Posts for: May, 2014

Health Tip: Keeping Seniors on Their Feet

By Diana Kohnle, HealthDay Reporter

(HealthDay News) -- Wearing a pair of sturdy, properly fitted shoes can help keep seniors upright.

The American Podiatric Medical Association suggests these shoe-buying tips for seniors:

  • Squeeze both sides of the heel to make sure it doesn't collapse. Check for appropriate flexibility in the toe box, and make sure the shoe doesn't twist in the middle.
  • Each time you go shopping, measure your feet. Also, shop late in the day and shop for the size that fits your largest foot.
  • Pack a pair of socks to try on with the shoes.
  • Don't buy shoes that aren't immediately comfortable or steady.
  • Talk to a podiatrist about the best shoes for any specific foot problems.

New Weight Loss Formula: Popular Diabetes Drug Melts Pounds, Studies Show

Melanie Haiken | April 30, 2014.

If the FDA says yes, a major new weight loss drug may hit the market this year. A high-dose formulation of liraglutide, the popular diabetes drug from Novo Nordisk melts up to 10 percent of body mass, studies show.

Liraglutide, available in 1.2 mg and 1.8 mg doses as Victoza, is already a huge success for Novo Nordisk. The company has now filed with the FDA seeking approval for a 3.0 mg dose after studies found major weight loss benefits (in conjunction with diet and exercise.)

In clinical trials, liraglutide helped those taking it lose 5 to 10 percent of their body mass, according to research published in the International Journal of Obesity. And while this study looked at people with diabetes, a previous study published in the Lancet tested the drug in non-diabetics and found similarly impressive weight loss.

In late December, Novo Nordisk filed two submissions for liraglutide, a new drug application (NDA) with the FDA, and a Marketing Authorization Application (MAA) with the European Medicines Agency, according to Drug Discovery & Development.

But some folks may not have to wait even that long. In February, Novo Nordisk made the unusual move of targeting Mexico for an initial approval of high-dose liraglutide. And others may not wait at all; while the studies warn against using liraglutide “off-label” for weight loss, it seems certain that patients will seek to use Victoza for that purpose.

Liraglutide works by mimicking a hormone known as GLP-1, which slows digestion and stimulates the body’s natural production of insulin. Victoza has been very successful for Novo Nordisk, with sales jumping 58 percent in 2012, and climbing an additional 14 percent in the third quarter of 2013.

Experts are projecting that liraglutide would have blockbuster potential as a weight loss application because the market for weight loss is so large.

The study in non-diabetics, conducted by Arne Astrup of the University of Copenhagen, tested four different doses of liraglutide: (1.2 mg, 1.8 mg, 2.4 mg, and 3.0 mg) against placebo and another drug, Orlistat and found that people taking the highest dosage of liraglutide lost an average of almost 16 pounds. People taking the lower doses also lost weight, between 10 pounds with 1.2 mg  and 13 pounds at 2.4 mg.

Just as exciting, liraglutide was found to reduce pre-diabetes, lower blood pressure, and even help reduce sleep apnea. The most common side effects from liraglutide were mild; some participants experienced nausea,vomiting and diarrhea when they first started taking the drug but in most cases the problems subsided over time.

However, there are also more serious safety concerns; currently the FDA is investigating the entire class of GLP-1 drugs to see if they raise the risk of pancreatitis. Victoza also carries a warning that animal studies found it caused thyroid tumors, both benign and cancerous, in mice, and that it’s “not known” if it could carry the same risk for humans.

And then there’s the fact that liraglutide is administered as a daily injection, which will likely prove a barrier for many people, especially given the availability of oral weight loss drugs like Qsymia and Belviq.

A Class of Potential Weight Loss Cures

Liraglutide belongs to a class of drugs known as incretin mimetics, all of which may turn out to be potential weight loss cures.

AstraZeneca's  evenatide (Byetta, Bydureon) the other GLP-1 analog on the market, has also been found to aid weight loss, and the obesity community is taking notice. Weight loss bulletin boards are a-buzz with questions, and health experts like Mayo Clinic are beginning to weigh in on the issue.

Meanwhile, more GLP-1 analogs come down the pipeline. Just a few weeks ago the FDA approved albiglutide (Tanzeum), GlaxoSmithKline's GLP-1 contender, which only has to be injected once-a-week.

