Health Newsfeed – Johns Hopkins Medicine Podcasts

Anchor lead: If you have diabetes what you eat really does make a difference, Elizabeth Tracey reports

Low carb diets do help people with diabetes improve their health, a recent meta-analysis found, although the benefits seemed to wane after a year. Rita Kalyani, a diabetes expert at Johns Hopkins, did a study finding a similar impact.

Kalyani: What we found in a real world setting, so not in a study setting, was the low carbohydrate diet was effective at reducing A1c, at reducing weight and in some of these metabolic outcomes too, even at three months and even up to six months later.  :15

Kalyani cautions that adopting such a diet may prove challenging for some.

Kalyani: Having greater availability of foods to choose from is important. Unfortunately many of these foods that we might consider quote unquote higher quality also are more expensive, so I think looking at the translatability and to prompt us to multiple communities of diverse backgrounds will be important.  :18

At Johns Hopkins, I’m Elizabeth Tracey.

Anchor lead: How can the impact of carbohydrates be tested best? Elizabeth Tracey reports

Carbohydrate consumption may be an important tool in helping control diabetes, a new meta-analysis suggests, and most helpful is knowing which carbs to avoid. Rita Kalyani, a diabetes expert at Johns Hopkins, says there is data on that.

Kalyani: The best study model of that is the glycemic index. Where you really look at how carbohydrates lead to elevation of blood sugar, both how fast and how high. It is definitely true that not all carbohydrates are the same. There’s the very simple carbohydrates that are concentrated sugars that spike the sugar right away and then the complex carbohydrates whole grains that might take a little bit longer. The issue is a bit more complicated when you talk about the effects on appetite. We still need to better understand how the quality of the carbohydrate impacts metabolic disease.  :33

Kalyani says that while research is ongoing, educating yourself about which carbs raise blood sugar fastest may be helpful. At Johns Hopkins, I’m Elizabeth Tracey.

Anchor lead: What is the impact of a low carbohydrate diet in people with diabetes? Elizabeth Tracey reports

Low carbohydrate diets seem to go in and out of favor, with a recent analysis of studies looking at their impact on those with diabetes. Rita Kalyani, a diabetes expert at Johns Hopkins, says there did seem to be benefits of these diets in the first several months of their adoption.

Kalyani: There was significantly greater weight loss, there was lower fasting glucose, and there was also beneficial effects on lipids. And interestingly they found that at 12 months most of these effects became less significant. What I concluded from this study is that while the low carbohydrate diet can be very beneficial and is safe for these multiple outcomes at six months, by twelve months perhaps because of the difficulty adhering to the diet for that length of time, many of these metabolic benefits were attenuated.  :29

Kalyani notes that this effect is similar to what is seen in many diet studies, but encourages those with diabetes who’d like to try to talk with their physician. At Johns Hopkins, I’m Elizabeth Tracey.

Anchor lead: Many healthcare workers have died in this pandemic, Elizabeth Tracey reports

Almost 3000 healthcare workers in the US had died of Covid-19 at the end of December 2020, Kaiser Health News reports. Patricia Davidson, dean of the Johns Hopkins School of Nursing, says she can only imagine what an outcry there would be if 3000 construction workers or long haul truckers had died.

Davidson: There has to be an acknowledgement from a national perspective from an occupational health and safety issue that there are real issues for all healthcare workers. Around the nation, healthcare workers, from the very junior, less trained to the professors have been losing their lives. So we really need to take a strong look at occupational health and safety in this context of the pandemic. And as everyone says this is not going to be the last.  :28

Davidson says some healthcare systems have fared much better than others in protecting their workers, yet standards and practices need to be implemented to help keep everyone safe. At Johns Hopkins, I’m Elizabeth Tracey.

Anchor lead: Even as the pandemic slows down, clinicians are wearier than ever, Elizabeth Tracey reports

Long shifts at the hospital, constantly wearing personal protective equipment, worrying about whether you might bring home Covid-19 to family and friends, and high rates of death. Many studies are pointing to these factors as important in the high rate of clinician burnout, with loss of experienced people from medicine. Patricia Davidson, dean of the Johns Hopkins School of Nursing, comments.

Davidson: This is not a new problem. We know the National Academies of Medicine have had a strategic focus on clinician burnout. It’s been really exacerbated during Covid-19. All the pandemic has done apart from the devastation has laid wide open the cracks in our society, in our institutions, and I would also say particularly within healthcare it’s identified frailties but opportunities.  :28

Davidson says the pandemic has given us the chance to look closely at our healthcare system and implement changes to support those who have chosen medicine as a profession. At Johns Hopkins, I’m Elizabeth Tracey.

Anchor lead: Raising awareness of hearing numbers may interrupt progression to dementia for some, Elizabeth Tracey reports

You should know your hearing number. That’s according to Frank Lin, a hearing expert at Johns Hopkins and advocate for making this number as well-known as blood pressure numbers. Lin says one reason is the link between hearing loss and dementia.

