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Mesa, AZ 85210
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RISK OF CORONARY ARTERY DISEASE – (08-17-09)
Risk of coronary artery disease associated with initial sulphonylurea treatment of patients with type 2 diabetes
Ok, so the TZDs for diabetes (i.e. Avandia, Actose) have been giving a black box warning for causing heart disease (the number one cause of death in diabetics, I might add). So let’s use the sulfonylureas, right? Well, they’re known to actually damage the beta cells of the pancreas–the very cells we want to protect!!. And, if that wasn’t bad enough, here we see more than a doubling of risk of heart disease with some of the older drugs in this class. Man…if I was an endocrinologist that really wanted to help my patients–I’d burn the prescription pad and open a gym.
ENVIRONMENTAL CHEMICAL EXPOSURE AND HEALTH PROBLEMS – (09-01-09)
Association of Organochlorine Pesticides with Peripheral Neuropathy in Patients with Diabetes or Impaired Fasting Glucose
Great. Another study linking environmental chemical exposure and health problems. The reason I flagged this one was because of the strength of the association. In those with the highest exposures, there was a massive 7.3 times the risk of getting peripheral neuropathy–even IF they did not have diabetes yet. Can anyone say “organic?”
TRENDS IN THE PREVALENCE OF CHRONIC MEDICATION USE – (09-01-09)
Trends in the Prevalence of Chronic Medication Use in Children: 2002-2005
If this does not become a wake up call, then our country is missing a pulse. The REAL, REAL scary aspect is that there is likely some type of epigenetic, in uteru IRREVERSIBLE changes that occur as a result of poor nutrition, forced fertilization coupled with environmental toxicants. That means we really haven’t even seen the tip of the iceberg when it comes to diseases in children. But where are the parents??? Have we so blindly accepted the wisdom of mainstream medicine that we will put our children on drugs for hypertension, diabetes or high cholesterol without making lifestyle changes. I would venture so far as to say that almost ANY child can improve their physiologies with the correct recommendations for lifestyle changes. So why are we doing it????????? Can pediatricians really think this is the best approach?
HOW TO MANAGE WEIGHT, HUNGER AND THE PROGRESSION TO DIABETES! (09-01-09)
Orlistat Inhibition of Intestinal Lipase Acutely Increases Appetite and Attenuates Postprandial Glucagon-Like Peptide-1-(7-36)-Amide-1, Cholecystokinin, and Peptide YY Concentrations
Quite a long title, but thought I’d leave it for affect. The bottom line is that, the use of drugs like Orlistat (and the over the counter blockbuster weight loss product called Alli) actually SLOW down the process the body uses to manage weight, hunger and the progression to diabetes!! Ugghhhh!!! Given the massive promotion of the release of Alli on the market some time ago we should expect further increases in obesity and diabetes any day now…Better make sure we double up on the artificial sweeteners.
DID YOU GET ONE OF THOSE FANCY NEW DIABETIC DRUGS?
We all like to have the latest and greatest new stuff. IPhone 27, IPad 9, Prius, 3D TV. Far too often, this new technology is very expensive and has a tendency to break down. But despite these shortcomings, you need to admit it–buying the latest stuff is built into our DNA. But do you want your doctor to have this same attitude when it comes to your medications?
Many falsely belive that, once a new drug hits the market that the FDA has fully evaluated the safety profile of the drug. This couldn’t be further from the truth. The list of medications that were pulled off the market years after their release is quite long and covers all different classes of drugs used to treat many different conditions. It is not until years later, after the new drug has been used in a large number of patients, that some of the more dangerous side effects come to light.
We are certainly seeing this right now with diabetic treatments. The new medications that affect the GLP-1 pathway are all the rage. I have been very vocal in my own little personal disdain for the rapid adoption of this direction for diabetic treatments. There are some small hints as to what this class of drugs may have hiding in the deep dark basement of side effects, but it will be years yet before it hits the radar screen of the FDA for a closer look.
Metformin is a drug used to treat diabetes for many years and we’ve got a pretty good idea of what it does and doesn’t do. While I would never recommend a drug in lieu of lifestyle changes, and I feel that metformin only improves insulin sensitivity in the liver and not anywhere else in the body, metformin is probably a good place to start on the drug pathway.
This particular article evaluated how often doctors are putting newly diagnosed diabetic patients on metformin vs the newer, more expensive diabetic drugs and whether patterns changed from 2006 to 2008. There were some very simple but interesting findings:
- Patients treated with metformin increased from 14%
- Sulfonylureas use decreased from 8%
- Thiazolidinediones (TZD) use dropped 12.8%
- Prescriptions for dipeptidyl peptidase-4 (DDP-4) inhibitors went from 0.4% to 7.3% (for the math wizzess, this is an 18X increase
- Younger patients, women, and those on Medicare were least likely to initiate treatment with metformin
- Spending for patients who were not initiated on metformin was $1354 / year
- Metformin for a year was $232
- Again, for those math wizzes, this is a cost difference of approximately $1120 annually per patient
While it is good that the use of sulfonylureas and TZDs are dropping because these are just bad drugs to use for diabetes, it is disheartening to see the massive spike in the new class of drugs (DDP-4 inhibitors) despite the lack of a long term safety profile and the much greater cost.
