Tag Archives: diabetes

Triglyceride/HDL Ratio Predicts Diabetes in Men

September is National Cholesterol Education Month, and in recognition of this today’s post will discuss research examining the relationship between certain lipid parameters and the development of diabetes.

Statistics from the CDC indicate more than 100 million American adults have total cholesterol levels above 200 mg/dl , with more than 35 million having total cholesterol levels above 240 mg/dl.

A research group from China examined the triglyceride to high density lipoprotein cholesterol (TG/HDL-C) ratio as a possible independent predictor for development of diabetes.

There were nearly 12,000 participants enrolled in the retrospective study, 53% men, 47% women, with a mean age of 44 years. The participants were followed on average for three years.

The research revealed that a high TG/HDL-C ratio has a positive correlation with risk of diabetes in men. Interestingly this ratio did not show correlation with the female subjects

This is a large study, with a huge number of subjects. It shows that the TG/HDL-C ratio may well be an independent predictor of diabetes, at least among men. Triglyceride and HDL levels are commonly measured during routine lab work, and are therefore easy to obtain. As this study was undertaken in a relatively homogeneous population in China, it would be helpful to undertake a similar study among a more diverse population, such as in the U.S. 

A high TG/HDL-C ratio provides us with another parameter to consider as we analyze routinely ordered lipid panels, and perhaps gives an early indication of those who may be at risk for diabetes.

“The devil has put a penalty on all things we enjoy in life. Either we suffer in health or we suffer in soul or we get fat.”– Albert Einstein

(Source- Journal of Diabetes Investigation, 2019)

This blog is a review of published medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discus any health concerns with your personal physician.

 

Olive Oil May Help Prevent Type 2 Diabetes

August is designated National Olive Oil Month, and so several posts this month will cover some of the health benefits of olive oil. Today’s post will discuss research on the potential role for olive oil in prevention of Type 2 diabetes (T2D). 

Olives are a traditional tree crop of the Mediterranean Basin. The largest producer of olive oil by far is Spain, with about 50% of the world’s production, followed by Greece, Italy and Turkey. In the U.S. olive oil is produced in California, Hawaii, Texas, Georgia, and Oregon. Extra Virgin Olive OIl is of the highest quality, and is processed simply by mechanical press, without any chemical processing. This is thought to result in the health benefits of olive oil.

A research group from Austria, Germany, and Spain performed a meta-analysis of existing studies, to examine the role of olive oil in type 2 diabetes mellitus. They included four cohort studies with over 183,000 subjects, and 29 random controlled trials with nearly 4000 subjects. The majority of these studies were either completed in Europe or the United States. The study duration of the cohort studies varied between 6 and 22 years, while the length for the random controlled studies varied between 2 weeks and 4 years.

After analyzing the various studies the researchers found that the use of olive oil was inversely associated with a lower risk of type 2 diabetes mellitus. The risk of T2D decreased by 13% as the intake of olive oil increased, up to 15-20 grams per day. There was no apparent benefit in increasing intake above the 15-20 grams/day amount.

In addition, those in the olive oil intervention groups were found to have lower fasting glucose levels, and significantly reduced HbA1c levels.

Incorporating olive oil into your diet appears to be a simple way to lower one’s risk of developing type 2 diabetes, and would be easy to implement.

“The olive tree is surely the richest gift of heaven. I can scarcely expect bread.”- Thomas Jefferson

(Source- Nutrition and Diabetes (2017))

This blog is a review of published medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

Increasing Glucose Leads to Heart Attacks and Strokes

Today is Diabetes Alert Day, and in recognition our post will review a recently published study on change in fasting glucose levels and subsequent risk of heart attack, stroke and all-cause mortality.

A reasearch group in Korea analyzed data from over 260,000 Korean adults enrolled in the Korean Health Insurance Service. These were adults over 40 years old, and with no diagnosis of diabetes or cardiovascular disease at time of enrollment in the study. The study included both men and women.

At initial enrollment, subjects were divided into two groups- a normal fasting glucose group (glucose <100 mg/dL) and an impaired fasting glucose group (glucose 100-125.9 mg/dL). Data such as smoking status, body mass index, blood pressure, physical activity level, total cholesterol, and alcohol consumption was also collected.

The subjects had a second examination in two years. At this second visit, any changes in fasting glucose between the two visits was noted. On average, these participants were then followed for up to eight years. Data on the number of heart attacks, strokes, and all-cause mortality were collected.

