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Common heartburn meds linked to higher diabetes risk

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Often-used drugs called proton pump inhibitors, or PPIs, ease heartburn symptoms, but a new study suggests they might also increase the risk of type 2 diabetes.

Chinese researchers drew on information from studies of more than 200,000 U.S. health care professionals and found that regular use of PPIs — such as Aciphex, Nexium, Prilosec, Prevacid, Protonix — was associated with a 24% higher risk of developing type 2 diabetes.

The researchers also found that the longer people used the drugs, the higher their odds of diabetes.

“Regular PPI use was likely to be associated with an increased risk of type 2 diabetes, particularly for those with prolonged use,” the authors wrote in the report published online this week in the journal Gut.

Jinqiu Yuan, a researcher from the Sun Yat-Sen University, Shenzhen, Guangdong, China, led the study.

PPIs are available by prescription or over-the-counter to treat acid reflux, peptic ulcers and other digestive conditions. They are among the top 10 drugs used worldwide. Long-term use has previously been linked to a greater risk of bone fractures, kidney disease, digestive tract infections and stomach cancer.

Based on the new findings, the researchers suggested that people taking PPIs for a long time should have their blood sugar monitored for changes that might indicate developing diabetes.

It’s important to note, however, that this study was not designed to prove a cause-and-effect relationship between PPIs and type 2 diabetes. It can only show a link between the two.

The researchers relied on data from three long-term studies of U.S. health professionals that began in the 1970s and 1980s. They included more than 176,000 women and nearly 29,000 men.

Participants provided information on their health and behaviors every two years. In the early 2000s, the questions expanded to include whether they had used a PPI two or more times a week.

The investigators tried to control for factors that might affect type 2 diabetes risk, including high blood pressure, weight and physical inactivity.

Besides linking regular use of PPIs to an increased risk of type 2 diabetes, the researchers found that long-term use increased the odds, too. Study participants who used PPIs for up to two years had a 5% increased risk, and the risk rose 26% for those who took the drugs more than two years.

The study authors also noted that when people stopped taking these drugs, the risk of diabetes fell, and it continued to do so even more over time.

Surprisingly, the risk of diabetes associated with PPI use appeared to be highest in people with normal blood pressure and lower weight. Typically, higher weight is a risk factor for type 2 diabetes.

The study also found a 14% higher risk of type 2 diabetes in people taking another type of heartburn medication called H2 receptor blockers — such as Pepcid, Tagamet, Zantac.

It’s unclear exactly how taking acid-reducing medications might increase diabetes risk, the researchers said. One possible way might be through altering the body’s natural balance of bacteria, or microbiome, they suggested. Another possibility: PPI use may lead to weight gain that can increase the odds of diabetes. More research is needed.

Dr. David Bernstein, a digestive disease specialist from Northwell Health in Manhasset, N.Y., reviewed the findings.

“PPIs are the most effective therapies for the treatment of acid reflux, gastritis and peptic ulcers,” Bernstein said. “When first introduced, they were considered ‘miracle’ drugs as they alleviated previously refractory abdominal pains.”

Unfortunately, as the study authors noted, these drugs have been linked to some serious long-term side effects.

“This report, despite its weaknesses, adds yet another potential consequence to an already growing list of medical conditions associated with long-term PPI use,” Bernstein said. Weaknesses included the observational nature of the study and lack of randomized comparison groups, he noted.

Still, based upon the findings, it seems reasonable to check patients who have been taking PPIs for more than two years for development of diabetes at regular intervals, he said. “Further studies are required to determine what that interval should be,” Bernstein explained.

Another digestive disease specialist, Dr. Arun Swaminath, from Lenox Hill Hospital in New York City, agreed that the study had limitations.

“The main limitation of the study is that the true estimation of PPI exposure is based on memory and recall bias,” he said.

But, due to this study’s findings and other associated risks of long-term PPI use, Swaminath said, “it’s reasonable to always see if a patient still needs their PPI” or if their dose could be lowered.

For those who need to stay on PPIs, doctors and patients need to discuss the drugs’ risks and benefits, he advised. Because PPIs are available over-the-counter, “it will not be a simple process to identify all at-risk patients,” Swaminath pointed out.

More information

Learn more about proton pump inhibitors from the International Foundation for Gastrointestinal Disorders.

Copyright 2020 HealthDay. All rights reserved.



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Study: Less restrictive reproductive rights reduce birth complications risk by 7%

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Oct. 13 (UPI) — Women living in states with less restrictive reproductive rights policies are 7% less likely have low birth weight babies than those living in states with more stringent laws, according to an analysis published Tuesday by the American Journal of Preventive Medicine.

The risk was 8% lower for Black women living in less-restrictive states, the data showed.

“Our study provides evidence that reproductive rights policies play a critical role in advancing maternal and child health equity,” study co-author May Sudhinaraset, of the UCLA Fielding School of Public Health, said in a statement.

Since the Supreme Court‘s decision in Roe v. Wade in 1973, which effectively legalized abortion, states have had “substantial discretion” in creating policies governing whether Medicaid covers the costs of contraception or reproductive health care.

