May 1, 2013
Diabetes News Items Posted During April
4 comments:
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Jenny -- Did you see the NYTimes well blog post about Diabetes Advice for the Elderly http://newoldage.blogs.nytimes.com/2013/04/26/diabetes-advice-for-the-elderly-relax/?ref=health ? "Dr. Munshi assures family members that a 7.5 or 8 reading isn’t as risky as it might appear. The serious complications of diabetes commonly develop over decades. So while younger diabetes patients should work hard to prevent them, for seniors with fewer years ahead, 'we are not looking at tight control to prevent complications in 40 years,' she said. 'You don’t want to harm people today to avoid things that might not happen tomorrow.' "
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3:45 AM, May 02, 2013
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Betsy,
I had missed that.
If he was referring to people in their middle 80s, there is some point to his advice. But complications develop not in 40 years, but in 10 or more, so I sure hope it wasn't intended for those of us in our 60s. -
7:43 AM, May 02, 2013
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I just got a 23andme genetic analysis. I have an elevated risk for diabetes because current research seems to indicate that I have a SNP associated with decreased insulin production. but then I got another report, that I am more likely to live to 100 possibly because I am more insulin sensitive. Is this contradictory? I take the results with a grain of salt, but am still interested since both my parent have diabetes and my paternal grandparents both lived to 94 (without diabetes).
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9:04 PM, May 03, 2013
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Insulin sensitivity is independent of much insulin you produce. So you could have both traits.
I'm not entirely convinced of the accuracy of those commercial tests, though. -
10:45 PM, May 03, 2013
India's Supreme Court says drug companies can't continue the patents on old drugs by making trivial changes to them, making it possible for the world's poor to afford generic versions of many drugs otherwise priced beyond their reach.
If only the U.S. had a similarly enlightened policy. But here the companies can extend the patents by doing things like combining an old drug with another drug and calling it a new drug, or selling an extended release form.
India rejects Novartis drug patent
Heart disease is found in significant amounts in prehistoric mummies including those living "paleo" pre-agricultural lifestyles.
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)60598-X/abstract.
It probably has something to do with changes to calcium metabolism that occurred during our evolution in conjunction with some other, highly beneficial development.
Yet another blow to the idea that ancient people lived in some kind of metabolic paradise ruined by the development of agriculture. Note the average age of death of the mummies. "Paleo" people were lucky to live into their 50s.
There are "as many as 4,000 predatory journals today, at least 25 percent of the total number of open-access journals." They will publish anything, as long as the author pays a hefty fee.
Many of these vanity journals are where you find the studies that claim that supplements are effective for a wide selection of incurable and chronic diseases.
http://www.nytimes.com/2013/04/08/health/for-scientists-an-exploding-world-of-pseudo-academia.html
The research says that eating meat leads to people having more carnitine and some bacteria that break it down in their guts. However, the conclusion you read in the headlines, that this causes heart disease is based entirely on rodent research>.
Since the mice who developed heart disease when fed diets rich in carnitine have not evolved over millions of years to eat meat-rich diets it is scientifically irresponsible to claim this means that dietary carnitine causes heart disease in humans.
But because it is an article of religious belief that eating meat is bad, this research is getting front page treatment.
Washington Post Fat and Cholesterol Aren't Only Heart Dangers of Red Meatl
Most family doctors prescribe new, heavily marketed drugs with no idea of their dangerous side effects. That's why you need to check out diabetes drugs on bloodsugar101.com before you take them.
Science Daily: Doctors Not Informed of Harmful Effects of Medicines During Sales Visits
Belly fat is associated with a higher risk of kidney disease. Though this mystifies the experts, the explanation is almost certainly that people with supposedly "normal" blood sugars can have blood sugars high enough to damage the kidneys.
Diagnosing diabetes with the current standard allows people to be told they have "normal" blood sugars when their sugars rise into the 200s 1 hour after the start of a glucose tolerance test as long as they drop under 240 mg/dl by the 2nd hour.
