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NEW YORK (Reuters Health) - Athletes with diabetes should be sure to have a game plan to manage blood-sugar highs and lows, according to new guidelines.

The recommendations, from the National Athletic Trainers' Association (NATA), focus on athletes with type 1 diabetes, the form of diabetes that usually arises in childhood or by young adulthood and requires insulin therapy.

While regular exercise is recommended for people with diabetes, the intensity of competitive sports can cause sudden, large shifts in blood sugar levels. However, a "well-organized plan" can help athletes to keep their blood sugar in check during practice and competitions, according to the NATA guidelines, published in its Journal of Athletic Training.

First, athletes should check their blood sugar levels before, during and after exercise. They may need to eat carbohydrates right before or during practice or competition, depending on their sugar levels, according to the guidelines. All diabetic athletes should eat after exercising to make sure sugar levels don't drop too much.

Athletes are also advised to talk with their doctors about their insulin doses, which may need to be reduced on days when they are working out or competing.

Intense exercise can also trigger a sudden, dangerous increase in blood sugar in certain cases, however. To prevent this, the NATA says that athletes should be cautious about exercising when their blood sugar is high to begin with.

Athletes with diabetes should also give a list of all medications they take to the team trainer, as well as all the medical supplies necessary to treat a diabetes-related emergency. The guidelines also recommend that athletes carry a medic alert tag with them at all times.

"Athletes with diabetes can benefit from a well-organized plan that may allow them to compete on equal ground with their teammates and competitors without diabetes," Dr. Carolyn C. Jimenez, an athletic trainer who helped write the new guidelines, and her colleagues conclude.

SOURCE: Journal of Athletic Training, December 2007.

Copyright © 2007 Reuters Limited.

NEW YORK (Reuters Health) - Taking a "statin" drug to keep cholesterol levels down may have another benefit for smokers and former smokers: the drugs apparently slow the annual decline in respiratory function.

While statins are best known for their cholesterol-lowering properties, they are also thought to have anti-inflammatory effects, note Dr. Jean I. Keddissi and colleagues in the medical journal Chest. This may be beneficial for chronic pulmonary disease, which is common among smokers.

To investigate, the researchers, from the University of Oklahoma Medical Center in Oklahoma City, assessed lung function changes in 418 current or former smokers, including 215 who were taking a statin. Statins include drugs such as Pravachol or Crestor, for example.

All of the participants had abnormal spirometry results at the beginning of the study, and they had at least two pulmonary function tests performed 6 months apart.

As noted, the annual decline in pulmonary performance was significantly lower for those taking a statin compared with those not on a statin. This difference was apparent regardless of the type of lung disease and whether the patient was a current or former smoker.

"Our study adds to a growing body of evidence suggesting that statins may have a beneficial effect in inflammatory lung diseases," Keddissi's team concludes. Trials designed specifically to assessing the effect of this group of medications in lung diseases, they add, "are not only justified but also urgently needed."

SOURCE: Chest, December 2007.

Copyright © 2007 Reuters Limited.

NEW YORK (Reuters Health) - Contrary to expectations, the higher a woman's percentage of body fat at menopause, the more likely she is to experience symptoms such as hot flashes and night sweats, a new study shows.

Such so-called "vasomotor symptoms" had previously been thought to be less common in heavier women at menopause, because body fat can convert male hormones into estrogen, Dr. Rebecca C. Thurston of the University of Pittsburgh School of Medicine and colleagues note. Fatter women would therefore have a reserve source of estrogen that could shield them from these symptoms.

However, there is mounting evidence that heavier women may actually experience more vasomotor symptoms with menopause, the researchers add in their report in the American Journal of Epidemiology.

To better understand the relationship between body fat and menopausal symptoms, Thurston and her team looked at 1,776 women going through menopause. Fifty-nine percent reported having vasomotor symptoms.

As body fat increased, the researchers found, so did the likelihood that a woman would have hot flashes and night sweats.

The findings contradict the hypothesis that being fatter protects women from vasomotor symptoms, they write. Instead, they suggest, it's possible that excess fat makes it more difficult for the body to dissipate heat.

