The connection between diabetes, heart disease

By Cami Wells

Diabetes is a serious condition that happens when your body can’t make enough of a hormone called insulin or can’t properly use the insulin it has. Insulin helps your body digest sugars that come from what you eat and drink. Without enough insulin, sugar builds up in your blood. Over time, that sugar buildup damages your nerves, blood vessels, heart, and kidneys.

More than 29 million Americans have diabetes, or about 1 of every 11 people. About 8 million of them don’t know they have diabetes. Another 86 million — more than 1 in 3 Americans older than 20 — have prediabetes, a condition in which a person’s blood sugar is high, but not yet high enough to trigger diabetes. Most people with diabetes have type 2 diabetes. Adults with type 2 diabetes are about twice as likely to die from heart disease as adults who do not have diabetes. Here are a few more surprising facts about diabetes:
-- Women with diabetes have a 40 percent greater risk of developing heart disease and a 25 percent greater risk of stroke than men with diabetes do. Experts aren’t sure why the risk is so much greater in women with diabetes than in men with diabetes. Women’s biology may play a role: Women usually have more body fat, which can put them at greater risk for heart disease and stroke.

-- Diabetes is the seventh leading killer of Americans. In 2014, more than 76,000 people in the United States died from diabetes. But diabetes often contributes to deaths from other causes, including heart disease, the leading killer of Americans.

-- Type 2 diabetes among young people is on the rise. So is obesity. Type 2 diabetes was once thought to be a condition that developed only in older adults. Now, because obesity is common at all ages, type 2 diabetes is becoming a problem for people of all ages.
Making healthy lifestyle changes can help you prevent or control diabetes and lower your chances of getting heart disease and stroke. Take the following steps to lower your risk of diabetes:

-- Stay physically active. Physical activity helps keeps your blood vessels healthy and your weight under control.

-- Choose healthy foods. Choose fiber-rich foods, such as fresh vegetables, fruits, and whole grains.

-- Reach a healthy weight. Research shows that losing even a small amount of weight by exercising and making healthy eating choices can prevent or delay type 2 diabetes in people with high risk. Talk to your doctor about what a healthy weight is for you.

-- Quit smoking. If you have diabetes and use tobacco, your risk of heart and blood vessel problems is even greater. Smoking raises your blood sugar, cholesterol, and blood pressure.

-- Take your medicine as directed. It is important that you take any medicine you have been prescribed for your diabetes, such as medicine to control your blood sugar, as directed. You may also need to take medicine for related conditions, such as high blood pressure or high cholesterol.

http://www.theindependent.com/life/food/the-connection-between-diabetes-heart-disease/article_045abb4a-bd91-11e6-9eb7-2f561e81831f.html

How to lose excess weight – diet, exercise or both?

