Centers for Disease Control and Prevention. About 7. 9 million Americans aged 2. Diabetes and Cancer. Type 2 diabetes increases the risk for certain types of cancer, according to a consensus report from the American Diabetes Association and the American Cancer Society. Diabetes doubles the risk for developing liver, pancreatic, or endometrial cancer. Certain medications used for treating type 2 diabetes may possibly increase the risk for some types of cancers. Pregnant women with risk factors for diabetes should be screened for type 2 diabetes at the first prenatal visit. Aspirin for Heart Disease Prevention. The American Diabetes Association now recommends daily low- dose (7. Guidelines for Treatment of Diabetic Neuropathy. The anticonvulsant drug pregabalin (Lyrica) is a first- line treatment for painful diabetic neuropathy, according to recent guidelines released by the American Academy of Neurology (AAN). New Drug Warning. In 2. 01. 2, the Food and Drug Administration (FDA) warned that statin drugs, which are used to treat high cholesterol, may raise blood sugar levels and increase some people. Studies have found that this risk is more likely with high doses of statins. However, for most people with diabetes the benefits of statin drugs still outweigh the risks. Other types of cholesterol drugs, such as niacin, can also increase blood sugar levels. New Drug Approvals. Juvisync is a two- in- one pill that combines the diabetes medication sitagliptin (Januvia) with the cholesterol drug simvastatin. Bydureon is a longer- lasting version of exenatide (Byetta) that requires injection only once a week. What is a low carb diet, really? When can a low carb diet be beneficial? Should everyone follow a low carb diet? Or, can a low carb diet ruin your health? The Obesity Algorithm is intended to be a . It is intended to be an educational tool used to. The best part of parenting (so far)? Helping your kids overcome things you struggled with. Last Saturday my daughter came home from. Finding a good 1500 calorie diabetic diet plan can be a challenge. This difficulty exists despite the 1500 calorie diet being one of the most popular weight loss. Gestational diabetes is a form of type 2 diabetes, usually temporary, that first appears during pregnancy. It usually develops during the third.Changes in Diet and Lifestyle and Long-Term Weight Gain in Women and Men. Dariush Mozaffarian, M.D., Dr.P.H., Tao Hao, M.P.H., Eric B. Byetta is injected twice a day. Peginesatide (Omontys). It is given as a once- a- month injection. Similar anemia drugs require more frequent injections. New Vaccination Recommendation. The CDC now recommends that adults ages 1. The hepatitis B virus is transmitted through blood. Unvaccinated patients with diabetes can become infected with hepatitis B through sharing fingerstick or blood glucose monitoring devices. Introduction. The two major forms of diabetes are type 1 (previously called insulin- dependent diabetes mellitus, IDDM, or juvenile- onset diabetes) and type 2 (previously called noninsulin- dependent diabetes mellitus, NIDDM, or maturity- onset diabetes). Insulin. Both type 1 and type 2 diabetes share one central feature: elevated blood sugar (glucose) levels due to insufficiencies of insulin, a hormone produced by the pancreas. Insulin is a key regulator of the body's metabolism. It works in the following way: During and immediately after a meal the process of digestion breaks down carbohydrates into sugar molecules (including glucose) and proteins into amino acids. Right after the meal, glucose and amino acids are absorbed directly into the bloodstream, and blood glucose levels rise sharply. The rise in blood glucose levels signals important cells in the pancreas, called beta cells, to secrete insulin, which pours into the bloodstream. Within 1. 0 minutes after a meal, insulin rises to its peak level. Insulin enables glucose to enter cells in the body, particularly muscle and liver cells. Here, insulin and other hormones direct whether glucose will be burned for energy or stored for future use. When insulin levels are high, the liver stops producing glucose and stores it in other forms until the body needs it again. As blood glucose levels reach their peak, the pancreas reduces the production of insulin. About 2 - 4 hours after a meal, both blood glucose and insulin are at low levels, with insulin being slightly higher. The blood glucose levels are then referred to as fasting blood glucose concentrations. The pancreas is located behind the liver and is where the hormone insulin is produced. Insulin is used by the body to store and use glucose. In type 2 diabetes, the body does not respond properly to insulin, a condition known as insulin resistance. The disease process of type 2 diabetes involves: The first stage in type 2 diabetes is insulin resistance. Although insulin can attach normally to receptors on liver and muscle cells, certain mechanisms prevent insulin from moving glucose (blood sugar) into these cells where it can be used. Most patients with type 2 diabetes produce variable, even normal or high, amounts of insulin. In the beginning, this amount is usually enough