Health

Nearly 25 Million U.S. Workers Now Have High-Deductible Health Plans

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FRIDAY, Sept. 15, 2017 (HealthDay News) — The number of American workers with high-deductible health insurance plans rose by 3.2 percent in 2016 — reaching 24.8 million, new research reports.

While premium prices rose modestly for people with employer-provided coverage, their deductibles rose 10 percent on average, University of Minnesota researchers found.

“High-deductible health plans are increasingly becoming the norm in commercial insurance, and there is every reason to expect this trend to continue,” said Katherine Hempstead, senior advisor at the Robert Wood Johnson Foundation. The foundation funded the study.

For the study, researchers analyzed national data and found more than 58 million American workers were enrolled in an employer-sponsored insurance plan in 2016.

The average deductible was $1,696 for single plans, a 10.1 percent increase from 2015. The increases averaged $155, the study determined.

Premiums for individual coverage, on the other hand, rose 2 percent ($138) in that time period. However, premiums for individual coverage had already climbed 13 percent from 2012 to 2016, the researchers pointed out.

A high-deductible plan was defined as one with a minimum annual deductible of $1,300 for an individual and $2,600 for a family.

There were significant differences between states. Fourteen states had statistically significant increases in average deductibles for single plans between 2015 and 2016, ranging from $306 to nearly $600. No state had significant declines.

Average deductibles for single plans ranged from a low of $988 in Hawaii to a high of $2,434 in New Hampshire. New Hampshire also had the highest percentage of workers enrolled in high-deductible health plans (69 percent) while Hawaii had the lowest (about 12 percent).

“Deductibles rose considerably faster than premiums, and the share of health care spending made directly by consumers will continue to grow,” Hempstead said in a Robert Wood Johnson news release.

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Parents Getting Better At Using Car Seats Safely

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FRIDAY, Sept. 15, 2017 (HealthDay News) — Parents are doing a better job of properly positioning infants and toddlers in their car seats, but older kids aren’t always safely seated, a new study reports.

The research suggests that child passenger safety education programs are working for infants and young children, increasing the number of parents and caregivers who understand that children younger than 2 years of age should ride in rear-facing car seats.

“This study shows that child passenger safety education has been a success in making sure young children are positioned correctly in the car, but there is still room for improvement,” said lead researcher Dr. Joseph O’Neil. He is medical director of the Automotive Safety Program at Riley Hospital for Children at Indiana University Health.

For the study, researchers conducted spot checks to look at where children were sitting in a car. Specifically, the researchers monitored the type of car seats used, as well as how and where they were positioned in cars, according to an American Academy of Pediatrics (AAP) news release.

The spot checks included more than 7,700 children aged 15 and younger. The spot checks took place at 25 different locations throughout Indiana between 2009 and 2015.

The AAP recommends that children be placed in rear-facing safety seats until they are at least 2 years old.

The researchers found rear-facing seat placement among infants increased from 84 percent in 2009 to 91 percent in 2015. During this time, use of rear-facing car seats also increased from 12 percent to 61 percent among toddlers aged 12 months to 17 months.

The AAP also recommends that children aged 4 to 8 years ride in booster seats. But use of these seats fell during the study period, from 72 percent in 2009 to 65 percent in 2015.

The study authors noted that educational campaigns should also make sure children continue to ride in booster seats until they are at least 8 years old. Plus, parents should keep all children out of the front seat until they are at least 13 years old.

The study findings are scheduled for presentation on Sept. 18 at the American Academy of Pediatrics meeting, in Chicago. Research presented at meetings should be viewed as preliminary until published in a peer-reviewed journal.

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When Hurricanes Strike, People Aren’t the Only Victims

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FRIDAY, Sept. 15, 2017 (HealthDay News) — Judi Hudek and David Clevinger braved Hurricane Irma at a friend’s home in Florida rather than a shelter for one reason — their three cats.

They had planned to huddle in a nearby hurricane shelter, but when they arrived they found that the cats would be forced to stay in a small room with a group of loud, barking dogs.

