TIME ebola

Woman’s Remains in New York Test Negative for Ebola

Nurses from the New York State Nurses Association protest for improved Ebola safeguards, part of a national day of action, in New York
Nurses from the New York State Nurses Association protest for improved Ebola safeguards, part of a national day of action, in New York City November 12, 2014. © Mike Segar—Reuters

She had arrived from Guinea about three weeks earlier

The remains of a woman in New York who died while under observation for potential Ebola exposure have tested negative for the virus, health officials said Wednesday.

The woman arrived from Guinea, one of the three nations hit hardest in the Ebola outbreak in West Africa, nearly three weeks ago and was being monitored out of “an abundance of caution” because her trip fell within the virus’ 21-day incubation period, the New York Times reports. She had shown no symptoms for the disease.

She was one of some 300 people being monitored by New York City as a potential case. The city’s sole diagnosed case to date, Dr. Craig Spencer, was successfully treated and released.

[NYT]

TIME Diet/Nutrition

How Trans Fat Eats Away at Your Memory

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Eating lots of trans fats has been linked to memory impairment

What’s the opposite of brain food?

Trans fat, finds a new study presented at the American Heart Association’s Scientific Sessions 2014. Eating a lot of the compound that magically rejuvenates junk food that should have expired long ago is linked to higher rates of memory impairment.

After analysis of food questionnaires and memory tests from about 1,000 adult men, trans fat intake was linked to worse memory in people under age 45, even after controlling for mind-influencing factors like age, depression and education. Every gram of trans fat eaten per day was linked to 0.76 fewer words recalled. Put another way? Those who ate the most trans fat remembered 11 fewer words.

MORE: 7 Foods That Wouldn’t Be The Same If Trans Fats Are Banned

That relationship eased when researchers adjusted for BMI and blood pressure, and a study like this can’t prove cause and effect. But the study author believes trans fat may be contributing to oxidative stress, a cell-damaging process. Trans fat appears to be a pro-oxidant: the opposite of an antioxidant. And indeed, prior research from the study’s lead author, Beatrice A. Golomb, MD, PhD, professor of medicine at the University of California-San Diego, found that antioxidant-rich chocolate is linked to better word recall.

We’re not eating as much trans fat as we used to: a recent study found that between 1980-2009, we cut down on trans fats about 35% thanks to regulations and reformulations. Still, trans fat is the bane of every health nut’s label-reading experience—it travels under sneaky ingredient adjectives like “partially hydrogenated” and can even creep into foods labeled “0 grams of trans fat.”

But as hard as it is to figure out whether or not your snack contains trans fat, what the compound does to your brain is even more cognitively complex. “From a health standpoint, trans fat consumption has been linked to higher body weight, more aggression and heart disease,” Golomb said in a press release. “As I tell patients, while trans fats increase the shelf life of foods, they reduce the shelf life of people,” Golomb said.

Read next: The Surefire Way To Eat Healthier

TIME Research

How to Survive a Spaceship Disaster

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One of the most dangerous parts of an astronaut’s journey is the very beginning

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Falling from ten miles up, with no spacesuit on, in air that’s 70 degrees below zero and so thin you can hardly draw breath…Conditions were not ideal for Peter Siebold, a test pilot flying on Virgin Galactic’s SpaceShip Two, to survive. But he did. Siebold told investigators that he was thrown from the plane as it broke up, and unbuckled from his seat at some point before his parachute deployed automatically. It’s unclear at this point why the same thing didn’t happen for his copilot, Michael Alsbury.

Now, as spaceflight goes commercial, the destruction of both Spaceship Two and the Antares unmanned rocket is likely to bring the eyes of federal regulators back towards an industry that has until now enjoyed minimal red tape. The Commercial Space Launch Amendments Act, first passed by Congress in 2004, was designed to encourage innovation by keeping the rules not so stringent for the fledgling private space industry. But “the moratorium [was designed to] be in place until a certain date or the event of the first death,” Joanne Irene Gabrynowicz, editor-in-chief of the Journal of Space Law, told the MIT Technology Review. “Unfortunately, the first death has now occurred, and the FAA will likely revisit the need for regulations, if any.”

A Virgin Galactic spokesperson said in an email that the company couldn’t comment too broadly about the escape mechanisms for its spacecraft, due to the pending investigation. The spokesperson did confirm there are two exits from the cabin, but said that “specific design elements of the passenger cabin and spacesuits are still being developed and have not been made public.”

