More Kids Than Ever Have Type 2 Diabetes

Doctors seek to establish a gold standard for their care of Kids with Type 2 Diabetes

 

By Erika Gebel, PhD

 

Fifteen years ago type 2 diabetes  in children was almost unheard of. Since then, as the number of cases has crept up, scientists have sought to figure out how best to treat this type of diabetes in young people.

 

A 2007 study in the Journal of the American Medical Association estimated that there are about 3,700 new cases of type 2 diabetes a year among youth in the United States. The evidence suggests that type 2 behaves differently in children than in adults, an insight that may help doctors give kids with type 2 the best possible care.

 

Kids With Diabetes in the U.S., 2009 (Under age 20)

More than 19,000 have type 2

More than 168,000 have type 1

Source: SEARCH trial

 

Rising Numbers
In June, researchers from the SEARCH for Diabetes in Youth study released data showing that type 2 diabetes in 10- to 19-year-olds had increased 21 percent between 2001 and 2009. “Twenty-one percent is substantial,” says Elizabeth Mayer-Davis, MSPH, PhD, RD, of the University of North Carolina–Chapel Hill, who is a SEARCH researcher. “That was really driven by the Hispanic and non-Hispanic white youth.” Type 2 diagnosis rates didn’t increase in Native Americans, Asian/Pacific Islanders, or African Americans during these years. This may be good news, says Mayer-Davis, suggesting that rates may be leveling off, but only time will tell. The researchers also noted that the number of cases of type 2 rose faster among girls than in boys.

SEARCH researchers excluded children under 10 years old from their calculations. “Really, type 2 diabetes is exceedingly rare under the age of 10,” says Mayer-Davis, a former American Diabetes Association president of health care and education. The great majority of people with diabetes under 21 years old have type 1, she adds. In 2009, only 1 in 3,000 people between ages 10 and 19 had type 2 diabetes. With type 1, there were 6 cases per 3,000 people between newborn and 19. However, the ratio of type 1 to type 2 diabetes varies among ethnic groups. In new cases of diabetes among African American adolescents over 10 years old, “about 40 percent have type 1 and 55 percent or so have type 2,” says Mayer-Davis. With non-Hispanic white kids, 80 percent are being diagnosed with type 1.

The main culprit for the rise in type 2 among children, experts agree, is weight. “We don’t even entertain the possibility of type 2 when a child isn’t overweight,” says Silva Arslanian, MD, a pediatric endocrinologist at the Children’s Hospital of Pittsburgh. Obesity isn’t the only factor, though. Many kids are overweight and don’t develop diabetes, says Mayer-Davis, so something must lead the beta cells of the pancreas to stop producing enough insulin to control blood glucose in children who develop type 2. That part, she says, remains a mystery.

A complicating factor is that obesity is rising among type 1s as well, just as in the general population. “It becomes hard to make the distinction,” says Arslanian, between type 1 and type 2 diabetes in children. To confirm that a child has type 2, doctors can check the blood for autoantibodies, the hallmark of type 1.

Prevention and Treatment
Because type 2 in kids is such a recent phenomenon, doctors still don’t have a gold-standard treatment. To address this knowledge gap, scientists conducted the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) study, which included 700 children between 10 and 17 with recently diagnosed type 2 diabetes. All participants started on metformin to achieve an A1C (average blood glucose over the previous two to three months) of 8 percent or less. Then a third of kids continued metformin, another third took metformin and rosiglitazone (Avandia), and the rest added a weight-loss program to their metformin. Over an average of four years, researchers tracked how many of the children failed to maintain an A1C of 8 percent or less. None of the regimens worked particularly well: By the study’s end, about half the kids in all the groups had experienced a decline in blood glucose control that required treatment with insulin.

The researchers learned that the need for insulin in type 2 comes “three times faster in children than in adults,” says Arslanian. “As of now, it looks like the deterioration in beta cell function in teenagers occurs sooner than in adults.” This suggests that type 2 in kids progresses rapidly. However, at least part of the reason so many kids with type 2 are on insulin is because they have limited options. There is an abundant selection of medications for type 2 in adults. But in children, the only approved diabetes meds are metformin and insulin.

Diabetes complications are a concern in children with uncontrolled type 2. “A higher percentage of kids with type 2 than type 1 have complications,” such as kidney disease, says Mayer-Davis. Children with type 2 often have risk factors for heart disease, such as high blood pressure and high LDL (“bad”) cholesterol. Kids with these conditions are at increased risk for heart attacks and strokes as adults, so Arslanian says it’s important to treat these risk factors with medications that improve cholesterol and blood pressure. The American Diabetes Association also recommends that children with type 2 get annual screenings for diabetic eye and kidney disease.

The future for adolescents with type 2 diabetes is still uncertain. The condition is so new that scientists don’t know what will happen when these kids grow up. But that’s changing, as researchers continue to learn more about the disease in youth. The goal is to establish a gold standard for treatment so that kids with type 2 get the care they need to become healthy adults.

 

Source: http://forecast.diabetes.org/print/3868

Photo credit: Photo: Erik Isakson/Getty Images

 

Polycystic Ovary Syndrome (PCOS) - Symptoms & Natural Solution

 

What is PCOS?

PCOS is a condition in which a woman’s ovaries and, in some cases the adrenal glands, produce more androgens (a type of hormone) than normal. High levels of these hormones interfere with the development and release of eggs as part of ovulation. As a result, fluid-filled sacs or cysts can develop on the ovaries. Because women with PCOS do not release eggs during ovulation, PCOS is the most common cause of female infertility.

How does PCOS affect fertility?

A woman's ovaries have follicles, which are tiny, fluid-filled sacs that hold the eggs. When an egg is mature, the follicle breaks open to release the egg so it can travel to the uterus for fertilization. In women with PCOS, immature follicles bunch together to form large cysts or lumps. The eggs mature within the bunched follicles, but the follicles don't break open to release them.
As a result, women with PCOS often have menstrual irregularities, such as amenorrhea (they don’t get menstrual periods) or oligomenorrhea (they only have periods now and then). Because the eggs are not released, most women with PCOS have trouble getting pregnant.