By Jill Barker

There are more reasons to lose weight than trying to fit into those skinny jeans relegated to the back of your closet. Being overweight raises the risk of various chronic health conditions that, over the long haul, reduce not just quality of life but longevity. For every five-point increase in BMI (body mass index), mortality from diabetes surges by 116 per cent, mortality from renal disease by 60 per cent and mortality from vascular disease by 30 per cent.
With stats so dramatic, it’s no wonder health care professionals recommend losing excess weight before it starts to affect health. And unlike the amount you might need to drop to get into those skinny jeans, losing even small amounts of weight can have a positive effect.
But weight loss isn’t the only way to ward off chronic disease. Exercise has a proven track record for boosting health and longevity, even if the numbers on the scale refuse to move. Given the efficacy of both approaches, could the combination of eating less and exercising more offer double the health benefits when compared to exercise or dieting alone?
A U.S. research team, who already reported that weight loss — through diet or exercise — resulted in similar improvements in reducing cardiovascular risk factors, decided to test the theory on a group of 52 overweight men and women. Dividing the group into three, the goal was a six to eight per cent weight loss over 12-14 weeks by diet, exercise or a combination of the two.
All three approaches to weight loss were designed to create an energy deficit of 20 per cent. Those in the diet-only group were expected to reduce their portion sizes and to replace high calorie foods and snacks with fruit, vegetables and whole grains. The exercise-only group was encouraged to engage in moderate to high intensity cardiovascular exercise daily. The diet-and-exercise group used both methods. All subjects were monitored throughout the study and their diet and exercise prescriptions adjusted so that everyone could realize the same degree of weight loss.
As per the study’s design, all three groups lost the same amount of weight, about seven per cent, which resulted in a similar decrease in fat mass (15 per cent) and waist circumference. And surprisingly, despite differences in how they lost the weight, all experienced the same 10 per cent decreased risk of developing cardiovascular disease.
“We hypothesized that calorie restriction and exercise would yield greater improvements in risk factors for cardiovascular disease than would similar weight loss from calorie restriction or exercise alone. However, the results did not support this hypothesis,” said the researchers. “A straightforward interpretation of the findings from the present study is that weight loss itself provides the major cardioprotective effect of calorie restriction and exercise and that the benefits do not depend on which approach to weight loss is used.”
But that doesn’t mean exercise is without its added benefits. The exercise-only group lost the weight without losing valuable muscle, compared to a 2.5 per cent and 1.6 per cent decrease in fat free mass in the diet-only and diet-and-exercise groups, respectively.
Also of interest is the difference in the amount of exercise and calorie restriction needed to realize the same weight loss in all three groups. The diet-only group decreased the number of calories they consumed by 32 per cent, compared to 27 per cent fewer calories consumed by the diet and exercise group. Meanwhile the exercise-only group realized their weight loss by burning 412 calories daily (about 7.5 hours of exercise a week) through exercise, almost double that of the diet-and-exercise group, who sweated off 217 calories a day (roughly 4.5 hours a week).
Worthy of consideration, too, is the short duration of the study and the fact that the results were measured only in terms of their ability reduce cardiovascular risk, offering a very narrow view of the potential health benefits of all three weight loss strategies. Extending the study over a longer period of time or until a more significant weight loss is achieved may indeed show that eating less and exercising more results in more significant health gains than exercising or dieting alone.
In addition, the diet-and-exercise group actually exercised less and ate more than the diet-only and exercise-only crowd, which could be why the results didn’t have more of an impact on cardiovascular risk. It may be that the necessary threshold needed for exercise to significantly influence health wasn’t reached in those who combined diet and exercise.
So what’s the best way to lose weight so that it has the maximum impact on health? The answer is: any way you think you can be the most successful. As for exercise, consider it a value-added opportunity in that it helps preserve valuable fat-free mass (muscle) and requires you cut back fewer calories to achieve the same results as dieting alone. Then of course there’s exercise’s ability to help you have more energy in the day, sleep better at night and improve your overall mood, something this study wasn’t designed to capture but makes life just that much better no matter what your weight.

http://news.nationalpost.com/health/how-to-lose-excess-weight-diet-exercise-or-both?__lsa=f487-d536

How Fasting Reverses Type 2 Diabetes

By Dr Jason Fung

While many consider type 2 diabetes (T2D) irreversible, fasting has been long known to cure diabetes. In our previous post, we considered bariatric surgery. While extreme, these surgeries have proven the point that the metabolic abnormalities that underlie T2D (hyperinsulinemia, insulin resistance) can be fully reversible even after a few short weeks.
Many early studies were done with the heavy-duty Roux-en-Y surgery, which is the heavyweight champions of surgeries. The best weight loss. The most complications. This is the surgery that has ‘Go Big or Go Home’ tattooed on its massive bicep.
But even milder forms of bariatric surgery show the same reversibility of T2D. A gastric band is essentially a belt implanted around your stomach. The surgeon keeps tightening the belt so that you can’t eat. If you try to eat too much, you’ll puke it all back up. Lovely. It ain’t pretty, but it sure does work. Again, long term results are kind of iffy, but short term results are pretty good.