Since the earliest days of the space program, researchers have tried to develop realistic ways to provide astronauts with an emergency exit. But in an emerging field of such complexity, what mechanisms are plausible…and practical? Here’s a brief history of the effort so far.

Condition One: Failure To Launch

One of the most dangerous parts of an astronaut’s journey is the very beginning. To maximize the chance of survival during a launch, most spacecraft from the Mercury project onwards have incorporated a launch escape system (LES), which can carry the module containing the human crew away from a sudden threat to the rest of the craft—either while still on the launch pad, or during the initial ascent.

The Apollo LES was powered by a solid fuel rocket. At the first sign of trouble (transmitted by the loss of signal from wires attached to the launch vehicle), the LES would fire automatically, steering the command module up and away from danger, then jettison and allow the module to open its parachute and land. A similar principle lies behind the launch escape mechanisms used for Russia’s Soyuz capsules and the Shenzhou capsule used by the Chinese space program. The Orion spacecraft, NASA’s next generation of manned craft in development, also features an LES mounted on top of the craft, called a Launch Abort System.

On the private industry side of LESs, SpaceX’s Dragon capsule incorporates the rocket motors of the escape mechanism into the sides of the capsule itself, instead of mounting the LES on top. Since the LES isn’t discarded after launch, this “pusher” method provides the capsule with emergency escape capability throughout the entire flight—something the Space Shuttle and Apollo crafts never had, the company notes. (The drawback is that, if unused, all that fuel for the escape system is extra weight to carry around). Testing Dragon’s abort system both on the launch pad and in flight is something SpaceX expects to have done by January.

Using one of these devices is no picnic. Orion’s LAS was estimated to put about 15.5 Gs of force on an astronaut—more than a fighter pilot experiences, but a little alleviated by the fact that the astronauts are lying on their backs. “They’ll feel the effects,” Orion’s launch abort systems director Roger McNamara told Space.com, but “the bottom line is they’ll be walking away.”

Condition Two: Disaster In Orbit

In the 1960s, General Electric tested an emergency inflatable device called MOOSE (Manned Orbital Operations Safety Equipment, but originally Man Out Of Space Easiest) that was basically a small rocket motor attached to a six-foot-long polyester bag equipped with a heat shield, life support system, radio equipment and parachute. After a space-suited astronaut exited his or her space vehicle and climbed into the bag, he or she would activate pressurized canisters that filled it up with polyurethane foam.

More recently, NASA explored a new escape pod design called the X-38, a 7-person lifeboat designed to provide an escape route for astronauts on the International Space Station (say in case the Soyuz space capsule were damaged, or made unavailable because of political infighting, or hijacked by Sandra Bullock). This design made it as far as test flights, but was scrapped in 2002 over budget concerns.

Condition Three: Extraterrestrial Rescue

What if a disaster trapped astronauts on the moon? To prepare for that contingency, NASA worked on designs for unmanned Gemini Lunar Rescue Vehicles that could scoop up a marooned crew of two or three astronauts from the lunar surface, or from orbit around the moon. But funding cutbacks during the Apollo program prevented the agency from fully exploring these designs.

Condition Four: Trouble With The Landing

NASA’s space shuttles had an inflight escape system to be used only when the orbiter could not land properly after reentering orbit, which used a pole that extended out from one of the side hatches. The astronauts would hook themselves to the pole with a Kevlar strap and then jump out, allowing the pole to guide them out and underneath the left wing of the spacecraft. However, for this exit system to work, the space shuttle would have to be in pretty good shape, capable of staying in controlled, gliding flight. You can see the pole being used in this test footage here:

This article originally appeared on World Science Festival.

TIME Diet/Nutrition

How Much Arsenic Is In Your Rice?

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Why you might want to lay off the rice milk

All rice and rice products are not created equal, according to a new study released today by Consumer Reports. Some types of rice, and some rice grown in specific regions, contain much higher levels of inorganic arsenic (IA) than others.

The report, available online and in the January 2015 issue of Consumer Reports magazine, offers new information to consumers who were left with questions after a 2012 report revealed measurable levels of arsenic in more than 60 rice samples. Arsenic exposure, especially long-term and at high levels, can lead to higher rates of skin, bladder and lung cancer, and heart disease.

For the latest findings, scientists at the Consumer Reports Food Safety and Sustainability Center tested 128 samples of white, basmati, and jasmine rice for arsenic levels. They combined these results with tests and data from the original 2012 study, along with data from tests done by the U.S. Food and Drug Administration (FDA). The total number of samples tested was 697.

