Tag Archives: diabetes

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.

 

Diet, Exercise and Metformin Help Prevent Diabetes

 Today is American Diabetes Association Alert Day, and in recognition today’s posts will be covering topics in diabetes.

Diabetes Mellitus Type II (DM2) is common in the U.S. and worldwide and it’s incidence and prevalence are increasing. The implications of DM2 are serious and widespread, including kidney and eye disease, heart and blood vessel disease, and neuropathies.

Because of the large numbers of people with DM2, there has been much research looking at ways to prevent or forestall its development. A landmark study in this area was published in 2002, and was conducted at George Washington University and 27 affiliated centers.

Over three thousand participants with elevated fasting and post-load plasma glucose concentrations were included in the study. Subjects were randomly assigned to a lifestyle modification plus metformin group (850 mg twice a day), a lifestyle modification plus placebo group, or a program of intense lifestyle modifications. The goals for the intensive lifestyle modification group were to maintain a 7% weight reduction and engage in moderate physical activity for at least 150 minutes each week. The average follow-up period was 2.8 years.

The primary outcome measure of this preventative study was the development of diabetes. The incidence of diabetes was 58% lower in the intensive lifestyle intervention group compared to the placebo group, while the incidence of diabetes in the metformin group was 31% lower than the placebo group.

Comparing the intensive lifestyle-modification group to the metformin group shows the incidence of diabetes was 39% lower in the intensive lifestyle modification group.

One of the important features of the study design were that substantial numbers of female subjects were enrolled (68% female, 32% male), and that a large percentage of African-American, Hispanic, Indian American and Asian-American individuals were enrolled, which supports the generalizeability of these results to a broad heterogeneous population such as seen in the U.S.

This study demonstrates that substantial lifestyle modifications including weight loss and increased exercise may have a profound impact in preventing or delaying the development of DM2 in those at risk. Given the serious health implications of DM2 perhaps those who are in the pre-diabetic stage may want to consider incorporating improved diet, exercise and weight loss in to their daily regimen.

 

(Source- New England Journal of Medicine, Vol. 346, No. 6)

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.

Black Cumin Helps With Symptoms of Metabolic Syndrome

blackcumin1

Today’s post is about metabolic syndrome and lipids, another in our series of blogs for Cholesterol Education Month.

Black cumin (Nigella Sativa) is an annual flowering plant found in southern Europe, southwest Asia and north Africa. The black cumin seeds have long been used as a spice in both Indian and Middle Eastern cuisines. Written references to black cumin appear in ancient texts, and the Book of Isaiah (28: 25,27) references cumin seeds. Modern research has focused on the pharmacologic properties of black cumin.

A group of researchers in Pakistan recently performed an interesting study in which they looked at black cumin to treat the symptoms of metabolic syndrome (also known as insulin resistance). There are five metabolic risk factors associated with metabolic syndrome, these include large waistline, high triglyceride level, low HDL (“good cholesterol”), high blood pressure, and high fasting blood sugar. Having at least three of these five symptoms is considered to be a diagnosis of metabolic syndrome. Recent data estimates from 2011-2012 show that 35% of all U.S. adults and 50% of those 60 years and older meet the criteria of metabolic syndrome. As metabolic syndrome is very often a precursor to diabetes this is a national health issue of first order.

The researchers enrolled 159 subjects into the study, of which there was a black cumin supplemented group, and a non-supplemented group. All subjects were recently diagnosed with metabolic syndrome, and the study included both men and women, ages 25-65 years.  All subjects were on a standard treatment regimen for metabolic syndrome, including pharmaceutical medicines such as atenolol, clopidogrel, enalapril, metformin, and simvastatin. In addition the black cumin group took Nigella seeds in a capsule form 250 mg twice daily. The study ran for six weeks.

Several clinical parameters of metabolic syndrome were measured, both at the start of the study and then again at conclusion. These included body mass index (BMI), circumference of the abdomen and hip, body weight, waist-hip ratio, blood pressure, blood glucose, total cholesterol, LDL (“bad cholesterol”), triglycerides, and HDL.

At the conclusion of the six-week trial the clinical parameters were again measured. There were improvements in all parameters, both in the standard treatment group as well as in the black cumin supplemented group, as one would expect. In addition, in the black cumin seed group, there was a statistically significant improvement in fasting blood sugar, LDL and HDL, over the standard treatment (non black cumin seed supplemented) group. To see a statistically significant improvement in just six weeks is profound.

Metabolic syndrome is a serious health issue, not only in the U.S., but world-wide. Proper diet and exercise are a mainstay of treatment, as well as medications. Part of the solution may well be use of ancient or traditional foods, such as black cumin.

(Source- African Journal of Biotechnology, Vol. 11948), June 2012).

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.

Got ED? Get Checked for Diabetes

MHW_15

“I give you bitter pills in sugar-coating. The pills are harmless, the poison is in the sugar”
Stanislaw Jerzy Lec

 

In our continuing series of blogs in June dedicated to Men’s Health Month today’s post will examine the relationship between erectile dysfunction (ED) and undiagnosed diabetes, high blood pressure, and high cholesterol.

A research group in Canada looked at data from the National Health and Nutrition Examination Survey (NHANES) during 2001-2004. The NHANES is designed to be a retrospective survey of the U.S. population. Researchers studied more than 4500 men ages 20 and older.

Researchers examined the association of ED with undiagnosed diabetes, undiagnosed high blood pressure, and undiagnosed high cholesterol amongst the sample of 4500 men.

ED was found to be strongly associated with undiagnosed diabetes, and in particular in men ages 40-59 years old. In the 40-59 year old age group undiagnosed diabetes was present in 19.1% of men with ED, whereas diabetes was present in only 3.3% of men without ED. Interestingly there was no statistically significant relationship between undiagnosed high blood pressure and ED, or undiagnosed high cholesterol and ED.

Given this convincing data men who develop ED should strongly consider being tested for diabetes.

 

(Source- Annals of Family Medicine, Vol. 13, No. 4)

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.

 

Want to Avoid Diabetes? Consider Walnuts

May 17th is National Walnut Day, and in honor of this day I will review some recent research regarding the walnut.

Compared to other tree nuts such as almonds, cashews, hazelnuts and pecans, walnuts are particularly high in polyunsaturated 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.

A study published in 2013 examined the effects of walnut consumption with the risk of developing type II diabetes in women. Researchers from Harvard University and the National University of Singapore looked at data from two large studies, the Nurses Health Study (NHS) and the Nurses Health Study II (NHS II). There were approximately 138,000 women total involved in the two studies. In the NHS women were followed from 1986 to 2008, and from 1991 to 2009 for the NHS II. Walnut consumption was determined by a food frequency questionnaire which evaluated walnut consumption by the participants. Researchers found that the intake of walnuts was associated with decreased risk of the development of type II diabetes in women.

So in honor of National Walnut Day consider adding some walnuts to your diet, they taste great and may lower your risk of diabetes in the future.

“God gives the nuts, but he does not crack them.”- Franz Kafka

(Source- The Journal of Nutrition, 143: 512-518, 2013)

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.