The results of gastric banding versus medical treatment showed a significant and pretty damn good drop in their fasting blood sugars. In other words, their T2D was reversing in a b-i-g way. Those given medicines alone basically stayed the same. They were no better than before.
Gastric banding a 500 pound patient will still reverse 20 years of diabesity within weeks. One of the main questions is why? There are many hypotheses, but essentially, it is the sudden severe restriction of all calories that causes this beneficial effect. This is the same thing as the time tested, ancient healing tradition of fasting. Fasting is the voluntary restriction of food for religious, health or other purposes (eg. hunger strikes). Is bariatrics simply a surgically enforced fast? The short answer is yes.

It’s not a progressive disease

The success of both bariatrics and fasting proves that T2D is not progressive and chronic. It’s in fact a fully reversible disease. Consider this real life example. A lady in her mid 60’s was injecting 120 units of insulin daily along with 2 grams/day of metformin (a type of medication used for T2D). She had T2D for 27 years and had been progressively using higher and higher doses of insulin in an effort to control her blood sugars. However, things were getting worse.
In desperation, she was referred to the Intensive Dietary Management Program. We started her on a regimen that included fasting under strict medical supervision. We started with a full week of fasting and immediately reduced her medications. When she was feeling well, she continued for a second week, then a third. By that time she was off her insulin. We then switched to a LCHF diet along with alternate daily fasting. It’s been over a year now, and she continues to be off all insulin and medications with a HbA1C of 5.9%. Technically, she is no longer diabetic (defined by an A1C of less than 6%).
She feels terrific – with more energy now than she has had for over a decade. Her husband was so impressed that he also started our program and has recently come off all his insulin, too.
But wait! The diabetes ‘experts’ insist that T2D was a chronic and progressive disease! How can this lady, with her 27 year history of T2D, suddenly reverse all her disease and become non-diabetic? How can this possibly happen?

The answer is fasting

The answer is quite simple. The statement that T2D is chronic and progressive is just a lie. The ‘experts’ were being economical with the truth. Spinning a yarn. Pulling a ‘Bill Clinton’. But any lie, repeated often enough with enough authority, gains the semblance of truth.
But the fact that fasting cures diabetes has been known for close to 100 years! One of the most famous diabetologists in the history of the world – Dr. Elliot Joslin wrote about it in the Canadian Medical Association Journal in 1916! In fact, he thought that it was so obvious that fasting was helpful that studies would not even be necessary. This, from the guy that Harvard University used to name its world famous Joslin Centre for Diabetes.
What happened to Joslin and fasting for diabetes? Well, back then, medical science had not yet distinguished Type 1 and Type 2 diabetes. Fasting is not useful for type 1, and type 2 was still quite unusual back then. After the discovery of insulin in the early 1920’s, all the focus turned to it as the ‘cure’ for diabetes. While it was a major advance for type 1, it was not quite the panacea for type 2s. However, most of the interest in fasting disappeared as doctors focused on what would be their mantra for the next century – drugs, drugs, drugs. All types of dietary therapy fell into disrepute, since they were really not useful in type 1 diabetes, and have stayed there ever since.
The effect of wartime starvation on T2D also obviously highlights the effect of reducing food consumption on diabetes. During both world wars, the mortality from diabetes dropped precipitously. In the interwar period, as people went back to their accustomed eating habits, it went back up. This, of course is quite easy to understand. Since T2D is essentially a disease of excessive sugar in the body, reducing intake of sugars and carbohydrates should cause less disease.

Bariatrics or fasting?