What are the symptoms of PCOS?

In addition to infertility, women with PCOS may also have:

• Pelvic pain
• Hirsutism, or excess hair growth on the face, chest, stomach, thumbs, or toes
• Male-pattern baldness or thinning hair
• Acne, oily skin, or dandruff
• Patches of thickened and dark brown or black skin

Also, women who are obese are more likely to have PCOS.
Although it is hard for women with PCOS to get pregnant, some do get pregnant, naturally or using assistive reproductive technology. Women with PCOS are at higher risk for miscarriage if they do become pregnant.
Women with PCOS are also at higher risk for associated conditions, such as:

• Diabetes
• Metabolic syndrome—sometimes called a precursor to diabetes, this syndrome indicates that the body has trouble regulating its insulin
• Cardiovascular disease—including heart disease and high blood pressure

What is the treatment for PCOS?

There is no cure for PCOS, but many of the symptoms can often be managed. It is important to have PCOS diagnosed and treated early to help prevent associated problems. There are medications that can help control the symptoms, such as birth control pills to regulate menstruation, reduce androgen levels, and clear acne. Other medications can reduce cosmetic problems, such as hair growth, and control blood pressure and cholesterol.
Lifestyle changes such as regular exercise can aid weight loss and help reduce blood sugar levels and regulate insulin levels more effectively. Weight loss can help lessen many of the health conditions associated with PCOS and can make symptoms be less severe or even disappear.
Surgical treatment may also be an option, but it is not recommended as the first course of treatment.
NICHD-funded research has also examined the effects of the anti-diabetes drug metformin on fertility in women with PCOS. To learn more about this research, check out the news releases about PCOS.

How is PCOS diagnosed?

Your health care provider will take a medical history and do a pelvic exam to feel for cysts on your ovaries. He or she may also do a vaginal ultrasound and recommend blood tests to measure hormone levels. Other tests may include measuring levels of insulin, glucose, cholesterol, and triglycerides.

The NATURAL SOLUTION
If you are dealing with the symptoms of PCOS, then try the natural solution to address high cholesterol, triglycerides, high blood sugar and obesity - BIOS LIFE SLIM. It's the only natural solution that is listed in the Physicians Desk Reference to address these major health matters. For more information on how you can TAKE BACK YOUR HEALTH - contact me:

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Franchise # 108573501
Phone:312-324-4914
Email: 4HealthyLifeNow@gmail.com
Website: http://www.my.unicity.net/pamelataylor

Follow me on Twitter & Facebook: 4healthylifenow

Source: http://www.nichd.nih.gov/health/topics/Polycystic_Ovary_Syndrome.cfm


 

Top 10 Myths about Cardiovascular Disease

In light of Rosie O'Donnell's recent Heart Attack and the death of a co-worker and Michael Clark Duncan from Heart Disease, I decided to find a resource article to help everyone understand the gravity of heart disease and to help you learn what YOU CAN DO to prevent this illness. My prayers go out to everyone affected by Heart Disease and I cherish loving memories of those individuals that have fought the good fight and are now in their Heavenly Home. Namaste.


Article from American Heart Association - Heart.org

How much do you really know about your heart’s health? It’s easy to be fooled by misconceptions. After all, heart disease only happens to your elderly neighbor or to your fried food-loving uncle, right? Or do you know the real truth – that heart disease can affect people of any age, even those who eat right?
Relying on false assumptions can be dangerous to your heart. Cardiovascular disease kills more Americans each year than any other disease. But you can boost your heart smarts by separating fact from fiction. Let’s set the record straight on some common myths.

1.“I’m too young to worry about heart disease.” How you live now affects your risk for cardiovascular diseases later in life. As early as childhood and adolescence, plaque can start accumulating in the arteries and later lead to clogged arteries. One in three Americans has cardiovascular disease, but not all of them are senior citizens. Even young and middle-aged people can develop heart problems – especially now that obesity, type 2 diabetes and other risk factors are becoming more common at a younger age.

2.“I’d know if I had high blood pressure because there would be warning signs.” High blood pressure is called the “silent killer” because you don’t usually know you have it. You may never experience symptoms, so don’t wait for your body to alert you that there’s a problem. The way to know if you have high blood pressure is to check your numbers with a simple blood pressure test. Early treatment of high blood pressure is critical because, if left untreated, it can cause heart attack, stroke, kidney damage and other serious health problems. Learn how high blood pressure is diagnosed.

3. “I’ll know when I’m having a heart attack because I’ll have chest pain.” Not necessarily. Although it’s common to have chest pain or discomfort, a heart attack may cause subtle symptoms. These include shortness of breath, nausea, feeling lightheaded, and pain or discomfort in one or both arms, the jaw, neck or back. Even if you’re not sure it’s a heart attack, call 9-1-1 immediately. Learn you risk of heart attack today!

4.“Diabetes won’t threaten my heart as long as I take my medication.” Treating diabetes can help reduce your risk for or delay the development of cardiovascular diseases. But even when blood sugar levels are under control, you’re still at increased risk for heart disease and stroke. That’s because the risk factors that contribute to diabetes onset also make you more likely to develop cardiovascular disease. These overlapping risk factors include high blood pressure, overweight and obesity, physical inactivity and smoking.

5.“Heart disease runs in my family, so there’s nothing I can do to prevent it.” Although people with a family history of heart disease are at higher risk, you can take steps to dramatically reduce your risk. Create an action plan to keep your heart healthy by tackling these to-dos: get active; control cholesterol; eat better; manage blood pressure; maintain a healthy weight; control blood sugar; and stop smoking.


6.“I don’t need to have my cholesterol checked until I’m middle-aged.” The American Heart Association recommends you start getting your cholesterol checked at age 20. It’s a good idea to start having a cholesterol test even earlier if your family has a history of heart disease. Children in these families can have high cholesterol levels, putting them at increased risk for developing heart disease as adults. You can help yourself and your family by eating a healthy diet and exercising regularly.