Plus, high insulin levels raise blood pressure, which also damages kidneys.
http://health.usnews.com/health-news/news/articles/2013/04/11/belly-fat-may-be-tied-to-kidney-damage
A review of diabetes research as reported by the newsletter EndocrinologyToday reveals that "...funding sources included industry (50.9%), NIH (7.5%) or other, with most being single-center trials of other sponsorship (37.7%) or industry-funded multicenter studies (27.4%). Only 1.4% of trials listed primary outcomes that included mortality or clinically significant cardiovascular complications, according to data."
In addition, "30.8% excluded patients aged older than 65 years and the majority excluded patients aged older than 75 years,"
The majority of studies intended to change outcomes were drug studies. They broke down into studies of "drugs (63.1%) and behavioral (11.7%)... Additionally, most trials were designed to enroll fewer than 500 (91.1%) or 100 (58.6%) patients, with mean completion periods of 1.8 years."
In short, most of the studies we have are very short, small, studies sponsored by drug and device companies meant to promote the use of their products which give no clue as to the impact of these drugs on the many people older than 65 who form the bulk of the diabetes patient community.
The report concludes that "recently registered diabetes trials may not adequately address issues needed to inform evidence-based practice. " In short, we don't know squat about what works in the most important diabetic populations over long periods of time.
But your busy, overworked doctor is unlikely to be aware of any of this and will prescribe whatever drugs look good in the studies the drug reps tout.
The study can be found here:
http://link.springer.com/article/10.1007/s00125-013-2890-4
Portion size trumps portion size training. Big portions make aware people overeat..
http://www.sciencedaily.com/releases/2013/04/130416102316.htm
RLL,
I deleted your post as it was not fair use. It was a review of a book propounding a speculative theory that did not look to me as if it was based on a real understanding of the underlying science, but was twisting it to fit the current fashion in the more hand waving branch of biology.
The review can be read here:
http://www.sciencebasedmedicine.org/index.php/doves-diplomats-and-diabetes/#more-25640
..to add to the last post there is not an iota of proof that as falsely claimed restoring truly normal blood sugars won't prevent diabetic complications. Following mediocre, drug-company promoted medical standards that do not lower blood sugar safely or effectively won't prevent them, but I hear from too many people doing extremely well who are healthy because they achieve normal sugars without the unsafe drugs.
I will write a longer defense of why the book could be significant later.
Nano particles in cosmetics etc are another cause of diabetes.
http://www.sciencedaily.com/releases/2013/04/130418162138.htm
This article might interest you: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3580884/ It interests me because my husband has autonomic system failure from other causes (multiple system atrophy)
Pem,
Thanks! That article is very interesting indeed. It is Diabetic cardiac autonomic neuropathy, inflammation and cardiovascular disease. Aaron I Vinik, et al., J Diabetes Investig. 2013 January; 4(1): 4–18.
Dr. Bernstein has been writing about the impact of autonomic neuropathy on people with diabetes since the 1990s. Good to see that someone else has picked up on it.
Most important takeaway for people with diabetes: Autonomic neuropathy begins at blood sugars in the prediabetic range.
This is another reason why diagnosing diabetes at far lower blood sugars than doctors use could save lives. Keep your blood sugar under 140 mg/dl at all times and you can slowly reverse neuropathies of all kinds.
Several people have emailed me wondering why I didn't comment on the item that has been in the news about a newly discovered hormone that supposedly; causes the regrowth of the pancreas. This is being reported as if it was a breakthrough that held out the promise of a cure for diabetes.
Here's what I have been replying to these queries:
I had seen this report, but since it is a) rodent research and b) very, very far from having any practical applications for people with diabetes now, I have refrained from commenting on it.
It's one thing to get cells growing, it's another thing to get them growing properly. The evidence emerging about the impact of the GLP-1 drugs on pancreatic cell growth stands as a warning. Yes, these drugs seem to grow a lot of new cells, but they are not secreting properly and they appear to be growing invasively and causing tumors.
There is a continual flow of this kind of research, which is always hailed as the Next Big Thing that will cure diabetes. Often it "cures" mouse models of diabetes that are, like 99% of the mouse models completely different conditions than human diabetes. You never hear another word about most of them.
So I concentrate on things with practical applications or implications for people dealing with diabetes now.