Returning to the point that bariatrics is simply a surgically enforced fast, you can directly compare the effects of fasting and bariatrics. One fascinating study assessed patients waiting for bariatric surgery who were given a period of fasting beforehand. The reasoning was that many morbidly obese patients had enormous fatty livers. If you could somehow reduce this fatty liver and reduce their weight somewhat, the risk of surgical complications would be reduced since there is now more room to work within the surgical field.
The reduction in liver size would make working in the abdominal cavity much easier, with better vision. Since many of these procedures are done laparascopically, being able to see better is a huge benefit. Also, with less abdominal distention, abdominal wound healing was significantly improved. Therefore, fasting before surgery makes total sense.
In the meantime, you could compare both sugar control and weight loss during the fasting period and also during the post surgical period. Since bariatrics is considered the heavy weight champ, this was a real David vs Goliath battle (Fasting vs Surgery).
In the graph below, you can see the results. In the first graph, fasting caused 7.3 kg weight loss compared to only 4 kg for surgery. The second graph shows the overall ‘glycemia’ or the total amount of sugar in the blood over the day. During fasting, there was far less sugar in the blood (1293 vs 1478). On both counts you can see that the fasting was actually significantly better than the surgery! Blood sugars came down faster, as did weight. David (fasting) did not simply beat Goliath (bariatrics), he beat him like a rented mule
If all the benefits of bariatric surgery accrue because of fasting, why not simply do the fasting and skip the surgery? The standard answer is that people cannot do the fasting without the surgical enforcement. But have they ever tried? How do you know that you cannot fast for an extended period of time if you have never tried it? Shouldn’t you at least give it a shot before giving up?
But my main point is again, not to criticize or praise surgery. Rather my point is this. Fasting cures diabetes. Rather than the chronic and progressive disease that we have been promised, instead T2D turns out to be a treatable and reversible condition. Both practices of fasting and bariatric surgery prove the point. This is a curable disease. Type 2 diabetes is entirely reversible. This changes everything. A New Hope arises.

https://www.dietdoctor.com/fasting-reverses-diabetes

New diabetes treatment could eliminate need for insulin injections

By Hannah Devlin

A cell-based diabetes treatment has been developed by scientists who say it could eliminate the need for those with the condition to inject insulin.
The therapy involves a capsule of genetically engineered cells implanted under the skin that automatically release insulin as required. Diabetic mice that were treated with the cells were found to have normal blood sugar levels for several weeks.
Scientists said they hope to obtain a clinical trial licence to test the technology in patients within two years. If successful, the treatment would be relevant for all type 1 diabetes patients, as well as those cases of type 2 diabetes that require insulin injections.
Martin Fussenegger, who led the research at the ETH university in Basel, said: “By 2040, every tenth human on the planet will suffer from some kind of diabetes, that’s dramatic. We should be able to do a lot better than people measuring their glucose.”
Fussenegger said that, if confirmed as safe and effective in humans, diabetes patients could be given an implant that would need to be replaced three times a year rather than injections, which do not perfectly control blood sugar levels, leading to long-term complications including eye, nerve and heart damage.
In Britain, about 400,000 people have type 1 diabetes and three million have type 2 diabetes, about 10% of whom need to inject insulin to control the condition.
Type 1 diabetes normally begins in childhood and is an autoimmune disease in which the body kills off all its pancreatic beta cells. The cells respond to the body’s fluctuating glucose levels by releasing insulin, which regulates blood sugar. Without beta cells, patients need to monitor glucose and inject insulin as required – typically several times each day.

  

Previously, scientists have attempted to artificially cultivate pancreatic cells from patients’ stem cells. However, scientists have struggled to manufacture the cells at the scale necessary for clinical use, and the cells are naturally prone to dying off once introduced into the body, according to Fussenegger. “They are prima donnas in the cellular context,” he said.
His team took a different approach, choosing to re-engineer human kidney cells, known as HEK cells, to perform the function normally carried out by the pancreas. Two genes were introduced into the cells – one to make them sensitive to glucose levels and a second to instruct the cell to pump out insulin when glucose levels exceeded a threshold.
“We believed we needed a more robust cell type if you go for cell-based therapies,” he said.
In the study, published in Science, the engineered HEK cells were found to outperform normal pancreatic cells in terms of their ability to regulate blood sugar in mice. They were healthy three weeks after the implant and performed normally on various tests designed to measure their ability to control blood sugar.
“It’s hard to understand why ours should be better than something that evolved for millions of years,” said . “It shows that as engineers, thinking rationally, we can also do a very good job.”
In the study, mice were treated such that they lost all their insulin-producing pancreatic cells. The cells were then implanted into the mice, enclosed in a teabag-like porous capsule that protected the human cells from the mouse immune system, but allowed insulin to diffuse out.
In humans, the same approach would mean cells would not need to be genetically matched to the patient, and frozen capsules could be manufactured on an industrial scale.
The team behind the work have created a start-up to commercialise the technique and hope it could reach the market within a decade.

