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* Neuropathy. A study published in the February 2006 issue of Diabetes Care evaluated whether patients who had received intensive diabetes therapy for an average of 6.5 years had fewer signs and symptoms of neuropathy than those receiving conventional therapy 8 years after completing the Diabetes Control and Complications Trial (DCCT). Subjects in the intensive group had received at least 3 insulin injections daily, whereas those in the conventional group had received no more than 2 injections daily. When the DCCT ended, participants in its intensive therapy group were encouraged to maintain a therapeutic regimen; those in the study's conventional group were asked to begin intensive therapy. The investigators assessed neuropathy in the 1257 subjects annually as part of the Epidemiology of Diabetes Intervention and Complications study.


On physical examination, participants who had been in the intensive therapy group during the trial showed a lower prevalence of neuropathy than the conventional therapy group (17.8% vs 28%). The researchers concluded that the benefits of 6.5 years of intensive therapy affected a patient's neuropathy status for at least 8 years following the completion of the DCCT.


Source: Martin CL, Albers J, Herman WH, et al. Neuropathy among the diabetes control and complications trial cohort 8 years after trial completion. Diabetes Care. 2006;29:34-4.


* Urinary Incontinence. In another study published in the February 2006 issue of Diabetes Care, researchers examined whether a lifestyle intervention or metformin therapy is linked to a reduced risk of urinary incontinence among overweight, prediabetic women. They evaluated data from the Diabetes Prevention Program, a randomized trial of 1957 women in 27 US centers. Of those participants, 660 were randomized to intensive lifestyle therapy, 636 to metformin, and 661 to placebo with standard advice about lifestyle habits. At the end of the trial, participants were asked to complete a questionnaire that measured incontinence symptoms and frequency.


Results of the survey showed that women in the intensive lifestyle group (38.3%) had a lower weekly prevalence of stress or urge incontinence than those randomized to the metformin (48.1%) or placebo (45.7%) groups. For women who suffered from stress incontinence, a change in their weight accounted for the most protective effect against symptoms.


The researchers concluded that a lower prevalence of urinary incontinence may help motivate women to modify their lifestyle to prevent diabetes.


Source: Brown JS, Wing R, Barrett-Connor E, et al. Lifestyle intervention is associated with lower prevalence of urinary incontinence. Diabetes Care. 2006;29:385-90.


Venous Ulcers

Health care providers continue to debate which type of compression is most effective in helping to heal venous ulcers. A study published in the December 2005 issue of the Journal of Vascular Surgery examined the effects of a four-layer elastic bandage versus a nonelastic compression garment in 12 patients with bilateral venous ulcers. The 7 men and 5 women had an average age of 61 years and had similar hemodynamic venous characteristics. The nonelastic compression was applied on one limb and the 4-layer elastic compression was applied on the opposite limb of the patient.


Although conventional elastic compression is regarded as the gold standard treatment for venous ulcers, results of this limited study showed faster healing rates with the nonelastic compression garment. This suggests that further large-scale studies are needed to determine the role of these modalities in managing patients with venous leg ulcers.


Source: Blecken SR. Comparison of elastic versus nonelastic compression in bilateral venous ulcers: a randomized trial. J Vasc Surg. 2005;42:1150-5.


Wound Care

Bioelectronics Corporation, Frederick, MD, and the Lahey Clinic, Boston, MA, are launching a 3-year study of ActiPatch on a variety of soft tissue injuries and related medical conditions. The Lahey Clinic, whose faculty is affiliated with the medical schools at Harvard and Tufts, will initiate double-blind clinical studies on ActiPatch in the areas of plastic surgery, orthopedics, and chronic wound care.


ActiPatch is a drug-free, anti-inflammatory product with an embedded battery-operated microchip that delivers weeks of continuous pulsed therapy, according to the manufacturer. Its patented technology is designed to provide a cost-effective method to reduce soft tissue pain and swelling.


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