Vitamin D for fall prevention Combo best
Older adults may need more vitamin D to prevent mobility difficulties.
noninstitutionalized postmenopausal women. In addition, the USPSTF draft statement recommends against daily supplementation with up to 400 IU of vitamin D3 and 1,000 mg of calcium carbonate for the primary prevention of fractures in noninstitutionalized postmenopausal women. Older adults may need more vitamin D to prevent mobility difficulties, according to data from 2,099 community-dwelling men and women aged 70 to 79 years reported online ahead of print in The Journal of Gerontology: Medical Sciences. Over the course of six years, Denise K. Houston, PhD, and colleagues observed an estimated 30% increased risk of mobility limitations for the participants with low levels of vitamin D—that is, levels of 25-hydroxyvitamin D (25[OH] D) lower than 75 nmol/L—and almost a twofold higher risk of mobility disability for those individuals.
Be sure to test baby-boomers for hepatitis C The CDC has proposed that all adults born between 1945 and 1965 undergo a one-time test for hepatitis C, noting that one in 30 members of this generation has been infected. Similarly, the American Gastroenterological Association (AGA) has launched the “I.D. Hep C” campaign (www.IDHepC.org) to educate people, particularly baby-boomers, about hepatitis C and encourage them to get tested. According to results of an AGA survey, 74% of baby-boomers have never
been tested for the illness or are unsure as to whether they have been tested. The survey also revealed that 83% of baby-boomers don’t realize that their generation is most likely to have hepatitis C. In fact, of the nearly 5 million Americans infected with hepatitis C, 82% are babyboomers, but three in four people don’t know they have it, contend AGA representatives in a statement issued by the organization.
for youths with type 2 diabetes COMBINING rosiglitazone (Avandia) with metformin helped children and adolescents with new-onset type 2 diabetes achieve glycemic control more effectively than metformin alone in a recent study. Adding an intensive lifestyle intervention to metformin provided no more benefit than metformin therapy alone. Despite the increasing prevalence of type 2 diabetes in youth, few data are available to guide treatment, wrote Phil Zeitler, MD, PhD, and other members of the TODAY Study Group in The New England Journal of Medicine, which published the study findings online ahead of print. They studied 699 youths aged 10 to 17 years, with a mean duration of diagnosed type 2 diabetes of 7.8 months, who had been randomized to metformin 1,000 mg b.i.d., or to metformin combined with rosiglitazone 4 mg b.i.d., or to metformin plus intensive lifestyle changes designed to help participants lose weight and increase physical activity. Metformin alone proved to be inadequate for maintaining acceptable, long-term blood glucose control in 51.7% of the patients over an average follow-up of 46 months. The failure rate was 46.6% in the metformin-plus-lifestyle group, but only 38.6% in the metforminand-rosiglitazone group. ■
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CLINICIANS SHOULD recommend vitamin D supplementation as well as exercise or physical therapy in communitydwelling adults aged 65 years or older who are at increased risk for falls, advised the United States Preventive Services Task Force (USPSTF) in a recommendation appearing online ahead of print in Annals of Internal Medicine. However, in a separate draft recom mendation statement that has yet to be finalized, the USPSTF expressed more hesitation about other uses of vitamin D supplementation. Specifically, the group found that currently, there is insufficient evidence to assess the balance of the benefits and harms of the following: combined vitamin D and calcium supplementation for the primary prevention of fractures in premenopausal women or men; and daily supplementation with more than 400 IU of vitamin D3 and 1,000 mg of calcium for the primary prevention of fractures in