LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

Diabetes Mellitus

CRP as Predictor for Incident Diabetes Mellitus Among Middle-aged Men – (01-18-03)

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CRP as Predictor for Incident Diabetes Mellitus Among Middle-aged Men

It’s very nice to finally see the mainstream medical journals viewing inflammation as a factor in many (actually all…) chronic diseases. Much press was given to CRP as an independent risk factor for heart disease and now we see the same association with diabetes. What I do find amusing is the “chicken with their head cut off” mentality looking for drugs to lower CRP. A huge trial is underway to see if statin drugs can lower CRP. Hey…save the money and have patient avoid refined carbs and exercise. That should do it most of the time!!

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The Role of nutrition Therapy in the management of Diabetes Mellitus – (02-22-01)

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The Role of nutrition Therapy in the management of Diabetes Mellitus

This author has a wonderful concluding line in this article about nutrition being the “cornerstone of therapy” for diabetes. This is so true, and, coupled with exercise, can be some of the most powerful tools we have to prevent and treat this chronic disease responsible for so many deaths in the civilized world. Unfortunately, many (if not most) patients who are given the diagnosis of diabetes are not given the info they need. Many I have come across are never told to avoid pasta (most pasta is made of enriched wheat flour) and never educated in whole grains vs refined carbs.

Synergy Abstract

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The Painfully Slow Death of a Common, Deadly Diabetic Drug

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Glucotrol (glipizide). Glyburide.  Glucovance.  It goes by many names, but they all contain the diabetic drug sulfonylurea.

It is a compound that basically forces the beta cells of the pancreas, the cells that release insulin, to work harder.  At first glance, this may sound like a good idea.  But all diabetics already have problems with the way they produce insulin as well as the way that insulin reacts with each individual cell.  So, coming full circle, the sulfonylurea class of drug forces the body to do what it already having problems doing.

The first generation of sulfonylureas were introduced in the US in 1955 and quickly became one of the most popular classes of drugs used to treat diabetes, and accounts for about 25% of the prescriptions written for diabetic medications.

Given the length of time this class of drugs has been used and the volume of prescriptions written, one would think that all the bugs have been worked out and all the dangers and side effects are well known.

Yeah.

About a decade ago, researchers started to realize that this class of drugs had two big shortfalls:

  1. The sulfonylureas destroy the beta cells of the pancreas, increasing the chance that the type 2 diabetic will become an insulin dependent type 1 diabetic.  This is very well established.
  2. This drug is linked to higher rates of deaths in diabetics, most commonly due to cardiovascular related causes.

This particular study just continues to confirm the fact that this class of drugs is bad for the heart.  Considering that 70% of diabetics die of cardiovascular related complications, this is not a good thing.

Researchers looked at 115 trials, 62 of which reported information on major cardiovascular events.  Here’s what they found:

  • Sulfonylureas increased with risk of stroke by 28%.
  • Overall risk of death was increased by 22% with sulfonylureas

Keep in mind that this is a drug used to protect diabetics from damage from the condition.  Ironically, this class of drugs does nothing of the sort.  Rather, this class of drugs destroys the very cells that are needed to protect against diabetes while, on the even darker side, patients taking this class of drugs are more likely to die, most likely from heart disease and stroke.

It would seem that the risk of dying from all the available diabetic drugs is increased.  Given that I’m a “lifestyle guy,” this would be the point at which I would bring up the fact that lifestyle remains the ONLY answer to avoiding and managing diabetes.  Period.  Any other path will kill you before it saves you.

Think You’re NOT Prediabetic? Better Think Again

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It’s pretty clear that the percentage of the US population that is prediabetic is startlingly high. But of course, this does not apply to you, right?  Better rethink that.

I won’t repeat my belief that the diabetic spectrum is the worst thing that the human physiology experiences (oops…I guess I just did).  But this article isn’t about the horrendously high risk to your long term health that the diabetic spectrum produces, but rather just how common it is.

With my depth of understand into diabetes, it doesn’t take much time for me to decide if someone is headed towards diabetes.  Looking at a new patient’s health history, family history and the patient’s body type is usually enough.  Rarely, an additional tidbit from the patient is needed (very poor dietary habits despite a lean body type, high stress, etc..).  Labwork usually just confirms what I was already suspecting.

