The glycated hemoglobin, or HbA1c blood test has been approved as a legit means to diagnose diabetes.

An international committee of experts made the announcement at the recently concluded meeting of the American Diabetes Association.

The test is fit for use, it concluded, in people of all ages but not for pregnant women.

“This is a major departure from the way diabetes has been diagnosed in the past,” David Nathan told USAToday.

Nathan, the director of the Diabetes Center at Massachusetts General Hospital, chaired the august body which included investigators from the ADA, the International Diabetes Federation (IDF), and the European Association for the Study of Diabetes (EASD).

The committee based its conclusion on a review of scientific literature on the matter.

Prior to the announcement, diabetes had been diagnosed using either a fasting blood glucose or an oral glucose tolerance test. Both tests are sensitive but prone to false positive results caused by eating prior to the test and intercurrent illnesses.

In contrast, the HbA1c test assesses glucose levels over the 2-3 months prior to the stick. It is not nearly as likely to produce a false positive result, does not require that one fast prior to the test, and can be done at any time of the day.

The thing that had been preventing the test from being used as a diagnostic tool before the announcement was that influential diabetes groups had not agreed on the result that constitutes a positive diagnosis.

Nathan’s group more or less settled the matter, saying that anyone with a level of 6.5% or higher had diabetes.

The ADA itself has yet to sign off of these recommendations, however. It’ll begin its own investigation in the near future.

Extreme obesity, defined as a Body Mass Index of 40 or higher, which for most people means being about a hundred pounds overweight, cuts life expectancy by 10 years, according to Richard Peto and colleagues at Oxford University in England.

That deleterious impact is the equivalent of a lifelong cigarette smoking habit.

The merely obese, who have a BMI in the range of 30-35, are sacrificing 2-4 years, while overweight folks, who have BMIs in the 25-29.9 range, short themselves and their loved ones by a year or so.

(If you know your height and weight, you can calculate your BMI here.)

The relationship between excessive weight and premature mortality turns out to be linear; for every 5-point jump in BMI above the optimal range, the risk of early death jumps by 30%.

The scientists reached these conclusions after pooling data from 57 studies of nearly 900,000 US and Western European adults that had been followed for 10-15 years.

Nearly 70,000 people died during the observation period. The scientists adjusted the data for age, smoking status and gender.

Almost all excess mortality was caused by cardiovascular disease and stroke, study co-author Gary Whitlock told USA Today. The epidemiologist explained that “obesity causes heart disease and stroke by pushing up blood pressure, mucking up blood cholesterol and triggering diabetes.”

The write-up appears in Lancet.

This is a “valuable study that provides a much clearer picture of the risk associated with various levels of being overweight or obese,” Michael Thun, an emeritus vice president of epidemiological research at the American Cancer Society told USA Today.

Nearly two-thirds of US adults are either overweight or obese, and fully half of those are obese.

“Once you gain weight, it’s hard to lose it and easy to gain more. So the goal to stop your weight gain now,” Thun warned.

The American Cancer Society has reported yet again that African-Americans are more likely to develop and die from cancer than all other groups.

Cancer mortality in black men and women is 33% and 16% higher than in whites respectively, and these yawning gaps haven’t closed a bit since at least 1981, according to Ahmedin Jemal, a co-author of the report.

A key reason for the disparity is that whites tend to get diagnosed at an earlier stage in the disease, when chances for a cure are higher.

But it’s also true that blacks are less likely to receive high-quality treatment, Peter Bach told USAToday.

The Sloan-Kettering oncologist had shown in 2004 that physicians treating black cancer patients were less likely to be cancer specialists and to have access to the latest diagnostic imaging facilities.

Blacks also tend to have lower educational levels, and that makes a big difference regardless of race. In the ACS study, cancer mortality for people with a high school education or less was twice as high as that for people who attended college.

Earlier studies have shown that cancer patients with low educational levels experience significantly longer delays between diagnosis and onset of treatment, as well.

And if that’s not enough, blacks tend to exercise less and are more likely to be obese than whites. These are both major risk factors for cancer. And they receive fewer colonoscopies and other cancer screening tests, and on and on and on.

“This study shows a real disparity in mortality between the haves and the have-nots in this country,” Jemal concluded.

Hurricane Katrina was hell on Charity Hospital, but things haven’t improved much since the day it left patients stranded in sweltering, unsanitary conditions with no power and vanishing supplies of water, food and medicine.

Charity was the place where caregivers stored bodies in hallways because the morgue was flooded, and made horrible decisions about patients for whom they could not comfort, let alone care for properly.

It’s been 3 ½ years since Katrina and now the ghost of Charity stands in silence, surrounded by a chain-link fence and barbed wire, boarded up like a set for a B-grade horror movie.

Until the storm, the 70-year old facility had been the go-to place for the city’s poor and uninsured. It was the only Level One trauma center in town and by far the most important site for training new physicians.

But plans to replace the gigantic structure and restore these services are dead in the water. The hang-up according to USA Today, is money.

Louisiana requested $492 million in disaster aid from the federal government. It wants to pick up the balance on a $1.2 billion downtown medical center.

But FEMA contends Charity was neglected and in disrepair before the storm. Disaster aid doesn’t cover that, so it countered $150 million, or $51 million more than what it calculated were the costs of storm-related damage.

Nothing’s going to happen until the stand-off is settled, according to LSU’s general counsel Raymond Lamonica. The dispute is likely headed to court.

Meanwhile, the state is focusing on site-designs and buying land for a new Charity. “That’s going to take a couple of years,” Lamonica said. “Hopefully by then we’ll have our money.”

Nine months after the FDA approved Genentech’s cancer-fighter Avastin for advanced breast cancer, scientists reported that it increases the risk of venous thromboembolism (VTE), a potentially serious side-effect.

Shobha Nalluri and her group at Stony Brook University combined results from 15 randomized controlled trials of 7,956 patients that were treated for advanced solid tumors. Overall, 7.3% of the patients developed VTE, and those treated with Avastin had a 33% higher risk.

The increased VTE risk was observed regardless of the site of the primary tumor and the Avastin dosing schedule.

Last year, an FDA advisory panel voted 5-4 against approving Avastin for advanced breast cancer because the drug’s beneficial effects in slowing disease progression did not, in its opinion, outweigh its potential for causing cardiovascular complications and VTE. Approval was granted anyway.

The FDA had approved Avastin for colon and lung cancer in 2004. The drug works by choking off the blood supply to a tumor rather than killing tumor cells directly. Scientists had hoped Avastin could replace traditional cancer drugs which are debilitating and increase the risk of serious infections, but this has not turned out to be the case. Avastin is typically used in conjunction with old-school cancer fighters.

Annual treatment costs for Avastin can exceed $50,000 per year. Its 2007 sales were $2.3 billion.

Previous studies were too small to detect the adverse effect found in the present study.

Avastin’s label already warns about the risk of VTE, but the Stony Brook scientists suggest in their publication that a tougher, “black box” warning should be affixed.