I guess this means that many doctors are also falling prey to the “newest and greatest” when it comes to prescribing new drugs to their diabetic patients.
DOES HIGH INTENSITY INTERVAL TRAINING IMPROVE INSULIN? (08-24-09)
Extremely short duration high intensity interval training substantially improves insulin action in young healthy males
I’ve become more and more of a fan of interval type training when it comes to aerobics. Personally, I subscribe to Dr. Sears’ PACE program (Progressive Accelerating Cardiopulmonary Exertion), which involves sets of increasing intensity but shorter duration. Makes sense when you look at what our bodies were designed to do (can’t imagine any type of sustained aerobic jog to chase after a running antelope for food…). The research is increasingly in support of this type of program.
In this particular study, a miniscule level of intense exercise (15 mins over 2 wks) led to a 23% improvement in the way insulin was functioning in the body in a small group of sedentary young men. We’re talking 4-6 sets of cycling as fast as they could for 30 seconds. This was done in 6 sessions over the course of 2 wks. Listen..if you can’t do 9 minutes of exercise per week, you should just hang it up now.
SHOULD I GET A MASSAGE AFTER I WORKOUT?
The easy answer is, of course, yes. But why? Massage therapists, personal trainers and chiropractors have stated forever that massage helps to “wash out” lactic acid produced during a workout and this will help reduce soreness from competition or exercise. Turns out, this isn’t exactly true.
Actually, in this particular study, the levels of lactic acid went up after massage while, at the same time, blood flow was reduced in the muscle region being treated. This just continues to sound like the opposite of what has always been promoted under the health benefits of massage. So what did the researchers find?
Overall, massage sent chemical signals into the cells of the muscles (for those technical junkies… it activated the mechanotransduction signaling pathways focal adhesion kinase (FAK) and extracellular signal–regulated kinase 1/2). This resulted in two powerful effects.
First, it lowered the production of inflammation in the injured / exercised muscle. Imagine this–forget taking anything like ibuprofen or Tylenol or Alieve because you worked out too hard–just call our office for an appointment instead! Not only do you avoid derailing the healing process with over the counter drugs, but you will actually lower the damage that would have otherwise occurred from the exertion. Pretty neat.
Second, and even more astounding, massage (via the signalling pathway noted above) actually increased the number of mitochondria! For those of you who are new readers, you may be scratching your head trying to remember what Ms. Pendleton had said about mitochondria in your high school biology class 30 years ago. Regular readers, however, will understand that the mitchondria are the holy grail of good health. The more mitochondria we have and the better they function, the less likely we are to get any disease. Period.
Could this mechanism be one of the reasons we see some of the benefits of massage and improvements in chronic pain patients, patients with fatigue or fibromyalgia patients? Could massage actually lower your risk of diabetes by improving mitochondrial function?? Stay tuned…
In the meantime, if you are local and have a strong desire to increase your own mitochondrial function, sign up for our massage club today and start improving your health.
THE “PERFECT STORM” FOR TYPE 1 DIABETES (08-24-09)
The “Perfect Storm” for Type 1 Diabetes: The Complex Interplay Between Intestinal Microbiota, Gut Permeability, and Mucosal Immunity
This is an interesting article, and one that again leads us away from the purely genetic susceptibility to Type 1 diabetes and into one that is preventable, so long as we stand up and admit to it. If the gut plays a pivotal role in the development of Type 1 diabetes (and it does for other autoimmune conditions like Crohn’s, ulcerative colitis and psoriasis), than we again have to look at the wisdom of bombarding our infants (and pregnant mothers) with antibiotics. Some 90+% of infants have had antibiotics by the time they are 2, and I have NEVER, in my decade of practice, had a parent told that they should follow up use of antibiotics with administration of probiotics. And yet the devastation that may ensue is strewn about the medical literature, if we would just READ IT!!
In the particular case of T1D, I would also include to avoidance of dairy and the indiscriminate use of every vaccination know to man used in infants.
ARTIFICIAL SWEETENERS LEADS TO CHRONIC DISEASE (08-24-09)
Splenda alters gut microflora and increases intestinal p-glycoprotein and cytochrome p-450 in male rats
Ok. We need to remember that this is a rat study, but the bacteria in the gut of these rats do not care whether they are residing in a rat or a human. With this said, I will reiterate my firmly held position that artificial sweeteners are leading to chronic disease to include obesity and diabetes. There are no studies to suggest that they help with these same conditions.
In this particular study, if we can assume that the results would be the same in humans, the long term ramifications of alteration in gut flora are many. And these include obesity, the very reason many people mistakenly increase their intake of these compounds.
TEA CONSUMPTION AND RISK OF BREAST CANCER – (08-17-09)
Tea Consumption and Risk of Breast Cancer
For those of you doing the math, in just these few studies we’ve pretty much wiped breast cancer risk off the face of the planet with just a small handful of the hundreds of known lifestyle factors that influence breast cancer risk. Here tea led to a 37% reduced risk of breast cancer in younger women drinking 3 or more cups per day. Consider this–everyone seems to have this idea that we need to lug a plastic BPA laden bottle of water around with us everywhere we go because we’ve been told by “them” that it’s good for us.
Good luck finding any studies to support this concept. What we DO find is studies linking the BPA in plastic water bottles to diabetes, cancer and birth defects. Switch to tea. Period.
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