Some states have taken steps that effectively limit access to abortion services and other reproductive care, Sudhinaraset and her colleagues said.

Black women are more likely to die in pregnancy and childbirth than any other race group, experience more maternal health complications than White women and generally have lower quality maternity care, they said.

In addition, women of color are more likely to experience adverse birth outcomes.

Compared to infants of normal weight, low-birth-weight babies face many potential health complications, including infections early in life and long-term problems, such as delayed motor and social development or learning disabilities.

Sudhinaraset and her colleagues analyzed birth record data for the nearly 4 million births that occurred in the 50 states and Washington, D.C., in 2016, comparing reproductive rights policies and adverse birth outcomes in each state.

They also evaluated if the associations were different for women of color and immigrants.

The findings indicate that expanding reproductive rights may reduce the risk of low-birth weight, particularly for U.S.-born Black women, the researchers said.

“Important policy levers can and should be implemented to improve women’s reproductive health overall, including increasing abortion access and mandatory sex education in schools,” Sudhinaraset said.



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Pandemic-related job cuts have led 14.6M in U.S. to lose insurance

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Up to 7.7 million U.S. workers lost jobs with employer-sponsored health insurance during the coronavirus pandemic, and 6.9 million of their dependents also lost coverage, a new study finds.

Workers in manufacturing, retail, accommodation and food services were especially hard-hit by job losses, but unequally impacted by losses in insurance coverage.

Manufacturing accounted for 12% of unemployed workers in June. But because the sector has one of the highest rates of employer-sponsored coverage at 66%, it accounted for a bigger loss of jobs with insurance — 18% — and 19% of potential coverage loss when dependents are included.

Nearly 3.3 million workers in accommodation and food services had lost their jobs as of June — 30% of the industry’s workforce. But only 25% of workers in the sector had employer-sponsored insurance before the pandemic. Seven percent lost jobs with employer-provided coverage.

The situation was similar in the retail sector. Retail workers represented 10% of pre-pandemic employment and 14% of unemployed workers in June. But only 4 in 10 retail workers had employer-sponsored insurance before the pandemic. They accounted for 12% of lost jobs with employer-sponsored insurance and 11% of potential loss including dependents.

The study was a joint project of the Employee Benefit Research Institute, the W.E. Upjohn Institute for Employment Research and the Commonwealth Fund.

“Demographics also play an important role. Workers ages 35 to 44 and 45 to 54 bore the brunt of [employer insurance]-covered job losses, in large part because workers in these age groups were the most likely to be covering spouses and other dependents,” said Paul Fronstin, director of EBRI’s Health Research and Education Program.

“The adverse effects of the pandemic recession also fell disproportionately on women,” Fronstin added in an EBRI news release. “Although women made up 47% of pre-pandemic employment, they accounted for 55% of total job losses.”

More information

The U.S. Centers for Disease Control and Prevention has more on COVID-19.

Copyright 2020 HealthDay. All rights reserved.



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Study: Medicines, frequent counseling helps cancer patients quit smoking

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Oct. 13 (UPI) — A program that included telephone counseling sessions and one of two smoking cessation drugs was 50% more effective than telephone consultations alone at helping cancer patients quit smoking, a study published Tuesday by JAMA found.

Among cancer patients who underwent treatment with four bi-weekly and three monthly counseling sessions by telephone and either bupropion, marketed as Wellbutrin, or varenicline, marketed as Chantix, for up to six months, 35% were able to successfully quit smoking, the data showed.

But only 22% of the cancer patients who underwent treatment with the telephone counseling sessions had successfully quit after six months, according to the researchers.

“Counseling plus medication is the state-of-the art tobacco treatment for cancer patients,” study co-author Elyse R. Park told UPI.

“Smoking cessation assistance should be an integral part of cancer care and sustained tobacco support can be effective for cancer patients who smoke,” said Park, an associate professor of psychiatry at Harvard Medical School.

More than 34 million adults in the United States smoke, and some 16 million are living with smoking-related diseases, including cancer, according to the Centers for Disease Control and Prevention.

Up to 20% of cancer survivors continue to smoke, despite the fact that quitting improves prognosis with the disease, research suggests.

For their study, Park and her colleagues evaluated smoking cessation treatment programs in 303 adults recently diagnosed with breast, gastrointestinal, genitourinary, gynecological, head and neck, lung, lymphoma or melanoma cancers.

Roughly half — 153 — underwent “intensive” treatment for smoking, with telephone counseling and their choice of bupropion or varenicline, with the rest receiving “standard” care, with telephone counseling only, for up to six months, the researchers said.

Both bupropion and varenicline have been approved for smoking cessation treatment by the U.S. Food and Drug Administration.

The most common adverse events in the two treatment groups were nausea, rash, hiccups, mouth irritation, difficulty sleeping and vivid dreams, and all were more common in the patients who received “intensive” care, the researchers said.

“Nausea is a side effect of varenicline, so [its use] should be monitored for patients who are experiencing nausea from their cancer treatment,” Park said.

In addition, patients on tamoxifen for breast cancer should not take bupropion, or receive a reduced dose, because of interactions between the two drugs, she said.



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