Higher Insulin Doses May Increase Risks for Patients with Type 2 Diabetes

Researchers have uncovered a link between an increased dosage of insulin and a heightened risk of premature death and other events in patients with type 2 diabetes. The observational study included 6484 patients with type 2 diabetes who progressed to treatment with insulin monotherapy and were followed for an average of 3.3 years. Increased risks in relation to 1-unit increases in insulin dose were 54% for all-cause mortality, 37% for major adverse cardiovascular events, and 35% for cancer during follow-up. The results are published in Diabetes, Obesity, and Metabolism.

BPA Exposure from Canned Beverages May Increase Blood Pressure

In a new study, when older adults drank 2 cans of soy milk, their average concentration of urinary bisphenol A (BPA) increased 16 times above baseline within 2 hours. Systolic blood pressure increased 4.5 mm Hg on average. On days when they drank the same beverage from glass bottles, which do not use BPA linings, there was no significant change in their BPA levels or blood pressure. The Hypertension study included 60 older adults who drank soy milk from cans or glass bottles on 3 separate occasions, weeks apart. BPA is an endocrine disruptor that can mimic estrogen.

Report: Half Of Patients Prescribed Opioid For 30 Days Still Using Drug Three Years Later.

In continuing coverage, ABC World News (12/9, story 7, 1:10, Muir) Chief Medical Editor Dr. Richard Besser reported on a study from Express Scripts that looked at 36 million prescriptions and found that “nearly half of those patients who are described a narcotic and took it for more than 30 days, they were still on it three years later.” Dr. Besser said these drugs “are meant for short-term use,” and according to the CDC “46 people die from narcotic overdose, when they are combined with anxiety medication or sleeping pills” every day.

TIME (12/10, Sifferlin) reports that although “the rate of Americans using pain medications like codeine, morphine, oxycodone and hydrocodone long term has remained stable in the last five years,” the amount “of medication they take has increased.” The report found that “use was most rampant in small Southeastern cities, and two-thirds of patients were prescribed the drugs by two or more physicians.” Nearly “40% filled their prescriptions at multiple pharmacies.”

CBS News (12/10) reports on its website that according to the National Institute on Drug Abuse, “the U.S. accounts for only 5 percent of the world’s population, yet as a country we consume at least 75 percent of all opioid prescription drugs.”

Intravenous Magnesium Sulfate May Help Prevent Contrast-Induced Nephropathy

Research suggests that prophylactic use of intravenous magnesium may provide added benefits to traditional hydration for preventing contrast-induced AKI. In a study of 122 patients undergoing percutaneous coronary interventions who were randomized to receive routine treatment or routine treatment plus intravenous magnesium sulfate just before the procedure, contrast-induced AKI occurred in 26.6% of patients in the control group and 14.5% of patients in the study group. There were no deaths or need for hemodialysis in either group in the International Urology and Nephrology study.

US Adults at High Lifetime Risk of Developing CKD, Model Suggests

A new simulation model projects that more than half of healthy US adults between the ages of 30 and 64 will develop CKD at some point during their lifetimes. US adults without CKD who are 30 to 49, 50 to 64, and ≥65 years of age were estimated to have a 54%, 52%, and 42% risk, respectively. The prevalence of CKD in adults ≥30 years of age is projected to increase from 13.2% currently to 14.4% in 2020 and 16.7% in 2030. Based on the American Journal of Kidney Diseases findings, knowing these risks may raise general awareness among the public while encouraging individuals to take steps to prevent CKD.

Iron Supplementation Linked with Reduced Risk of Premature Death in Dialysis Patients

In a study of 235 incident dialysis patients, those who took iron supplements had a 78% decreased risk of death over a median follow-up of 34 months. They also had a 69% reduced risk of death due to cardiovascular and sepsis-related causes. Increasing ferritin concentrations in patients with normal C-reactive protein was associated with a decreased risk of death, whereas in patients with elevated C-reactive protein values, ferritin levels >800 ng/mL were linked with increased mortality. For the PLOS One study, 191 patients received intravenous iron, 13 patients received oral iron, and 31 patients never received iron supplements.

New Kidney Allocation System Begins this Month

The Organ Procurement and Transplantation Network (OPTN) is implementing substantial changes to the US deceased donor kidney (DDK) allocation system this month. These modifications aim to increase life years for DDKs that are transplanted by adding allocation priority for longevity matching for potential recipients with an estimated survival in the top 20%; improve access to transplantation for moderately and highly sensitized candidates on the waiting list; improve access to transplantation for ethnic minorities; and improve efficiency and utilization of DDKs by providing more granular information regarding organ quality. OPTN has provided numerous resources related to the change.