Researchers discovered that those participants who shifted from the normal fasting glucose group into diabetes (glucose >126 mg/dL) were associated with a much higher risk of stroke and all-cause mortality, compared to the participants who remained in the normal glucose group. In addition, those participants initially diagnosed with impaired fasting glucose who later moved into diabetes had a much higher risk of heart attack and all-cause mortality.

The statistics for diabetes are a cause for alarm- it is estimated that the total cost for diabetes in 2017 was $327 billion. About 84 million Americans are currently in the pre-diabetic category, with one of three adults age twenty and older now being pre-diabetic. Given the results of this very robust study, with over two million person-years of follow-up, serious consideration should be given to those interventions which help those who currently have normal or impaired glucose levels from progressing into diabetes.

“No one had ever told me junk food was bad for me. Four years of medical school, and four years of internship and residency, and I never thought anything was wrong with eating sweet rolls and doughnuts, and potatoes, and breads, and sweets.”– Robert Atkins

(Source- Cardiovascular Diabetology (2018) 17:51)

This blog is a review of published medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

 

 

Insomnia Increases Risk of Diabetes

Today is World Sleep Day, and in recognition of this day our post will review recent research regarding insomnia as a risk factor for diabetes mellitus type 2.

The statistics for diabetes are a cause for alarm. According to the American DIabetes Association, over 9% of the U.S. population has diabetes, with 1.5 million new cases diagnosed yearly. Over 84 million Americans are classified as pre-diabetic, and are at high risk for progressing into diabetes. The total cost for diabetes for 2017 was estimated at $327 billion.

A research group in the Portland, Oregon area conducted a retrospective cohort study. The participants numbered over 81,000 and all had been diagnosed with pre-diabetes, and with and without insomnia. On average the subjects were followed over 4 years. The mean age was 57 1/2 years.

What the researchers discovered was that the subjects who had insomnia had nearly a 30% increased risk of developing type 2 diabetes, compared to the group that did not have insomnia, even after adjusting for risk factors such as age, body mass index, and cardiovascular issues.

The mechanism by which insomnia increases the risk of diabetes type 2 is not entirely clear, but may involve activation of the sympathetic nervous system (and hence increased stress hormones), increased inflammation in the body, increased appetite, decreased exercise due to fatigue, or perhaps some other factor. It may well involve multiple factors and not just one.

This study is robust- a large number of subjects were enrolled in a real world clinical setting. It examines a modifiable risk factor for diabetes. Those who have ongoing issues with insomnia may well want to consider the possible implications of developing diabetes from their lack of sleep.

“The worst thing in the world is to try to sleep and not to.” – F. Scott Fitzgerald

(Source- BMJ Open Diabetes Research&Care, 2018)

This blog is a review of published medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

HIgh Glycemic Index Diet Increases Cancer Risks

In honor of World Cancer Day, today’s post will examine research from Italy published last year, regarding dietary glycemic index, glycemic load, and subsequent cancer risk.

Researchers enrolled nearly 48,000 subjects into this study, from five different clinical centers in Italy. Subjects completed food frequency questionnaires, and were followed for an average of nearly 15 years. The questionnaires were designed to access glycemic Index, as well as glycemic Load, of the diet of each participant.

The Glycemic Index is a measure of the ability of different types of carbohydrate containing foods to raise blood glucose levels within two hours. Pure glucose is given the value of 100. High Glycemic Index foods cause more rapid rise in blood glucose levels. High Glycemic Index foods include white bread, white rice, high fructose corn syrup, and sodas. Low Glycemic Index foods include beans, most vegetables, and nuts such as cashews, peanuts, and walnuts. High Glycemic foods elevate blood glucose as well as insulin levels, and in turn promote fat storage. Low Glycemic Index foods tend not to overly elevate blood glucose levels or insulin levels in the body.

The Glycemic Load on the other hand is a function of the amount of carbohydrate and the Glycemic Index of that particular food. The Glycemic Load is calculated as the Glycemic Index multiplied by the grams of carbohydrate per serving size.

What the Italian researchers found was a high Glycemic Index diet increased risk of colon cancer, bladder cancer, and melanoma, among others. High Glycemic Load diets were related to a high risk of developing colon cancer, liver cancer, cervical cancer, and endometrial cancers, among others.

This study provides evidence that limiting carbohydrates may be a strategy for limiting risk of certain cancers later in life.

(Source- Scientific Reports, 7:9757)

This blog is a review of medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss and health concerns with your personal physician.

 

 

Let’s Help Prevent Diabetes in Women-Just Say No to Soda for 2018 Part 3

On Wear Red Day 2018, we will review a recently published study that examined the relationship between beverages, both artificially sweetened and sugar-sweetened, and subsequent development of diabetes, in a group of menopausal women. This is our third recent post regarding the ill effects of drinking soda.

