Category Archives: Diabetes

Mediterranean Diet Among The Best For Type 2 Diabetes

Posted on June 16, 2013 | Leave a comment

…announces an article at Reuters.  An excerpt:

Ajala and her colleagues reviewed the results of 20 studies comparing the effect of seven popular diets on adults with type 2 diabetes. Mediterranean diets, low-carb diets, high-protein diets and low glycemic index diets – which rank foods by how quickly their carbs turn into glucose – all lowered participants’ blood sugar.

After following the diet for at least six months, the people on a Mediterranean eating plan also lost an average of 4 pounds. No other diet had a significant impact on weight, according to the findings published in the American Journal of Clinical Nutrition.

“We were quite surprised by the Mediterranean diet in particular,” Ajala said. “I would have thought that low-carb would have been the best for losing weight, but Mediterranean seems to be better.”

Beautiful woman smiling as she is wine tasting on a summer day.Here’s the traditional healthy Mediterranean diet.

The researchers also found that HDL cholesterol (“good cholesterol) and triglycerides improved on the Mediterranean diet, low-carb diets, and low glycemic index diets.  Those moves tend to protect against heart disease.

Steve Parker, M.D.

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Posted in Diabetes, Low-Carb Mediterranean Diet

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Insulin Resistance Linked to Brain Shrinkage (Atrophy)

Posted on May 29, 2013 | Leave a comment
MRI scan of brain

MRI scan of brain

…according to a new report in Diabetes Care.  As if that weren’t bad enough, brain functioning was also adversely affected! The next question is: Would prevention or reversal of insulin resistance preserve the brain?  Stay tuned, because nobody knows yet.

Only a few of the study participants had diabetes.  The study at hand supports others that suggest diabetes predisposes to dementia.

What Can I Do About It Now?

You could have your doctor order some expensive blood tests to see if you’re insulin resistant. (Insurance may not pay for them, either.) Or you can measure your waist size. If your waist circumference is over 39 inches (99 cm) and you’re overweight or obese, odds are good that you have some insulin resistance.

A couple ways to improve your insulin sensitivity (reduce insulin resistance) are:

  • lose your excess fat weight
  • start a regular exercise program

Steve Parker, M.D.

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Posted in Dementia, Diabetes

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Do Fruits and Vegetables Prevent Disease? Which Ones?

Posted on January 31, 2013 | Leave a comment

Potential answers are in the American Journal of Clinical Nutrition (2012).  I quote:

For hypertension, coronary heart disease, and stroke, there is convincing evidence that increasing the consumption of vegetables and fruit reduces the risk of disease. There is probable evidence that the risk of cancer in general is inversely associated with the consumption of vegetables and fruit. In addition, there is possible evidence that an increased consumption of vegetables and fruit may prevent body weight gain. As overweight is the most important risk factor for type 2 diabetes mellitus, an increased consumption of vegetables and fruit therefore might indirectly reduces the incidence of type 2 diabetes mellitus. Independent of overweight, there is probable evidence that there is no influence of increased consumption on the risk of type 2 diabetes mellitus. There is possible evidence that increasing the consumption of vegetables and fruit lowers the risk of certain eye diseases, dementia and the risk of osteoporosis. Likewise, current data on asthma, chronic obstructive pulmonary disease, and rheumatoid arthritis indicate that an increase in vegetable and fruit consumption may contribute to the prevention of these diseases. For inflammatory bowel disease, glaucoma, and diabetic retinopathy, there was insufficient evidence regarding an association with the consumption of vegetables and fruit.

It bothers me that vegetables and fruits are lumped together: they’re not the same.

All of my diets—Advanced Mediterranean, Low-Carb Mediterranean, and Ketogenic Mediterranean—provide plenty of fruits and vegetables.

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Posted in Coronary Heart Disease, Dementia, Diabetes, Heart Disease, Low-Carb Mediterranean Diet, Lungs, Osteoporosis, Stroke

Dietitians Weigh In On Mediterranean Diet for Diabetes

Posted on January 27, 2013 | 1 Comment

An eating pattern similar to the traditional Mediterranean diet can be integrated with existing national guidelines for the management of diabetes, blood pressure, and cholesterol. Existing data suggest that the Mediterranean diet has health benefits, including improved glycemic control and reduced cardiovascular risk, and may offer benefits to diabetes patients and clinicians alike in terms of palatability, ease of explanation and use, and promotion of improved health.