7.“Heart failure means the heart stops beating.” The heart suddenly stops beating during cardiac arrest, not heart failure. With heart failure, the heart keeps working, but it doesn’t pump blood as well as it should. It can cause shortness of breath, swelling in the feet and ankles or persistent coughing and wheezing. During cardiac arrest, a person loses consciousness and stops normal breathing.

8.“This pain in my legs must be a sign of aging. I’m sure it has nothing to do with my heart.” Leg pain felt in the muscles could be a sign of a condition called peripheral artery disease. PAD results from blocked arteries in the legs caused by plaque buildup. The risk for heart attack or stroke increases five-fold for people with PAD.

9.“My heart is beating really fast. I must be having a heart attack.” Some variation in your heart rate is normal. Your heart rate speeds up during exercise or when you get excited, and slows down when you’re sleeping. Most of the time, a change in your heartbeat is nothing to worry about. But sometimes, it can be a sign of arrhythmia, an abnormal or irregular heartbeat. Most arrhythmias are harmless, but some can last long enough to impact how well the heart works and require treatment.

10.“I should avoid exercise after having a heart attack.” No! As soon as possible, get moving with a plan approved for you! Research shows that heart attack survivors who are regularly physically active and make other heart-healthy changes live longer than those who don’t. People with chronic conditions typically find that moderate-intensity activity is safe and beneficial. The American Heart Association recommends at least two and a half hours of moderate intensity physical activity each week. Find the help you need by joining a cardiac rehabilitation program, or consult your healthcare provider for advice on developing a physical activity plan tailored to your needs.

Source: American Heart Association

Diabetes Hits Women Hard at Menopause: Beat It Back

Article from The North American Menopause Society


Diabetes hits women hard, especially at midlife. In the United States, it’s the number 6 killer of women ages 45 to 54 and the number 4 killer of women ages 55 to 64. What’s more, diabetes increases your risk of heart disease, stroke, and many other serious conditions, including blindness, kidney disease, and nerve disease.

Diabetes is on the rise in the United States. The Centers for Disease Control and Prevention (CDC) estimates that 1 in 10 US adults has diabetes now, and if current trends continue, that figure could rise to 1 in 3 by 2050. The increase is nearly all because of the rise of type 2 diabetes, which is most common in obese people age 40 and older. (Type 1 diabetes is much less common and usually starts in childhood or adolescence.) A huge proportion of US adults—more than a third of all of them and half over age 65—have prediabetes, and thus are poised to develop the full-blown disease.

Does menopause increase diabetes risk? That hasn’t been an easy question for researchers to answer. It’s hard to separate the effects of menopause from the effects of age and weight. But it does look like hormones do have something to do with it. If you are a woman over age 50, you’re especially vulnerable, and women pay a heavy price for the disease. They lose more years of life than men with diabetes do. In addition, the death rate for women with diabetes has risen dramatically since the 1970s, while it has not for men with the disease.

Age and overweight (or obesity) are the most common traits that make someone likely to develop type 2 diabetes. A family history of diabetes, prediabetes, minority ethnicity (Hispanic, African American, Native American, Asian, or Pacific Islander), high blood pressure, cardiovascular disease or abnormal cholesterol levels, and inactivity also put people at higher risk of developing diabetes. For women, having high blood pressure develop during pregnancy (called preeclampsia), diabetes during pregnancy (called gestational diabetes), or polycystic ovary syndrome raise the risk even more.

What do the experts say?

•Get tested. The CDC estimates that more than a quarter of people who have diabetes haven’t been diagnosed. The American Diabetes Association recommends that you get tested every 3 years starting at age 45, especially if you are overweight. The US Preventive Services Task Force recommends that adults with blood pressure above 135/80 be screened every 3 years. If you have some additional risks, such as a family history of diabetes, then you should get tested more frequently.

•Diet and exercise. The best way to prevent diabetes is with a healthy lifestyle. The National Institutes of Health sponsored a Diabetes Prevention Program trial, that used “intensive” lifestyle training. The participants in this large clinical trial were overweight and had prediabetes. More than two thirds of them were women, and nearly half were from an ethnic minority group. Some got intense training to change their diet, physical activity, and habits with the goal of losing just 7% of their body weight. Another group took the diabetes drug metformin and got standard advice about diet and exercise. A third group got the standard advice only. The modest but focused lifestyle change did more than anything else to prevent diabetes. It reduced the number of new diabetes cases 58% more than standard advice alone. In contrast, metformin plus standard advice didn’t do nearly as well, reducing the number of diabetes cases 31% compared with standard advice. The message is that many people can benefit from adopting such.

•Take hormone therapy (HT) to prevent diabetes? The NAMS Advisory Panel of experts who helped to develop our NAMS 2012 Hormone Therapy Position Statement say no. Although it is clear that HT can reduce the risk of developing diabetes, that shouldn’t be the reason you start taking it. If you take HT for your menopausal symptoms, it can offer benefits for diabetes prevention and for some of the complications of diabetes but it can also increase risk of stroke. Some of the large clinical trials of HT suggest that starting early—as you go through the menopause transition or shortly after that—may be less risky.

Take some healthy steps

•There are many ways to reduce your risk of diabetes and the risk of diabetes complications:
•Do weight-bearing exercise
•Exercise more in general
•Eat a healthy diet that limits sugar and fat
•Control your weight
•Limit your alcohol intake
•Increase sources of omega-3 fatty acids in your diet with fatty fish (such as mackerel, salmon, sardines) or plant-based sources (such as soy, canola oil, flax seeds, and walnuts)
•For women with osteoporosis, use of bisphosphonate medication may cut the need for insulin

source: http://www.menopause.org/for-women/-i-menopause-flashes-i-/diabetes-hits-women-hard-at-menopause-beat-it-back

Heart Disease Diet: Do You Have a "Wheat Belly"?

