Sep
01
2007

Gene Identification Helps To Screen for Diabetes Risk Of Juvenile Diabetes (type 1 diabetes)

Gene therapy is the new buzzword in a hope for cure of disease, and genetic tests also assist in predicting the risk for disease.

These predictions are reaffirmed by research that comes from McGill University in Montreal under Dr. Constantin Polychronakos, a professor of pediatrics and human genetics. A new DNA chip has been used for testing the genetic makeup that produces diabetes type 1 (also called Juvenile Diabetes). So far the analysis has confirmed four previously identified genetic locations that contribute to the development of diabetes 1, and the test identified a new location occupied by the gene.

With the research team working on the discovery of all the remaining genes, they are confident to develop a test which will predict the risk of developing diabetes. According to Dr. Polychronakos the findings will influence future treatment options. The most promising treatment for those already diagnosed with diabetes1 are stem cell regenerative treatments, such as islet transplantation, since the Langerhans islets are responsible for the production of insulin in the pancreas.

Gene Identification Helps To Screen for Diabetes Risk Of Juvenile Diabetes (type 1 diabetes)

Family tree for inheritance of type 1 diabetes

These therapies will only work if the immune system is also treated, so the patient does not suffer a relapse of the disease. Once all the diabetes genes are identified, there will not only be fast screening but also therapies that can be targeted more effectively.

Reference: The Medical Post, August 7, 2007, page 1 and 60 of the Medical Post

More on genetics and diabertes: http://www.who.int/genomics/about/Diabetis-fin.pdf

Last edited December 5, 2012

Aug
01
2007

More Fiber in Diet Lowers Diabetes Risk

Skipping breakfast seems to be nothing unusual for many individuals. Busy lives and hectic schedules contribute to a rush in the early morning. It has been emphasized by several articles, that breakfast is indeed important for a healthy jumpstart of the day. A German study which has been published in the May 14 edition of the Archives of Internal Medicine points out more clearly why breakfast may well be the most important meal of the day.

More than 25,000 adults were enrolled in a study, which found that the intake of fiber can be an effective nutritional tool to reduce the risk of developing type 2 diabetes. The connection between type 2 diabetes and the intake of cereal, fruit, vegetable and associated fiber intake, also the intake of soluble and insoluble fiber and magnesium were closely examined. During the seven year period of follow-up 844 cases of diabetes 2 were identified.

The study found that the consumption of 29 grams per day of soluble fiber was associated with a significantly lower risk of 21% less diabetes. Soluble fiber, including pectin is mostly found in fruit, vegetables and legumes. Roughage alone such as wheat bran, whole grains and brown rice was not associated with a lower diabetes risk.

Once the source of fiber was broken down according to origin (fruit, vegetable or cereal), the study found that the participants who consumed the highest part of cereal fiber had a 28% lower risk of diabetes compared to those who had the lowest amount of cereal fiber intake. High magnesium intake was associated with a 23% lower risk.

More Fiber in Diet Lowers Diabetes Risk

More Fiber in Diet Lowers Diabetes Risk

It has to be stressed that not every breakfast cereal qualifies as a source of high cereal fiber. Consumers must become educated and be aware of the fiber content in food servings to ensure that they are getting the necessary amount to reap the benefits.

More information on:

1. fiber in diet (also helps with metabolic syndrome): http://nethealthbook.com/hormones/metabolic-syndrome/

2. diabetes (type 2): http://nethealthbook.com/hormones/diabetes/type-2-diabetes/

Reference: May 14, 2007 Edition of the Archives of Internal Medicine

Last edited November 3, 2014

Apr
01
2007

Red Meat Linked To Heart Disease In Diabetics

Red meat is one of the sources of protein, but doctors from the Harvard School of Public Health reporting in the January edition of Diabetes Care, that a type 2 diabetes diet should be lean in red meat.

Type 2 diabetics are at risk for subsequent coronary heart disease (CHD), and intake of iron rich food was significantly associated with a greater risk of fatal CHD. The results come from a prospective study of 6,161 women from the Nurses’ Health Study. All of these patients reported a diagnosis of adult onset diabetes, and they were followed between 1980 through 2000, which amounts to an impressive 54,455 person-years follow-up. Attention was paid to the food questionnaires, which were monitored for the consumption of iron and red meat such as beef, pork or lamb as a main dish, also for the use of beef in roast beef sandwiches and mixed dishes, hamburger, hot dog, processed meat and bacon. Note was also taken of other nutrients such as seafood and poultry.
Women with diabetes who ate the most iron in the form of heme found in red meats had a 50% increased risk of total coronary heart disease as compared to those with the lowest intake. The risk ratio with women was more obvious in post menopause when compared with pre menopause.

