Insulin pumps can help folks with type 1 diabetes get better control of their disease and minimize how often they inject insulin, and use of the devices has taken off in the past 20 years. That’s the good news from a new study. The not-so-great news is that a large gap in who is using these insulin pumps remains. Specifically, white patients are twice as likely to receive an insulin pump as Black patients, and better-educated, wealthier people are also more likely to be using one. “The big message is that over a 20-year period, we saw a pretty large increase in insulin pump use across all patients, but no change in distribution by race or socioeconomic status,” said study author Dr. Estelle Everett, an assistant professor at the David Geffen School of Medicine at the University of California, Los Angeles. “Despite the overall increase, most populations are really not able to benefit from insulin pump use and these are the groups who have more challenges managing their diabetes and a higher risk of complications, so they may actually gain the most benefit from diabetes technology,” she said. Unfortunately, such race and socioeconomic disparities exist throughout medicine. “This study is another example of a larger issue in the medical field,” Everett said. People with type 1 diabetes produce little to no insulin, the hormone tasked…  read on >  read on >

Surprisingly, most people suffering from chronic obstructive pulmonary disease (COPD) are in excellent mental health, Canadian researchers report. Two-thirds of COPD patients don’t suffer from common mental health issues such as depression, anxiety or addiction to drugs, the new study found. The key to well-being seems to be having the support of loved ones and not being isolated or lonely, according to a new study. COPD is a progressive, debilitating chronic lung disease that includes emphysema and chronic bronchitis. The condition has previously been tied to mental health problems, researchers noted. “This is not an easy disorder,” said senior researcher Esme Fuller-Thomson, director of the Institute for Life Course and Aging at the University of Toronto. But to see that two-thirds of people who have COPD — which can make it hard to breathe and interfere with their ability to work and participate in family activities — are overcoming those difficulties to the point that they are mentally flourishing is heartening, she said. For the study, Fuller-Thomson and her colleague Sally Abudiab, a graduate of the University of Toronto’s Factor-Inwentash Faculty of Social Work, looked at the mental health of 703 COPD patients. They found that 67% of the participants were in excellent mental health. According to Fuller-Thomson, that meant being happy and satisfied with their life most of the time, having social and psychological…  read on >  read on >

Patients who undergo angioplasty and stenting to open clogged arteries in and around the heart should also be screened for depression, according to a new study. Researchers found that depressed patients were less likely than their mentally healthy peers to take their prescribed medications, including beta-blockers, antiplatelets and statins. These medications reduce the likelihood of another heart attack or cardiovascular event after angioplasty and stenting (also called percutaneous coronary intervention, or PCI). “It is well-appreciated that depression carries adverse cardiovascular risk. We wanted to understand better why that is the case,” said Dr. Jared Magnani, a cardiologist and associate professor of medicine at the University of Pittsburgh. “We found that 10% to 20% of individuals with depression were less likely to take their medicine after PCI, which is significant because this group is at a higher risk for serious complications or dying from a heart attack,” he said in a university news release. Using medical claims data that included prescriptions filled at pharmacies, the researchers examined the records of more than 124,000 patients who had the procedure and were also diagnosed with depression. Patients were followed for a year. Medication adherence may depend on social factors, such as having the money to cover medication costs, the study authors noted. Pharmacy access is another challenge. Prior research has found that a high percentage of people with…  read on >  read on >

For those who care about their teeth, a new study sounds a pretty clear alarm: using tobacco in any form — including the increasingly popular practice of vaping — is a recipe for a dental nightmare. The warning comes from the U.S. National Institute of Dental and Craniofacial Research (NIDCR), after scientists analyzed several years of tracking data that looked at associations between smoking and poor dental health among thousands of American men and women. The bottom line: regular users of cigarettes, electronic cigarettes (vapes), cigars, pipes, hookahs and/or smokeless tobacco face a notably higher risk for various forms of dental trouble. Depending on the type of tobacco involved, that includes a significantly heightened likelihood for six different types of dental concerns, including gum disease; precancerous oral lesions; bone loss surrounding the teeth; loose teeth; and/or tooth loss due to tooth decay or gum disease. And vaping, which is sometimes viewed as a safer form of tobacco use, was linked to a 27% higher risk for bleeding following brushing or flossing. “We’ve always known that smoking increases your odds for gum disease,” said Dr. Purnima Kumar, a spokesperson for the American Dental Association. Though not a part of the study team, Kumar — who is also chair of the department of periodontics and oral medicine at the University of Michigan School of Dentistry, in Ann…  read on >  read on >