The results show a clear connection between geography and toxicity. Basmati rice from California has the lowest arsenic levels. Rice from Texas, Arkansas, and Louisiana tend to contain the highest levels of IA. White basmati rice from California, India and Pakistan, and sushi rice from the U.S., on average, have half the IA of other types.

In a surprising twist, brown rice has 80 percent more arsenic than white rice of the same type since arsenic accumulates in the grain’s outer layers. Brown rice from California, India, or Pakistan are the best choices in this category, according to the report. Contrary to what one might think, organic, in this particular case, doesn’t mean safer; organic rice sucks up arsenic at the same levels as conventional rice of the same type.

The report also establishes a point system for consumers, which serves to guide people towards understanding what rice products have the highest amounts of arsenic and how to limit intake through serving size and consumption frequency.

In one example, it’s suggested that children consume rice pasta and hot rice cereal only once every two weeks as these products have higher point values.

Dr. Michael Crupain, a board-certified physician and associate director of the Consumer Safety and Sustainability Group, said that children are the most vulnerable population and should either consume certain products rarely, or, in the case of rice milk, never.

“Children younger than five should not drink rice drinks as a substitute for milk,” he explained, echoing the report’s findings.

Rice holds higher levels of arsenic than other grains and acts as one of nature’s “great scavengers of metallic compounds.” Unlike, millet or polenta, rice planted in arsenic-contaminated fields acts as a vacuum for the toxin. Inorganic arsenic, as opposed to the less toxic organic arsenic, which comes from minerals in the earth’s crust, was introduced into the water and soil through pesticides and drugs injected into animal feeds. The FDA rescinded approval for three of these drugs in 2013 after connections were found between poultry feces used as fertilizer on fields and elevated arsenic levels.

“Some parts of the country just have more arsenic in their soil than others,” Crupain explained. “Rice happens to be a plant that tends to take up arsenic when it’s present. It’s probably based on variety, different types of plants take on different amounts.”

Currently, the FDA does not have safety levels for arsenic in rice. The governmental organization has cautioned against making state-by-state or country-by country comparisons in IA levels for rice, citing the varying factors that can influence arsenic concentrations, such as soil composition, fertilizers, seasonal variability, and water-use practices.

In a statement to Civil Eats, FDA press officer Lauren Sucher said that the organization’s assessment of arsenic in rice remains a priority.

“Last year, the FDA released what we believe to be the largest set of test results to date on the presence of arsenic in rice and rice products, and we are planning to release a draft assessment of the potential health risks associated with the consumption of arsenic in these same foods,” she added.

Until then, the FDA and Consumer Reports have similar recommendations: Consumers should strive to maintain a balanced diet and eat a variety of grains. Parents should consider options other than rice cereal as a first solid food for their baby. Cooking rice in volumes of water five to six times that of the rice, and then draining the water, can reduce arsenic content, though this may also reduce the nutritional value of the rice.

The Consumer Reports study also analyzed arsenic levels in other grains. The data shows that quinoa, amaranth, buckwheat, millet, and polenta all contain lower IA levels, making them good alternatives. Bulgur, barley, and farro also contain negligible amounts of arsenic.

At the same time, food safety advocates like Dr. Crupain ultimately believe the government should set stronger standards.

“Consumers won’t have to make such difficult decisions about rice intake levels if we ensure that there is less arsenic in rice to begin with,” he said.

This post originally appeared on Civil Eats

TIME Developmental Disorders

Why Screening Young Children for Language Delays Isn’t Helpful

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Evidence to support language screening for all young children is weak

Doctors and new parents are eager to do everything they can to help young babies develop well. But the latest research shows that testing infants for signs of speech or language difficulties may not end up helping the young ones.

The U.S. Preventive Services Task Force, a government-appointed group of experts that reviews existing health and behavior data, analyzed the available studies on how effective screening for speech and language delays during infancy can be in improving children’s communication skills later. Most such screening is done by pediatricians during routine well-child visits and includes specific tests requiring parents to answer questions about their babies’ development, as well as the doctors’ own observations of the babies’ behavior and responses to verbal cues.

The task force reviewed 24 studies that looked at how accurate the most popular screening tools are. The trials involved children younger than five years old and revealed that the data is not strong enough to support using these studies as a reliable way to identify children who may have speech or language delays or who might have the early symptoms of language disorders.

The group came to a similar conclusion when it evaluated interventions designed to improve children’s development in speech and language areas. The studies showed inconsistent results and were of varying quality.