Red Meat Linked To Heart Disease In Diabetics

Red Meat Linked To Heart Disease In Diabetics

While lean beef may be a good protein food to the average population, type 2 diabetics might choose to cut back on red meat and processed red meat sources and replace it with a heart-friendlier choice. Fresh seafood, rich in omega -3 fatty acids, would rank high on the list of a healthy eating plan.

Reference: The Medical Post, February 20, 2007, page21

Last edited December 5, 2012

Feb
01
2007

Lycopene Benefits Backed By Science

Lately a lot of attention has been directed to the health benefits of vegetables and fruit. Vitamin C has long been an accepted household term, and nobody questions the benefits. Newer buzz words are the terms “bioflavonoids” and “antioxidants”. Some products are aggressively marketed extolling the above named beneficial substances, but often the consumer is left mildly bewildered by exaggerated claims. Often the sale prices of these miracle foods are as lofty as the bold statements that go along with them.
For any shopper it is important to know that some of the most beneficial foods are not high priced items, but very common staples. Take tomatoes, for instance. They are a significant source for the substance lycopene, which lately has received a lot of attention. Lycopene and its dietary sources as well as its benefits have been researched world wide, and the results are now in. It is responsible for the red color in fruit or vegetables, such as tomatoes, and its isomeric form 5-cis-lycopene is the most stable form having the highest antioxidant properties. Common dietary sources are tomatoes, watermelons, pink guava, pink grapefruit, papaya, apricot and other fruit. In the Western diet tomato-based foods account for about 85% of dietary sources of Lycopene. Studies have shown that lycopene is more efficiently absorbed from processed tomato products compared to raw tomatoes. Once it is absorbed it is distributed throughout the body. The highest levels showed up in the testes, the adrenal glands, prostate, breast and liver.
Research going back to 1995 showed an inverse relationship between the consumption of tomatoes and the risk of prostate cancer. A follow up publication in 1999 showed that the same inverse relation of lycopene intake and cancer also included breast, cervical, ovarian, liver and other organ sites. Further studies have followed these initial publications, and the great majority of them suggest that an increased intake of lycopene showed an association with a significant reduction in the risk of many cancers.
Coronary heart disease and lycopene benefits were also examined. The strongest population based evidence comes from a multi center case control study in Europe (EURAMIC). 662 Cases and 717 controls were recruited from 10 different European countries, and there was a significant relationship between levels of lycopene in fatty tissue and the risk of myocardial infarction. Lower lycopene levels were associated with a higher risk of heart attacks.Lycopene was also shown to decrease levels of oxidized LDL (LDL or low density lipoprotein is known as the “bad” cholesterol). Another small study showed that lycopene was reducing total cholesterol levels and as a result was lowering the risk of coronary heart disease (CHD).
The list of benefits does not end here: the dietary oxidant reduces oxidative stress and levels of bone turnover markers, meaning that it may contribute to the bone health, especially reducing the risk of osteoporosis in postmenopausal women.

Lycopene Benefits Backed By Science

Lycopene Benefits Backed By Science

For people with mild hypertension (high blood pressure), consumption of lycopene resulted in significant reductions of systolic and diastolic blood pressures.
Infertility in males was significantly helped by lycopene intake. In a study infertile man received 8 mg lycopene per day in capsule form. Laboratory tests confirmed an increased sperm density along with functional sperm concentration and mobility. This treatment protocol with lycopene supplementation resulted in a success rate of 36% pregnancies in their partners.
Pregnant women with pre-eclampsia who were treated with lycopene supplement significantly improved, which was shown by decreased diastolic blood pressure, the reduction of pre-eclampsia and a decrease of intrauterine growth retardation, resulting in a healthier mother and baby.
Future research is pending surrounding lycopene in metabolic and inflammatory diseases and in its role of possibly preventing neurodegenerative diseases such as Alzheimer’s disease. Other inflammatory conditions such as arthritis and emphysema will likely also be shown to benefit from lycopene. Preliminary data has already indicated this.
The Food and Drug Administration (FDA) of USA has recently approved lycopene as a safe “natural coloring agent” and a Generally Recognized as a Safe (GRAS) component. The Department of Nutritional Sciences , Faculty of Medicine, University of Toronto, c/o Dr. A.V. Rao et al. who completed this meta analysis of the recent literature have recommended that we all consume a regular daily lycopene dose in our food and supplements as part of our diet for good health.