Olive oil and vinegar

Olive oil and vinegar

This excerpt is from an article by three dietitians writing in Diabetes Spectrum in 2009.  Click through for details if interested.

—Steve

Reference:  doi: 10.2337/diaspect.24.1.36 Diabetes Spectrum January 1, 2011 vol. 24 no. 1 36-40

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Major Diabetes Complications on the Run

Posted on January 26, 2013 | Leave a comment

Here’s a quote from a recent Diabetes Care:

Improved therapeutics and health care delivery have brought remarkable declines in the incidence of … complications, with a 50% reduction in amputations from their peak in 1997 and ∼35% reduction in the incidence of end-stage renal disease. Similarly, 10-year coronary heart disease risk dropped from 21% in 2000 to 16% in 2008.

Exercise helps prevent and control diabetes

Exercise helps prevent and control diabetes

Nevertheless, diabetes remains the leading cause of blindness, renal failure, nontraumatic lower-limb amputation, in adults 18 to 65 years of age.  We gotta stay after it!

In addition to lower rates of major diabetes complications, we now have 11 classes of drugs for treating diabetes, compared with just three or four a generation ago.

The essay by Dr. Robert Ratner also notes 79 million Americans with prediabetes.  They need my Conquer Diabetes and Prediabetes book.  It’s only $9.99 (USD), a drop in the ocean compared to the $174 billion spent on diabetes in 2007 in the U.S.

—Steve

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Posted in Diabetes, Shameless Self-Promotion, Uncategorized

Prevention of Type 2 Diabetes Depends on the Cause

Posted on January 8, 2013 | Leave a comment

(moonlights as a clown)

The U.S. Centers for Disease Control predicts that one of every three Americans born in 2000 will develop diabetes, mostly type 2.

You can lower your risk of type 2 diabetes significantly by avoiding overweight and obesity, by exercising regularly, and by choosing the right parents.  These provide clues as to the causes of diabetes.

UpToDate.com offers a deceptively simple explanation of what causes type 2 diabetes:

Type 2 diabetes mellitus is caused by a combination of varying degrees of insulin resistance and relative insulin deficiency. [Insulin is the pancreas hormone that lowers blood sugar.] Its occurrence most likely represents a complex interaction among many genes and environmental factors, which are different among different populations and individuals.

So what causes the insulin resistance and relative insulin deficiency?

Understanding the pathogenesis [cause] of type 2 diabetes is complicated by several factors. Patients present with a combination of varying degrees of insulin resistance and relative insulin deficiency, and it is likely that both contribute to type 2 diabetes. Furthermore, each of the clinical features can arise through genetic or environmental influences, making it difficult to determine the exact cause in an individual patient. Moreover, hyperglycemia itself can impair pancreatic beta cell function and exacerbate insulin resistance, leading to a vicious cycle of hyperglycemia causing a worsening metabolic state.

The UpToDate article then drones on for a couple thousand words discussing mouse studies, various genes, free fatty acids, adiponectin, leptin, amylin, insulin secretion, insulin resistance, impaired insulin processing, insulin action, body fat distribution, inflammation, various inflammatory markers, low birth weight, high birth rate, prematurity, etc.  More excerpts:

Increased free fatty acid levels, inflammatory cytokines from fat, and oxidative factors, have all been implicated in the pathogenesis of metabolic syndrome, type 2 diabetes, and their cardiovascular complications.

Insulin resistance may, at least in part, be related to substances secreted by adipocytes [fat cells] (“adipokines” including leptin adiponectin, tumor necrosis factor alpha, and resistin).

Type 2 diabetes most likely represents a complex interaction among many genes and environmental factors.

While it’s too late to pick your parents, you can modify environmental factors that affect your risk of diabetes.  See the second paragraph above.  The Mediterranean diet also prevents diabetes.

Steve Parker, M.D.

Reference: “The Pathogensis of Type 2 Diabetes Mellitus”  by David K McCulloch, MD, and R Paul Robertson, MD, at UpToDate.com, updated June 2012, and accessed November 19, 2012.

