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By Nancy Lapid, Health Science Editor

Hello Health Rounds readers! October is one of the busiest months for medical conferences, and today we highlight presentations from two of the largest. At the European diabetes meeting (EASD 2023), researchers suggested the blood test threshold for diagnosing the disease may need to be lowered in young women, while a separate team reported that testosterone replacement may help control the disease in men. Meanwhile, at a radiation oncology meeting in San Diego (ASTRO 2023), researchers reported that the course of radiotherapy in breast cancer patients following mastectomy and immediate placement of implants can be shorter than it is now.

(For more news from these meetings, look for hashtags #EASD2023 and #ASTRO23 on social media.)

In breaking news, see these stories from our Reuters journalists: 

Court tosses $223.8 million verdict against J&J in talc cancer case; dozens of Jamaican kids hospitalized after eating cannabis rainbow candy; U.S. appeals court weighs challenge to Pfizer diversity fellowship; French agency curbs weedkiller use due to children’s health concerns; and drugmakers sign on, under protest, to negotiate Medicare prices.

Blood loss in menstruating women may complicate the diagnosis of type 2 diabetes, new research suggests. REUTERS/Stefan Wermuth

The threshold for diagnosing type 2 diabetes should be lowered in premenopausal women as blood test results for the condition may be skewed by menstruation, a new study suggests.

Diagnosis of type 2 diabetes is primarily based on a test that estimates the average blood sugar level over the past three months by measuring how many sugar molecules are attached to oxygen-carrying hemoglobin A1c (HbA1c) molecules.

But blood lost during menstruation carries with it those sugar molecules, the researchers noted in a presentation on Saturday at the annual meeting of the European Association for the Study of Diabetes (EASD) in Hamburg.

When they analyzed HbA1c test results from more than one million British adults who had not been diagnosed with diabetes, levels in women under age 50 were consistently lower than in men of similar ages, they found.

At the current HbA1c cutoff for a diagnosis of diabetes – 48 mmol/mol, or 6.5% – 50% fewer women would be diagnosed with type 2 diabetes than men in that age group, according to the study.

“A cut point for diabetes mellitus that does not account for gender differences in diabetes could potentially lead to underdiagnosis of diabetes mellitus in women and missed opportunities for intervention,” the researchers said.

If that threshold were lowered slightly to 46 mmol/mol (6.4%) for women under age 50, an additional 35,345 currently undiagnosed women in England would be reclassified as having type 2 diabetes and could receive treatment to improve their health outcomes, the researchers said.

The results were also published in Diabetes Therapy.

Testosterone replacement therapy helps control blood sugar levels in men with type 2 diabetes, new data suggests.

Around 40% of men with type 2 diabetes have symptoms of testosterone deficiency. Doctors, however, have been slow to prescribe hormone replacement despite recent large studies showing the treatment does not increase cardiovascular risks, researchers said on Tuesday at the EASD meeting in Hamburg.

The study involved 428 men with diabetes and testosterone deficiency in eight countries. After three months of testosterone replacement with injections or gels, average HbA1c had fallen by 2.6 percentage points, researchers found.

After 12 months, average HbA1c had fallen by 3 percentage points, and after two years it had dropped by 3.6 percentage points.

These results, which align with findings from other, smaller studies, the researches said, may encourage doctors to “ask patients with type 2 diabetes about their symptoms and investigate and diagnose testosterone deficiency appropriately and treat them with testosterone where indicated.”

A three-week course of radiation therapy after mastectomy and immediate breast reconstruction instead of five weeks may provide the same protection against breast cancer recurrence, according to new research.

The shorter radiation course could also substantially reduce life disruptions and financial burdens, researchers reported on Sunday at the American Society for Radiation Oncology (ASTRO) annual meeting in San Diego.

The trial results suggest that giving the same total amount of radiation in higher amounts at fewer appointments “can safely be used in this setting without compromising efficacy or increasing side effects,” study leader Dr. Rinaa Punglia of Dana-Farber Brigham Cancer Center in Boston said in a statement.

For the study, 400 patients with stage 0 to stage III breast cancer who underwent mastectomy and immediate placement of a tissue expander or implant and who required postoperative radiation were randomly assigned to receive the treatment over five or three weeks.

With half of the patients followed for more than 40 months so far, there was no difference between the groups in rates of cancer recurrence, the researchers found.

The shorter course of treatment did not reduce the risk of radiation-related side effects, such as formation of scar tissue around the breast that causes hardness and asymmetry.

The shorter course of radiation therapy did, however, reduce the burden on patients.

“These patients have already had so much treatment, including chemotherapy and a lot of surgery,” Punglia said. “They underscored for us in survey responses how onerous it was for them to have five weeks of treatment.”

This newsletter was edited by Bill Berkrot.

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