“It was maybe the most difficult decision I’ve made in my entire life,” said Clevenger, 47, who lives with Hudek, 48, in Bradenton, Fla. “I had the choice of either putting our three cats through that, or sheltering with our friends and hoping we could withstand the storm.”

Their dilemma is all-too-common. Pet owners facing a natural disaster often have to compromise their own safety to make sure their furry friends are safe, according to the American Society for the Prevention of Cruelty to Animals.

Unfortunately, a new ASPCA study reports that many states and counties do not have adequate emergency response plans for the care of animals during a natural disaster.

Fewer than a third of U.S. counties that regularly face natural disasters have an animal response team in place to help address the needs of pets, farm animals and their owners in an emergency, said lead author Vic Spain, an epidemiologist and consultant for the ASPCA.

A significant number of counties also don’t have plans in place for emergency shelters where people can either stay with their animals or shelter their animals elsewhere in the facility, the study found.

These plans can be the difference between life and death in an emergency, Spain said. About 56 percent of homes have at least one pet, and most people don’t want to leave their furry family members behind.

“From previous studies, we know that people with pets are more likely than people without pets to refuse to evacuate in an emergency situation — putting their lives, as well as the lives of the people sent to rescue them, in danger,” Spain said.

Hudek and Clevinger decided a couple days before Irma struck Florida this week that they would ride out the storm at home. They were worried they would run out of gas while evacuating the state, and be trapped in their car with their cats.

But then Irma changed tracks. Instead of coming up Florida’s east coast, it instead veered to the west coast. “We realized the storm tracker had Irma coming through our neighborhood as a category 4 hurricane,” Hudek said.

The couple made arrangements to stay at a shelter in a nearby elementary school. On Sunday morning, as the storm began its march up Florida, they packed their cats into carriers and headed to the shelter.

Once in the shelter, they found that all the pets people brought were being put in one small room. Their cats would not be able to get out of their carriers to eat, drink or use the litter box, and they would be subjected to loud barking from stressed-out dogs.

“We thought we’d be able to stay with our cats and sleep with our cats, and that’s just not how it is,” Hudek said.

So the couple instead decided to stay at a friend’s house, even though they were worried it would not be as safe as the shelter. They found an interior bathroom, and they and their pets huddled there until the storm’s fury subsided.

They and their pets made it safely through the hurricane, but others in earlier storms were not as lucky.

More than 15,500 pets in New Orleans needed to be rescued after Hurricane Katrina hit in 2005, the ASPCA said. Four out of five of the animals were never reunited with their owners.

State and local governments have been urged in the years since Katrina to include animals in emergency planning, but Spain and his colleagues found serious gaps in response plans:

  • Only 30 percent of counties with a regular track record of disasters — more than 30 emergencies within the past six decades — have an animal response team in place.
  • Only 48 percent of large counties and 23 percent of small counties in the U.S. have an animal response team for disaster preparedness.
  • Half of small counties do not have plans for emergency shelters that can accommodate people and their pets, compared with 20 percent of large counties and 27 percent of states.
  • Only two out of five small counties have set aside a cache of supplies for managing dogs and cats in an emergency, compared with nearly four out of five large counties.

“Organizations at the county or city level are critical for emergency response to occur quickly enough to prevent animal emergencies,” Spain said. “It is important to remove barriers to evacuation.”

“In our experience with Hurricane Sandy, residents were more likely to comply with evacuation orders when pet friendly emergency shelters were available, their presence was known to local residents, and pet-friendly transportation to the shelters was offered,” Spain continued, referring to the 2012 superstorm that ransacked the northeastern United States.

Why aren’t better plans in place? In some cases, local emergency preparedness staff may not be aware of the need to include pets and livestock in their planning, Spain said.

Some counties also reported that they didn’t have enough money to cover planning for animals in an emergency, Spain continued. Other locales may have become complacent because they’ve gone a long time without a disaster occurring in their area.

The Gulf Coast Humane Society is a part of Florida’s animal response team network, and the help it provided pet owners prior to Irma revealed the value of planning, executive director Jennifer Galloway said.