And the FDA is currently reviewing Eli Lilly‘s GLP-1 analog, dulaglutide, which appears to be as promising for weight loss as liraglutide, and also has once-a-week dosage. Eli Lilly hopes to have dulaglutide in pharmacies by the end of 2014. Pharmacists project weight loss benefits may be just as important as diabetes control in determining which GLP-1 drug is most successful.

 

Sanofi's  GLP-1 analog Lyxumi launched in Europe in late 2013, but the company recently withdrew it’s application for FDA approval in the U.S. pending an investigation into the drug’s cardiovascular safety.


Increasing Daily Coffee Consumption May Reduce Type 2 Diabetes Risk

By: News Staff | April 27, 2014.

Boston, MA — People who increased the amount of coffee they drank each day by more than one cup over a four-year period had a 11% lower risk for type 2 diabetes than those who made no changes to their coffee consumption, according to a new study led by Harvard School of Public Health (HSPH) researchers. In addition, the study found that those who decreased their coffee consumption by more than a cup per day increased their type 2 diabetes risk by 17%.

"Our findings confirm those of previous studies that showed that higher coffee consumption was associated with lower type 2 diabetes risk," said Shilpa Bhupathiraju, lead author and research fellow in the Department of Nutrition at HSPH. "Most importantly, they provide new evidence that changes in coffee consumption habit can affect type 2 diabetes risk in a relatively short period of time."

The study appears online Thursday, April 24, 2014 in Diabetologia(the journal of the European Association for the Study of Diabetes).

The researchers analyzed data on caffeinated and decaffeinated coffee, and caffeinated tea consumption from 48,464 women in the Brigham and Women's Hospital-based Nurses' Health Study (1986-2006), 47,510 women in Nurses' Health Study II (1991-2007), and 27,759 men in the Health Professionals Follow-up Study (1986-2006). Participants' diets were evaluated every four years with a questionnaire, and those who self-reported type 2 diabetes filled out additional questionnaires. A total of 7,269 cases of type 2 diabetes were documented.

Results showed that participants who increased their coffee consumption by more than one cup per day (median change=1.69 cups/day) over a four-year period had a 11% lower risk of type 2 diabetes in the subsequent four years compared to those who made no changes in consumption. (A cup of coffee was defined as eight ounces, black, or with a small amount of milk and/or sugar.) Those who lowered their daily coffee consumption by more than one cup (median change=2 cups/day) had a 17% higher risk for diabetes. Changes in decaffeinated coffee consumption and caffeinated tea consumption were not associated with changes in risk for type 2 diabetes.

"These findings further demonstrate that, for most people, coffee may have health benefits," said Frank Hu, senior author and professor of nutrition and epidemiology at HSPH. "But coffee is only one of many factors that influence diabetes risk. More importantly, individuals should watch their weight and be physically active."

 

 

 


Healthy Feet for Spring

 

Denise Pritchard | March 31, 2014.

In 1914, eight doctors formed the Michigan Podiatric Medical Association (MPMA). Their founding document stated the purpose of the organization was to "improve the profession, safeguard the public and encourage scientific investigation." Although many medical advances have been made over the past 100 years, the mission of the MPMA has remained unchanged.

"Foot and ankle concerns are too often overlooked by the general public," said Dr. Jodie Sengstock, MPMA past president. "Our feet are the foundation of our body. One of the goals of the MPMA is to reach out to the public to let them know that annual foot exams can lead to a better quality of life and also may help detect the onset of other life threatening diseases."

Throughout the month of April, the MPMA will celebrate and promote the national Foot Health Awareness campaign. This is the perfect time to determine what shape ones' feet are in.

Examining our feet can help us identify early symptoms of other serious disorders such as vascular disease and diabetes. Foot issues can also cause other problems throughout our body.

Most Americans log an amazing 75,000 miles on their feet by the time they reach age 50. Through the years, aging and repetitive use lead to normal changes in our feet. Keeping up with those changes is important to an individual's overall health and wellbeing. MPMA podiatrists are uniquely qualified to identify changes, normal and irregular, and to determine the appropriate action or treatment to be taken.

