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July 1, 2015
Digest

Eye Study Underscores Long-Term Benefits of Diabetes Control

Dr. Emily Chew of the National Eye Institute examines a patient’s eyes.
Dr. Emily Chew of the National Eye Institute examines a patient’s eyes.

PHOTO: NEI

People with type 2 diabetes who intensively controlled their blood sugar level during the landmark Action to Control Cardiovascular Risk in Diabetes (ACCORD) Trial Eye Study were found to have cut their risk of diabetic retinopathy in half in a follow-up analysis conducted 4 years after stopping intensive therapy. Investigators who led the ACCORD Follow-on Eye Study (ACCORDION) announced the results June 13 at the American Diabetes Association annual meeting. The study was supported by NEI.

“This study sends a powerful message to people with type 2 diabetes who worry about losing vision,” said Dr. Emily Chew, deputy director of NEI’s Division of Epidemiology and Clinical Applications and lead author of the study report, published online in Diabetes Care. “Well-controlled glycemia, or blood sugar level, has a positive, measurable and lasting effect on eye health.”

A complication of diabetes, diabetic retinopathy can damage tiny blood vessels in the retina—the light-sensitive tissue in the back of the eye.

Results from ACCORDION suggest that lowering blood glucose can reduce progression of retinal disease relatively late in the course of type 2 diabetes and that even short-term changes in glucose have an effect.

Proper Maternal Folate Level May Reduce Child Obesity Risk

Proper maternal folate levels during pregnancy may protect children from future obesity, an NIH-funded study finds.
Proper maternal folate levels during pregnancy may protect children from future obesity, an NIH-funded study finds.

Proper maternal folate levels during pregnancy may protect children from a future risk of obesity, especially those born to obese mothers, according to a study led by researchers funded by NICHD. The study was published online in JAMA Pediatrics.

“Maternal nutrition during pregnancy can have long-lasting effects on child health, as well as the health of a mother after pregnancy,” said the study’s principal investigator, Dr. Xiaobin Wang of Johns Hopkins University. “Our results suggest that adequate maternal folate may mitigate the effect of a mother’s obesity on her child’s health.”

Obesity in children and adults is a serious health issue in the United States, contributing to such conditions as heart disease, stroke and type 2 diabetes. During pregnancy, maternal obesity also increases the risk for a range of pregnancy complications such as stillbirth, birth defects and preterm birth. Furthermore, babies born to obese mothers have long-term health risks, including a higher risk of obesity in childhood.

Folate, an essential B vitamin, reduces the fetus’ risk for neural tube defects, which are malformations affecting the brain, spine and spinal cord. The Centers for Disease Control and Prevention recommends that women of childbearing age take 400 micrograms of folic acid (a synthetic form of folate) daily to reduce their children’s risk for neural tube defects.

“Folate is well-known for preventing brain and spinal cord defects in a developing fetus, but its effects on metabolic disorders, such as diabetes and obesity, is less understood,” said Dr. Cuilin Zhang, NICHD senior investigator and a study co-author. “This study uncovers what may be an additional benefit of folate and identifies a possible strategy for reducing childhood obesity.”

Endocannabinoids May Play Key Role in Habit Formation

Daily activities involve frequent transitions between habitual behaviors, such as driving home, and goal-directed behaviors, such as driving to a new destination on unfamiliar roads. An inability to shift between habitual and non-habitual behaviors has been implicated in obsessive-compulsive disorder, addiction and other disorders characterized by impaired decision-making. In a new NIAAAfunded study conducted with mice, scientists report that endocannabinoids, natural messengers in the body that are chemically similar to the active compound in marijuana, play an important role in how the brain controls this fundamental process.

“The new findings point to a previously unknown mechanism in the brain that regulates the transition between goal-directed and habitual behaviors,” said Dr. George Koob, NIAAA director. “As we learn more about this mechanism, it could reveal how the brain forms habits and, more specifically, how both endocannabinoids and cannabinoid abuse can influence habitual behavior pathophysiology.”

A report of the findings is now online in the journal Neuron.

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