More info about lycopene and prostate cancer: http://nethealthbook.com/news/lycopene-reduces-prostate-cancer-risk/

Reference: The Whitehall-Robins Report, December 2006, Volume 15, No.4

Last edited November 2, 2014

Jan
01
2007

Prevent Type 2 Diabetes With Diet And Moderate Exercise

The almost epidemic proportions of Type 2 diabetes has raised grave concern, but healthcare providers agree that adult onset diabetes is not just a disease that strikes out of the blue. Patient education remains a basic concern, as there are factors that predispose people to the disease. There are known risks for those who are overweight and when inactivity is the main lifestyle. Family history plays a role and ethnic origin can make the patient more vulnerable to the development of diabetes. Population groups at risk are African-Americans, Native Indians, Pacific Islanders, Hispanic-Americans and Asian-Americans. There is a stage which is known as pre-diabetes. The blood glucose level is elevated, but it is not high enough that the condition is labeled as a full-blown diabetes. The good news is that with screening of the blood sugar the first signs of elevation can be detected with a blood sugar monitor at home. This way this condition can be picked up and the progression to diabetes can be avoided with proper diet and exercise.

In a large study of the Diabetes Prevention Program people who lost 7 % of their body weight and exercised 150 minutes per week cut their risk of developing type 2 diabetes by 58%. For patients in the age group over 60 the risk was reduced by 70%.

Prevent Type 2 Diabetes With Diet And Moderate Exercise

Diabetics need exercise and a proper diet

It is important that all persons who are at risk are screened. The laboratory tests involve fasting overnight, after which the fasting glucose levels are checked. A glucose tolerance test is the second test. After overnight fasting the patient receives a glucose-rich drink and blood sugar levels are monitored afterwards to establish how well the glucose is metabolized. These tests are inexpensive and are usually covered by health insurance.

More information about:

1. Diabetes type 2: http://nethealthbook.com/hormones/diabetes/type-2-diabetes/

2. Exercise (fitness): http://nethealthbook.com/health-nutrition-and-fitness/fitness/

Reference: Dec. 25, 2006/January 1, 2007 issue of U.S. News & World Report, page 55

Last edited November 2, 2014

Nov
01
2006

Think Feet With Diabetes

This article is about “think feet with diabetes”. About 2 million Canadians are currently living with diabetes. It can be a “silent” disease, as patients may have few symptoms. Once diagnosed with diabetes it is of great importance to be vigilant of lifestyle and nutrition to keep the condition under control. A common problem for about 15% of diabetics is the development of a diabetic foot ulcer. Of those afflicted 14-24% will require an amputation of a lower extremity as a result. In addition to this the mortality rate of patients with below knee amputation due to the complications of a diabetic foot ulcer is 19-55% after three years.
Even though these statistics sound ominous, patients can do a lot in the way of prevention. According to the Canadian Diabetes Association guidelines, a diabetic patient should have a foot exam performed at least annually. Diabetic peripheral neuropathy is the leading cause of diabetic foot ulcers. The physician can examine the feet for loss of sensation. He will check for foot calluses and will debride those, which are pre-ulcer state. The physician also checks for poor circulation in the foot at that time.
If there is no loss of protective sensation, an annual exam will suffice, but if there is loss of sensation, several exams per year may be needed. A vascular surgeon may have to assess the patient to see if the foot circulation is sufficient. Infection is a warning sign and has to be treated promptly. Finally, any source of pressure to the foot needs to be removed or offloaded.
A proactive approach to keep the feet healthy starts at home.

Think Feet With Diabetes

Think Feet With Diabetes

The following points are important especially to the patient with diabetes:
-Inspect your feet on a daily basis. Check for sores, blisters or cracks that don’t heal.
-Check your footwear. If there is debris (sand, pebbles) remove promptly.
-Wash your feet daily with warm, not hot water and dry them well, especially between your toes.
-Trim your toenails. If you have difficulties doing that, seek out the help of a podiatrist. Also don’t use the homemade approach cutting corns and calluses.
-Keep the circulation to your feet going: put up your feet when you sit. Wiggle your toes, move your ankles, don’t cross your legs for long stretches of time.
-Shop for suitable footwear! Ask the sales clerk to measure both of your feet in order to determine the proper size. Shop in the afternoon, as your feet can swell during the day.
-Don’t break in a tight fitting new shoe! This may injure your feet. A new shoe should be comfortable right away.
-Don’t delay looking after problems. If a cut, sore, bruise or blister does not start to heal after a day, see a physician.

