Latest news with #TheLancetDiabetes&Endocrinology
Medscape
20-05-2025
- Health
- Medscape
Surgery Treats Hypertension in Patients With Adrenal Tumours
In patients with unilateral adrenal incidentalomas and mild autonomous cortisol secretion (MACS), adrenalectomy was well tolerated and enabled a reduction or cessation of hypertensive treatment while maintaining blood pressure within normal ranges. METHODOLOGY: Researchers conducted this clinical trial in university hospitals across Europe to assess the effect of adrenalectomy on hypertension in patients with unilateral benign adrenal incidentalomas and MACS. They enrolled patients with a unilateral adrenal adenoma (≥ 2 cm) and MACS, in whom hypertension was confirmed through multiple home blood pressure measurements; a standardised stepped-care antihypertensive treatment was implemented until the measurements normalised to less than 135/85 mm Hg. A total of 52 patients (median age, 63.3 years; 69% women) were then randomly assigned to either undergo adrenalectomy or receive conservative management and were followed up for 13 months; after randomisation, antihypertensive medications were adjusted on the basis of the stepped-care treatment approach. The primary outcome was the proportion of patients in each group who reduced their antihypertensive treatment by at least one step while maintaining normal home blood pressure measurements (< 135/85 mm Hg). TAKEAWAY: A higher proportion of patients in the adrenalectomy group were able to reduce antihypertensive treatment by at least one step while maintaining normal home blood pressure measurements than those in the conservative management group (46% vs 15%; adjusted risk difference, 0.34; P = .0038). = .0038). Among the patients who underwent adrenalectomy, more than half (52%) were able to discontinue all antihypertensive medications while maintaining normal systolic home blood pressure measurements (< 135 mm Hg); however, none of the patients achieved this after conservative management. Serious adverse events were reported in 35% of patients who underwent adrenalectomy and 31% of those who received conservative management, with no deaths reported in either group. IN PRACTICE: "For individuals with hypertension and clear biochemical evidence of MACS, especially those with larger adrenal adenomas, this study helps support the case for adrenalectomy," experts wrote in a commentary. SOURCE: This study was led by Antoine Tabarin, MD, Department of Endocrinology, Diabetology, Metabolism and Nutrition, CHU Bordeaux, Bordeaux, France. It was published online on May 12, 2025, in The Lancet Diabetes & Endocrinology . LIMITATIONS: This study was limited by a small sample size. The criteria used for diagnosing adrenal insufficiency might have led to the overdiagnosis and potential overtreatment of patients. The findings cannot be extrapolated to patients with bilateral adrenal incidentalomas and MACS. DISCLOSURES: This study was supported by a grant from the French Ministry of Health, and the German part of the study was additionally supported by the German Research Foundation. Some authors reported receiving honoraria, research grants, and support for attending meetings and having several other ties with various pharmaceutical companies and other sources.
CBS News
10-04-2025
- Health
- CBS News
Diabetes during pregnancy linked to higher rates of ADHD, autism in children, study says
Having diabetes during pregnancy is linked to higher rates of ADHD , autism and other neurocognitive issues in children, according to new research. The meta-analysis, published earlier this week in The Lancet Diabetes & Endocrinology , analyzed over 56 million pregnancies across more than 200 studies. Researchers found children born to women who had diabetes during pregnancy were 28% more likely to have a neuro-developmental issue than those whose mothers didn't have the disease. The risk was heightened by both gestational diabetes , which can develop during pregnancy, and pre-existing Type 2 diabetes , according to the study. "We know that high blood sugar levels during pregnancy can cause other neurological issues," Dr. Céline Gounder, CBS News medical contributor and editor-at-large for public health at KFF Health News, said on "CBS Mornings" Thursday. "What's probably happening is a combination of the blood sugar levels themselves, but also how that triggers inflammation, other hormonal changes, how it turns certain genes on and off during fetal development." It also increases the risk of having a baby who is more overweight at the time of birth, which means the delivery itself can be more complicated, Gounder added. If you're looking to start a family but have diabetes or another medical condition, Gounder says it's recommended to hold off getting pregnant until those conditions are under control. The people behind forming guidelines like these to keep mothers and their children safe have recently faced cuts at the Centers for Disease Control and Prevention under the Trump administration . "This relates to some of the cuts we've recently seen at the CDC. One of the cuts was the people in the Maternal and Child Health Division," she said. "The people in that division were developing guidelines for contraception for women who had underlying medical issues, were medically complicated." For those women, regular birth control pills and other common methods may not be the right thing, Gounder explained, highlighting the importance of that work.
