Healthy lifestyle helps to prevent gestational diabetes

 Researchers have developed a genetic-risk score for identifying individuals who would benefit the most from lifestyle counselling to prevent gestational and postpartum diabetes.

Gestational diabetes is the most common health-related challenge during pregnancy. Today, it is diagnosed in every fifth expectant mother in Finland. Gestational diabetes has a significant impact on the health of both the mother and the child, both during pregnancy and after delivery.

A study conducted at the University of Helsinki investigated the effects of lifestyle intervention on the prevention of gestational diabetes in women at high risk of developing gestational diabetes. In the Finnish Gestational Diabetes Prevention Study (RADIEL), the study subjects received intensified physical exercise and dietary counselling during pregnancy and for the first year following delivery.

In this study, a polygenic risk score (PRS) describing the genetic risk of diabetes was calculated using gene variants known to increase the risk of type 2 diabetes. The risk score for type 2 diabetes was associated with elevated glucose levels in mid- and late pregnancy as well as one year after delivery.

"Gestational diabetes as well as prediabetes and diabetes one year after delivery were also more common among those with higher scores," says Emilia Huvinen, specialist in obstetrics and gynaecology.

Targeted measures produce better results

The study discovered that genetic risk also affected the link between lifestyle counselling and gestational diabetes as well as diabetes.

"Based on our research, intensified lifestyle interventions benefitted only women at highest genetic risk of developing type 2 diabetes," Huvinen confirms.

According to her, the results are significant and even globally unique.

"Our study offers one possible explanation for the contradictory results of previous studies investigating the prevention of gestational diabetes till now ," Huvinen explains.

According to the researchers, genetic-risk scoring would make it possible to identify the expectant mothers most at risk as well as to direct resources and the most effective preventive measures specifically at them. This would be of great importance in terms of both limited societal resources and the health of these mothers and their children.

"At the same time, it's important to realise that, in the case of diabetes, our genetic background does not determine our future. With the help of a healthy lifestyle, you can reverse the effect of a high genetic diabetes risk," Huvinen says, offering encouragement.

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Story Source:

Materials provided by University of Helsinki. Note: Content may be edited for style and length.

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Journal Reference:

1. Emilia Huvinen, Jari Lahti, Miira M. Klemetti, Paula H. Bergman, Katri Räikkönen, Marju Orho-Melander, Hannele Laivuori, Saila B. Koivusalo. Genetic risk of type 2 diabetes modifies the effects of a lifestyle intervention aimed at the prevention of gestational and postpartum diabetes. Diabetologia, 2022; DOI: 10.1007/s00125-022-05712-7

https://www.sciencedaily.com/releases/2022/05/220504110443.htm

Daily steroids safe and slows progression of duchenne muscular dystrophy

 New research published in JAMA recommends daily steroid doses for children with Duchenne muscular dystrophy (DMD), marking a significant change in how the disease is treated. University of Rochester Medical Center (URMC) neurologist Robert Griggs, M.D., and Michela Guglieri, M.D., with Newcastle University in the U.K., led the study, which was conducted by a global team of researchers dedicated to improving care for this fatal disease.

"Corticosteroids are likely to remain the main treatment for DMD for the foreseeable future and worldwide so it is critical that we establish a standard of care that is backed by scientific evidence," said Griggs. "This study shows that health concerns over the daily use of corticosteroids are overstated and that there is a clear benefit in terms of improved motor and pulmonary functions. These findings clearly support the daily regimen over an intermittent one as an initial treatment for boys with DMD."

DMD is a condition found almost exclusively in boys and characterized by muscle weakness, which appear at age 3-4 and progresses rapidly leading to significant disability. The symptoms eventually spread to the heart and muscles responsible for breathing, and the disease is often fatal by the time the boy reaches his late teens. An estimated 28,000 people in the U.S. suffer from the disease.

While corticosteroids prednisone and deflazacort are known to improve muscle strength and function in patients with DMD and have been a frontline treatment for years, there is currently no universally accepted standard for steroid use in DMD. A global survey of physicians who treat DMD found 29 different regimens, with the most common being ten days on and ten days off. This intermittent dosing regimen was put in place in an effort to limit the potential side effects associated with prolonged steroid use in children, such as weight gain, stunted growth, and loss of bone density.

The Finding the Optimum Regimen of Corticosteroids for DMD (FOR-DMD) study was launched in 2013 to compare daily and intermittent steroid use and establish, from clinical benefit and safety perspective, the most beneficial regimen for DMD patients. Griggs and Kate Bushby, M.D., with Newcastle University initiated the phase 3 clinical trial conducted through the Muscle Study Group, an international network of muscular dystrophy researchers that Griggs helped create in 1997 to advance clinical research in neuromuscular disorders, including DMD.