Reference: Parkhurst Exchange, October 2006 Edition, page 26

Last edited November 1, 2014

Oct
01
2006

Lowering Cholesterol Aggressively Saves Lives

A 5-year multinational prospective study (“Treating to New Targets or TNT Study” involving top cardiologists from around the world has found significant benefits in using higher doses of statins. They investigated the effects of increasing the statin concentration (a cholesterol lowering medication) and have now come to new insights how to approach the metabolic syndrome, which is the metabolic derangement associated with obesity. Of 10,001 patients aged 35–75 years with clinically proven heart disease 5,584 patients had metabolic syndrome at the same time. Half of them were put on 10 milligrams of Atorvastatin (brand name: Lipitor, made by Pfizer Inc.), the other half on 80 milligrams per day. They were followed for 5 years and many questions were asked, blood tests done and statistics kept. Of particular concern was whether survival rates and numbers of heart attacks or strokes would be different for the various groups. The major focus of interest was on people who were over weight or obese.

As the image above shows, percentages of complications (heart attacks and strokes) were used as clear end points of cardiovascular complications to measure the response to the statin. The results showed that two subgroups of obese patients, those who have at the same time diabetes and those who don’t, were both benefitting from the higher dose of Lipitor in an equal manner (about a 30% relative reduction of risk).

The amazing result was that dosage of the statin mattered very much. In the past it was thought that taking a pill for high cholesterol was all that mattered. However, now we know that physicians need to watch the blood level response of the bad cholesterol (LDL cholesterol) and titrate the abnormal levels down to a normal level by using adequate dosing. The authors came to the conclusion that metabolic syndrome patients with heart disease, and particularly those where diabetes was present at the same time, would need more intensive statin therapy (higher dosage) than patients who were only having cardiovascular disease. The new goal post for lowering the low-density lipoprotein cholesterol (LDL cholesterol) of 1.8 mmol/L (70 mg/dL) was recommended.

5-Year Study Shows Further Reduction of Major Cardiovascular Complications In Patients
(Expressed as %) With Metabolic Syndrome Using Higher Doses of Atorvastatin(P. Deedwania et al. Lancet 368, No. 9539: 919-928, Sept. 9, 2006)
 

 

 

 

 

 

 

 

 

 

This study showed that there was a 44% increase in absolute risk for an adverse outcome in coronary heart disease patients who also have metabolic syndrome than those without metabolic syndrome. This justifies a very aggressive treatment with Lipitor down to the new target blood values indicated above that your doctor needs to monitor. In high risk patients for heart attacks and strokes where more than 3 cardiovascular risk factors are present the patient’s outlook (longer survival) can be improved by several years. This was shown with treatment using the higher dose of Lipitor when blood levels and cardiovascular complications were compared between 5 years of treatment and the treatment results after the first year of the study.

More information on:

1. Treatment of a heart attack: http://nethealthbook.com/cardiovascular-disease/heart-disease/heart-attack-myocardial-infarction-or-mi/treatment-heart-attack/

2. Metabolic syndrome and obesity: http://nethealthbook.com/hormones/metabolic-syndrome/

Reference: The Lancet 2006; 368:919-928 (09 September 2006)

Last edited November 1, 2014

Jan
01
2006

Prevent Foot Problems In Diabetics

Diabetes has reached epidemic proportions in North America. Two million Canadians (about 20 million in the US) have diabetes, and the number is expected to rise dramatically. At one time or another about 15-20% of patients with diabetes will need hospitalization with a diabetic foot complication. The conditions, which are of concern, are diabetic foot ulcers, severe infection and circulation problems in fingers and feet (peripheral circulation). Health budgets are stretched, as the cost of treating a single foot ulcer has been estimated at $2,183, so the total cost over the lifetime of current diabetics will exceed $650 million (about 6.5 billion $ in the US). Foot ulcers appear like a small item considering the fact that the need for amputation of a lower extremity is the next severe problem that can arise. The average patient who undergoes a below knee amputation will spend 84 days in hospital and another 38 days in rehabilitation.
To prevent the development of foot ulcers, it is important to screen diabetic patients for predisposing factors like the loss of protective sensation in the feet (diabetic neuropathy) as well as structural changes resulting in areas of increased pressure. A study conducted in southwestern Ontario found that only 15% of patients with type 2 diabetes were screened to identify those at risk for foot ulcers. Screening is the first step, after which a podiatrist will have to take over. Footwear prescribed by a podiatrist can be an avenue of prevention, but ongoing podiatric care as well. The small number of diabetic foot screenings shows that podiatric medicine has not been used as a tool to recognize and treat diabetic foot problems.

Prevent Foot Problems In Diabetics

Prevent Foot Problems In Diabetics

The proactive approach of seeking the input of a podiatrist early will translate into significant benefits for the patient with type 2 diabetes.