The research group examined data from the Women’s Health Initiative, a massive study of more than 90,000 women spread out at over 40 clinical centers throughout the US. Nearly 65,000 women were eventually part of this prospective observational study, with over 8 years of follow-up on average.

Participants were queried about their intake of artificially sweetened beverages, sugar-sweetened beverages, and plain water, via questionnaires. Subjects were assessed for diabetes at enrollment, and at annual follow-up.

Even when researchers controlled for other risk factors such as body mass index or total energy intake, their analysis showed both artificially sweetened beverages and sugar-sweetened beverages were associated with an increased risk of developing diabetes, in this group of post-menopausal women.

Both artificially sweetened and sugar-sweetened beverages showed a dose-dependent increase risk of diabetes. The more soda one drank, the higher the risk of developing diabetes.

One of the most interesting “take-home messages” from this study was that while the risk of developing diabetes was a bit lower in the artificially sweetened group, compared to the sugar-sweetened group, there still was an increased risk. This casts doubt over whether or not artificially sweetened beverages are a safer alternative to the sugar-sweetened ones. Both should be avoided.

Data from the American Heart association show that adults with diabetes are two to four times more likely to die from heart disease than those without diabetes. In addition, of those 65 and older with diabetes, 68% will die from some sort of heart disease. So on Wear Red Day 2018 let’s take a step in avoiding diabetes and heart disease by eliminating or avoiding entirely soda, both the artificially and sugar-sweetened varieties.

(Source- American Journal of Clinical Nutrition 2017; 106)

This blog is a review of medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

Just Say No to Soda for 2018- Part II

In our second post regarding sodas and soft drinks, we will review research from China which examines the association between sugar-sweetened beverages and the development of Type 2 Diabetes.

The research group pooled data from 8 studies published between 2004 and 2014. This comprised over 286,000 participants. Of the 8 studies, one was from Asia, two from Europe, and five from the US. In general, the studies included in the meta-analysis were considered to be of “high-quality”.

Researchers found that those subjects with a higher-intake of sugar-sweetened beverages had a 30% greater risk of developing Type 2 diabetes. When the data was adjusted for body mass index, the increased risk for developing Type 2 diabetes continued to be significantly positive, at 26%. The follow-up period varied from 5 to 20 years.

This is a compelling study, with a huge number of subjects, spread out over three continents, and included both men and women.

The statistics for Type 2 diabetes in the US are staggering. According to the CDC’s National Diabetes Statistical Report approximately 30 million people in the US have diabetes, making up more than 9% of the population. Complications of diabetes include cardiovascular disease (heart attacks and strokes) and kidney disease. It is estimated that the cost of diabetes in the US in 2012 was $245 billion.

US per capita soda consumption is approximately 41 gallons per person. While this is a substantial decrease from the 1998 peak consumption of 53 gallons per capita, it still represents nearly 500 cans of soda per year for the typical American. These are calories which are devoid of nutritional value, but do substantially increase your risk of Type 2 diabetes. Cutting back or eliminating soda for 2018 might go a long way towards improved health, and may reduce your risk of developing diabetes in the future.

(Source- Journal of Diabetes Investigation, Vol 6 No 3, May 2015)

This blog is a review of medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with you personal physician.

Exercise and Weight Loss Good for Diabetes

With the New Year now here, it is a great time to consider resolutions for exercise and weight loss for 2018.

A small study published in 2015 shows some of the benefits of exercise and weight loss, even over a short period of time. In this study, completed at the University of Vermont, patients were enrolled that had recently been diagnosed with Type 2 diabetes. These patients were typical of what is seen in a primary care setting, with HbA1c readings between 6.5-8.0%, and BMI from 27-40 Kg/M2. 

The patients engaged in exercise 5-6 days each week, including walking and supervised exercise. In addition, participants engaged in weekly group counseling sessions led by a registered dietician. It is important to note that participants were not on diabetes medications during the six month study.

At completion of the six month study, the majority of the participants went into at least partial remission of their diabetes, with the mean HbA1c dropping from 6.8 to 6.2, while one individual achieved what was termed a “total remission” with an HbA1c=5.6%. Mean weight loss amongst the group was 21+ pounds, and peak aerobic activity increased by 18%. Other cardiac risk factors such as CRP, fasting insulin and triglyceride levels all improved. Women made up the majority of those enrolled.

This study shows what is possible with directed efforts towards diet and exercise modifications. The authors suggest that no medication similarly used in this patient population would have provided such “broad reaching preventative efforts”, and perhaps that is true.