The new study recruited 196 boys with DMD at 32 research sites across North American and Europe and followed them for three years. Participants were assigned to three groups consisting of daily regimens of prednisone or deflazacort, or intermittent prednisone, and followed for three years. The researchers found that the daily regimens of both drugs significantly slowed disease progression as measured by strength testing and muscle function, as compared to the intermittent group. While the daily regimen increased side effects overall, there were minimal serious side effects.

The lead biostatistician for this study was Michael McDermott, Ph.D., and other URMC investigators include Kimberly Hart, Rabi Tawil, William B. Martens, Barbara E. Herr, and Mary Brown. Other investigators involved in study include Elaine McColl, Chris Speed, Jennifer Wilkinson and Michelle Eagle with Newcastle University, Janbernd Kirschner with University Hospital Frieburg, Germany, Wendy King with Ohio State University, Tracey Willis with the Robert Jones and Agnes Hunt Orthopaedic Hospital in the U.K. The FOR-DMD study was supported with funding from National Institute of Neurological Diseases and Stroke, the Muscular Dystrophy Association, the Parent Project for Muscular Dystrophy, PTC Therapeutics, Sarepta Therapeutics, and Santhera Pharmaceuticals.

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Story Source:

Materials provided by University of Rochester Medical Center. Original written by Mark Michaud. Note: Content may be edited for style and length.

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Journal Reference:

1. Michela Guglieri, Kate Bushby, Michael P. McDermott, Kimberly A. Hart, Rabi Tawil, William B. Martens, Barbara E. Herr, Elaine McColl, Chris Speed, Jennifer Wilkinson, Janbernd Kirschner, Wendy M. King, Michelle Eagle, Mary W. Brown, Tracey Willis, Robert C. Griggs, Volker Straub, Henriette van Ruiten, Anne-Marie Childs, Emma Ciafaloni, Perry B. Shieh, Stefan Spinty, Lorenzo Maggi, Giovanni Baranello, Russell J. Butterfield, I. A. Horrocks, Helen Roper, Zoya Alhaswani, Kevin M. Flanigan, Nancy L. Kuntz, Adnan Manzur, Basil T. Darras, Peter B. Kang, Leslie Morrison, Monika Krzesniak-Swinarska, Jean K. Mah, Tiziana E. Mongini, Federica Ricci, Maja von der Hagen, Richard S. Finkel, Kathleen O’Reardon, Matthew Wicklund, Ashutosh Kumar, Craig M. McDonald, Jay J. Han, Nanette Joyce, Erik K. Henricson, Ulrike Schara-Schmidt, Andrea Gangfuss, Ekkehard Wilichowski, Richard J. Barohn, Jeffrey M. Statland, Craig Campbell, Giuseppe Vita, Gian Luca Vita, James F. Howard, Imelda Hughes, Hugh J. McMillan, Elena Pegoraro, Luca Bello, W. Bryan Burnette, Mathula Thangarajh, Taeun Chang. Effect of Different Corticosteroid Dosing Regimens on Clinical Outcomes in Boys With Duchenne Muscular Dystrophy. JAMA, 2022; 327 (15): 1456 DOI: 10.1001/jama.2022.4315

https://www.sciencedaily.com/releases/2022/05/220504135635.htm

UK will NOT appeal Court ruling that care home pandemic policy was unlawful

 The Government has said it will not be appealing against a High Court ruling which stated its care home discharge policies were unlawful.

Last week, the High Court ruled policies in March and early April 2020 were unlawful because they failed to take into account the risk to elderly and vulnerable residents from non-symptomatic transmission of coronavirus.

It came after a claim was brought against the Government by two women – Cathy Gardner and Fay Harris – after their fathers died from Covid-19.

Former health secretary Matt Hancock apologised for people's 'pain and anguish' following the ruling.

A High Court judgment stated government policies were unlawful as they failed to take into account the risk of Covid. Around 40,000 died in care homes during the first year of Covid

On Wednesday, the Government said it would not be pursuing an appeal.

A spokesperson said: 'The Government notes the court's judgment and that the court dismissed most aspects of the claimants' judicial review.

'While we are disappointed that the court did not accept all of the points we put before it, we do not see a public interest in an appeal on those points, as the right place for these matters to be considered is the public inquiry.

'Our thoughts are with all those who lost loved ones during the pandemic. Our aim throughout has been to protect the public from the threat to life and health posed by Covid and we specifically sought to safeguard care home residents.'

Hancock, pictured in June last year, did not take into account the risk of Covid's spread among care home patients, the court said

In the early part of the pandemic in 2020, patients were rapidly discharged into care homes without testing, despite the risk of asymptomatic transmission, with Government documents showing there was no requirement for this until mid-April.

The judges said there was no evidence that Mr Hancock – or anyone advising him – addressed the issue of the risk of asymptomatic transmission to care home residents in England, or that he considered or was asked to consider the question of isolating asymptomatic admissions.