“There’s not enough evidence to say that these instruments should be used regularly,” says Dr. Alex Kemper, professor of pediatrics at Duke University and a member of the task force. “It could be that the instruments work well, and it could be that they don’t; we just don’t have enough evidence to say that all children ought to receive these tests at well-child visits routinely. We just don’t know whether or not they lead to benefit.”

In fact, the committee noted, the tests could contribute to harm, as the identification of potential problems could cause anxiety and result in time, effort and money spent by parents to address the problem. While an estimated 2.6% of children between ages three and five years received additional services for speech and language disabilities in 2007, the researchers say that many children who may be slower to develop speech or language skills eventually catch up and may not need specific services or interventions.

In his own practice, Kemper says that he employs the screening only when he or the parents of infants have concerns about a child’s language development. And that should be the guideline for other physicians and parents as well, he says—at least until stronger data can provide support for the idea of screening all infants, and for determining how to conduct the screening so that infants who need the most help can receive it.

TIME Mental Health/Psychology

The Most Surprising Tool for Transforming Your Body

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Mindset is the greatest fitness motivator

Want to know one of the best workout secrets I’ve learned? Attitude is everything. You’re either mentally in the game or you may as well be sitting on the sidelines. Not only does your attitude help motivate you, it’s the only tool that guarantees lasting results.

Ask any professional athlete: So much of their training is mental preparation. If pro athletes are not mentally pumped and focused on winning, they’re almost guaranteed to lose. But for those of us who aren’t pro athletes, no amount of encouragement from a trainer—or even an upcoming high school reunion—will help you achieve long-lasting results. But your attitude can.

Attitude, along with a motto, helps maintain a focus that is everlasting. It’s a simple theme that translates from pro sports to even the simplest children’s book. For example, in The Little Engine That Could, a long train gets stuck up a mountain only to be rescued by a much smaller engine who continuously repeats, “I think I can, I think I can.” Yes, the train was small, but mental prowess saved the day.

Here are 6 ways to improve your attitude and help you get in shape and stay there.

Get a motto and use it

Mindset is a powerful tool that can motivate and encourage big changes, along with lasting results. With the aid of a motivating motto, that little train did something none of the larger engines could achieve. The power of words can drive a person to completely change herself.

HEALTH.COM: 24 Motivational Weight Loss and Fitness Quotes

Value your mistakes

Altering your outlook will guarantee results if you stick with it. And if you get derailed from your goals of eating healthy and regularly working out (like many of us do), shrug it off and learn from your mistakes. Treat yourself with the same compassion you would offer a close friend. You’re human, cut yourself some slack—no one is perfect. If you happen to skip a workout or end up eating more pizza than you planned, dust yourself off and start fresh. Tomorrow is a new day.

Celebrate your victories

Remember that it’s important to set realistic goals when beginning a new workout regime. Celebrate the minor triumphs; one day they will become big ones. In my book, Strong Is The New Skinny, I encourage people to start a brag box where you can stash mementos and reminders of your greatest accomplishments (i.e. your first 5K race number). Your very own personalized brag box will be your greatest asset on days when you’re feeling unmotivated or like you’ve fallen off the wagon.

HEALTH.COM: 20 Ways to Stick to Your Workout Routine

Invest in yourself

No one will take care of you like you. So take care of yourself. Imagine the best version of yourself: physically, mentally, and emotionally. Keep that image alive in your mind as you continue to pursue your fitness goals.

Update your strategy

Just because you think of yourself as Xena, Princess Warrior once, won’t mean that every time you look in the mirror, you’ll see a powerful warrior glancing back. Sometimes you need to shake things up and re-strategize. Back in 2013, shortly after having a baby, I received a great opportunity to create and appear in a new Weight Watchers fitness DVD series–an experience I could not pass up. The only problem was I had just had a baby five months prior. I needed to motivate and fast! What did I do? I instantly took action. Besides eating wholesome foods, I changed my outlook, confident I could achieve my goal. The idea is to fake it till you make it, genuinely feeling strong and powerful until you ultimately get there.

HEALTH.COM: 14 Reasons You’re Always Tired

Visualize the new you

Take a minute and imagine how you’d look, move, and feel if you already had the strong, fit body you’ve always wanted. Stand tall, walk, run, or dance with assurance. Adopting a posture that suggests confidence can literally change our feelings, our behavior, and even our hormone levels, according to the research of Harvard Business School social psychologist, Amy Cuddy.