Just before the storm, the Fort Meyers animal welfare organization made available 200 pet crates for anyone to take, whether or not they left a donation, Galloway said.

“They were gone within hours,” Galloway said. “I think what people are seeing after Katrina and Harvey is they want to be with their pets. They want to keep their animals safe.”

Although planning is important, Galloway isn’t sure that the situation Hudek and Clevinger faced at their shelter can always be avoided.

“It’s probably always going to be an issue, because at the last minute people are scrambling to open up shelters,” Galloway said. “While it might not be ideal for cats and dogs to be in the same room, at least they’re safe.”

The ASPCA study appears in the Journal of Homeland Security and Emergency Management.

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Type 2 diabetes plan targets those at high risk

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People with the very highest risk of developing type 2 diabetes are being prioritised for places on NHS lifestyle change programmes.

Updated guidance from the National Institute for Health and Care Excellence (NICE) said this would cover 1.7m people in England.

The programmes help people to change their diet and do more exercise.

The guidance reaffirms that all adults over 40 should go and see their GP for a diabetes risk assessment.

Adults with conditions such as obesity, stroke or high blood pressure and high-risk ethnic minority groups are also encouraged to go for an assessment.

Weight loss help

Last year, NHS England and Public Health England developed an NHS Diabetes Prevention Programme in response to the guidance.

This means that in many parts of the country those at high risk are referred for personalised help to lose weight, eat more healthily and start a physical exercise programme.

The new guidance means that where resources are limited, those with the highest glucose levels should be prioritised for places on the lifestyle programmes.

Image copyrightGetty Images
Image caption Personalised physical exercise programmes are part of measures to prevent type 2 diabetes

NICE said the programmes should also be designed to help as many people as possible, including those with mental illness or dementia.

There are currently five million people in England at high risk of developing type 2 diabetes, NHS England says.

It says one in 10 will develop the condition by 2034, potentially leading to kidney failure, heart attack, stroke and sight loss, unless prevention is made a priority.

Access to care

Prof Mark Baker, director of the centre for guidelines at NICE, said: “We know that helping someone to make simple changes to their diet and exercise levels can significantly reduce their risk of developing type 2 diabetes.

“This approach is a cost-effective way of managing an illness that currently costs the NHS around £8.8bn a year.

“We need to make sure that the people most at risk have access to the care they need.”

He said the updated guidance would help NHS England and Public Health England to prioritise when necessary.

But GPs said they were already under pressure and would advise caution over blanket checks for all over 40s.

Prof Helen Stokes-Lampard, chair of the Royal College of GPs, said: It has the potential to subject healthy people to unnecessary tests, and this both deflects resources away from delivering patient care to those who really need it and could cause unintended harms.

“Any new national screening programme would need formal evaluation by the relevant bodies.”

She said there also needed to be more investment for general practice, and more GPs.

Dan Howarth, head of care at Diabetes UK, said the charity welcomed the updated guidelines.

“We know that globally, diabetes prevention programmes do work, and we know that with the right advice and support, people at increased risk of developing type 2 diabetes can take simple but significant steps to prevent the condition developing.”

There are currently 2.8m people with type 2 diabetes in England and about 200,000 new diagnoses every year.

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Rare pregnancy condition placenta accreta awareness call

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Media captionCeri Bostock wrote a will and letters to her loved ones before the birth

A woman who suffered a life-threatening pregnancy complication has called for more awareness of the condition.

Ceri Bostock, who lives near Penygroes, Gwynedd had placenta accreta during her pregnancy with her third child, Shari Fflur, born four months ago.

It affects about one in every 6,000 pregnancies, when all or part of the placenta attaches to the muscular layer of the uterine wall.

Ms Bostock was surrounded by more than 20 medics during Shari’s birth.

Women who have previously had a caesarean section have a higher risk of developing placenta accreta, according to the NHS and Betsi Cadwaladr University Health Board.

