March 10, 2011

Research Round Up

Here are some more items I've collected over the past few months that don't justify a separate post but are still of interest. Click on the link to see the study.

  1. Users of DPP-4 Inhibitors (i.e. Januvia and Onglyza) report far more infections than metformin users, especially respiratory infections which were twelve times more likely. This is not surprising, DPP-4 plays a significant role in the immune system and turning it off modifies how the immune system works.
  2. Alpha cells secrete glutamate that damages beta cells. There have been several intriguing studies recently that suggest that an imbalance between the alpha cells that secrete glucagon, the hormone that raises blood sugar, and the insulin-secreting beta cells may play a part in causing diabetes. Keep an eye on this topic for further developments.
  3. WHI finds NO relationship between blood Vitamin D levels and the later development of Type 2 diabetes in older women over a 7.3 year period. More cold water thrown on the latest fad cure-all. There may be reasons to normalize vitamin D levels, but I have been able to find zero evidence that preventing or improving diabetes is among them.
  4. Whole fat dairy consumption lowers insulin resistance, raises HDL and correlates with "a substantially lower incidence of diabetes." The researchers who discovered this, by analyzing data from the 3736 adults studied in the Cardiovascular Health Study, appear to have been so disturbed by the implications of their study that they gave it a title that will keep anyone from noticing what they found, which is that eating butter and cream will improve your cardiovascular health.
  5. Yet another study finds that A1c is a much better predictor of heart attack than a diabetes diagnosis or other "many other established risk factors" [i.e. cholesterol. "Every 1% increment [over 5.4%] independently predicts a 19% higher odds of MI [myocardial infarction, i.e. heart attack] after accounting for other MI risk factors including diabetes."

  6. Higher saturated fat intake slows the progression of coronary artery disease in post-menopausal women. Carbohydrate intake speeds it up. In addition, "polyunsaturated fat intake was positively associated with progression when replacing other fats (P = 0.04) but not when replacing carbohydrate or protein. Monounsaturated and total fat intakes were not associated with progression."

  7. Cortisone injections relieve pain of tendon problems in the short term but make them worse and more likely to recur long term. Tendon problems like frozen shoulder are a common diabetic complication. The evidence suggests that the best way to treat them is to leave them alone. They usually get better on their own in a few months. If they don't, my experience has been that acupuncture may help after the acute inflammation phase is over.
  8. If you don't wash your hands before testing your blood sugar wiping away the first drop of blood and using the second drop will be more accurate--but don't squeeze Shockingly, the journal "Diabetes Care" actually published a study this month that is useful to people with diabetes.
  9. Supplementation with Myo-Inositol may be very helpful in reducing insulin resistance and other characteristics of metabolic syndrome in post-menopausal women Don't go crazy with supplementation, based on this one study, since such studies are often paid for and skewed by companies selling the supplement, but keep alert to see if this finding is confirmed elsewhere.

18 comments:

Howard said...

Not sure why you thought none of these was worth a separate blog post. They are all important bits of research, and I will be reading the references you gave on all of them. I will look into #4 especially, and maybe cover that in my own blog. I have experience some problems with dairy myself, but there might be something I've missed in the research.

Gretchen said...

Note that in the postmenopausal women study, the women were on a "relatively" (whatever that means; I haven't read full text) low-fat diet:

"In postmenopausal women with relatively low total fat intake"

IOW, it may mean that you need a certain amount of dietary sat fat, and if you limit fat intake, you're not getting enough, although if you limit fat severely, you will synthesize saturated fat.

I think the "relatively low total fat intake" qualifier is important, because many people are citing this article to argue that the more fat you eat, the better. This may turn out to be true, but we don't know yet.

Jenny said...

Howard, When I do a post that concentrates on one study I try to link it to other studies or give some kind of commentary that goes beyond what is in the study. That takes time and these were studies that I feared if I didn't deal with them would never get written up.

Every year I have ended up purging off many dozens of bookmarks to studies I never get around to using, so this year I've decided to share the best of them with my readers.