Not only did I improve my posture, but I also posted pre-baby photos all around my house in an effort to motivate myself back into shape. Everywhere I looked, I had visual reminders reaffirming that I, just like the Little Engine that could, was going to make it.

HEALTH.COM: The 25 Best Diet Tricks of All Time

This article originally appeared on Health.com

TIME ebola

India’s First Ebola Patient Has Been Quarantined

Man was already treated and cured in Liberia

An Indian resident who tested positive for Ebola—and was cured—has landed in Delhi from Liberia.

The 26-year-old man is being isolated in a facility at Delhi’s Indira Gandhi International airport, The Times of India reports.

According to the Times, the man had already been treated for Ebola in West Africa, currently does not have symptoms and tested negative for the virus before he flew. However, his semen tested positive for the virus.

He had a medical clearance certificate from the Liberian government saying the had been treated and was confirmed negative from blood tests—that would deem him Ebola-free, according to the World Health Organization and Centers for Disease Control and Prevention (CDC). His blood also tested negative in India. Semen can test positive after clinical clearance for up to three months, according to the CDC. The agency recommends abstinence from sex—including oral sex—for at least three months. If abstinence cannot be followed, the CDC recommends condoms to prevent disease spread.

The patient in India is being kept in isolation in a health facility at the airport until his semen tests negative.

It’s not likely that he poses a threat, given the negative test from his blood, but experts have long been concerned that a spread of Ebola in India could be devastating given the population size.

TIME Diet/Nutrition

The Surefire Way To Eat Healthier

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Why cooking cuts calories

There is a great deal of anecdotal evidence to suggest that cooking at home is better for our health. It’s also well known that eating convenience food is associated with poorer nutrition, obesity, and other metabolic diseases. Food experts, ranging from NYU professor Marion Nestle to author Michael Pollan and New York Times columnist Mark Bittman, have long argued that homemade meals belong at the center of a healthy diet.

Yet little research to date has focused on the relationship between how often people cook at home and the quality of their diets. A new study presented at the American Public Health Association annual meeting and published in the journal Public Health Nutrition provides strong evidence to support the connection.

“If a person—or someone in their household—cooks dinner frequently, regardless of whether or not they are trying to lose weight, diet quality improves,” write authors Julia Wolfson and Sara Bleich, researchers in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health. “This is likely due to the relatively lower energy, fat, and sugar contents in foods cooked at home compared with convenience foods or foods consumed away from home,” they explain.

Wolfson and Bleich analyzed data from the U.S. Centers for Disease Control and Prevention’s National Health and Nutrition Examination Study (NHANES) to find out whether the link between healthier diets and frequency of home cooking can be documented scientifically.

As part of the NHANES data gathered between 2007 and 2010, approximately 9,500 adults 20 and older were asked about their cooking habits. Researchers found that households that reported cooking dinner at home most frequently (6 to 7 times a week) consumed “significantly fewer” calories and ate better than those who relied more heavily on restaurant meals and frozen foods.

The researchers found that 8 percent of adults lived in households in which someone cooked dinner no more than once a week; 44 percent cooked dinner 2 to 5 times a week; and 48 percent reported cooking dinner 6 to 7 times a week. Compared to the low-cooking category, those in the high-cooking category consumer significantly more fiber, fewer carbohydrates, and less sugar.

“From first-hand knowledge, I know how much fat and salt can be in restaurant food, whether it’s fine dining or fast food,” said Wolfson, who worked for 10 years as a chef in restaurants in New York and Los Angeles. “The food is formulated for flavor, so health is not at the top of a list of concern.”

The same is often true for processed and pre-packaged meals, as Michael Pollan noted in his recent book Cooked. “Corporations cook very differently from how people do…” and “tend to use much more sugar, fat, and salt than people cooking for people do,” he writes.

What the study doesn’t reveal, Wolfson explained during her APHA presentation, is what people mean by “cooking.” While the NHANES data includes questions about frozen meals, including pizza, it doesn’t ask about other prepared ingredients, including those now available in most major supermarkets.

The researchers also found no significant relationship between cooking frequency and body weight. As they note, “not all cooking is healthy.” Additional questions remain about what obstacles might be keeping some cooks from cooking with fresh, whole ingredients.

At the APHA meeting, Wolfson presented some follow-up research suggesting that when it comes to cooking with fresh fruit and vegetables, income is a significant piece of the puzzle. Their research to date shows that people of lower income are buying and eating less fresh produce regardless of how often they cook at home.