To be sure, this was a small study with only 12 patients enrolled and ten who completed. However, given the robust results, a more extensive study certainly seems warranted. Particularly for those patients who are very early in their diabetes disease process a diet and exercise regimen seems worthy of consideration. Combined with medication when appropriate, this intervention would likely yield even more profound results.

(Source- Journal of Cardiopulmonary Rehabilitation and Prevention, Vol 35(3), May/June 2015)

This blog is a review of medical and scientific literature and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

Walnut Oil Lowers Cholesterol in Diabetics

May 17th is National Walnut Day, and in recognition of this today’s post will review recently published research on walnut oil.

A group of researchers in Iran designed a study to examine the effects of walnut oil on lipids in a group of patients with Type 2 diabetes. Compared to other tree nuts such as almonds, cashews, hazelnuts and pecans, walnuts are particularly high in essential fatty acids, such as linoleic acid and alpha-linolenic acid. Because of favorable nutritional qualities such as this walnuts have been the subject of research in regards to potential health benefits. China is the largest producer of walnuts in the world, while the U.S. is the largest exporter of walnuts.

The researchers completed a double-blind, randomized placebo-controlled trial, enrolling 45 diabetic patients in the walnut oil group, and another 45 patients in the placebo group. Those in the walnut oil group ingested four capsules of walnut oil three times each day. Those in the placebo group ingested similar capsules which contained simply water.

Labs were drawn at the start of the study and again at the conclusion after three months. The primary outcome measure was change in total cholesterol, triglycerides, LDL (“bad cholesterol”) and HDL (“good cholesterol”).

After 90 days researchers found that the participants in the walnut oil group had a significant decrease in total cholesterol, triglycerides and LDL. There was also a trend towards higher HDL. The walnut oil preparation was well tolerated, with no significant side effects. 

Walnuts may be part of a low-risk diet strategy for primary prevention in a high risk population of diabetic patients.

 (Source- Nutrition&Diabetes (2017) 7, 259)

This blog is a review of medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.

 

Curcumin May Help Prevent Diabetes Type 2

 

In recognition of American Diabetes Alert Day, today’s posts will be covering diabetes, and in particular focusing on prevention strategies. Diabetes mellitus Type II (DM2) is increasing not only in the U.S., but worldwide as well. It is estimated that in 2012, 29 million Americans had DM2, and as many of 8 million of these were undiagnosed. 

Pre-diabetes is defined as a fasting plasma glucose of 100-125 mg/dl, or a two-hour oral glucose tolerance test with a reading of 140-199 mg/dl. It was estimated in 2012 that as many as 86 million Americans fell into the pre-diabetes category.

There is much research activity focusing on identifying those at risk for developing DM2 (such as those with pre-diabetes) and for ways to help prevent or forestall it’s progression. A recent study examined the use of curcumin extracted from turmeric as a way to prevent development of DM2 in those already diagnosed with pre-diabetes.

Curcumin is an active ingredient of the Asian spice turmeric, which is a member of the ginger family. Turmeric is a widely used spice in South Asian and Middle Eastern cooking and is grown in India, Nepal, Indonesia, Thailand, Vietnam and elsewhere. Turmeric is also used in Ayurvedic Medicine, and is currently being studied in Western Medicine for possible uses. Curcumin has been shown to have antioxidant and anti-inflammatory properties.

In this study conducted in Thailand. 240 individuals who were diagnosed with pre-diabetes were enrolled. These included both men and women, with an average age of 57. Enrollees were randomly assigned to either the placebo group, or the curcumin treated group. Those in the curcumin group took capsules containing curcumin powder twice a day.

Data was collected for both groups at baseline (prior to initiation of treatment), and at 3, 6, and 9 months. The primary outcome measure was development of DM2. Other measures included changes in beta-cell function, c-peptide (an inflammatory marker), insulin resistance, adiponectin (an anti-inflammatory cytokine), and obesity.

At nine months, 0% of the curcumin group developed DM2, whereas 16.4% in the placebo group developed DM2. This was statistically significant.

In addition, in the curcumin group beta-cell function improved, c-peptide dropped, insulin resistance decreased, and adiponectin increased, all of which represent potential beneficial improvement. Also important, no significant adverse effects of curcumin treatment were noted.

Given the results of this study, curcumin would seem to be a possible way to help prevent diabetes in those at risk.

 

(Source- Diabetes Care 2012 Nov; 35 (1); 2121-2127)

This blog is a review of medical and scientific literature, and should only be used to informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.