Shari was born healthy, but Ms Bostock told S4C’s Newyddion 9 programme she and her partner, Dyfed Thomas, struggled to enjoy the pregnancy and found it traumatic.

Because of the risks involved, Ms Bostock wrote a will and letters to her loved ones while in hospital for four weeks before the birth.

Ms Bostock said she was only diagnosed when a locum doctor working at Bangor’s Ysbyty Gwynedd for a week noticed the complication on her scan – though she has praised all the care she received.

The health board said all pregnant women who book for maternity care in north Wales are offered an anomaly scan at 20 weeks and may be offered additional scans.

Image caption Shari is now a healthy four-month-old

“I feel like I’ve got a guardian angel or something, for that locum to be there that week,” Ms Bostock said.

“Not everybody’s so lucky to get it diagnosed, because it’s so hard to get diagnosed, even to the last day before I was going in they said ‘we don’t know how bad it is until we get in there so we’re prepared for the worst but we’ll hope for the best’.”

She called for awareness to be raised about the condition, so expectant mothers have information before opting for a caesarean.

“Initially I wanted to forget about it and put it behind us, but I know there are so many women out there that have lost their lives or been very ill afterwards due to it not being diagnosed, I feel I have a responsibility to talk about it.

“The more people who talk about it the better. The more people that know about it, the higher the chance that it will get diagnosed.”

The Welsh Government said it was aware of the condition and recognised the importance of prompt clinical management in line with guidelines.

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Every childhood vaccine may go into a single jab

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A technology that could eventually see every childhood vaccine delivered in a single injection has been developed by US researchers.

Their one-shot solution stores the vaccine in microscopic capsules that release the initial dose and then boosters at specific times.

The approach has been shown to work in mouse studies, described in the journal Science.

The researchers say the technology could help patients around the world.

Childhood immunisations come with tears and screams. And there are a lot of them.

  • Diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B at eight, 12 and 16 weeks.
  • Pneumococcal jab at eight weeks, 16 weeks and one year
  • Men B vaccine at eight weeks, 16 weeks and one year
  • Hib/Men C vaccine at one year
  • Measles, mumps and rubella at one year and three years and four months

Source: NHS Choices

A team at Massachusetts Institute of Technology has designed a new type of micro-particle that could combine everything into a single jab.

The particles look like miniature coffee cups that are filled with vaccine and then sealed with a lid.

Crucially, the design of the cups can be altered so they break down and spill their contents at just the right time.

One set of tests showed the contents could be released at exactly nine, 20 and 41 days after they were injected into mice.

Other particles that last for hundreds of days have also been developed, the researchers say.

The approach has not yet been tested on patients.

‘Significant impact’

Prof Robert Langer, from MIT, said: “We are very excited about this work.

“For the first time, we can create a library of tiny, encased vaccine particles, each programmed to release at a precise, predictable time, so that people could potentially receive a single injection that, in effect, would have multiple boosters already built into it.

“This could have a significant impact on patients everywhere, especially in the developing world.”

The work differs from previous attempts, which slowly released medicines over a long period of time.

The idea is the short, sharp bursts of vaccine more closely mimic routine immunisation programmes.

Fellow researcher Dr Kevin McHugh said: “In the developing world, that might be the difference between not getting vaccinated and receiving all of your vaccines in one shot.”

Follow James on Twitter.

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NHS workers demand 3.9% pay rise

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Unions representing nurses and other NHS staff have written to the chancellor to demand a 3.9% pay rise and an extra £800 to make up for the “cut” they have seen in recent years.

Fourteen unions have joined together to ask for the increase, saying pay has fallen by 15% since 2010 once inflation is taken into account.

They said it was unfair ministers had selectively lifted the cap by agreeing a rise for police and prison officers.

The unions have over a million members.

But the British Medical Association, the doctors’ union, has not put its name to the letter, which has also been sent to the devolved nations.

In it, the unions argue that increasing pay would help tackle the shortages of staff being seen in the health service.

Public sector pay rise cap to be lifted

Reality check: Is public sector pay higher than private sector?

