Daily ReCAP April 11, 2017

Chronic: Diabetes Responsible for More Deaths in the United States Than Estimated, Study Suggests

Diabetes may be responsible for more deaths in the United States than previously believed, reported theWashington Post. In a study published inPLOS One, investigators used data from 2 large national surveys to compare death rates of survey participants with diabetes to information on their death certificates. The results of the study showed that nearly 4 times as many Americans may die of diabetes as indicated on death certificates. This estimated rate would bump the disease from the seventh-leading cause of death up to number 3. “We argue diabetes is responsible for 12% of deaths in the US, rather than 3.3% that death certificates indicate,” lead author Andrew Stokes told thePost. The investigators also found that patients with diabetes had a 90% higher mortality rate over a 5-year period than individuals without diabetes. “These findings point to an urgent need for strategies to prevent diabetes in the general population,” Stokes said. “For those already affected, they highlight the importance of timely diagnosis and aggressive management to prevent complications, such as coronary heart disease, stroke, and lower-extremity amputations. We hope a fuller understanding of the burden of disease associated with diabetes will influence public authorities in their messaging, funding, and policy decisions, such as taxation of sugar-sweetened beverages and use of subsidies to make healthy foods more accessible.”

Acute: Evidence Suggests Tissue Plasminogen Activator is Safe in Stroke Patients with Sickle Cell Disease

Scientists have provided the first systemic evidence of the safety of treatment with tissue plasminogen activator (tPA) in patients with sickle cell disease (SCD) who experienced an acute stroke. For the study, investigators used in-hospital data compiled by the quality improvement program Get With The Guidelines — Stroke to identify 832 patients with SCD and 3325 age, gender, and race-matched controls. The results of the study, published inStroke, found no statistically significant differences between the 2 cohorts in the rate of tPA use, timeliness of administration, or the rate of in-hospital complications. Of the patients in the tPA arm, 4.9% with SCD experienced intracerebral hemorrhage compared with 3.2% without SCD. There were also no significant differences between the cohorts in overall rate of complications, in-hospital mortality, and length of stay above 4 days. Although more research needs to be done, the findings suggest that tPA is safe in patients with SCD and could potentially be used as a complementary therapy to rapid and complete red blood cell exchange.

Preventive: Single Dose of Live-Attenuated Vaccine Candidate Completely Protected Mice Against Zika Virus

A live-attenuated Zika virus vaccine that is still in the developmental stage completed protected mice from the virus with just a single dose. In a study published inNature Medicine, investigators pursued a safe vaccine made from live virus that had been sufficiently attenuated rather than from inactivated versions of the virus used in other developing vaccines. For the current vaccine, the investigators engineered the virus by deleting 1 segment of the viral genome. “Such live-attenuated vaccine has the advantage of a single-dose immunization, rapid and strong immune response, and potentially long-lived protection,” said senior author Pei-Yong Shi. “A successful vaccine requires a fine balance between efficacy and safety—–vaccines made from attenuated live viruses generally offer fast and durable immunity, but sometimes with a trade-off of reduced safety, whereas inactivated and subunit viruses often provide enhanced safety but may require several doses initially and periodic boosters.” Thus far, data indicate that the vaccine candidate has a good balance between safety and efficacy. A single immunization with the vaccine produced strong immune responses and prevented the Zika virus from infecting the mice at all.