Having COPD can make it hard to breathe as it taxes both the lungs and the heart, but a new study offers a possible solution: Using an air purifier helped patients’ hearts work better. Researchers found that when people with COPD, also known as chronic obstructive pulmonary disease, consistently used air purifiers, their hearts were better able to adapt their heart rates in response to daily demands, something known as heart rate variability (HRV). HRV is a key measure of overall heart health. In fact, the participants who used air purifiers daily saw a 25% increase in their HRV. Study author Dr. Sarath Raju, an assistant professor of medicine who specializes in lung diseases at the Johns Hopkins University School of Medicine in Baltimore, explained that an increase in HRV is important. “People with poor HRVs are at risk for a number of cardiac problems, such as heart attacks or a worsening of COPD symptoms,” he said. “All of these things increase the odds of someone with COPD being hospitalized, which is of course something we want to avoid.” The study also looked at the role of what scientists call ultrafine particles, tiny pieces of irritants in the air that people breathe. Raju and his colleagues found there was an association between the presence of these particles in a person’s home environment and a negative…  read on >  read on >

Capitalism is thought to bring out the best in workers, but there’s a dark side to tying a person’s everyday efforts to their weekly paycheck. Folks relying on short-term, freelanced office jobs, or jobs where pay is linked to hustle — depending largely on tips, commissions and bonuses — may often suffer poor health related to their financial insecurity, new research has shown. Employees with fluctuating and unpredictable pay tend to have poorer sleep, more stress and miserable physical symptoms that affect their work and home life, said lead researcher Gordon Sayre, an assistant professor of organizational behavior at Emlyon Business School in France. Those symptoms grow worse as a person’s finances become more unstable, Sayre said, and the amount of savings they might have on hand seems to provide no solace. “There’s a lot of research looking at how performance-based pay, commission-based pay, piece-rate based pay leads to higher levels of motivation or higher levels of performance. That’s been sort of fairly well-established, and that’s one of the reasons why these pay practices have become popular,” Sayre said. “But there are some costs to these types of pay arrangements, and we need to consider them in addition to the performance benefits they bring,” he added. “They also have these health costs.” Millions of Americans are in jobs where they can’t count on a steady…  read on >  read on >

Both extremely hot and very cold days take their toll on people who have heart disease, particularly those with heart failure. A new multinational analysis of 32 million heart-related deaths over the past 40 years found more occurred on days with severe temperatures, an issue that climate change could make even worse. Although the greatest number of deaths were due to heart failure, extreme weather also led to a rise in stroke; arrhythmia (an irregular heartbeat); and ischemic heart disease (which is caused by narrowed heart arteries). “The decline in cardiovascular death rates since the 1960s is a huge public health success story as cardiologists identified and addressed individual risk factors such as tobacco, physical inactivity, type 2 diabetes, high blood pressure and others,” according to researcher Dr. Barrak Alahmad. He is a fellow at Harvard T.H. Chan School of Public Health in Boston. “The current challenge now is the environment and what climate change might hold for us,” Alahmad said in a news release from the American Heart Association (AHA). Heart disease is the leading cause of death worldwide. To study the impact of temperatures, researchers analyzed data for 32 million heart-related deaths in 27 countries between 1979 and 2019. The investigators compared heart-related deaths on the hottest and the coldest 2.5% of days in 567 cities with those on days when temperatures were…  read on >  read on >

If someone is stricken with a blood cancer or life-threatening clot, they’ll probably fare better if they are white and wealthy, three new studies show. The ongoing impact of patient race and income to medical outcomes was in the spotlight Saturday in New Orleans at the annual meeting of the American Society of Hematology (ASH). In one study, a team led by Dr. Matthew Maurer, of the Mayo Clinic in Rochester, Minn., looked at who got enrolled (or didn’t) in clinical trials for new treatments against a blood cancer known as diffuse large B-cell lymphoma (DLBCL). It’s the most common form of lymphoma in the United States. According to ASH, existing therapies help cure about 60% of patients, but another 40% may not be helped. So, enrollment in clinical trials can be crucial for some patients. The Mayo study examined data on enrollment in DLBCL trials from eight large academic medical centers across America. It found that 76% of enrollees were white. Results from lab tests were key to getting accepted into the trials, but Black or Hispanic Americans were much less likely to meet those lab-based criteria than were whites, the research showed. That means trial organizers may need to take a closer look at lab-based eligibility criteria to help level the playing field for entry into future clinical trials. “These exclusion criteria are…  read on >  read on >