UK inflation rises to 2.9%

Earlier this year, research by the Royal College of Nursing suggested there were 40,000 posts unfilled – one in nine of the total.

The cost of the pay rise, which the unions want implemented across the UK from next year, would total £2.5bn.

It comes after ministers agreed to give police officers a 1% rise plus a 1% bonus, with prison officers getting a 1.7% rise – both funded from existing budgets.

The health unions, which represent a wide range of staff including nurses, midwifes, cleaners, porters, pharmacists, paramedics and dental technicians, said that still represented a pay cut.

Image copyrightScience Photo Library
Image caption Nurses will be balloted on taking industrial action unless a 1% pay cap is dropped, says the RCN

Since 2010, pay has been frozen and then capped at 1% for public sector workers.

Unison head of health Sara Gorton said: “Health workers have gone without a proper pay rise for far too long.

“Their wages continue to fall behind inflation as food and fuel bills, housing and transport costs rise.”

RCN general secretary Janet Davies said it was important the money to pay for the rise would have to be found by the Treasury rather than taken from the NHS budget.

“When ministers hold pay down, it drives too many nurses out of the NHS,” she added.

A government spokeswoman said: “Public sector workers, including NHS staff, do a fantastic job, and the government is committed to ensuring they can continue to deliver world-class public services.

“The government will continue to ensure that the overall package is fair while also being affordable to taxpayers as a whole.”

She added next year’s pay award would be “discussed and agreed” as part of the Budget process and through the official pay review bodies and would be “set out in due course”.

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Which Single Behavior Best Prevents High Blood Pressure?

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THURSDAY, Sept. 14, 2017 (HealthDay News) — You probably already know that certain healthy lifestyle behaviors can reduce your risk of developing high blood pressure, but is any one behavior more important than the others?

Maybe, as new research suggests maintaining a healthy weight is the No. 1 behavior to prevent unhealthy blood pressure levels.

“Our results indicate by maintaining a healthy body weight into middle age, you can help preserve low blood pressure,” said the study’s lead author, John Booth III. He’s a postdoctoral fellow at the University of Alabama at Birmingham.

“There have been increases in blood pressure at younger ages, which are linked to heart disease and stroke,” Booth said. “We evaluated the long-term impact of maintaining healthy behaviors on [high blood pressure].”

Booth and his colleagues looked at the effects of five healthy behaviors:

  • Never smoking
  • Drinking 7 or fewer alcoholic drinks weekly for women or 14 or fewer drinks a week for men
  • Eating a healthy diet (following the Dietary Approaches to Stop Hypertension, or DASH diet)
  • Getting 150 minutes or more a week of moderate to vigorous physical activity
  • Maintaining a healthy weight.

The study included almost 4,700 volunteers. They were between 18 and 30 years old when the study started in 1985 and 1986.

Over 25 years of follow-up, the researchers measured blood pressure and health behaviors eight times.

People who maintained a healthy body weight were 41 percent less likely to see their blood pressure rise as they approached middle age.

Study volunteers who maintained at least four of the healthy behaviors had a 27 percent decreased risk of high blood pressure by middle age.

Staying physically active and eating a healthy diet weren’t specifically linked to a better blood pressure.

On the other hand, never smoking and drinking little to no alcohol seemed to keep blood pressure lower in middle age. But the researchers said a larger study is needed to confirm these because they may have been a chance finding.

Since maintaining a healthy body weight appears to be a more important behavior than the others, does that mean you don’t need to be concerned about a healthy diet or getting enough exercise?

Not at all, Booth said.

He said other health behaviors are linked to maintaining a healthy weight, with exercise and a healthy diet chief among them.

“Multiple factors are contributing to the risk for developing high blood pressure across the life span, and these factors all interact together,” Booth noted.

Still, the study showed a clear benefit to staying trim from a young age through middle age.

Just what is it about weight that may boost blood pressure?

Dr. Howard Selinger is chair of family medicine at the Frank H. Netter M.D. School of Medicine at Quinnipiac University in North Haven, Conn. He said weight may contribute to high blood pressure in a number of ways.