By Dr. William Davis, Health Pro

Low HDL cholesterol, high triglycerides, small LDL particles: the most common triad of abnormalities today behind heart disease.

Along with this pattern comes high blood pressure, high blood sugar, diabetes and pre-diabetes, increased inflammation, increasingly blood clot-prone blood. This common collection that now afflicts over 50 million Americans goes by a number of names, including metabolic syndrome, insulin resistance syndrome, and syndrome X.

But I call it “wheat belly.” Let me explain.

You've heard of "beer bellies," the protuberant, sagging abdomen of someone who drinks excessive quantities of beer.

Wheat belly is the same protuberant, sagging abdomen that develops when you overindulge in processed carbohydrates. It represents visceral fat that laces the intestines.

While nearly everyone knows that candy bars and soft drinks aren’t good for health, most Americans have allowed processed carbohydrates, but especially wheat products like pretzels, crackers, breads, waffles, pancakes, breakfast cereals and pasta, to dominate diet. I blame the extreme over-reliance on these foods for the obesity and related abnormalities: wheat belly.

How did this all come about?

Back in the 1960s, we had sandwiches on white bread, hamburgers on white flour buns, spaghetti made with bleached, enriched flour. Data from the 1970s and 1980s, however, demonstrated conclusively that using whole grains, with the bran and B-vitamins left in, was better: better for bowel health, blood pressure, cholesterol values.

Fast-forward to the 1990s and the new century, and the mantra has evolved to “eat more whole grains, eat more whole grains,” repeated by “official” organizations and propagated by countless media conversations. And Americans have complied.

But while video games, unhealthy snacks, and vending machines have been roundly blamed for the nationwide epidemic of obesity and diabetes, it’s curious that increased weight has befallen even active people who eat “healthy”: yes, plenty of whole grains.

In my view, it is the grains that are largely behind the obesity and diabetes epidemic, at least among the frustrated health-conscious.

But not all grains. Oats and flaxseed, for instance, seem to not contribute to weight and the associated patterns like small LDL.

The wife of a patient of mine who was in the hospital (one of my rare hospitalizations) balked in disbelief when I told her that her husband's 18 lb weight gain over the past 6 months was due to the whole wheat cereal for breakfast, turkey sandwiches for lunch, and whole wheat pasta for dinner.

"But that's what they told us to eat after Dan left the hospital after his last stent!"

Dan, at 260 lbs with a typical wheat belly, had small LDL, low HDL, high triglycerides, etc.

Many people, on hearing this peculiar perspective, are incredulous. “You’re nuts!” Whole grains are full of fiber and B vitamins. Everybody ‘knows’ they’re healthy!”


I thought so, too, 12 years ago when I followed a strict vegetarian, low-fat diet, rich with “healthy” whole grains. I gained 30 lbs, my HDL dropped to 27 mg/dl, triglycerides skyrocketed to 350 mg/dl, small LDL went crazy, my blood pressure was 150/90, and I developed diabetic blood sugars─while running 5 miles a day. It’s the wheat. I eliminated the wheat and promptly reversed the entire picture.

If you don't believe it, try this experiment: Eliminate all forms of wheat for a 4 week period--no breakfast cereals, no breads of any sort, no pasta, no crackers, no pretzels, etc. Instead, increase your vegetables; healthy oils; lean proteins (lean red meats, chicken, fish, turkey, eggs, Egg Beaters, yogurt and cottage cheese); raw nuts like almonds, walnuts, and pecans; and fruit. Of course, avoid fruit drinks, candy, and other garbage foods, even if they're wheat-free. (And don’t confuse this conversation with celiac disease or gluten enteropathy, an allergy to wheat gluten, an entirely different issue.)

Most people will report that a cloud has been lifted from their brain. Thinking is clearer, you have more energy, you don't lose in the afternoon, you sleep more deeply. You will notice that hunger ratchets down substantially. Most people lose the insatiable hunger pangs that occur 2-3 hours after a wheat-containing meal. Instead, hunger is a soft signal that gently prods you that it's time to consider eating again. You may even find that you miss meals, just because you forgot to eat. Very curious.

It’s unconventional, I know. The last 500 patients I’ve done this with also thought so─until they lost 15, 20 . . .70 lbs along with all the undesirable metabolic “baggage.”

Source: http://www.healthcentral.com/heart-disease/c/1435/33213/heart-disease/2?ic=2601

Insulin Resistance - Why you can't lose weight

A problem with insulin could be preventing your from losing weight. Insulin resistance is a common problem and causes obesity, heart disease, Polycystic Ovarian Syndrome and rapid ageing. It also increases the risk for cancer, Alzheimer's disease, menopausal symptoms and osteoporosis. How could one little hormone do all that?

What is Insulin?

Insulin is an ancient, anabolic hormone, which is found in all forms of animal life. Insulin's main function is to stimulate the cell to store nutrients. This was important in the days when starvation was a real possibility for our ancestors. In our modern era of abundant food, "nutrient storage" is not something that we want to promote in our bodies.

Hormone of Ageing

Insulin does more than store nutrition. It has been shown to limit the lifespan of cells. In other words, it is the chemical signal that determines when a cell has lived long enough and it's time to die. In this way, insulin can be thought of as the hormone that promotes ageing. Certainly in humans, excess insulin accelerates the rate of ageing. Insulin sounds bad, and yes, in excess it is harmful, but do not forget that it is essential for life. Without insulin, our cells cannot use food for energy. Before the invention of injectable insulin, diabetes was a life-threatening disease.

What is Insulin Resistance?

Under normal circumstances, insulin is tightly controlled by a natural homoeostatic feedback mechanism. With every meal, insulin is released as carbohydrates enter the blood stream. In a healthy body, the insulin receptors in the cell membranes respond to the hormone, and take up carbohydrates and other nutrients. This, in turn, reduces the production of insulin. The problem starts when the tissue fails to respond to insulin. When this happens, the sugar in the blood remains high despite the presence of insulin, and the body has no choice but to release more insulin. It becomes a vicious cycle because it is actually the presence of insulin that makes the tissue more and more resistant to it. This is how insulin exposure determines the rate of ageing: with every insulin release, cell membranes become a little bit more insulin resistant. A gradual increase in insulin concentration over time is normal, but the current epidemic of severe insulin resistance is a modern phenomenon.