Normal changes to the foot include:

· The foot becomes wider and longer

· There is mild settling of the arch which is seen as flattening of the foot

· The fat pad on the bottom of the heel thins out, causing loss of natural padding and spring in the step

· The foot and ankle lose some of their normal range of motion and become stiffer

· There can be some loss of balance while walking

As these physical changes occur, shoe sizes and support needs also change and must be addressed.

Some foot changes can occur that are abnormal or pathological. These problems do not happen naturally and many can be prevented, or their progress halted, by addressing ill-fitting shoes, adding supportive orthotics, surgery, or other modifications.

Abnormal changes to the foot include:

· Bunions (the formation of a large bump on the big toe, which starts to point toward the little toes)

· Hammering of the toes (curling of the toes)

· Clawing of the toes (more severe curling of the toes)

· Tailor's bunion (the formation of a large bump on the smallest toe, which starts to point toward the large toe)

· Calluses or corns, which occur on the toes or foot due to high pressure over bony areas

· Morton's neuromas ("pinched nerve" between the toes)

· Arthritis of the joints

A yearly exam with an MPMA podiatrist is vital to tracking changes, checking for proper sensation and circulation, and calling attention to abnormalities. Early detection and treatment of problems help keep individuals on their feet and active.

 

Take time to schedule an annual foot exam today.


MORE WOMEN ARE GETTING FOOT SURGERY TO COMFORTABLY WEAR DESIGNER SHOES

Erin Mayer | April 2014.

How far would you go for a pair of Louboutins? What about foot surgery? More and morewomen are surgically altering their feet so they can comfortably wear designer heels. Sound extreme to you? Good, you’re human.

The New York Times recently spoke to some high-profile podiatrists who all had stories about women seeking to change the shape of their feet to accommodate their beloved stilettos. Dr. Ali Sadrieh, who founded Evo Advanced Foot Surgery in Beverly Hills, said he was originally disturbed by the trend but eventually came to understand why women would take such dramatic action.

“Patients would bring in shoes they dreamed of wearing,” he said over tea recently at the St. Regis New York, where he was staying to see New York patients. “On the surface, it looked shallow. But I came to see she needs these shoes to project confidence, they are part of her outside skin. That’s the real world.”

Um, what? That’s the real world? I think the “real world” is about wearing shoes that are right for the feet you have, not shelling out thousands of dollars to literally carve your feet to fit your closet full of Manolos. But I guess that’s just me.

Dr. Sadrieh has capitalized on the trend by coining a few fashionable names for various procedures. There’s the Cinderella (a colloquial name for a bunionectomy), the Perfect 10! (aesthetic toe-shortening), the Model-T (toe-lengthening), and the Foot Tuck (a fat-pad augmentation that makes high heels more comfortable). These cutesy names are clever and probably excellent for business. What’s troubling is how many women were asking for these procedures before they had quirky names.

Another podiatrist, Dr. Neal Blitz (coolest name ever, by the way), who works out of Manhattan, calls the feet “the final frontier” of cosmetic surgery. ”My practice has exploded because of Manolo Blahnik, Christian Louboutin and Nicholas Kirkwood,” he told the Times. “There’s nothing like opening a shoe closet that’s been closed to somebody for years.”

An America Now segment from 2013 refers calls this phenomenon ”stiletto surgery,” which involves one of several procedures:

removing a cylinder of bone from the toe, slimming down down it’s length, or injecting fillers into the foot to add padding, or simply lobbing off the pinky toe to add extra wiggle room inside a shoe that’s notoriously painful to walk in.

Despite the enthusiastic endorsements from the New York Times podiatrists, America Now found that many doctors believe foot surgery should only be performed for restorative purposes.

The American Podiatric Medical Association and many of their physicians warn that foot surgery should only be performed for medical reasons — to restore function or reconstruct a deformity.

I suppose that if you have the disposable income (America Now quoted $500 to $1,500 per toe), the ability to wear designer heels comfortably is preferable to hobbling around in pain. But this just seems crazy to me! I love shoes, and, were I fabulously wealthy, would certainly own a closet full of Nicholas Kirkwood pumps. But, rather than foot surgery, maybe these women would be happy investing in some Dr. Scholl’s inserts and sticking to flats on a day-to-day basis?




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