May 26, 2015

More Evidence that Gastric Bypass is NOT a Cure for Diabetes

There is so much money in selling gastric bypass that it is no surprise that surgeons have talked a lot of family doctors into believing that this risky operation will cure their patients of Type 2 diabetes. Now yet another study documents exactly how this is not true and what the real risks of the procedure are for people with diabetes.

 The study is reported here: Gastric bypass helps treat diabetes, but has risks. The actual study is found here: Roux-en-Y gastric bypass for diabetes (the Diabetes Surgery Study): 2-year outcomes of a 5-year, randomised, controlled trial

The meat of the report is in this statement: "'Some doctors had thought that gastric bypass could cure diabetes, but that did not happen for most of our patients,' said coauthor Dr. Charles J. Billington. 'Also unexpected was the extent of complications in the bypass patients,' said Billington, of the endocrinology and diabetes division at the University of Minnesota, Minneapolis."

Two years after the surgery, 75% of the people who had the surgery achieved A1cs below 7% (though exactly how much lower is not disclosed.) The serious side effects included severe infections and nutritional deficiency bad enough to produce fractured bones.

Note that this study only reported the results at 2 years after the surgery. The study is meant to last 5 years. By then, if their results are similar to others I've reported on in previous blog posts, most of the subjects with diabetes will have seen their blood sugars revert to diabetic levels. Some previous studies are reported here:
No, WLS Does NOT Cure Diabetes--Study By Doctor with Conflict of Interest

and

The REAL Truth about Gastric Bypass's Supposed "Cure" of Type 2 Diabetes

Contrary to what surgeons suggest, there is no permanent physiological change caused this surgery that heals diabetes. All it does is make it so that people can't eat very much carbohydrate at one time. As we know, the less carb you eat, the lower your blood sugar. By forcing people to eat less carb, the surgery will lower blood sugar.

But over time the stomach stretches out and people who have had this surgery but were not told the connection between carbohydrate intake and blood sugar levels will eat more carb and become diabetic again. But this time they will be diabetic with severe nutritional deficiencies, since this surgery prevents the normal absorption of important minerals and nutrients.

When assessing any claim for surgery, be aware that unlike drugs which must go through a lengthy process of clinical trials and FDA approval before they may be sold surgeries can be performed by any physician, with the only limiting factor being whether or not insurers will pay for them. Even when insurers won't pay for them, sleazy doctors can still do surgeries on patients willing to pay the bills themselves.

In this loosely regulated system, there is no control over what surgeons can claim about their surgeries and as we can see here, it takes many years until any studies are done to determine if any of the surgeons' claims are true.

There is no question that weight loss surgery does reduce weight, but if you are considering this risky surgery mainly to cure your diabetes, try cutting back on your carbs for six months first. How well you do with that approach will give you a very good idea of how well you'll do with the surgery--during the first year or two when you can't eat much carbohydrate even if you want to.

You can learn how to lower your blood sugar to normal levels with diet HERE.

March 27, 2015

Study Discovers How Avandia and Actos Stimulate Brain to Increase Hunger and Weight Gain

A new study casts new light on a new reason why the TZD drugs, Avandia and Actos, pack weight on people. This was a side effect that many patients complained about quite vocally online, but doctors insisted it was not caused by the drug. It was.

Medical News Today: Study finds why drug for type 2 diabetes makes people fat

I wonder what else stimulates those brain receptors. So many of us struggle with hunger that is physiological in origin. Sadly, too many of us take it personally and blame ourselves for moral weakness.

Remember, most of the time, hunger is a symptom. When you feel hungry, you need to do detective work to find out what is causing that hunger. If it is irrational, consider the medications you are taking.

My guess is that for some of us fluctuating blood sugars also stimulate receptors like these in the brain which is why people with Type 2 Diabetes so often get fat when their blood sugars first get out of control--at levels that do not show up on doctor's crude blood sugar tests.

January 28, 2015

Updates: Inhaled Insulin on Market, Diabetic Mouse Studies Discredited, GI Index too

I haven't posted in a while, but there are three news-worthy items that need attention.

1. Afrezza, the super-fast-acting insulin I wrote about after it got FDA approval last year is finally on the market. I discuss it on this new web page: Afrezza - Inhaled Insulin. If you try Afrezza, please email me a report at mailto:jruhl9999-d12@yahoo.com with a title, "Afrezza report." You can also post about it in the comment section here.

Note: Many people have been emailing me that they are having trouble replying to this blog. It is a Google problem. Usually using Explorer for your browser will fix it.

2. Diabetic Mice: I've never been a fan of mouse research. Now a disturbing new finding confirms just how flawed it has been.  It turns out that the engineered mouse model for diabetes that has been used in 250+ studies also has an abnormal human growth hormone gene that causes the mouse to have extremely abnormal levels of that hormone, which causes them to produce insulin in a highly abnormal fashion.

Mainstream scientists are calling these "tainted mice."

You can read the details here:  Medical News Today: Diabetes Research Takes an Unexpected Turn

3. The Glycemic Index. Research has found that the Glycemic Index is uselss for people for diabetes. I've discussed that at length, HERE.  Now it turns out, it's also useless for normal people. Carbs, it turns out are carbs for them, too. Fast or slow, doesn't matter. Eating lower GI foods did not produce better health outcomes.

