THURSDAY, May 8 (HealthDay News) -- A gene called erythropoietin (EPO) is linked to severe diabetic eye and kidney diseases, a new study finds.
The study, led by a researcher at the John A. Moran Eye Center at the University of Utah, included 1,618 people with proliferative diabetic retinopathy (PDR) and end-stage renal disease (ESRD) and 954 diabetic patients without any eye or kidney disease.
PDR is the most common cause of legal blindness in working-age adults in the United States, accounting for 10 percent of new onset blindness overall. Diabetes is the leading cause of ESRD.
The researchers found that people with a copy of mutant EPO gene have an increased risk of developing PDR and ESRD.
"We know that the development of PDR and ESRD in diabetic patients can be inherited. Although genetic factors are known to be important in the susceptibility [or resistance] to these complications, until now, the genes involved have been mostly unknown," study leader Dr. Kang Zhang, director of the division of ophthalmic genetics at the Moran Eye Center and an associate professor of ophthalmology and visual sciences, said in a prepared statement.
The study was published online May 5 in the Proceedings of the National Academy of Sciences.
This finding may affect the use of EPO in treating patients with anemia, Zhang said.
EPO is used extensively to help in the production of red blood cells when treating patients with anemia resulting from renal failure or chemotherapy. In the United States, erythropoietin represents one of the largest single drug expenses for the Center for Medicare & Medicaid Services, approximately one billion dollars per year," Zhang said.
"Patients with anemia due to chronic renal disease [many of whom have diabetes] who receive frequent dosing of EPO to maintain higher hemoglobin levels have a higher rate of cardiovascular complications than patients who maintain a lower hemoglobin level. A similar effect of EPO on accelerating the decline of kidney function had been suggested by earlier studies. Our study suggests that caution may be warranted when maintaining higher hemoglobin concentration using exogenous EPO treatment in diabetic patients, as it might accelerate progression to PDR and ESRD."
Study co-author Dr. Dean Li, from the Program in Human Molecular Biology and Genetics at the University of Utah, added: "Though there is no proven pharmacologic treatment for diabetic vascular eye diseases, inhibiting the growth of unwanted blood vessel growth using antibodies directed against vascular endothelial growth factor [anti-VEGF therapy] has been advocated. This genetic study suggests that future therapeutic strategies need to consider blunting the effects of erythropoietin in addition, or as an alternative, to an anti-VEGF strategy."
More information
The U.S. National Eye Institute has more about diabetic eye disease.
THURSDAY, May 8 (HealthDay News) -- Arthritis strikes more than half of the 20.6 million American adults who have diabetes, and the painful joint condition may be a barrier to exercise among these patients, a new government report shows.
Being physically active helps people manage both diseases better by controlling blood sugar levels and reducing joint pain, according to the report in the May 9 issue of Morbidity and Mortality Weekly Report, a publication of the U.S. Centers for Disease Control and Prevention.
"The prevalence of arthritis is astoundingly high in people with diabetes," said Dr. John H. Klippel, president and CEO of the Arthritis Foundation. "Over half the people with diabetes have arthritis."
Although there appears to be a connection between arthritis and diabetes, the reason for it isn't known, Klippel said. A possible explanation is obesity, which is a risk factor for both osteoarthritis and diabetes, he speculated.
"In addition, those individuals who have diabetes and arthritis are less physically active," Klippel said. "We know that physical activity is critically important for the control of diabetes, both for the control of blood glucose and the prevention of complications."
Using data from the Behavioral Risk Factor Surveillance System, CDC researchers found 29.8 percent of people with both diseases were more likely to be inactive, compared with 21 percent of those who only have diabetes, 17.3 percent of those with arthritis alone, and 10.9 percent of those with neither condition.
For people who suffer from both diabetes and arthritis, arthritis appears to be a barrier to being physically active. But being physically active by doing aerobic exercise, strength training, walking, swimming or biking can benefit people with both diseases, according to the CDC.
"Public health efforts to control diabetes are going to have to begin to pay attention to this problem of arthritis, if we ever hope to get people physically active," Klippel said.
Klippel thinks the importance of physical activity needs to be emphasized. "Many people with arthritis don't exercise because it hurts them. But they have to understand that if they exercise, it will actually reduce their pain and prevents the disease from progressing," he said.
One of the keys to controlling diabetes is exercise, Klippel stressed.
"People with diabetes are going to have to pay a lot more attention to their arthritis if they hope to achieve better control of their diabetes," Klippel said. "People with arthritis are going to have to recognize that there is an association between diabetes and arthritis."
For people with arthritis and diabetes, the Diabetes Foundation recommends getting physically active by taking a walk at least three days a week.
The foundation recommends starting with a 10-minute walk, increasing it to 30 minutes over time. Before taking that walk, it's important to stretch your legs, lower back, chest and arms, Klippel said.
To keep yourself motivated, walk with a friend, the foundation suggests.
In addition, maintaining a healthy weight will place less stress on joints, particularly the knees. Also, being overweight can cause you to tire more quickly and give up on your exercise program.
More information
For more on arthritis, visit the Arthritis Foundation 
.