It may be the cause of many of your health problems

When your body becomes resistant to insulin, it cannot metabolize carbohydrates properly. Untreated, this leads to Type 2 diabetes.  Decades before it becomes diabetes, however, Insulin Resistance can cause real problems. As the master hormone, it's presence in excess can lead to many different conditions such as:
High cholesterol
High blood pressure
Heart disease
Alzheimer's Disease
Polycystic Ovarian Syndrome
Breast cancer
Prostate cancer
Under-active thyroid
Premature ageing
Acne

A problem with insulin worsens menopausal symptoms

-Low libido. Women with insulin resistance are more likely to experience a drop in libido with menopause. 

-Osteoporosis. Women who are overweight and/or diabetic are more at risk for osteoporotic fractures. This overturns the conventional belief that body weight protects against osteoporosis. Overweight women often have normal bone density scores, but they go on to suffer fractures anyway. Excess insulin causes bone-remodeling cells to degrade into fat cells. In this regard, osteoporosis can be viewed as "obesity of the bone".

-Hot Flashes. A new study from the University of California has found that women who are overweight are more likely to suffer hot flashes.Weight loss causes a significant improvement in symptoms. (10) Perhaps you take different medications for your cholesterol, blood pressure, and thyroid but those are only band-aids. They do not address the insulin resistance that may be the single problem that is causing the other conditions.

Are you sure that you do not have Insulin Resistance?

Insulin Resistance is such an important health condition, and yet it may be completely off your doctor's radar. Forget your cholesterol and your female hormone readings on blood test, and look deeper. Ask yourself this very important question: "Are you a pre-diabetic?" Here are some warning signs: fasting glucose greater than 5.0 mmol/L (the official reference range is 3.5-6.0) elevated triglycerides and bad cholesterol (LDL) elevated ALT on liver function test waist measure greater than 80cm for women and 90cm for men high blood pressure The definitive pathology test for insulin resistance is the Glucose Tolerance Test (GTT) with insulin. One hour after the glucose load, normal insulin should be less than 60mU/L. Other useful tests include fasting insulin, fasting glucose, liver function test, lipid profile, C-RP, thyroid function and serum vitamin D.

How did you get in it in the first place?

-Leptin resistance: New research suggests that leptin resistance may be the driving force behind insulin resistance.

-Pollution: A study published in Diabetes Care has found that people who have the highest level of stored toxins were 38 times more likely to have diabetes than people with a lower level of stored toxins. Even if they were overweight, people with low level of toxins did not develop diabetes. An editorial about the study published in the Lancet made the following statement: 'This finding might imply that virtually all the risk of diabetes conferred by obesity is attributable to persistent organic pollutants, and that obesity is only a vehicle for such chemicals. This possibility is shocking'.  (In other words, obesity causes diabetes simply because it a vehicle for toxins.)

-Herbicides: Rats exposed to low doses of the common herbicide Atrazine gained 10% more abdominal weight over 5 months than non-exposed animals. The cells of the exposed rats were found to contain damaged mitochondria, which prevents normal cell response to insulin. Blood tests showed significantly higher blood sugar and insulin levels.

-Smoking: Toxins in cigarette smoke damage the insulin receptor, and cause distinctive weight gain around the waist.  No more smoking to stay thin!

-Inflammation: New research from the University of Maryland has correlated inflammatory products in the blood with insulin resistance. This means that inflammation caused by infection, stress and pollution may be a direct contributor to insulin resistance and its outcomes: obesity, diabetes and heart disease.  Too much sugar and flour in the diet: Carbohydrate intake compared to protein has increased dramatically in the last century. Since the onset of large-scale flour refinement in the 1890's, the average person consumes more fibre-free carbohydrate in a week than a nineteenth century person did in a year!

-Fructose: Studies have shown that fructose is a particularly harmful type of carbohydrate. It inactivates the insulin receptor, and it interferes with the way the brain responds to leptin (the anti-hunger hormone).  The result is constant hunger, and a progression towards insulin resistance and fatty liver. Fructose is in modern sweeteners such as high-fructose corn syrup and sucrose (table sugar). It is in prepared foods like fizzy drinks and baked goods, and even so-called healthy foods like yoghurt and muesli bars. Whole pieces of fruit do contain fructose, but it is balanced by healthy fiber, so fruit is ok to eat in moderation. Care should be taken with dried fruit and fruit juice.

-Trans Fat: Trans fats are damaged polyunsaturated fatty acids, found in processed vegetable oil such as margarine, deep-fried food, or commercially prepared oil. Conventionally touted as the healthy oils, these Frankenstein molecules have become a large part of the modern diet. They are damaged, distorted molecules, and when they are incorporated into the cell membrane, then interfere with the functioning of the insulin and other receptors.

-Vitamin D deficiency has been linked with Insulin Resistance. Birth control Pill worsens insulin resistance.

-Lack of exercise

-Problems with digestion. (unhealthy intestinal bacteria)

Natural Treatment for Insulin Resistance

The good news is that insulin resistance is reversible with diet and lifestyle. Detoxify. Help your body to remove stored residues of pollutants, cigarette smoke and herbicides. Intermittent fasting. Research from the Institute on Aging has shown that intermittent fasting improves insulin sensitivity. When participants skipped the evening meal, their fasting insulin improved, and they had fewer inflammatory markers on blood tests. 

How to do it: Always have a large breakfast and lunch. (As you become healthier, you will find that you regain an appetite for breakfast.) Then 1 to 3 nights per week, you must skip dinner, or replace dinner with a protein smoothie. They should not be consecutive nights. Reduce carbohydrates, especially fructose sweeteners.

