MONDAY, July 28 (HealthDay News) -- Packing on the pounds by drinking too many sugary drinks and not eating enough fruits and veggies appears to be associated with increased risk for type 2 diabetes, while a low-fat diet doesn't alter your risk of developing the blood sugar disease.

That's the conclusion of three studies published in the July 28 issue of the Archives of Internal Medicine. Obesity is one of the strongest risk factors for developing diabetes. By 2030, 11.2 percent of the adult population in the United States is expected to suffer from type 2 diabetes, according to the journal report.

In one study, Julie R. Palmer, a professor of epidemiology at the Slone Epidemiology Center at Boston University, and her colleagues looked at the association between type 2 diabetes and drinking sugar-sweetened soft drinks and fruit drinks. For the study, Palmer's team collected data on 43,960 black women, 2,713 of whom developed type 2 diabetes during 10 years of follow-up.

"Drinking sweetened soft drinks or fruit drinks was associated with an increased risk of developing diabetes," Palmer said. "Specifically, women who drank two or more soft drinks per day or two or more fruit drinks per day had a 25 to 30 percent increased risk of diabetes. Drinking diet soft drinks did not increase risk."

Both soft drinks and fruit drinks, if consumed frequently, will increase the risk of type 2 diabetes. The main mechanism seems to be through their effects on weight gain, Palmer said. "Reducing consumption of these beverages may be a concrete way to reduce weight gain and prevent diabetes," she said.

"Fruit drinks, which are increasingly being consumed by the U.S. population, are not a healthy alternative to soft drinks, at least with regard to risk of type 2 diabetes," Palmer said. "Fruit drinks typically contain as many or more calories as soft drinks and, like soft drinks, may not decrease satiety to the same extent as solid foods."

In another study, British researchers led by Nita Forouhi, from the Medical Research Council Epidemiology Unit at the Institute of Metabolic Science of Addenbrooke's Hospital in Cambridge, collected data on 21,831 healthy middle-aged men and women who did not have diabetes. Over the 12 years of the study, 735 people developed diabetes.

To determine how much fruit and vegetables these people ate, the researchers measured blood levels of vitamin C, which serves as a marker for the amount of fruits and vegetables eaten.

"We have found that eating greater amounts of fruits and vegetables is associated with lower risk of future type 2 diabetes," Forouhi said.

For people with the highest blood level of vitamin C, the risk of developing diabetes over 12 years was reduced by 62 percent, compared with those with the lowest levels of vitamin C, Forouhi said. "We also found an association of eating fruit and vegetables with lower risk of diabetes, with a 22 percent reduction of risk of future diabetes in the highest compared to lowest intake of fruits and vegetables," she said.

Eating even a small quantity of fruit and vegetables is good for you, Forouhi said. "Eating some fruits and vegetables is still better than none. In addition, the association of fruits and vegetables with reduced diabetes risk gets stronger progressively with the amount of fruits and vegetables eaten -- the more that you eat, the greater the potential benefit," she said.

In a third study, Lesley F. Tinker, from the Women's Health Initiative at the Fred Hutchison Cancer Research Center in Seattle, and colleagues found no significant reduction in the risk of developing diabetes among women on a low-fat diet. However, the low-fat diet did increase weight loss, which can result in fewer cases of type 2 diabetes.

For the study, Tinker's team collected data on 48,835 post-menopausal women who were randomly assigned to a low-fat diet, which contain more fruits and vegetables and whole grains, or to a continuation of their usual diet. The researchers found that 7.1 percent of the women on the low-fat diet developed diabetes compared with 7.4 percent of the women who continued their usual diet.

Women on a low-fat diet lost about 4.2 pounds more weight during the study than women on a regular diet, the researchers noted.

"Modest weight loss, rather than macronutrient composition, may be the dominant predictor of reduced risk of diabetes," Tinker said. "The beauty of a low-fat diet that includes lots of vegetables and fruits is that it is sustainable," she said.

Dr. David L. Katz, director of the Prevention Research Center at Yale University School of Medicine, thinks that these studies confirm that diet is an important component of producing the risk of diabetes.

"An excess of simple sugar tends to be bad for health and to promote both weight gain and the development of diabetes," Katz said. "An abundant intake of fruits and vegetables defends health and defends against diabetes."

In addition, portion control helps prevent obesity, and by so doing, helps prevent diabetes, Katz said. "The power of diet has been well-established in both diabetes control and prevention. The Diabetes Prevention Program demonstrated a 58 percent reduction in the occurrence of diabetes in high-risk adults with a balanced, wholesome, mostly plant-based diet in combination with regular physical activity," he added.

Dr. Mark N. Feinglos, chief of Endocrinology, Metabolism, and Nutrition at Duke University Medical Center, and author of an accompanying editorial, no specific food by itself increases the risk for diabetes, rather it's eating too much and gaining too much weight.

"But it's clear that high fructose corn syrup is not a good actor, and it's everywhere now," Feinglos said. "People who have a lot of beverages with high fructose corn syrup are not compensating by having fewer other calories, and it may not function to allow you to feel full, he said. "High fructose corn syrup may also cause liver problems and insulin resistance."