Labs are an interesting phenomena.  I’ve had patients over the years (usually male) who are genuinely afraid of having labs drawn.  I think this stems from the environment we have created in medicine.  In medicine today labs are run to find something wrong.  It’s just a matter of time before something on them is going to come back abnormal.  In our office, if we run labs, we’re trying to find out just how well that patient is living for his or her genetic structure.

When I look to evaluate the diabetic spectrum, I am not merely looking at blood glucose or HbA1c.  Rather, I’m looking at liver enzymes (AST, ALT), GGT, the entire lipid panel, urinary microalbuminuria levels and uric acid levels.  It’s about stepping back and looking at the whole picture.

When your doctor is able to understand how all of these lab values create a picture that combines with your body type, heritage and family history–this is when the true picture of whether or not you are headed to diabetes or not and just how fast you’re moving on that path.

So why the diatribe?  Of course, it relates to this particular article.

In this article, the CDC looks at the problem with prediabetes.  In 2010, a whopping ONE-THIRD of the US population was prediabetic.  All of this is ok, because once someone realizes that they are on the path to diabetes, he or she can make the lifestyle changes needed to divert the diabetic diagnosis (which can be read in my free downloadable ebook, Dr. Bogash’ Lifestyle Recommendations).

But how many of you walking around fall into this 1/3 statistic but don’t know it?

Are you sitting down?

89%.  Yes—only a mere 11% of the prediabetic population were even aware that they were prediabetic.

On the bright side, this is up from 7% in 2005.  What a mess.

This is like having all the risks of being a smoker, but not knowing that you’re a smoker.  That is the problem.  It’s not like this unaware population is doing ok, and it’s merely a fact that, at some point in the future, they are likely to become diabetic.

Being prediabetic is in no way, shape or form a benign process.  It is just as bad for you as diabetes, maybe even more so because the vast majority of people who are prediabetic are not aware of it.

Maybe it’s time to take a very hard look at yourself.  Carrying even a little too much weight around the middle?  Cholesterol or triglycerides too high?  Skip breakfast on a regular basis?  Stressed out all the time?  Have’t had your heart rate over 120 in years?

Don’t rely on your doctor to tell you.  I’ve seen way too many cases over the years where patients were clearly on their way to diabetes but the primary care doctor did not inform the patient that this was the case.

If any of this even might fit you, it’s time to make some changes.  Today.  With the massive increase in heart attacks, cancer and stroke, tomorrow may be too late.

Does Your Neuropathy Support Formula Include This?

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As diabetes increases, so will peripheral neuropathy. Many turn to supplements for help, but you need to make sure your neuropathy support formula contains this.

Diabetic neuropathy is serious stuff and can become one of the most devastating and life-destroying side effects of diabetes.  Worse, there are few treatments that can effectively treat the pain.  Imagine that your feet are on fire.  Walking, sitting and even sleeping can be difficult.  I have had a grown man cry from the pain and frustration.

You can try some of the anti-seizure drugs like Neurotonin (gabapentin) or Lyrica, but the results from these drugs are not exactly stellar and can leave you walking around like a zombie.  And since you were probably limping around like a zombie before you took the medications, it’s hard to see this as an improvement.

The best approach possible to avoid diabetic peripheral neuropathy is to not become diabetic in the first place.  Diabetes is very bad for all of your nerves.  That is why Alzheimer’s dementia and Parkinson’s disease are being considered as a Type 3 diabetes.   That is why tinnitus may be a decades-early warning sign that you are on your way to diabetes.  It’s all because glucose is the preferred form of fuel for your brain and nerves.  Mess with that, and you’ve got problems.

Let’s say that the first hurdle to avoiding diabetic neuropathy is a little past (in other words–you’ve been diagnosed with diabetes).  The next most important step is to do everything possible to manage your blood sugar.  This does NOT mean taking the medications you’ve been given the way you’re supposed to be.  Here’s a wee bit of knowledge…the most commonly prescribed first line medication for diabetes is metformin.  Metformin is designed to improve the way your liver uses glucose.

Yep.  Just your liver.  As a prediabetic or a diabetic, every single cell in your body is having a problem using blood sugar the way and at the levels it is supposed to be used.  That means your liver, your heart, your muscles and your brain.  And how many of these important organs does metformin address?  Just one.  That means that, using metformin in the hopes of lowering your risk of developing peripheral neuropathy is not a bet you should be placing.

