Diabetes Increases Risk Of Heart Disease Death For Women

The word is out: women are at risk for heart disease, just like men. In fact, roughly twice as many women in this country will die of heart disease, stroke, and other cardiovascular diseases than from all forms of cancer combined, including breast cancer, according to the American Heart Association.


Risk factors for heart disease and stroke have long been identified. Several risk factors cannot be controlled by the individual, such as sex, increasing age and a family history of heart disease. Others can be modified and include:


-- Smoking


-- High blood pressure and cholesterol


-- Diabetes


-- Sedentary lifestyle


-- Body weight


Diabetes continues to be a growing problem in the United States for both men and women. A study published in the December 2007 issue of the European Heart Journal reveals that diabetes is a stronger risk factor for heart disease death in women than in men.


"The reason for the higher relative risk of coronary heart disease in women with diabetes than in men with diabetes is still unclear," explains Ane Cecilie Dale, M.D., the study's lead researcher and head of the Department of Circulation and Medical Imaging at the Norwegian University of Science and Technology in Trondheim. "But research in this field continues to go on."


According to the U.S. Food and Drug Administration, diabetes affects approximately 8.9 percent of American women. The occurrence of diabetes is significantly higher among African American, Hispanic/Latino, American Indian, and Asian/Pacific Islander women than in white women.


Women with diabetes have a two to four times higher risk of dying from heart disease and stroke compared to women without diabetes, according to data from the American Heart Association. Women with diabetes are often overweight and suffer from high blood pressure, also known as hypertension, and high cholesterol levels, which can add to the risk.


"Women with diabetes need to be aware of the associated risk of heart disease. The most important thing to do for all persons with diabetes to protect themselves from heart disease and other diabetes complications is to have a good glucometabolic control with a blood glucose as near normal as possible," Dale said. "They also need to control other risk factors like hypertension and blood cholesterol levels. In addition it is important to quit smoking, have a healthy diet and practice regularly exercise."


Considering how complex the management of diabetes and heart diseases risks are, women should talk to their health care providers to develop a plan of action. Without the support of health care professionals, patients can easily feel overwhelmed.


February is American Heart Month. For tips on reducing your heart disease risk, visit the American Heart Association Web site: http:/www.heart. For diabetes information, visit the American Diabetes Association: diabetes. WomenHeart, the National Coalition for Women with Heart Disease, provides patients with education and grassroots support networks. WomenHeart is online at womenshealthresearch.


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New Hampshire Senate Approves Bill That Would Allow Emergency Contraception To Be Sold Without Doctor's Prescription

The New Hampshire Senate on Thursday approved 14-10 a bill... (SB 30) that would allow emergency contraception to be sold without a doctor's prescription, the Concord Monitor reports. The measure would allow specially trained pharmacists to dispense EC, which can prevent pregnancy if taken within 72 hours of intercourse (Heckman, Concord Monitor, 4/1). Under the measure, only pharmacists who choose to participate in a training session sponsored by the state pharmacy board could provide the pills to patients without prescriptions. Pharmacists would not be required to undergo the training to dispense EC to patients with prescriptions (Kaiser Daily Reproductive Health Report, 6/9/04). Before approving the measure, the state Senate rejected 16-8 an amendment to the bill that would have allowed pharmacists to sell EC without a prescription to people ages 18 or older only, according to the AP/Nashua Telegraph (Love, AP/Nashua Telegraph, 4/1). Supporters of the bill say that easier access to EC will help to reduce the number of unintended pregnancies and abortions, according to the Monitor (Concord Monitor, 4/1). Opponents of the measure say it would "encourage promiscuity," according to the AP/Telegraph. The bill now goes to the state House. Pamela Walsh, a spokesperson for New Hampshire Gov. John Lynch (D), said the governor will sign the measure if it passes the state House, according to the AP/Telegraph (AP/Nashua Telegraph, 4/1). Former New Hampshire Gov. Craig Benson (R) in June 2004 vetoed an identical measure (SB 484) (Kaiser Daily Reproductive Health Report, 6/9/04).