"At this point, all we can say is -- calories trump everything," he said. "All these high-density, empty calorie foods that are adding to the caloric load of the population and making it heavier are the real culprits."

In another study in the same journal, John M. Jakicic, from the University of Pittsburgh, and colleagues found that exercise, as well is diet, is important in maintaining weight loss.

The researchers found that among a group of women who all had lost about 10 pounds, only about 25 percent maintain their weight loss. Moreover these were the women who exercised about 55 minutes a day five days a week.

"This clarifies the amount of physical activity that should be targeted for achieving and sustaining this magnitude of weight loss, but also demonstrates the difficulty of sustaining this level of physical activity," the authors wrote.

More information

For more about diabetes, visit the American Diabetes Association  .

THURSDAY, June 5 (HealthDay News) -- Diabetes doubles the risk of liver cancer in patients with chronic hepatitis C with advanced fibrosis, or cirrhosis, a Dutch study reports.

Researchers at the Erasmus MC University Medical Center in Rotterdam analyzed data on 541 European and Canadian patients with chronic hepatitis C with advanced cirrhosis. Of those patients, 85 had diabetes. Patients with more severe fibrosis were more likely to have diabetes.

"The prevalence of diabetes mellitus was 10.5 percent for patients with Ishak fibrosis score 4, 12.5 percent for Ishak-score 5 and 19.1 percent for Ishak-score 6," the researchers wrote.

The patients were followed for a median of four years. During that time, 11 patients with diabetes and 27 patients without diabetes developed liver cancer. The five-year liver cancer occurrence rate was 11.4 percent and 5.0 percent, respectively. The study also found that being male and older were significantly associated with increased risk of liver cancer.

Among patients with diabetes, there was a trend toward higher liver cancer risk as fasting glucose levels increased, which suggests that hyperinsulinemia might explain the increased liver cancer risk among diabetic patients, the study authors suggested.

Whatever the mechanism, it's clear that diabetes increases the risk of liver cancer in patients with chronic hepatitis C and advanced cirrhosis, the researchers concluded.

The study was published in the June issue of the journal Hepatology.

The American Liver Foundation has more about liver cancer  .

MONDAY, May 19 (HealthDay News) -- Diabetics with high blood pressure have only a 50-50 chance that their doctors will change their medications as needed or offer other treatment, a new study finds.

Treating high blood pressure in people with diabetes is very important, because elevated pressure can lead to increased risk for heart attack, stroke and kidney problems associated with diabetes, the researchers explained.

"We wanted to understand when doctors would respond to an elevated blood pressure, by changing the patient's medication or scheduling a very close follow-up," said lead researcher Dr. Eve Kerr, an associate professor of internal medicine at the University of Michigan Medical School.

"We found that primary-care providers change treatment for blood pressure about 50 percent of the time. Fifty percent is actually higher than what has been found in previous studies. Many studies have found treatment changes only 20 to 30 percent of the time," said Kerr, who's also with the Center for Clinical Management Research at the VA Ann Arbor Healthcare System in Michigan.

The report on high blood pressure, which is also called hypertension, is published in the May 20 issue of the Annals of Internal Medicine.

For the study, Kerr and her colleagues collected data on 1,169 people with diabetes who received care from the U.S. Veterans Administration during a one-year period. The patients were seen at nine different sites in three states.

At the start of the study, all patients had high blood pressure, which is defined as 140/90 mm Hg or higher. The blood pressure goal for people with diabetes is 130/80 mm Hg.

Among the patients in the study, 49 percent had their blood pressure treatment changed during a clinic visit. The change consisted of either a new medication, a change in dose of a current medication, or a plan to follow up within a month.

"In many ways, blood pressure is getting more attention in diabetic patients than it has in the past, which is a very good thing," Kerr said. "But unfortunately, we found that many providers did not have a systematic approach to determining when a blood pressure was truly elevated and when medication should be changed."

She noted that many doctors in the study only took one blood pressure reading during a patient's visit. In some cases, when more than one reading was taken, the results weren't compared. Also, many doctors didn't take into consideration home blood pressure measurements reported by the patients.

"Without clear guidance as to how to incorporate those additional blood pressure measurements into the decision-making, it could lead to inadequate treatment of hypertension," Kerr said.

Dr. Lawrence S. Phillips, who's with the Emory University School of Medicine Division of Endocrinology and wrote an accompanying editorial in the journal, thinks doctors need to be more aggressive in treating blood pressure.

"Hypertension is a treatable problem that has a major impact on health," he said. "It's the most important health problem about which we don't do as well as we could."

One of the main problems is that doctors don't start or change therapy as often or as aggressively as they should, Phillips said. "We call that 'clinical inertia,'" he said.

Phillips thinks doctors should intensify treatment every time blood pressure is high. And blood pressure should be the first thing doctors look at during a patient's visit, and it should be treated before moving on to other problems, he said.

Patients can play a role, too, Phillips added. "Patients should ask their providers: What is my blood pressure goal? Am I at goal? If I am not, what should we do about it?" he said.

More information

To learn more about diabetes and high blood pressure, visit the American Diabetes Association  .