycemia).

While doctors are warned about potential interaction between the drugs, there has been little actual data, said study author John Romely, an associate professor at the University of Southern California Center for Health Policy and Economics and School of Public Policy.

“Until now, no one had really studied the interactions between them,” he said in a university news release.

The risk was especially high for men aged 65 to 74, according to the study published Dec. 7 in the journal BMJ.

Of the approximately 100,000 older Americans hospitalized each year for medication-related problems, 40 percent are for reactions to warfarin or diabetes drugs, the researchers said.

Warfarin can intensify the effects of the diabetes drugs and cause blood sugar levels to crash. Patients with low blood sugar may appear drunk, lightheaded or confused, and are at risk of falling, Romely said.

“An interaction can occur that has clinical significance, so providers need to be aware in order to prevent a low blood sugar issue from occurring,” study co-author Anne Peters, a professor in the USC School of Medicine, said in the news release.

“Sometimes this means having the patient monitor their blood sugar levels more often,” she added. “There are many ways to deal with the issue if one is forewarned.”

There is no need for pharmacists to change patient instructions, the researchers added.

“What it does require is for pharmacists and other clinicians to be more vigilant when a sulfonylurea is added to a regimen that includes warfarin, as well as when a patient who is taking both has a change in their medical status,” study co-author Bradley Williams, a professor in the School of Pharmacy and School of Gerontology, said in the news release.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about hypoglycemia.

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