More information on complications of diabetes:  http://nethealthbook.com/hormones/diabetes/complications-diabetes/

Reference: Parkhurst Exchange, December 2005, page 162

Last edited October 30, 2014

Aug
01
2005

Tight Blood Sugar Control In Diabetics Cuts Heart Disease

Successful treatment of type 1 diabetes in the past usually meant compliance in taking insulin shots and paying attention to a diabetic diet. Since the arrival of specific lab tests like the HbA1c levels, patient education has become more sophisticated: it is not enough to just be on shots, eat sensibly and otherwise hope for the best. As a result, it is a must for patients to monitor their glucose levels closely.
Research that was presented at the American Diabetes Association during the 65th annual scientific session spelled out the benefits very clearly: strict control of glucose levels helps patients with type 1 diabetes to decrease the risk of stroke and cardiovascular disease by 57%!

It has been known that tight glucose control helped to reduce diabetic nephropathy (kidney disease) and diabetic retinopathy (eye disease) in diabetics, but this is the first time that controlling glucose levels has been associated with cardiovascular disease, reports the main investigator, Dr.David Nathan from, director of the diabetes center at Massachusetts General Hospital in Boston. He also reported that every 1% reduction in HbA1c (glycosated hemoglobin) correlated with a 20% reduction in cardiovascular risk for the diabetes type 1 patient.

These findings are significant, as the risk reduction is larger than seen in any other trials, like administering medication (statins) or placing stents.

Tight Blood Sugar Control In Diabetics Cuts Heart Disease

Tight Blood Sugar Control In Diabetics Cuts Heart Disease

A similar risk reduction may also occur in patients with type 2 diabetes, but at this point no specific research on this group is available. In the meantime it is of great importance to any patient with type 1 diabetes.

More information about:

1. Diabetes treatment: http://nethealthbook.com/hormones/diabetes/type-2-diabetes/treatment-type-2-diabetes/

2. Heart attacks: http://nethealthbook.com/cardiovascular-disease/heart-disease/heart-attack-myocardial-infarction-or-mi/

Reference: The Medical Post, July 5,2005,page1, 58.

Last edited October 29, 2014

May
01
2005

Inflammation Connected To Sudden Heart Death

It is a well-known fact that certain diseases go together, for instance diabetes and heart disease. Every effort has to be made for this reason to control a disease in order to minimize the risk for other associated illnesses.
New research from rheumatologist Dr. Sherin Gabriel at the Mayo Clinic points to another health condition. Patients affected by rheumatoid arthritis have a higher risk of early death than others, and these deaths are mostly due to cardiovascular disease. The relationship between these two diseases is complex, reports Dr. Gabriel, and the common denominator between heart disease and rheumatoid arthritis seems to be systemic inflammation.

Research from the Mayo Clinic in Rochester, Minnesota, has been published in March, and it was found that inflammation documented by laboratory tests such as an erythrocyte sedimentation rate of over 60mm per hour increased the risk for heart disease by a factor of two. Rheumatoid arthritis vasculitis increased the risk to 2.4, and RA lung disease showed a risk increase of 2.3. Traditional risk factors for heart disease like smoking, alcohol, obesity and diabetes were accounted for, yet the more dramatic risk factor in the population with RA (rheumatoid arthritis) was the aspect of inflammation. The results of this research are based on data from the Rochester Epidemiology Project, in which 603 persons with rheumatoid arthritis were followed over 15 years. In this time span 364 of these patients died, and heart disease was the primary cause of death in 176 of them. The subjects of this group were three times as likely as an age-matched population to have been hospitalized for a heart attack and had five times the risk of having an unrecognized heart attack. This group is also more vulnerable, because patients with rheumatoid arthritis suffer of joint pains, receive painkillers, and often chest pain can be masked by pain medication and go unrecognized.

Inflammation Connected To Sudden Heart Death

Inflammation Connected To Sudden Heart Death

Co-author Dr. Hilal Maradit points out that rheumatoid arthritis remains a multifactor problem, and one factor alone does not explain the entire story, but in the meantime the link of inflammation in RA to cardiovascular disease is an important step closer to early recognition and successful control.

More info about:

Rheumatoid arthritis: http://nethealthbook.com/arthritis/rheumatoid-arthritis/

Gingivitis: http://nethealthbook.com/dentistry/gingivitis/

Heart attacks: http://nethealthbook.com/cardiovascular-disease/heart-disease/heart-attack-myocardial-infarction-or-mi/

Reference: National Review Of Medicine, April 15, 2005, page 3

Last edited October 28, 2014