Lifestyle changes (my general recommendations can be read by clicking here), on the other hand, increase every single cell’s relationship with insulin and blood sugar in your body.  To me, this seems like a much better option than a medication that only works on a single cell type in your body.

Besides lifestyle, there are certain supplements that have been show to increase the efficiency at which your neurons work.  This particular article highlights one of the most powerful.

While you have to keep in mind that this is a mice study, researchers found some very interesting results when mice who were prone to diabetic neuropathy were given coenzyme Q10 and compared to mice who were not given CoQ10.  Here’s what they found:

  • The mice not given CoQ10 had a loss of sensation, decreased touch and pressure sensation, more pain sensitivity to cold (allodyna), and the sciatic nerve was not working as well (decreased conduction velocity). Overall, the nerves were not happy.
  • All these changes were mostly absent in the group with the daily CoQ10 treatment when started at 7 weeks.
  • There was a 33% loss of neurons in the lumbar 5 nerve root ganglia (DRGs).  This loss was not present when CoQ10 was used.

Overall, it was clear that coenzyme Q10, when used early, protects the nerves from damage that occurs during diabetes (Tweet this).  While lifestyle changes are a must, if would be a smart idea to include CoQ10 as a part of your neuropathy support formula.

The question is, however, can CoQ10 help with diabetic peripheral neuropathy once it’s already present?  If you have taken CoQ10 to help, did it work for you?

Risk Factors for Heart Disease: Diabetes Tops the List

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If queried, many would name high cholesterol as one of the major risk factors for heart disease. Not even close. Many wouldn’t think of a condition 50% of us have.

I was giving a short presentation last week and one of the participants asked about diabetes and heart disease.  I had mentioned that, for me, there is little difference between the two, and this appeared to be something she had not heard before.

While not surprising, this fact is very true.  84% of diabetics die of cardiovascular related complications (heart disease and stroke combined).  So it would seem to me that every diabetic needs to work on protecting his or her heart.

Here’s the good news: improving your lifestyle to protect or improve diabetes and improving your lifestyle to protect your heart are one and the same.  Good luck trying to find something to avoid or improve your diabetes that doesn’t have a protective effect on the heart.  Exercise?  Both.  Stress management?  Both.  Avoiding BPA in plastics?  Both.  Nuts?  Both.

You get the idea.

So why does this concept seem to be a secret?  Maybe it’s because primary care doctors or endocrinologists manage diabetes and cardiologists manage heart disease.  Sad to think this way, but it seems to fit.  The closest we seem to come to managing both conditions is to make sure that diabetics are taking his or her diabetic medications or that diabetics are taking their Lipitor.  No one seems to take into account that these two conditions are caused by the same lifestyle choices, rather than being two separate entities needing to be managed with distinct tools.

This particular study drives this concept home.  Researchers looked at HbA1c levels and how they related to the risk of heart disease.  HbA1c is a marker to see how well you have been managing your blood sugars over the past 3 months or so.  HbA1c is actually a protein in red blood cells that gets damaged by blood sugar when it goes up.  So, higher blood sugar = more damage to the proteins in your body.  EVERY protein, not just this one.  So lower is always better.  Higher means that every protein in every cell of your body is being damaged more.  Not good.

Here’s the problem: elevations in HbA1c do not just occur in diabetes.  Basically, it’s a spectrum, with lower numbers being better and higher numbers getting worse.  Whether or not you are diagnosed with diabetes, higher HbA1c numbers are not good, and in the study, elevated HbA1c levels were associated with heart disease regardless of whether or not the person had been diagnosed with diabetes (yet).

The bottom line is, regardless of whether you are diabetic or prediabetic, your heart is in grave danger.  Luckily, you don’t need to pick which condition you want to make lifestyle changes for.  My recommendations can be found here.

Are you at risk?

Healthy Diet Plans That Are Good for Diabetics: The VLCD

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Avoiding or controlling diabetes is critically important. You know that healthy diet plans can go a long way here, but is there one that is good for diabetics?

Diabetes is a chronic condition that will require a lifetime of management and, most likely, a slowly progressive need for more and more medications.  We can’t cure diabetes.  Or can we?