Emily Burns, research communications manager at Diabetes UK, said: “We can already replace the cells in the pancreas that are damaged in type 1 diabetes by using cells taken from donated pancreases, but one of the issues with this approach is that there aren’t enough donors. That’s why research like this is so important: finding ways to produce an unlimited supply of pancreatic cells, or cells that act like them, in the lab.”

https://www.theguardian.com/science/2016/dec/08/new-diabetes-treatment-could-eliminate-need-for-insulin-injections

New study indicates weekly consumption of chocolate lowers the risk for diabetes

By Margaret Nagle

New research from the Maine-Syracuse Longitudinal Study (MSLS) confirms that persons who eat chocolate at least once a week have a lower prevalence of diabetes and are at lower risk for a diagnosis of diabetes four to five years later.
The study also indicates that the relation between the frequency of chocolate consumption may be due to an active choice on the part of diabetics. For example, diabetics may choose to reduce their frequency of chocolate consumption in an effort to reduce sweets, noted the researchers, who published their findings in the journal Appetite.
The research team is led by nutritionist and psychologist Georgina Crichton of the University of South Australia, and University of Maine psychology researchers Merrill "Pete" Elias, Peter Dearborn and Michael Robbins. The research was supported by the National Institutes of Health and the National Health and Medical Research Council, Australia.
The MSLS study of 908 community-dwelling nondiabetic and 45 diabetic participants found that persons who ate chocolate less than once a week were at twice the risk of diabetes mellitus compared to those who ate chocolate more than once a week. Consumption more than once a week did not decrease risk further.

Persons who never or rarely ate chocolate had almost twice the risk of having diabetes five years later, compared to those who ate chocolate more than once per week.
Cause and effect relations between chocolate consumption and diabetes have not been established in any study in the literature, but in their research, the MSLS investigators concluded that a bidirectional relationship couldn't be ruled out, modest amounts of chocolate protect against diabetes, but some diabetic individuals chose to eat modest amounts of chocolate.
After 2000, when the health benefits of chocolate became more widely known, persons who ate moderate amounts of chocolate had less incidence of developing diabetes. Indeed, the study shows that the number of new cases of diabetes mellitus did not rise significantly for the next four to five years.
The MSLS investigators emphasize that their data do not argue against a causal relation between eating chocolate and developing diabetes. But they point out that the direction of the association may be reversed in some individuals.
"Regardless of the direction of the relation between chocolate consumption and diabetes mellitus, consuming chocolate at least once a week very much appears to be a win-win with regard to health benefits and cognitive performance for those who do not have special health restrictions on chocolate," says Elias, who directs MSLS.
In the MSLS study, specific quantities of chocolate eaten were not measured. However, findings from a number of studies would suggest that a moderate consumption of approximately one ounce (or 25 grams) of chocolate once a week, i.e. about a third of a typical chocolate bar, may be associated with health benefits, such as reduced arterial stiffness and better cognitive performance.
It is unclear if the benefits of chocolate are limited to dark chocolate. It is widely hypothesized that the cocoa flavanols, found in larger amounts in dark chocolate, are responsible for its health and cognitive benefits. Elias points out that clinical trials are necessary to establish whether only dark chocolate is beneficial.
This is the latest collaborative study involving the University of Maine and University of South Australia researchers using MSLS to examine the health benefits of chocolate, including increased cognitive function.

http://medicalxpress.com/news/2016-12-weekly-consumption-chocolate-lowers-diabetes.html

Diabetes and stress are strongly linked with each other

From knowridge.com

A Rice University study has found a link between emotional stress and diabetes, with roots in the brain’s ability to control anxiety.
That control lies with the brain’s executive functions, which handle attention, inhibition, working memory and cognitive flexibility and are also involved in reasoning, problem-solving and planning.
The study is published in Psychoneuroendocrinology.