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Which Are the Low-Carb Veggies?

Posted on January 4, 2013 | Leave a comment

A half cup of sliced bell pepper has about 2 grams of digestible carbohydrate

Laura Dolson over at About.com has a helpful list of low-carb veggies.  Helpful if you experience excessive blood sugar spikes from high-carb items, or if you’re restricting carbs for weight management.

-Steve

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Posted in Diabetes, Weight Loss

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U.S. Life Expectancy: Overall Versus Type 1 Diabetes

Posted on December 15, 2012 | Leave a comment

Type 1 diabetics diagnosed in childhood and born between 1965 and 1980 have an average life expectancy of 68.8 years.  That compares to a lifespan average of 53.4 years for those born earlier, between 1950 and 1964.  The figures are based on Pittsburgh, PA, residents and published in a recent issue of Diabetes.

Elizabeth Hughes, one of the very first users of insulin injections, lived to be 73.  She started on insulin around 1922.

Average overall life expectancy in the U.S. is 78.2 years—roughly 76 for men and 81 for women.

Don’t be too discouraged if you have diabetes: you have roughly a 50:50 chance of beating the averages, and medical advances will continue to lengthen lifespan.

Steve Parker, M.D.

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Posted in Diabetes, Longevity

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U.S. Diabetes Prevalence From 1935 to 1979 and Beyond

Posted on October 31, 2012 | Leave a comment

From 1935 to 1996, the prevalence of diagnosed type 2 diabetes [in the U.S.] climbed nearly 765%.

This shocking statistic is from the Centers for Disease Control and Prevention as cited in Increased Consumption of Refined Carbohydrates and the Epidemic of Type 2 Diabetes in the United States: an Ecologic Assessment, American Journal of Clinical Nutrition, 2004, vol. 79, no.5, pp: 774-779.

I thought 765% might be a misprint, so I did some digging.  A similar figure is in DHHS Publication No. (PHS) 82-1232 published in 1981:

  • Diabetes prevalence rose from 0.4% of the population in 1935,  to 2.4% in 1979.

This is a six-fold increase.  The major part of the upward trend started in 1960.  Interestingly, that’s when corn syrup started working its way into our food supply.  Coincidence?  The authors of the Department of Human Services paper write:

Preliminary evaluation of these trends suggests that the change in the prevalence of known diabetes has resulted from improvements both in detection of diabetes among high-risk groups and in survivorship among persons with diabetes.

Like type 1 diabetics, many type 2′s need insulin shots

To me, it sounds like they weren’t considering an true increase in the number of new diabetes cases (incidence), but better detection of existing cases and improved longevity of existing patients (prevalence).  Incidence and prevalence are often confusing.  Wikipedia has a clarifying article.  These days, both incidence and prevalence of type 2 diabetes are greatly increased over 1935 levels.

In January of 2011, the U.S. Centers for Disease Control and Prevention released the latest estimates for prevalence of diabetes and prediabetes.

  • 8.3% of the total U.S. population has either diagnosed or undiagnosed diabetes (earlier percentages in this post were for diagnosed cases only)
  • 6% of the U.S. adult population has diagnosed diabetes (My calculation: Population in 2011 was 311 million; with 18.8 million diagnosed cases of diabetes, 7 million undiagnosed)
  • Nearly 27% of American adults age 65 or older have diabetes (overwhelmingly type 2)
  • Half of Americans 65 and older have prediabetes
  • 11% of U.S. adults (nearly 26 million) have diabetes (overwhelmingly type 2)
  • 35% of adults (79 million) have prediabetes, and most of those affected don’t know it

Even if type 2 diabetes runs in your family, you may well be able to avoid it.  Here’s a post about prevention of type 2 diabetes.

Steve Parker, M.D.

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How Many Diabetic Diets Are There?

Posted on September 24, 2012 | Leave a comment

Elizabeth Woolley reviews most of them at her About.com column on type 2 diabetes. I don’t endorse everything there; just thought you might be interested.

I still see doctors at the hospital order “ADA diet” (American Diabetes Association) for their patients with diabetes.

There is no ADA diet.

-Steve

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