Ignore the headline and read the report here: Glycemic Index Shouldn't Concern People Without Diabetes

Bottom line, the Glycemic index shouldn't concern ANYONE. It's junk science made popular by grain companies afraid of losing customers to healthier, lower carb diets.

December 3, 2014

ACCORD Final Analysis: Lowering Blood Sugar Improves Heart Disease Outcomes

This paper, Effects of intensive glycaemic control on ischaemic heart disease: analysis of data from the randomised, controlled ACCORD trial, was published by the Lancet last week,

After analyzing the data from the ACCORD study including data from a few years of follow-up, the researchers concluded that lowering A1c resulted in fewer heart attacks, revascularizations (i.e. coronary bypass operations or placements of stents), and unstable angina. The researchers summarized their findings saying,


"Raised glucose concentration is a modifiable risk factor for ischaemic heart disease in middle-aged people with type 2 diabetes and other cardiovascular risk factors." This means you can change that risk by lowering your blood sugar.

You did not see this paper reported in your newspaper, and it is possible your doctor won't see it in his diabetes-related newsletter, either, because it doesn't sound like major news.

But it is very major news, because ACCORD study was the study that, when it was first published in 2008, was interpreted as showing that lowering A1c was dangerous. This was because slightly more people in the "intensive intervention" arm died of heart attacks than did people in the arm of the study who didn't strive to get A1cs of 6.5% or better.

As we blogged years ago, this original conclusion--that lowering A1c could prove fatal--turned out to be a classic case of poor data analysis.  It turned out that the people in the "intervention arm" of the study who had those excess heart attacks were people who though they were were supposed to be lowering their blood sugar had not done so.

Now, as you would expect, better analysis of the ACCORD data shows that lowering blood sugar most definitely does improve cardiovascular health.  This is exactly what we would expect to find, as there is plenty of other evidence from unrelated studies that as A1c rises out of the 5% range the risk for cardiovascular disease starts to rise steeply. You can read summaries of many of these studies HERE.

But the tragedy here is that, back in 2008, endocrinologists who should have known better took the original ACCORD report to mean that lowering your blood sugar below 6.5% is dangerous. And because fo this belief, they actually discouraged their patients from lowering their blood sugars to the levels that it turns out would have protected them from harm.

This is now a huge problem people face when asking doctors to help them achieve tighter control. I have heard from several people with diabetes who have been censured by their doctors for achieving A1cs below 6.5%.  I have also heard from others who were refused treatment that could lower A1cs of 7.0% and post meal numbers shooting into the 200 mg/dl range after meals because their doctors believed that intensive lowering of any kind would be dangerous.

If you fall into this category, or if you are not getting the support you need from your doctor to help you achieve a better blood sugar result, print out the abstract of the Lancet article above and bring it to your next doctor appointment.

Just remember that it isn't enough to lower your blood sugar. You have to do it using dietary approaches and drugs that have a long track record of safety. Cutting carbs works for most people and has been shown to be safe. But right now, only a few diabetes drugs that stand up to my rigorous standards for safety. They are:

metformin
acarbose
gliclazide (not available in the U.S.)
repaglinide
insulin

Other drugs like Glyburide, Januvia, Byetta, Actos, and Invokana, along with the many other drugs in the families as these drugs may be very effective for lowering blood sugar, but they lower blood sugar using mechanisms that may over a long period of time harm your body. Januvia and Byetta appear to cause pancreatitis, and may raise the risk of cancer, and alter the immune system. The sulfonylurea drugs like glyburide, glipizide, and glibenclamide stimulate a heart receptor and  increase the risk of heart attack. The drugs like Actos raise the risk of heart failure and osteoporosis. Invokana and related drugs cause urinary tract infections and may cause cancer.

You can learn more about the specific safety issues of the many drugs now prescribed for diabetes at the Drugs page of the main Blood Sugar 101 web site.

So stick to the safe drugs and dietary interventions to lower your blood sugar to as normal a level as you can attain.  Ideally an A1c near 5% is best, but many of us can't achieve them. (I sure can't!) A1cs anywhere in the 5% range are a huge improvement and should give most of us normal health. Keeping your blood sugar under 140 mg/dl as much as possible at all times no matter what your A1c is probably the very best way to protect your arteries and avoid heart disease.


November 19, 2014

New One Hour Kindle Short Read: Low Carb Problems Solved

Quite a few people have commented that my full-length book, Diet 101: The Truth About Low Carb Diets gives them more information about the science and studies backing up low carb diets than they want to read.

So for those dieters, I have put together an action-oriented, just-the-facts, Kindle short read that concentrates on the main problems low carb dieters encounter and explains how to solve them. It is designed to be read in roughly an hour.


If you already have Diet 101, you don't need this new book. But if you know people who might benefit from a simpler, less technical discussion of the many issues that arise when people try to diet on low carb diets, let them know about this new book. They'll find it helpful!

You can download this book from Kindle here:

Low Carb Problems Solved: Say Goodbye to Stalled Weight Loss, Failed Maintenance, and Poor Blood Sugar Control (Blood Sugar 101 Short Reads Book 2)