While these findings are not necessarily surprising, the data will be important in improving “access to high quality ingredients and circumstances that allow people to cook,” and to how cooking is used as a strategy in combating obesity, Wolfson said.

This post originally appeared on Civil Eats.

TIME Health Care

How Prioritizing Women’s Health Can Lift Countries Out of Poverty

Countries can tap the potential of the world's historic number of youth and adolescents

There are currently 1.8 billion young people between ages 10 and 14, and about 600 million are adolescent girls. Their needs, if addressed, could help countries achieve rapid economic growth, according to a new report from the UN Population Fund.

The global community has never before been home to so many youth, and therefore so much untapped potential, the study says.

It’s possible to turn all that womanpower into prosperity. When it comes to international development, a country can experience accelerated growth during a period if its working-age population grows larger than its non-working age population, typically because fertility and mortality rates have dropped. This allows the country to become a more profitable society, a benefit called the “demographic dividend.” Given the high number of youth and adolescents today, the UN report says several countries are poised for this transition if they can ensure that their young people actually make it into the workforce.

Several factors can contribute to this transition, like increasing living standards and creating transparent regulatory environments, but one of the greatest factors cited by the UN report is if a country significantly prioritizes and invests in women’s health, including sexual health.

MORE: Why It Takes Teens Equipped With Condoms to Encourage Family Planning in Africa

As the report points out, about one in every three girls will be married by the time she turns 18—every day, 39,000 girls become child brides—and an estimated 33 million young women between ages 15 and 24 say they would use contraceptives if they had access to them. Unfortunately, contraceptive use among adolescent females is only 22%, due to limited availability. In many developing countries, once a woman is married off and starts having children, it’s often too difficult for her to enter the workforce, especially if she was married at a very young age and did not finish school. Getting pregnant at a young age also increases the risk of a dangerous pregnancy, once again raising the mortality rates for mothers and children.

“Child marriage, because it usually results in early pregnancy, is linked to deaths from complications of pregnancy and childbirth, and married girls are more likely than married women to suffer violence and other abuse at the hands of their husbands,” says the report.

The UN says that some of the most successful ways to make sure women are safe and can enter the workforce are to enforce their reproductive rights via family planning initiatives, to stop child marriage, prevent adolescent pregnancies, stop sexual and gender-based violence and expand access to education. If women can enter the workforce, they can contribute to their local economies.

Family planning programs not only empower women to determine their life’s trajectory, but they mean big payoffs for a country’s workforce and economy—something many countries still need to embrace.

TIME diabetes

Why 3 in 10 People with Diabetes Don’t Know They Have It

The surprising similarities between diabetes and HIV/AIDS

New research on diabetes suggests that nearly 30% of adults with diabetes remain undiagnosed—the same rate as people with HIV. And just like many HIV patients, only about 20% of diabetes patients are treated satisfactorily, finds the new study published in the Annals of Internal Medicine.

The study used the cascade of care method, which aggregates data on people’s treatment for a particular disease and has been used to guide treatment of HIV/AIDS. Study leaders say that the new diabetes research is the first time the method has been applied to another disease.

The research found a lot of similarities between the two diseases and how they’re managed. To start, the consequences can be grave for patients who don’t receive treatment for either disease. HIV/AIDS weakens the immune system and allows patients to develop other ailments, while diabetes can lead to problems with the kidney, heart and brain. Researchers showed where people with diabetes fall through the cracks on the path from the onset of a condition to the development of other serious illnesses. Millions aren’t diagnosed, more than a million people haven’t been to the doctor in years despite a diagnosis and millions of others don’t take the proper medication.

“As health care systems move from fee-for-service to fee-for-quality, something like the cascade can really aid in that shift and help both providers and patients be more motivated and spot the gaps and close the gaps in care,” said study co-author Mohammed Ali, an assistant professor at Emory University. Incentives could encourage both patients and health care providers to screen and then treat diabetes.

“They’re extremely similar because they both require patients to be extremely proactive in managing their own condition,” said Ali, specifically citing diet, exercise and taking medication. “If you’re a good patient, you’re actually going to prevent a lot of those diseases that come with diabetes and a lot of those bad outcomes that come with HIV.”

As electronic records make it easier for doctors to look at large sets of data, the cascade-of-care method has potential to aid in understanding where the health system has failed at treating diseases, Ali said.

“This should be easy to do for anything,” he said.

Corrected Nov. 11, 2014: This piece has been updated. An earlier version of the story mischaracterized statements from Ali.

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