During the first couple of months of treatment, carbohydrate intake should be less than 50 grams per day. With a diet of meat and salad vegetables, this is not difficult. An average serving of broccoli, for example, contains only 13 grams of carbohydrate. Compare this to a serving of pasta, which contains over 40 grams of carbohydrate, or to refined sugar, the worst carbohydrate. A small can of soft drink contains at least 40 grams of carbohydrate. If you are addicted to a sweet taste, you can try the herbal sweetener Stevia, which has the added benefit of improving insulin sensitivity. Eliminate refined sugar from your diet. Sugar is the worst kind of carbohydrate.

-Eat protein regularly. Protein curbs the release of insulin and stimulates the production of the hormone glucagon, which opposes insulin. (Do not increase protein if you have kidney problems, and do not exceed 90-100 grams of protein per day.) Good sources include: 2 eggs (12 grams protein), 1 chicken breast (25 grams protein), 2 lamb chops (29 grams protein), 25 grams whey protein (23 grams protein). Avoid Trans fat.

-Eliminate soy oil, corn oil, cottonseed oil or any generic "vegetable oil". Particularly bad are margarine, vegetable oil spreads and deep-fried food. Eat only naturally occurring fats such as butter, avocado, olive oil, coconut milk, meat, fish, and nuts and seeds. It can take up to 6 months to give your cell membranes an "oil change".

- Exercise. Strength training dramatically improves insulin sensitivity. When the muscles increase their energy expenditure, they re-learn how to use carbohydrates rather than store them. Weight loss occurs not simply because of the calories burned, but because of a shift in metabolism. Exercise is also effective to relieve stress, a common cause of inflammation and insulin resistance.

-Avoid Wheat. Gluten generates inflammation and disrupts the insulin receptor, thereby worsening insulin resistance.  Avoid flour-containing bread, pasta, cereal, and biscuits. If you do have flour, choose flour made from rice, oats, barley, spelt, and rye. Ordinary "flour" is wheat.

-Mediterranean diet. Newly diagnosed diabetics can reduce their need for medication by following the Mediterranean diet. Only 44% of patients on a Mediterranean diet required sugar lowering medication compared to 70% of patients who followed a standard low fat diet.

-Nutritional supplements and herbs. Chromium, magnesium, selenium and omega 3 fatty acids will improve insulin's effectiveness at the cell membrane. B-vitamins and amino acids assist the liver to remove pollutants. Antioxidants such as vitamin C and vitamin E will act as natural anti-inflammatories. Gymnema and Bitter Melon have been documented to improve insulin sensitivity. Vitamin D should be supplemented once a deficiency has been determined on blood test.

-Correct Gut flora. Friendly bacteria in the intestine assist with weight loss. Changing the gut flora may improve insulin sensitivity and promote weight loss. (20) Intestinal flora is negatively affected by junk-food diet, antibiotics and Pill use. Lactobacillus supplements may be of benefit.

Source: http://www.sensible-alternative.com.au/metabolic-hormones/insulin-resistance

Want to Lose Weight? Turn Your Thermostat Down

By Deborah Huso Jan 27th 2011 12:31PM

If you're among the many Americans who have been enduring weeks of bitter cold and snowstorms, here's a thought that may help you get through the winter a little easier: increasing exposure to cold temperatures could increase weight loss.

A recently published article in Obesity Reviews presents evidence gathered from Dr. Fiona Johnson of the University College London and her colleagues supporting the theory that higher indoor temperatures and reduced exposure to cold may be a contributor to rising obesity rates.
Researchers believe that cooler external temperatures force our bodies to burn more energy to keep warm.

"By lowering the room temperature you can increase the speed of weight loss," Dr. Eric Braverman, author of "The Younger (Sexier) You," told AOL Health. "For those looking to lose weight, it can be an additional strategy for added impact." He adds that it should not be the only strategy, however.

According to Braverman, decreased temperatures have been shown to burn brown fat in the body. Brown fat, or stored calories, responds to mild cold and burns energy to create heat. "The cold actually helps activate the brown fat burning process," explains Braverman.

Studies have shown that obese individuals have less brown fat than skinny people. But brown fat loses its effectiveness in burning energy if it's not used and exposed to cooler temperatures.

Johnson and her team documented that household heating rates have increased in the United Kingdom as well as the United States over the last decade. In addition, people are not only turning up their thermostats a degree or two, but they're leaving them turned up all the time, not even turning them down at bedtime.

People are also spending less time outdoors. This, combined with the higher indoor temperatures, means most people are probably not exposed to the most effective level of cold for fat burning. So people are using less energy to maintain their body temperatures, and without that exposure to cold, humans seem to lose some of their ability to warm up on their own.

That doesn't mean if you turn down your thermostat you'll lose five pounds. Cutting the heat might tempt you to put on extra layers and eat more, but evidence suggests that even adding a sweater and snacking on a sandwich will not completely cancel out the potentail fat-burning effects of cold exposure.

Johnson told Discovery News evidence is still lacking. Researchers do not know how cold a person would have to be for what period of time in order for these effects to take place.

Barverman thinks Johnson's team may be onto something, however. "The Southern belt is much more obese than the Northern belt in America," he says, adding he believes the exposure to cold may play a role.

F.D.A.: Diet Pill Works, but Has Risks

December 3, 2010, 2:57 pm

 

By ANDREW POLLACK

A new diet pill from Orexigen Therapeutics narrowly meets the requirements for effectiveness but poses potential cardiovascular risks, reviewers from the Food and Drug Administration said Friday

The agency’s review of the drug was posted on the F.D.A. Web site in advance of a meeting Tuesday in which an advisory committee will be asked whether the drug, known as Contrave, should be approved as a treatment for obesity.

Contrave is the last of a trio of new weight-loss drugs to come before the F.D.A. this year. The first two, Qnexa from Vivus and lorcaserin from Arena Pharmaceuticals, failed to win committee endorsements, and were subsequently not approved by the F.D.A. In both cases, safety concerns were the major issues.
Now the question is whether the third time will be the charm, or whether it will be three strikes, you’re out.