"Reprinted with permission from kaisernetwork kaisernetwork. You can view the entire Kaiser Daily Reproductive Health Report, search the archives, or sign up for email delivery at www.kaisernetwork/dailyreports/repro The Kaiser Daily Reproductive Health Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Colorado Title Board Approves Proposal For Personhood Amendment

The Colorado Title Board on Wednesday voted in favor of a proposal that would amend the state constitution to extend legal protections to embryos, the AP/Colorado Springs Gazette reports. The proposal's language fundamentally is the same as that used in a ballot measure rejected by voters last year. However, this year the proposal also would protect embryos created through asexual methods of reproduction such as cloning, the Gazette reports.

Opponents say it would ban abortion as well as some types of birth control and in vitro fertilization. A rehearing on the Title Board's decision would have to be requested by Aug. 12 or else supporters can begin collecting signatures to have it put on the state ballot next year (AP/Colorado Springs Gazette, 8/5).


Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.


© 2009 The Advisory Board Company. All rights reserved.

Society Of Gynecologic Oncology Sets New Standards To Monitor Recurrence Of Gynecologic Cancer More Effectively

Although gynecologic cancers account for only 10 percent of all new cancer cases in women, these cancers account for 20 percent of all female cancer survivors. Because long-term survival is now more common, it is increasingly important to detect recurrence. The Clinical Practice Committee of the Society of Gynecologic Oncology (SGO) has released a Clinical Document outlining their expert recommendations for cancer surveillance, published today in the American Journal of Obstetrics & Gynecology (AJOG).


"The goal of follow-up evaluation for the detection of recurrent disease requires both clinical and cost-effectiveness," commented Ritu Salani, MD, MBA, Assistant Professor, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine. "Currently, most recommendations are based on retrospective studies and expert opinion. Taking a thorough history, performing a thorough examination, and educating cancer survivors about concerning symptoms is the most effective method for the detection of gynecologic cancer recurrences. There is very little evidence that routine cytologic procedures or imaging improves the ability to detect gynecologic cancer recurrence at a stage that will impact cure or response rates to salvage therapy. This article reviews the most recent data on surveillance for gynecologic cancer recurrence in women who have had a complete response to primary cancer therapy."


SGO's Clinical Documents are designed to improve the overall quality of women's cancer care, to reduce the use of unnecessary, ineffective, or harmful interventions, and to facilitate the treatment of patients with a goal to maximum the chance of benefit with a minimum risk of harm and at an acceptable cost. The role of surveillance is to provide clinical and cost-effective practices that detect recurrence and impact survival outcomes.


"Prevention is a big part of our mission as a collective membership," said SGO President John Curtin. "By sharing our best knowledge regarding surveillance of patients who have had a gynecologic malignancy with the medical team in the best position to detect a recurrence, we are helping our patients who do have a recurrence obtain appropriate care as soon as possible."


The article outlines in detail the surveillance techniques and appropriate monitoring intervals for endometrial, ovarian, nonepithelial ovarian, cervical, vulvar, and vaginal cancers. In some cases, certain techniques have been found ineffective in detecting recurrence and are discouraged in the recommendations. Patients should be counseled on the benefits and pitfalls of disease monitoring, which should include the psychologic impact of surveillance programs.


Coordination of care between gynecologic oncologists, primary care providers, other healthcare providers (such as radiation oncologists), and patients ideally will allow for compliance with cancer follow-up care and routine health maintenance. However, the Committee notes that as survivors are transitioned from oncology care to primary care, primary care providers may not be trained to deal with specific follow-up needs or practice standards for patients with cancer. The information in this clinical document is intended to help bridge that gap. The provision of a clear understanding of recommendations and responsibilities of appropriate surveillance will reduce unnecessary tests, ultimately result in cost savings, and better, earlier detection of disease recurrence.


"Post treatment surveillance and diagnosis of recurrence in women with gynecologic malignancies: Society of Gynecologic Oncology recommendations"

Ritu Salani, MD, MBA; Floor J. Backes, MD; Michael Fung Kee Fung, MB, BS; Christine H. Holschneider, MD; Lynn P. Parker, MD; Robert E. Bristow, MD, MBA; and Barbara A. Goff, MD

American Journal of Obstetrics & Gynecology, Volume 204, Issue 6 (June 2011), doi: 10.1016/j.ajog.2011.03.008