We generally don’t think of a “cure” in medicine today, unless it is cancer we are talking about.  And with cancer, it is looked at as more of a goal than an outcome.  As a goal, we generate emotions with such words as cancer “cure” and “survival.”  Emotions lead to donations (Hey!  That’s a pretty good slogan…).

Back to diabetes.  For those of you have been diagnosed with diabetes, did your doctor ever really discuss a cure?  From what I see in my patients the lifestyle recommendations are usually token recommendations only.  Carb counting, supportive nature of artificial sweeteners like Splenda and poor promotion of exercise seem to be the norm.

The medications usually start out with some version of Metformin.  We used to use the sulfonylureas like glipizide (Glucotrol), but their use seems to be decreasing.  Given that the research strongly suggest that this class of medications destroys the beta cells of the pancreas, it’s probably a good thing doctors are using them less.

Add to the Metformin some blood pressure medications (just hopefully not a beta blocker like Atenolol because these will actually make your diabetes worse and increase your risk of stroke) and probably something to control your cholesterol.  Just not statins, because they will probably make your diabetes worse as well.

And then we have the brand new and shiny drugs that affect GLP-1 pathways like Januvia, Byetta and Victoza.  These drugs are very expensive, of unsure effectiveness beyond currently available medications and are surrounded by concerns over thyroid cancer and destruction of the pancreas (this last one is my own concern, which I have covered in a prior blog post that can be read here).

And ultimately, all paths lead to insulin.

That’s pretty much the limit of what mainstream medicine has to offer.  No wonder we never discuss a “cure.”

Based on my knowledge of physiology and the vast amount of medical literature I read related to diabetes, I can tell you that a cure is very possible, provided you are willing to make some serious changes.  You cannot expect an answer within the lifestyle that made you diabetic in the first place.

Diet and exercise obviously play a massive role in the way our body manages sugar handling.  The right advice and motivation can go an incredibly long way.  While I have covered my views of short burst aerobic activity and the positive effects on diabetes in prior blog posts, this post will look at one of the most powerful dietary approaches.

Regular readers of the Rantings will know that I am a very big fan of calorie restriction without nutrient restriction.  This comes in a variety of flavors, from long term caloric restriction to alternate day caloric restriction to a short term very low calorie diet.

Our own in office weight loss program uses a very low calorie diet for 2-6 weeks to initiate weight loss.

 This particular study looks at what happens in the brains of diabetics on a 4 day very low calorie diet.  The results are heartening.

Before we go into the results, you need to understand what they hypothalamus does in the brain.  It controls body functions such as temperature, hunger, thirst and fatigue.  Let’s just say it’s really important.

In a normal person who is not diabetic, the hypothalamus responds to sugar in the bloodstream and responds appropriately.  In diabetics, however, the hypothalamus becomes insensitive to glucose and does not respond the way it is supposed to.  This is not a good thing.

Back to the study.  Researchers put 10 type 2 diabetic males on a very low calorie diet (typically anywhere from 500-700 calories / day) and looked at what happened to glucose sensitivity in the hypothalamus.

As expected, all participants in the study showed an increase in sensitivity to glucose in the hypothalamus.  (Tweet this)

What this means is that a very low calorie diet for a mere 4 days was able to begin the process of changing the diabetics system around.  This is consistent with studies that have shown that insulin dependent diabetics can be off of insulin in 1 week on a very low calorie diet.

4 days of dietary changes can do something that not a single medication used to manage diabetes can do.  And yet the recommendations given to diabetic patients remain rudimentary and basic and of little value.

What lengths would YOU go to to manage your diabetes?

Phenotypic effects of leptin replacement – (04-22-04)

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Phenotypic effects of leptin replacement on morbid obesity, diabetes mellitus, hypogonadism, and behavior in leptin-deficient adults

Remember that leptin is a hormone secreted by the adipose cell that, in a healthy state, will decrease appetite and speed up metabolism. It should act as a regulator of body weight–more adipose tissue, more leptin and faster metabolism to lose the fat–less fat, less leptin and metabolism slows down again. I really do believe that somewhere in the leptin pathway lies an important approach to obesity. As soon as we start to learn ways to make cells more responsive to leptin’s message, we will begin to see more effective approaches to weight loss.

PNAS — Abstracts: Licinio et al. 101 (13): 4531 –

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