In its review the F.D.A. said that patients treated with Contrave in clinical trials lost 4.2 percentage points more of their weight than those getting the placebo after a year. That falls short of the standard that a drug should produce at least 5 percentage points more of weight loss than a placebo.

But Contrave generally met a second standard — that about twice as many patients on the drug as on placebo lose at least 5 percent of their weight. Meeting one of the two criteria is enough for approval under F.D.A. guidelines.
The major safety concern was that patients who took Contrave had a small but statistically significant increase in blood pressure and heart rate.
The drug “attenuates or eliminates the blood pressure and pulse reduction that are normally seen with weight loss,’’ the F.D.A. reviewers wrote. “It is not known how these vital sign changes in the overweight and obese population would impact cardiovascular risk over the long term.’’

Orexigen’s trials were too short and small to evaluate long-term cardiovascular risks, and only 1 percent of the participants had a history of heart disease, heart attack or stroke.
The F.D.A. said a dedicated study would be needed to determine if the drug raises the risk of heart attacks and strokes. It will ask the advisory committee to vote on whether such a study should be conducted, and if so whether it should be done before the drug is approved – which would delay approval for years — or if it could be done afterward.

The situation is somewhat reminiscent of the obesity drug Meridia, approved in 1997, which also caused a small increase in blood pressure and heart rate.
A large cardiovascular safety study eventually found that the drug did increase the risk of heart attacks and strokes. Under pressure from the F.D.A., Abbott Laboratories removed the drug from the market in October.

“We believe a key goal for Orexigen at the panel will be to convince the members that a controlled trial in CV risk need only be conducted post-marketing,’’ Phil Nadeau, an analyst at Cowen & Company, wrote in a note Friday morning. He added that “the hint of Meridia-like CV effects and near-complete absence of safety data in high CV risk patients will weigh heavily in the assessment of Contrave risk-benefit.’’

But Mr. Nadeau and some other analysts said the F.D.A. review was about as expected and was even in its tone, not leaning toward approval or against it. At noon, Orexigen shares were trading at $4.99, down about 9 percent.

Contrave is a combination of two existing drugs that help quell food cravings. One of them, bupropion, is an anti-depressant also known by the brand name Wellbutrin that is also sold under the name Zyban to help people quit smoking. The other, naltrexone, is approved to treat alcohol and drug addiction.

Some side effects of the two component drugs – particularly the risk of seizures from bupropion – were also of concern to the F.D.A. reviewers of Contrave.

http://prescriptions.blogs.nytimes.com/2010/12/03/f-d-a-diet-pill-works-but-has-risks/?ref=health

Panel Votes to Expand Surgery for Less Obese

December 3, 2010

By ANDREW POLLACK

“I see this as the first step in the march toward changing the standard of care,” E. Francine Stokes McElveen, the consumer representative on the committee, said during the meeting in Gaithersburg, Md.

A federal advisory panel Friday endorsed an expansion of the use of Allergan’s Lap-Band stomach-restricting device to patients who are less than severely obese. The vote could pave the way to double the number of Americans who qualify for weight-loss surgery. And it could eventually lead to making other types of weight-loss surgery available to those who are not quite as heavy.

The advisory committee to the Food and Drug Administration voted 8 to 2 that the benefits of Lap-Band surgery exceeded the risks for patients in the lower range of obesity. It voted 8 to 2 that the device was safe, and 8 to 1, with one abstention, that the device was effective.

The F.D.A. usually agrees with its advisory committees, but it was not clear when a decision would be made.
Current guidelines say weight-loss surgery is appropriate for people who have failed to lose weight through diet and exercise and have a body mass index of 40 and above — or 35 and above if they have diabetes, hypertension or another severe health problem associated with diabetes.
Allergan wants to lower the threshold to a B.M.I. of 35 for people without health complications, and to 30 for people with health problems, which also would no longer have to be severe.

A person who is 5 feet, 5 inches with hypertension must weigh at least 210 pounds to qualify for surgery now. Under the proposal endorsed by the committee, that person would have to weigh only 180 pounds.
An Allergan executive said at the meeting that 27 million Americans had a B.M.I. between 30 and 35 and at least one associated health condition.
The panel’s endorsement coincided with the release of a new report by F.D.A. staff members on a diet pill, Contrave, that another panel plans to consider next week. The report said the drug seemed to be effective, but might pose potential cardiovascular risks.
Other new diet pills have been rejected by the F.D.A. in recent months, leaving few options for overweight Americans.

About one-third of American adults are obese, defined as a B.M.I. of 30 or more. A study published in the New England Journal of Medicine this week showed that women with a B.M.I. of 30 to 35 had a 44 percent higher risk of death than women of normal weight, which is a B.M.I. under 25.
The Lap-Band is an inflatable silicone ring that is placed around the upper part of the stomach. It restricts how much a person can eat and makes one feel full more quickly.
Allergan submitted a study to the F.D.A. in which 149 people in the new proposed weight range received the device. Those patients lost an average of about 18 percent of their weight after a year, an amount considered enough to have positive effects on their health.

But some committee members said the study was too small and too short, especially since people might have the band inside them for decades. Some wanted more evidence that the operation resolved diabetes or other health problems. Most panel members said the study included too few men, blacks and Hispanics.
Still, most of the committee, which included several bariatric surgeons, said that Allergan could do longer, larger studies after approval and there was enough evidence, including from other studies in the literature, that the band was safe and effective.

Two participants in Allergan’s study, whose transportation to the meeting was paid for by the company, testified that the surgery had changed their lives. “I couldn’t walk up a flight of stairs or even take a shower without taking a rest,” said one of them, Brandi Jirka of Nashville, who did not specify how much weight she lost. “Now I can run and play with my children, I do yoga and can shop at regular stores in the mall. I’ve even been snorkeling while wearing a bikini.”