Observer
08-04-2025
- Health
- Observer
Study confirms link between maternal diabetes and autism
WASHINGTON: A new American study has shown that diabetes during pregnancy is associated with an increased risk of brain and nervous system problems in children, particularly autism. The study, published in The Lancet Diabetes & Endocrinology journal, showed that diabetes diagnosed before pregnancy increases the risk of one or more neurodevelopmental disorders by 39 per cent compared to gestational diabetes, which begins during pregnancy and often resolves afterward. According to the researchers, the findings highlight the importance of medical support for women at risk of diabetes and continued monitoring of their children. Children born to mothers with gestational diabetes have a 25 per cent increased risk of autism, a 30 per cent increased risk of attention deficit hyperactivity disorder, a 32 per cent increased risk of intellectual disability, a 20 per cent increased risk of communication problems, a 17 per cent increased risk of motor problems, and a 16 per cent increased risk of learning disorders compared to children whose mothers did not have gestational diabetes. For her part, Dr Magdalena Janicka of New York University Grossman School of Medicine said: 'Such analysis allows us to compare groups more precisely, but they do not bring us closer to understanding the causes or underlying mechanisms'. A large 'meta-analysis' like this one allows for analyses of subgroups, such as mothers with pre-existing vs gestational diabetes, or children with autism vs those with ADHD or movement disorders, but it cannot prove cause and effect, Janecka said. "Meta-analyses allow us to compare groups more precisely. At the same time, they are not bringing us any closer to understanding the causes or the underlying mechanisms.' The study comes as Trump administration health officials have called for further research into whether vaccines are a cause of autism, a claim long championed by new Health Secretary Robert F Kennedy Jr. that has been debunked by established science. — Reuters
South China Morning Post
08-04-2025
- Health
- South China Morning Post
More evidence diabetes in pregnancy is linked to higher autism, ADHD risks in children
A large new study adds to evidence that diabetes during pregnancy is linked with an increased risk of brain and nervous system problems in children, including autism, researchers say. Advertisement Whether diabetes actually causes those problems remains unclear. But when mothers have diabetes while pregnant, children are 28 per cent more likely to be diagnosed with a neurodevelopmental disorder, according to an analysis of data pooled from 202 earlier studies involving more than 56 million mother-child pairs. The risks for children of mothers with diabetes during pregnancy were 25 per cent higher for autism, 30 per cent higher for attention deficit hyperactivity disorder (ADHD) and 32 per cent higher for intellectual disability. They were also 20 per cent higher for trouble with communication, 17 per cent higher for movement problems and 16 per cent higher for learning disorders than in children whose mothers did not have diabetes while pregnant. Diabetes diagnosed before pregnancy appeared to confer a 39 per cent higher risk for one or more of these neurodevelopmental disorders compared with gestational diabetes that begins in pregnancy and often resolves afterwards, the researchers reported in The Lancet Diabetes & Endocrinology. Children born to mothers who had diabetes while pregnant had a 16 per cent higher risk of developing learning disorders than children whose mothers did not, researchers found. Photo: Shutterstock Diabetes affects up to 9 per cent of pregnancies in the United States, with the incidence rising, according to the US Centres for Disease Control and Prevention. The rate of gestational diabetes worldwide, on average, is between 14 and 17 per cent.
Reuters
28-02-2025
- Health
- Reuters
Health Rounds: Weight loss can improve or reverse type 2 diabetes
Feb 28 (Reuters) - The more weight people with type 2 diabetes lose, the greater the odds that the disease will go partially or even completely into remission, according to a new analysis published in The Lancet Diabetes & Endocrinology, opens new tab. Reviewing 22 earlier randomized trials testing weight loss interventions in overweight or obese patients with type 2 diabetes, researchers found complete remission of the disease in half of those who lost 20% to 29% of their body weight. Nearly 80% of patients who lost 30% of body weight no longer appeared to have diabetes. That means their hemoglobin A1c levels – a standard measure reflecting average blood sugar levels over the past few months – or their fasting blood sugar levels had returned to normal without use of any diabetes medications. No one who lost less than 20% of their body weight achieved a complete remission, but some were in partial remission, with hemoglobin A1c and fasting glucose levels returning almost to normal. Partial remission was seen in roughly 5% of those who lost less than 10% of their body weight, and that percentage rose steadily with greater weight loss, reaching nearly 90% among those who lost at least 30%. Overall, for every 1 percentage point decrease in body weight, the probability of reaching complete remission increased by roughly 2 percentage points and the probability of reaching partial remission increased by roughly 3 percentage points, regardless of age, sex, race, diabetes duration, blood sugar control, or type of weight loss intervention. Type 2 diabetes accounts for 96% of all diagnosed cases of diabetes, and more than 85% of adults with the disease are overweight or obese, the researchers noted. 'The recent development of effective weight loss medications, if made accessible to all who could benefit, could play a pivotal role' in reducing the prevalence of diabetes and its complications, the researchers said. NEW BONE MARROW TRANSPLANT METHOD MAY CURE SICKLE CELL DISEASE A new bone marrow transplant method can help cure sickle cell disease and is more accessible than highly expensive gene therapies for the disease, researchers say. Sickle cell disease is a genetic blood disorder, primarily occurring in Black individuals, that changes the shape and function of red blood cells, leading to severe pain, organ damage, reduced quality of life, and increased mortality. The new transplant procedure, already available at multiple medical centers, is less costly than recently approved gene therapies for sickle cell disease, researchers reported in two separate papers. Among 42 young adults with severe sickle cell disease who underwent the procedure, called reduced intensity haploidentical bone marrow transplantation, 95% were alive two years later and 88% were considered cured and experienced no disease-related events, according to a report published in The New England Journal of Medicine Evidence, opens new tab. 'Our results... are every bit as good or better than what you see with gene therapy,' study coauthor Dr. Richard Jones of Johns Hopkins University School of Medicine said in a statement. Unlike traditional bone marrow transplants, the new method does not require marrow from a specifically matched donor to avoid triggering an immune response. That difference makes it much easier to find an appropriate marrow donor. 'A common misconception in the medical field is that transplantation for sickle cell disease requires a perfect matched donor... which this trial and other studies have shown aren't true,' coauthor Dr. Robert Brodsky, also of Johns Hopkins, said in a statement. Before the transplant, patients received low doses of chemotherapy and total body irradiation. Afterward, they were treated for one year with chemotherapy to prevent the donor's immune cells from attacking the recipient's body. In a separate paper published in Blood Advances, opens new tab, the research team estimated that new gene therapies for sickle cell disease cost $2 million to $3 million, compared to less than $500,000 for a bone marrow transplant. Furthermore, hospitalizations for bone marrow transplants average about eight days, as opposed to six-to-eight weeks for gene therapy, Brodsky said. While many with sickle cell disease have organ damage that would make them ineligible for the high-dose chemotherapy required with gene therapy, most would be eligible for the transplant, Jones said.