One issue I face, though, after having written the blog and site for so long is that I don't want to overload people with more data than they can take in. The tenth study confirming something isn't worth putting into the relevant page on the main Blood Sugar 101 web site because readers are already overwhelmed and most people who come to this blog and site are brand new to the subject of diabetes and need to learn the basics.

I analyze traffic patterns closely to ensure that what I post here will be of the most use to the people who come who are overwhelmingly brand new to diabetes and looking for basic information rather than the kinds of intriguing details we oldtimers find fascinating.

Jenny said...

Gretchen,

The diet specified was reported as 30% fat. Taken in conjunction with the study reporting how dairy fat improves metabolic syndrome symptoms, it is intriguing. I believe there are other studies pointing in this direction, but this is exactly the kind of thing I don't have time (or frankly, inclination) to fully research.

Gretchen said...

I agree with you that it's intriguing, and I too don't have time to dig into this one study.

Many people on LC diets are eating 60% fat. Will the same be true for them?

We don't know. Time will tell.

Stephan said...

I've noticed that my BG readings are ~5 mg/dL lower after I wash may hands or use a second drop from the same site. Glad to see that confirmed by a study.

Trev said...

You are my knew godess of info! Thanks for all the snippits.

LHL said...

Thank you for a useful set of information - I like the round-ups as they often confirm things I noticed elsewhere in the media but didn't get time to follow up.

semsons.group said...

Jenny,

I recently discovered your site. I'm not diabetic, but I find the information you provide is outstanding for anyone concerned with health. I just would like to congratulate and thank you by the great service you are doing to many people lost in a jungle of miss-information.

Best.

Geoffrey Levens said...

"I've noticed that my BG readings are ~5 mg/dL lower after I wash may hands or use a second drop from the same site."

Anybody know which way the reading will be pushed by squeezing? I haven't tried a comparison because my meter is not that consistent to get a "real" reading; I just use it for keeping tabs on the overall trend.

Jenny said...

Supposedly squeezing will release interstitial fluid into the blood diluting it and making the reading slightly lower.

Geoffrey Levens said...

Thank you Jenny, that makes perfect sense.

V said...

Research in diabetes is important to help understand the disease and how it can be treated. For the most part, we would be so much better off to treat type 2 diabetes with diet and exercise adn use medications as a last resort. I'm not sure doctors stress the importance of a wholesome, lower carb diet for diabetics.

Liz H. said...

V, most doctors don't even MENTION a low carbohydrate diet for diabetics, and some doctors (unfortunately, probably many) even think (because they are so misinformed) low carb diets are "dangerous" - This is a huge problem.

Jenny said...

Liz H, The really tragic thing is that the same doctors who tell people that low carb diets are dangerous then send them off for weight loss surgery--a surgery that is known to kill significant numbers of people in the very short turn and many, many more by a decade after surgery thanks to the severe malabsorption sydnromes it can cause.

Or they prescribe Actos, a drug that we know causes heart failure in people who didn't have it when they started the drug as well and, after a decade or so, broken bones and macular edema.

Those, apparently, doctors think aren't dangerous. Can it have something to do with who profits from them?

jkim said...

The directions in my Accu-Chek Aviva and my WaveSense booklets say to gently squeeze your finger (after you've lanced) to assist the flow of blood so you'll get a blood drop. WaveSense cautions not to squeeze directly around the lanced area.

This seems to contradict the study.

Jenny said...

Most of us will have to squeeze gently, but not near the puncture, to get blood out. But you don't want to put a lot of pressure near the puncture to cause the fluid in the tissue to mix with the blood.

Or so I've been told. This is another of those things that may be old wives tales. There's no money to be made from studying it.

Hoop said...

Myo-inositol is great for blocking
or preventing panic attacks. To stop an attack, I take a "crazy" dose of bulk inositol at one heaping tablespoonful which a I recall was 18 grams. And heaping teaspoonful worked as preventative for panic attacks which is 6 grams of myo-inositol. If one looks at the panic attack/inositol research
it takes the above mentioned doses.
I've not figured out whether if
has an influence on my BG values.
Then again I am old guy not an
old gal.