Lin: We have a big trial, and it’s called the ACHIEVE study, where we’ve been testing if you can treat hearing loss can you delay dementia. That trial is ongoing. The recruitment is closed now at just under 1000 people, so now everyone’s in the three year follow up phase. The final results won’t be ready until essentially the earliest end of 2022, early 2023. To be honest we really don’t know if you treat hearing would it make a difference. We think it could but we really don’t know. I’m hopeful it makes a difference. There’s every reason to think that treating hearing loss would work on and change the mechanisms through which hearing loss is linked to dementia.  :33

At Johns Hopkins, I’m Elizabeth Tracey.

Anchor lead: New technologies will help everyone make sense of their own hearing ability, Elizabeth Tracey reports

New hearing devices are poised to enter the market as a change enacted by Congress will allow hearing aids to be sold over the counter, and are expected to be dramatically less expensive than those sold now. Frank Lin, a hearing expert at Johns Hopkins and advocate for making hearing numbers as well known as blood pressure numbers, says smart phones will help, too.

Lin: Now with the current smartphone technology we have now, with the microphones, people could actually get a pretty good darn measure of their own PTA, at home with their own cell phone. Whereas before you had to visit an audiologist, get a measure, but increasingly we’ve been getting a measure with apps and some of them are actually quite good. Rather than being an exact number it might be off by about five. It’s not perfect but plus or minus five is like not terrible. Really the next year it’s all converging. It actually makes these numbers become accessible, and actionable and useful.  :32

At Johns Hopkins, I’m Elizabeth Tracey.

Anchor lead: One reason to know your hearing number is to help you decide if you’d like to treat it, Elizabeth Tracey reports

If you’ve ever had your hearing assessed, you may be unaware that your hearing is reported as a number. That number should be more widely used, says Frank Lin, a hearing expert at Johns Hopkins, in a position paper advocating its use. And knowing your number is about to become much more helpful.

Lin: I think there are a few things converged here that make this really appealing to the public too. One is this growing awareness that hearing is important, everyone sort of knows like, their grandparents and their parents have it, the second big thing that’s converging too is that one of our big wins a few years ago in the Senate was getting the over the counter hearing aid pacs passed in Congress. That was set to be enacted, it should have been a few months ago but it got delayed because FDA is swamped with Covid right now. But it should be essentially next year now, which means that beginning of next year, end of next year they’ll be over the counter hearing aids from Samsung, Apple, Bose, companies like that.   :30

Lin says these devices, known now as PADs for personal amplification devices, will then be allowed to be marketed to help with hearing loss. At Johns Hopkins, I’m Elizabeth Tracey.

Anchor lead: Knowing your hearing number will help in health related decisions, Elizabeth Tracey reports

There’s a compelling case to be made for reporting hearing levels using numbers that are already in use among audiologists. That’s according to Frank Lin, a hearing expert at Johns Hopkins, and colleagues in a recent position paper.

Lin: If you want to know whether or not your hearing theoretically puts you at risk of dementia, you have to know that number. I mean it’s based on that. And even among physicians like your internist, who’s taking care of you and wants to understand what your hearing is, mild, moderate and severe is not very helpful. But if they know what your number is they can say oh that’s the range where we can be thinking about this stuff and then you know you were only a thirty last year now you’ve really jumped to a forty, we probably need to do some further evaluation of that. The number is already there, it’s already measured, you just need to use that number and summarize it and tell patients what it is.  :30

Lin says it will take some time for a hearing number to gain traction among clinicians and with the public, but he believes it will become accepted and widely available, just as blood pressure numbers or weight are, and has just as many health implications. At Johns Hopkins, I’m Elizabeth Tracey.

Anchor lead: Hearing is a simple number you should know, Elizabeth Tracey reports

Hearing should be a reported number just like cholesterol. That’s according to Frank Lin, a hearing expert at Johns Hopkins, in a recent paper advocating for widespread adoption of the practice.

Lin: You know roughly your blood pressure, people who have diabetes will know their sugar, and things like that. The metrics really matter. Because the metrics are how we communicate things, it’s how you understand if it’s getting worse or better, it’s how you compare yourself to others in many ways. But hearing, ironically your realize, no one knows their quote unquote hearing number. We say oh it’s a mild, moderate, it’s severe. And there’s actually not a hearing number but the ironic thing about that is there are tons of hearing numbers.  Hearing is actually really straightforward and easy to measure with incredible precision. That’s what audiology is all about.  :30

Lin and colleagues have developed a staged plan to roll out awareness of hearing numbers and how important they are. The plan starts with getting experts in hearing to recognize and utilize a standard, then expanding that to other physicians and the public. At Johns Hopkins, I’m Elizabeth Tracey.