However, they added that the 'growing appreciation that asymptomatic transmission was a real possibility ought to have prompted a change in Government policy concerning care homes earlier than it did'.

They pointed out that these risks were highlighted as early as March 13 by figures including the Government's chief scientific adviser, Sir Patrick Vallance, who said it was 'quite likely'.

In a previous statement, Mr Hancock's spokesman said Public Health England had failed to tell ministers about asymptomatic transmission and he wished it had been brought to his attention sooner.

Around 40,000 care home residents died with Covid between March 2020 and March 2021, according to the Care Quality Commission.

https://www.dailymail.co.uk/news/article-10783327/Government-not-challenge-court-ruling-care-home-discharge-policies.html

Beijing restricts public transport as COVID spreads

 Dozens of metro stations and bus routes have been closed in Beijing as the Chinese capital struggles to contain COVID-19.

According to service providers, more than 60 subway stations, about 15% of the network, and 158 bus routes, have been closed.

Most of the suspended stations and routes are in the Chaoyang district, the epicenter of Beijing's outbreak.

The city is trying to stop the spread of COVID-19 and avoid the fate of Shanghai where millions of residents have been under strict lockdown for more than a month.

But nonetheless, residents like 52-year-old Mr. Ye, are concerned.

"This certainly affects our way of traveling and commuting, on this aspect we are doing our best to overcome the problem. We have to figure out different solutions, like going to work on a bicycle or waking up earlier to walk to work, or we have to think of other ways, like taking the bus. About other aspects, there is not much we can do to overcome it, but to collaborate. It definitely affects us in our commute to work, but we can only collaborate and accommodate.”

With dozens of new cases a day, Beijing is hoping mass testing will find and isolate the virus before it spreads.

Beijing officials also said closures of schools, restaurants, gyms and entertainment venues - as well as some businesses and residential buildings would be extended.

Yet another resident, Mr Zhang, is doubtful over the policy.

“I think there will be consequences to this situation, and I am worried that if the pandemic keeps going this way will affect our income and some aspects of our job, like not being able to carry out planned projects.”

Although Beijing’s caseload remains modest by global standards - with 46 new symptomatic cases reported on Tuesday (May 3), the fast spreading Omicron variant is proving to be a vital test of China's strategy to eliminate all COVID transmission.

https://news.yahoo.com/beijing-restricts-public-transport-covid-144044593.html

CDC bought cellphone data to track vaccination, lockdown compliance: report

 The Centers for Disease Control and Prevention used location data from tens of millions of Americans’ phones to track compliance with lockdown orders and vaccination efforts, according to newly revealed documents. 

The CDC specifically monitored Americans’ visits to churches and schools, as well as “detailed counts of visits to participating pharmacies for vaccine monitoring,” internal documents from the federal agency obtained by Vice show. 

The CDC also reportedly tracked peoples’ movement during curfews and visits between neighbors.

A controversial “data broker” called SafeGraph initially provided the data to the CDC for free during the outbreak of the pandemic, the documents show. Then in 2021, the CDC reportedly hatched a deal to pay the company $420,000 for continued access.

The CDC argued in the documents that data from SafeGraph — which is backed by tech billionaire Peter Thiel and ex-Saudi intelligence chief Turki bin Faisal Al Saud, among other investors — helped give the agency “deeper insights into the pandemic as it pertains to human behavior.” 

The CDC paid a controversial data broker $420,000 for access to Americans’ location data.

Bloomberg via Getty Images

Tech billionaire Peter Thiel is one of SafeGraph’s investors.

Getty Images

Other health authorities including the Public Health Agency of Canada and the Illinois Department of Transportation have also been accused of tracking millions of people’s phones in recent years.

Data brokers like SafeGraph say that the information they sell represents the movements of groups of people rather than individual users. But critics have raised concerns about the data being less anonymous than data brokers claim. 

In one example, a top Catholic priest from Wisconsin was forced to resign last year after a Catholic news site was able to de-anonymize data linked to his cellphone to reveal that he had allegedly used Grindr and visited gay bars. It was not clear whether that data had been obtained from SafeGraph or another data broker. 

The CDC monitored Americans’ visits to churches and schools, as well as “detailed counts of visits to participating pharmacies for vaccine monitoring,” the documents show.

Getty Images

Pro-choice activists have also raised concerns that cellphone data from firms like SafeGraph can be used to track women who visit abortion clinics. 

Google banned all app developers on its app store from working with SafeGraph last year after critics raised privacy concerns, according to Vice.

In the internal CDC documents, the agency said it was able to glean “extremely accurate insights related to age, gender, race, citizenship status, income, and more” based on the cellphone data.   

