NEW YORK, July 30, (RTRS): Pregnant women with a history of pregnancy-related diabetes, also called gestational diabetes, have a good chance of developing the condition again, suggests a large new study.
Researchers found that the risk of having gestational diabetes during a future pregnancy increases with each previously affected one — from 41 percent after the first to 57 percent after two pregnancies complicated by gestational diabetes.
Gestational diabetes typically strikes during late pregnancy and is characterized by high blood sugar that results from the body’s impaired use of insulin. While it rarely causes birth defects, complications can arise that threaten the health of both mom and baby.
“Because of the silent nature of gestational diabetes, it is important to identify early those who are at risk and watch them closely during their prenatal care,” lead researcher Dr Darios Getahun of Kaiser Permanente Southern California Medical Group, in Pasadena, told Reuters Health in an email.
In an attempt to distinguish factors that put women at risk, Getahun and his colleagues studied the first two pregnancies of about 65,000 women and the first three pregnancies of about 13,000 women who sought care at their health center between 1991 and 2008.
Approximately 4 percent of the women developed gestational diabetes during their first pregnancy, they report in the American Journal of Obstetrics and Gynecology. This matches the US rate estimated by the American Diabetes Association.
The team found that these women were about 13 times more likely to develop it again in their second pregnancy, compared to women without previous gestational diabetes. Among third pregnancies, the risk of diabetes for women who had two previous cases rose to 26 times that of women without any history of gestational diabetes.
Looking more closely at the data, it appeared that the most recent case of gestational diabetes was the most influential: About 44 percent of women with a diagnosis in their second but not first pregnancy developed gestational diabetes, compared to 23 percent of those with the condition in their first but not second pregnancy.
Hispanics, Asians and Pacific Islanders had approximately double the risk of gestational diabetes compared with white women, after taking into account factors such as age and education. The researchers guess that the relatively high consumption of rice in the latter two groups may cause elevated sugar and insulin levels, potentially triggering the condition.
The study, which was supported by funds from Kaiser Permanente, did not take into account lifestyle factors such as weight. This, the researchers say, limits the findings’ applicability given that overweight and obesity — now affecting approximately one out of every three women of childbearing age — is thought to contribute to the recurrence of gestational diabetes.  (RTRS)
q      q      q
Nasal allergies: Children who live in damp, water-damaged homes may be more likely than other kids to develop nasal allergies, a new study suggests.
Researchers found that of nearly 1,900 Finnish children they followed for six years, those who lived in homes with dampness or mold problems were more likely to develop allergic rhinitis during the study period.
Allergic rhinitis refers to symptoms of congestion, sneezing and runny nose caused by allergens such as pollen, dust, animal dander or mold.
In this study, published in the American Journal of Epidemiology, 16 percent of children whose parents reported dampness in the home went on to be diagnosed with allergic rhinitis over the next six years. That compared with just under 12 percent of children whose parents reported no dampness problems — that is, no visible signs of water damage to the ceilings, walls or floors, and no visible mold or mold odor in the home.
The researchers weighed a number of factors that might help account for the connection, including families’ socioeconomic status (asthma and allergies tend to be common in lower income children) and whether children were also exposed to second-hand smoke.
However, damp, moldy conditions in the home remained linked to an increased risk of children’s nasal allergies. Children whose parents reported any mold or water damage in the home at the outset were 55 percent more likely than other children to develop allergic rhinitis — connected to any allergen, and not just mold. “Our study strengthens the evidence that exposure to indoor dampness increases the risk of developing allergic rhinitis,” lead researcher Dr Jouni Jaakkola, of the Institute of Health Sciences in Oulu, Finland, told Reuters Health in an email.
Previous studies, he said, had measured children’s exposure to dampness and mold, and their rates of nasal allergies, all at one time — making it impossible to tell whether the exposure preceded the allergies’ development.
The fact that this study followed children’s rates of allergy development over time strengthens the case that household dampness is a risk factor for nasal allergies — though the findings alone do not prove cause-and-effect. It is still possible that there are other factors that explain the link.
However, Jaakkola said that based on other research, it is plausible that damp conditions in the house contribute to nasal allergies. Such conditions, he noted, encourage the growth of dust mites and fungi, and attract cockroaches — all of which can serve as allergy triggers. Moisture may also boost the emission of chemicals from building materials, according to Jaakkola, and those chemicals could potentially create inflammation in the airways. (RTRS)
q      q      q
Tuberculosis: A new diagnostic tool that reduces to two hours the time needed to detect drug-resistant tuberculosis must be made available to populations vulnerable to the disease, a World Health Organisation expert said.
Asia carries more than half the global caseload of drug resistant TB, which is very difficult to treat.
Patients need to take medication for up to two years and the worst type of TB, for which there is no cure, kills one out of every two patients. “New diagnostic tools offer the opportunity to increase the sensitivity of TB diagnosis in general and to shorten the diagnosis of MDR-TB (multi drug-resistant TB) from eight weeks to two hours,” Catharina van Weezenbeek, regional adviser on TB for the WHO in the Western Pacific region, said on Thursday.
“These tools are very expensive, but the scale up should be carefully planned. That requires money, training, infrastructure,” she said in a telephone interview after a meeting organised by the WHO in the Philippines on the disease.
The meeting was attended by representatives from countries in the Western Pacific region with a high TB burden, such as China, Cambodia, Vietnam, Laos, Philippines and Papua New Guinea.
According to the WHO, there are 120,000 new cases of MDR-TB in the Western Pacific each year, which makes up 28 percent of the global caseload. Combined with cases in southeast Asia, all MDR-TB cases in Asia make up 58 percent of the global caseload.(RTRS)
Drug-resistant TB emerges when patients fail to follow treatment regimens, take substandard drugs or stop treatment too early. Patients with drug-resistant TB can then transmit the disease to others.
“We are not detecting enough TB cases and we are not detecting them early enough. We have to target high risk TB groups, such as migrants, the homeless and patients with certain risk factors, like HIV,” Van Weezenbeek said.
“We are doing a poor job when it comes to diagnosing TB in children. We expect to increase the detection of childhood TB by the introduction of routine contact investigation, ensuring that the household contacts of infectious patients are screened.”
China ranked second in the world with 112,000 drug-resistant TB cases in 2007, after India with 131,000. Russia has 43,000 cases, while South Africa has 16,000 and Bangladesh 15,000.
TB killed 1.8 million people across the world in 2008, or a person every 20 seconds. It is not only a scourge in poor countries but also in the West, where it has flared anew in the last 20 years because of AIDS, which weakens the immune system.  (RTRS)