It establishes a metabolic chain reaction that starts with low attention control, which leaves a person vulnerable to tempting or distracting information, objects, thoughts or activities.
Previous studies have shown that such vulnerability can lead to more frequent anxiety, and anxiety is known to activate a metabolic pathway responsible for the production of pro-inflammatory cytokines, signalling proteins that include interleukin-6 (IL-6).
Along with cognitive tests that measured attention control, the Rice study measured levels of both blood glucose and IL-6 in more than 800 adults.
IL-6 is a protein the body produces to stimulate immune response and healing.
It is a biomarker of acute and chronic stress that also has been associated with a greater likelihood of diabetes and high blood glucose.
The research showed individuals with low inhibition were more likely to have diabetes than those with high inhibition due to the pathway from high anxiety to IL-6.
The results were the same no matter how subjects performed on other cognitive tests, like those for memory and problem-solving.
Researchers have suspected a link between anxiety and poor health, including diabetes, for many years but none have detailed the biological pathway responsible, said lead author Kyle Murdock, a postdoctoral research fellow in psychology.
He said the Rice study takes a deeper look at how inflammation bridges the two.
“Plenty of research shows that when individuals are stressed or anxious or depressed, inflammation goes up,” he said.
“The novel part of our study was establishing the pathway from inhibition to anxiety to inflammation to diabetes.”

https://knowridge.com/2016/12/diabetes-and-stress-are-strongly-linked-with-each-other/

2 easy ways people with diabetes can get better blood sugar control

From cbsnews.com

For people with type 2 diabetes, better blood sugar control may be as easy as getting up off the couch and standing every so often, or taking a leisurely walk, a new study shows.
Dutch researchers noted that “moderate to vigorous” exercise is often recommended for people with diabetes -- but most patients don’t comply with that advice.
This small new study suggests that even sitting a bit less might be of real benefit.
One diabetes expert in the United States agreed with that advice.
“For years, I would suggest an exercise regimen to my patients that I knew was doomed to failure,” said Dr. Robert Courgi, an endocrinologist at Northwell Health’s Southside Hospital in Bay Shore, N.Y.
However, “by tweaking the message a bit, the odds of success increase significantly,” he said. “Ultimately, any activity helps lower glucose [blood sugar]. The message of ‘sitting less’ will have a higher success rate than exercise regimens of the past.”
Current physical activity guidelines call for a minimum of 150 minutes of moderate to vigorous exercise a week to help prevent type 2 diabetes. But the study authors pointed out that nine out of 10 people fail to meet this guideline.
The new study was led by Bernard Duvivier of the department of human biology and movement science at Maastricht University Medical Centre in the Netherlands. His team wanted to see if a program to reduce sitting time -- by encouraging patients to simply stand and do light-intensity walking -- could offer an alternative to a standard exercise regimen.
The study included 19 adults, average age 63, with type 2 diabetes who did three programs, each lasting four days. In the first program, the participants sat for 14 hours a day and did only one hour a day of walking and one hour a day of standing.
In the second program (the “sit less” program), the participants did a total of two hours a day of walking and three hours a day of standing by breaking up their sitting time every 30 minutes.
In the third program (exercise), the participants replaced an hour a day of sitting time with indoor cycling.
The sit less and exercise programs were designed to burn similar amounts of energy, the researchers said.
Significant improvements in blood sugar control occurred when the patients did the sit less program or the exercise program, but the improvements were generally stronger during the sit less phase, according to the study.
Courgi said the new trial has helped him “rethink the way I treat diabetes with exercise.”
He said that, although it would be nice to see the results replicated in a larger trial, the study findings remain “very interesting.”
The study was published Nov. 30 in the journal Diabetologia

http://www.cbsnews.com/news/type-2-diabetes-blood-sugar-control-sitting-less-standing-walking-moving/