The documents, which Vice obtained through a Freedom of Information Act request,  also show that the CDC wants to use the data for more than monitoring coronavirus efforts. 

The CDC wrote that one potential use of cellphone data would be “Research points of interest for physical activity and chronic disease prevention such as visits to parks, gyms, or weight management businesses.”

Another would be tracking “population migration before, during, and after natural disasters.” 

“The mobility data obtained under this contract will be available for CDC agency-wide use and will support numerous CDC priorities,” the agency wrote.

“We’ve been public about the CDC’s use of our data since 2020, so there is not much new news here,” SafeGraph spokesperson Evan Barry told The Post, also disputing that SafeGraph had been banned from the Google Play store. Asked about the allegation, Google confirmed that it had taken action on SafeGraph last year. 

“SafeGraph made their social mobility data available free-of-charge to governmental and non-governmental agencies at the beginning of the pandemic for a period of approximately one year,” CDC spokesperson Jasmine Reed said. “In April of 2021, CDC awarded a contract to SafeGraph to purchase mobility data for an additional year, through April 2022.” 

https://nypost.com/2022/05/04/cdc-bought-cell-phone-data-to-track-lockdowns-vaccination-docs/

Becerra: HHS to ‘double down’ on care for women ‘they are entitled to’

 Health and Human Services Secretary Xavier Becerra on Wednesday said his department planned to “double down” on efforts to provide American women with access to “the care they are entitled to” when asked about continued family planning services in the wake of the bombshell leaked Supreme Court draft that would overturn Roe v. Wade.

During a subcommittee hearing for the Senate Appropriations Committee, Democratic members asked Becerra what his department and the administration planned to do if Roe v. Wade is overturned.

Sen. Jeanne Shaheen (D-N.H.) asked Becerra for an update on the work of the Department of Health and Human Services’ (HHS) Reproductive Healthcare Access Task Force, expressing concern over the future of family planning in light of the leaked draft.

“We are going to double down on the effort to make sure that the legal rights all Americans, women to access the care that they’re entitled to continues forward. I yesterday had an opportunity to address a number of representatives of many of the insurance plans, health insurance plans in America, and made it very clear that we intend to continue to enforce the law,” said Becerra.

“We will also make it clear what the law requires of anyone who accepts federal funding through Medicare, Medicaid to provide services to all Americans without discrimination. As I said, we’re gonna double down and make sure no one goes without the care they’re entitled to.”

Shaheen’s fellow Democratic, female members of the subcommittee all touched on the Supreme Court draft during the hearing. Sen. Patty Murray (D-Wash.), chair of the subcommittee, began the hearing by warning that overturning Roe v. Wade would be “devastating” and that “women’s lives are on the line.”

“Reproductive health care is under attack at every angle, and we need to be doing everything we can to protect it,” said Murray.

Wisconsin Sen. Tammy Baldwin (D) called for the Senate to pass the Women’s Health Protection Act and argued that the filibuster should be eliminated if necessary for the bill to be passed.

Becerra himself said it was “most important” that he discuss the “chilling” news of the Supreme Court draft in his opening remarks.

“Twenty-two years into the 21st century and nearly 50 years after Roe v. Wade, some, most men, seek to impose their judgment over every woman in America who may seek to exercise her constitutional right to privacy and personal decision-making,” Becerra said. “That is dangerous. That is wrong. That we must repel with every just bone in our body. “

“America is not a nation prone to regression. And the Department of Human Services is not in the business of stripping Americans of access and protections to care,” he added.

https://thehill.com/news/administration/3476969-becerra-says-hhs-plans-to-double-down-on-providing-american-women-with-the-care-they-are-entitled-to/

NY COVID-19 hospitalizations nearly triple in past month

 COVID-19 hospitalizations in New York almost tripled in the past month as figures exceeded 2,000 on Tuesday. 

The spike in hospitalized COVID-19 patients, which was first reported by NBC New York, marked the first time since late February that the state’s COVID-19 hospitalizations were over 2,000. The latest figures showed a 153 percent increase from this time last month.    

A COVID-19 update from New York Gov. Kathy Hochul (D) on Wednesday said that the state had 2,119 total hospitalizations, which is still well below numbers seen when the omicron variant contributed to a major uptick in infections and nearly 13,000 hospitalizations in the state earlier this year. 

Hochul’s most recent update also noted that the state had reported 9,139 positive COVID-19 test results on Wednesday. 

Just this week, New York City upped its COVID-19 alert level from “low” to “medium.” The change did not impact much in terms of restrictions, but should the warning level rise to “high,” the city’s mask mandate could return.  

At the end of last month, Hochul had warned that the state was beginning to see another rise in COVID-19 cases but insisted there was no reason to panic. 

https://thehill.com/news/3477268-new-york-covid-19-hospitalizations-nearly-triple-in-past-month/