Based on the findings, Thurston and her colleagues add, weight loss -- especially loss of fat -- may help women going through menopause to reduce hot flashes and night sweats.

SOURCE: American Journal of Epidemiology, January 1, 2008.

Copyright © 2007 Reuters Limited.

NEW YORK (Reuters Health) - Changes in nerve activity as we age may help explain why older adults typically drink less in response to thirst than younger people do, new research suggests.

It is known that older people tend to get less satisfaction from drinking water when they are thirsty, and that compared with younger adults, they drink less -- a fact that increases their risk of dehydration and heat illness on hot summer days.

In the new study, Australian researchers used a brain imaging technology called positron emission tomography (PET) to examine the mechanisms that might underlie this age difference.

The study included 12 healthy older men with an average age of 68, and 10 men with an average age of 24. The researchers gave each man an infusion of saline to make them thirsty, then let them drink as much water as they wanted.

They found that, on average, the older group drank only half as much water as the younger group, despite having similar salt levels in their blood and a similar response in a brain region called the anterior cingulate cortex (ACC).

Previous research has shown that the ACC is activated in response to thirst. These latest findings suggest that, in older people, this response may be prematurely shut down.

"Our findings suggest that the brain activity in the anterior cingulate cortex that subserves our motivation to drink when thirsty more rapidly turns off in elderly people after they drink a small amount of water," Dr. Gary Egan, one of the researchers on the study, told Reuters Health.

"This explains why older people drink less even though they have achieved a similar degree of thirstiness as younger people," explained Egan, of the University of Melbourne.

The findings are published in the early online edition of the Proceedings of the National Academy of Sciences.

Since the actual brain response to thirst was similar in younger and older men, Egan and his colleagues speculate that age-related changes in the nerves supplying the brain may be at work.

Egan explained that as we age, there may be changes in the "input" from nerves in the mouth, throat and stomach that sense how much water we've consumed.

According to the researchers, older adults should be careful to drink enough water on hot, humid days or when they are exercising -- possibly taking scheduled water breaks instead of relying on their thirst signals.

"The finding is particularly relevant to ensuring that older people drink regularly and in sufficient quantities, particularly during hot periods," Egan noted.

SOURCE: Proceedings of the National Academy of Sciences Online Early Edition, December 17, 2007.

Copyright © 2007 Reuters Limited.

NEW YORK (Reuters Health) - The general health of elderly hospitalized patients improved, along with their physical and social functioning, when they were given oral nutritional supplements in addition to the normal hospital diet, researchers report.

"Paying attention to and correcting nutrition in older people, specifically those who are ill, can lead to a significant improvement in their well-being," Dr. Salah Gariballa told Reuters Health.

Gariballa, of United Arab Emirates University in Al-Ain, and colleagues studied aspects of the quality of life of 225 hospitalized men and women, aged 75 years on average.

The patients, hospitalized for cardiovascular problems, lung disease, fractures, or infections, received a normal hospital diet plus either a placebo drink or a 995-calorie nutritional supplement twice daily for 6 weeks.

The nutritional supplement provided 100 percent of the Reference Nutrient Intakes for older adults for vitamins A, C, D, E, B1, B6, B12, folic acid, niacin, biotin, and pantothenic acid, as well as the minerals potassium, magnesium, calcium, phosphorous, iron, zinc, iodine, copper, manganese, and selenium, the investigators report in the Journal of the American Geriatrics Society.

Quality of life assessments after 6 weeks did not identify significant differences between the patients who received the supplements compared with those given the placebo.

However, after 6 months the patients given the nutritional supplement showed significantly better quality of life scores compared with patients who got the placebo. Measures of physical and social function were better, vitality was better, and mental health improved among the supplemented compared with non-supplemented patients.

This trial demonstrated that nutritional supplementation in hospitalized older people provides clinically important benefits, the investigators note.

Widespread use of nutritional supplements among older patients could have a substantial impact on the quality of life for older people, Gariballa and colleagues conclude.

SOURCE: Journal of the American Geriatrics Society, December 2007.

Copyright © 2007 Reuters Limited.