In her testimony, Diana Zuckerman of the National Research Center for Women and Families urged the committee to vote against approval, saying there was not enough long-term data. “We need that information before approval is expanded to include such a very large number of adults,” she said.
Some forms of weight-loss surgery, like gastric bypass, are considered medical procedures, not devices, so are not regulated by the F.D.A. But all types of bariatric surgery are covered by federal guidelines from 1991, 10 years before the Lap-Band was approved.

There are now efforts to revise those guidelines to lower the weight threshold. Some members of the committee said that the advent of minimally invasive surgery had made bariatric surgery much safer than it was in 1991. Some also said that B.M.I. was too crude a measure of how much a person needs surgery.
“The B.M.I. criterion is so seriously flawed,” said Dr. John G. Kral, professor of surgery and medicine at SUNY Downstate Medical Center in Brooklyn. “Removing this barrier of this idiotic number in itself would be an important step.”

Allergan, which is known mostly for Botox, hopes that expanding use of the Lap-Band to less obese adults — and also eventually to teenagers — will spur sales. Sales of its obesity products, mostly Lap-Band, fell 4 percent to $182.4 million in the first nine months of this year, a decline the company attributed to the weak economy. But obesity products make up only 5 percent of Allergan’s overall product sales.
Shares of Allergan rose 52 cents, to $68.80 in regular trading Friday. The shares rose 3 percent, to $70.89 in after-hours trading, following the panel’s vote.

A version of this article appeared in print on December 4, 2010, on page B1 of the New York edition.

Kids Who Eat Fruits, Veggies May Cut Heart Risk

And threats to heart can be seen in children as young as 9, second study says
By Steven Reinberg - HealthDay Reporter


MONDAY, Nov. 29 (HealthDay News) -- Children who eat a diet rich in fruits and vegetables may be able to help ward off atherosclerosis in adulthood, a precursor of heart disease, a new study suggests.And a second new study found that children as young as 9 years old may already be exhibiting health problems such as high blood pressure that put them at risk of heart disease as adults.
Both reports, from researchers in Finland, are published in the Nov. 29 online edition of Circulation.

Commenting on the first study, Dr. David L. Katz, director of the Yale University School of Medicine's Prevention Research Center, who was not involved with the study, noted that it had taken knowledge about diet and heart health a step further.

Atherosclerosis is a condition in which plaque -- a sticky substance consisting of fat, cholesterol, and other substances found in the blood -- builds up inside the arteries, eventually narrowing and stiffening the arteries and leading to heart problems. It's a process that can take years, even decades, and this study shows that diet even in childhood -- helps prevent the condition, Katz said.

"We certainly, before this study, knew that vegetable and fruit intake were good for our health in general, and good for cardiovascular health in particular," he said.
For the first study, researchers led by Dr. Mika Kahonen, chief physician in the Department of Clinical Physiology at Tampere University Hospital in Finland, looked at lifestyle factors and measured the pulse of 1,622 people who took part in the Cardiovascular Risk in Young Finns Study. The participants ranged in age from 3 to 18 when the study began and were followed for 27 years.

The researchers also assessed "pulse wave velocity" -- a measure of arterial stiffness.
The researchers found that those young people who ate fewer vegetables and fruits had higher pulse wave velocity, which means stiffer arteries. But those who ate the most vegetables and fruits had a pulse wave 6 percent lower than people who ate fewer fruits and veggies.
Because arterial stiffness is linked with atherosclerosis, rigid arteries makes the heart work harder to pump blood.

Besides low fruit and vegetable consumption, other lifestyle factors such as lack of physical activity and smoking in childhood was associated with pulse wave strength in adulthood, the researchers said.
"These findings suggest that a lifetime pattern of low consumption of fruits and vegetables is related to arterial stiffness in young adulthood," Kahonen said in a news release from the American Heart Association, which publishes Circulation. "Parents and pediatricians have yet another reason to encourage children to consume high amounts of fruits and vegetables."
"While it is never too late to use a healthful diet to prevent heart disease, it is certainly never too early," Katz said. "The best way to cultivate healthy blood vessels in adults, it seems, is to feed our children well."

In the second study, Finnish researchers found that children as young as 9 who had the most risk factors for heart disease -- including high levels of cholesterol, high blood pressure and a greater body mass index -- faced a greater risk of thicker carotid artery walls as adults, an early sign of heart disease.

"Cardiovascular risk factors measured at or after the age of 9 are predictive of vascular changes in adults," said lead researcher Dr. Markus Juonala, an adjunct professor at Turku University Hospital in Finland.

"Of the individual risk factors, childhood obesity was the most consistently associated with vascular changes across different age groups," he said.
Prevention of atherosclerosis should start in childhood, Juonala said, adding, "We should make all efforts to keep our kids fit, not fat."

For the study, Juonala's team collected data on 4,380 participants in four studies that looked at heart disease risk factors in children and carotid artery thickness in adulthood.
They found that children as young as 9 years old who had the most risk factors for heart disease had a 37 percent increased risk of thicker carotid arteries -- which supply oxygen-rich blood to the head and neck -- in adulthood, compared with other children.

By age 12, children in the highest heart disease risk factor group had a 48 percent increased risk of thicker carotid arteries. This risk rose to 56 percent by 15, the researchers noted.
Commenting on the study, Dr. Gregg Fonarow, American Heart Association spokesman and professor of cardiology at the University of California, Los Angeles, said "atherosclerotic vascular disease can begin early in childhood and adolescence but becomes clinically manifest later in life."

This study provides insights into the early development of vascular disease and has important implications for prevention efforts in children, he said.
"There is currently an important, but largely unmet, need to prevent and reverse cardiovascular risk factors in childhood," Fonarow said.

More information
For more on atherosclerosis, visit the American Heart Association.

SOURCES: Markus Juonala, M.D., Ph.D., adjunct professor, Turku University Hospital, Turku, Finland; David L. Katz, M.D., M.P.H., director, Prevention Research Center, Yale University School of Medicine, New Haven, Conn.; Gregg Fonarow, M.D., American Heart Association spokesman, and professor of cardiology, University of California, Los Angeles; Nov. 29, 2010, Ciurculation, online

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