“When you gain weight, your heart has to work harder because the weight has a compressive effect on the blood vessels. Over decades, that can produce cardiac problems. The vascular bed — the blood vessels — stiffens as we get older,” Selinger said.

But for people who don’t gain weight, there’s less stiffening. “That, in turn, keeps blood pressure lower and prevents more serious outcomes. If you lower your weight, you lower the pressure,” Selinger explained.

He said weight is clearly an important factor in keeping blood pressure at a healthy level. But he considers the other factors important too, especially never smoking.

Findings from the study were scheduled for presentation Thursday at an American Heart Association meeting, in San Francisco. Studies presented at meetings are generally viewed as preliminary until they’ve been published in a peer-reviewed journal.

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Early Onset of Pregnancy Complication May Raise Heart Risks

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THURSDAY, Sept. 14, 2017 (HealthDay News) — Women who develop pre-eclampsia earlier in pregnancy may be at increased risk for heart problems soon after giving birth, a new study finds.

“These women should be screened for major cardiovascular risk factors and prevention strategies should be implemented as soon as possible,” said study author Dr. GianLuca Colussi. He’s an assistant professor of medicine at the University of Udine in Italy.

Pre-eclampsia is a dangerous increase in blood pressure that occurs in the second half of pregnancy.

Researchers assessed heart structure and function in 65 women one month after they gave birth. None had high blood pressure before pregnancy, but developed pre-eclampsia during pregnancy. Thirty-seven percent of them had early onset pre-eclampsia — before the 34th week of pregnancy, the study authors said.

The study also included 16 nonpregnant women with high blood pressure; six healthy pregnant women and 30 healthy nonpregnant women.

Women with pre-eclampsia were more likely than pregnant women without the condition to have thickening of the left heart muscle one month after giving birth. The condition was more severe among women with early onset pre-eclampsia.

The findings show that pregnant women with pre-eclampsia and their doctors need to be aware that there is an increased risk of heart problems after delivery, the researchers said.

“We’ve shown that women with early onset pre-eclampsia might be at even greater risk,” Colussi said in an American Heart Association news release.

More research is needed to determine why women with early onset pre-eclampsia are at increased risk for these heart changes, he said.

The U.S. National Institutes of Health estimates that about 3.4 percent of pregnancies in the United States involve pre-eclampsia.

The study was presented Thursday at a meeting of the heart association and American Society of Hypertension, in San Francisco. Research presented at meetings is usually considered preliminary until published in a peer-reviewed medical journal.

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Increasing Salt Intake Tied to Diabetes Risk

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THURSDAY, Sept. 14, 2017 (HealthDay News) — High levels of salt consumption may increase an adult’s risk of developing diabetes, researchers say.

The new study included data from a few thousand people in Sweden. The findings showed that salt intake was associated with an average 65 percent increase in the risk of developing type 2 diabetes for each 2.5 extra grams of salt (slightly less than half a teaspoon) consumed per day.

People with the highest salt intake (about 1.25 teaspoons of salt or higher) were 72 percent more likely to develop type 2 diabetes than those with the lowest intake, the investigators found.

The study, led by Bahareh Rasouli of the Institute of Environmental Medicine at the Karolinska Institute in Stockholm, was scheduled for presentation Thursday at the annual meeting of the European Association for the Study of Diabetes (EASD) in Lisbon, Portugal.

The current study didn’t look at how salt might increase the risk of diabetes. But the researchers suggested that increasing salt intake may spur insulin resistance, a condition that can lead to type 2 diabetes. Or, it could be that salt intake was related to a higher weight.

The study can’t prove a direct cause-and-effect relationship, only an association.

High salt consumption was also associated with a significantly increased risk of latent autoimmune diabetes in adults, a form of type 1 diabetes that develops very slowly and appears in adulthood.

The study findings may prove important in efforts to prevent diabetes in adults, the researchers said in an EASD news release.

Findings presented at meetings are generally viewed as preliminary until they’ve been published in a peer-reviewed journal.

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