to overcome such resistance. Over time, the pancreas becomes unable to produce enough insulin to overcome resistance. In type 2 diabetes, the initial effect of this stage is usually an abnormal rise in blood sugar after a meal (called postprandial hyperglycemia). Eventually, the cycle of elevated glucose further damages beta cells, thereby drastically reducing insulin production and causing full- blown diabetes. This is made evident by fasting hyperglycemia, in which glucose levels are high most of the time. Type 1 Diabetes. In type 1 diabetes, the pancreas does not produce insulin. Type 1 diabetes is considered an autoimmune disorder. The condition is usually first diagnosed in childhood or adolescence. Patients with type 1 diabetes need to take daily insulin for survival. Gestational Diabetes. Gestational diabetes is a form of type 2 diabetes, usually temporary, that first appears during pregnancy. It usually develops during the third trimester of pregnancy. After delivery, blood sugar (glucose) levels generally return to normal, although some women develop type 2 diabetes within 1. Because glucose crosses the placenta, a pregnant woman with diabetes can pass high levels of blood glucose to the fetus. This can cause excessive fetal weight gain, which can cause delivery complications as well as increased risk of breathing problems. Children born to women who have gestational diabetes have an increased risk of developing obesity and type 2 diabetes. In addition to endangering the fetus, gestational diabetes can also cause serious health risks for the mother, such as preeclampsia, a condition that involves high blood pressure during pregnancy. Causes. Type 2 diabetes is caused by insulin resistance, in which the body does not properly use insulin. Type 2 diabetes is thought to result from a combination of genetic factors along with lifestyle factors, such as obesity, poor diet, high alcohol intake, and being sedentary. Genetic mutations likely affect parts of the insulin gene and various other physiologic components involved in the regulation of blood sugar. Some rare types of diabetes are directly linked to genes. Diabetes Secondary to Other Conditions. Conditions that damage or destroy the pancreas, such as pancreatitis (inflammation), pancreatic surgery, or certain industrial chemicals, can cause diabetes. Certain genetic and hormonal disorders are associated with or increase the risk of diabetes. High doses of statin drugs, which are used to lower cholesterol levels, may increase some people. Some types of drugs can also cause temporary diabetes including corticosteroids, beta blockers, and phenytoin. Risk Factors. Nearly 2. American children and adults have diabetes. Up to 9. 5% of these cases are type 2. In addition, 7. 9 million American adults have pre- diabetes, a condition that increases the risk for developing diabetes. Type 2 diabetes used to mainly develop after the age of 4. Obesity is likely the major factor behind this dramatic growth rate. According to the National Institutes of Health, people have an increased risk for diabetes or pre- diabetes if they have: Age of 4. Family history of diabetes. Overweight. Inactive lifestyle (exercise less than 3 times a week)African- American, Hispanic/Latin American, American Indian and Alaska Native, Asian- American, or Pacific Islander ethnicity. High blood pressure (1. Hg or higher)HDL (. Obesity is the number one risk factor for type 2 diabetes. Excess body fat appears to play a strong role in insulin resistance, but the way the fat is distributed is also significant. Weight concentrated around the abdomen and in the upper part of the body (apple- shaped) is associated with insulin resistance and diabetes, heart disease, high blood pressure, stroke, and unhealthy cholesterol levels. Waist circumferences greater than 3. The syndrome consists of abdominal obesity, unhealthy cholesterol and triglyceride levels, high blood pressure, and insulin resistance. Polycystic Ovary Syndrome. Polycystic ovary syndrome (PCOS) is a condition that affects about 6% of women and results in the ovarian production of high amounts of androgens (male hormones), particularly testosterone. Women with PCOS are at higher risk for insulin resistance, and about half of PCOS patients also have diabetes. Depression. Severe clinical depression may modestly increase the risk for type 2 diabetes. Schizophrenia. While no definitive association has been established, research has suggested an increased background risk of diabetes among people with schizophrenia. In addition, many of the new generation of antipsychotic medications may elevate blood glucose levels. Patients taking antipsychotic medications (such as clozapine, olanzapine, risperidone, aripiprazole, quetiapine fumarate, and ziprasidone) should receive a baseline blood glucose level test and be monitored for any increases during therapy. Gestational Diabetes Risk Factors. Gestational diabetes is a type of diabetes that develops during the last trimester of pregnancy. A pregnant woman's risk factors include: Family history of diabetes. African- American, Hispanic, Asian, or Pacific Islander ethnicity. Overweight. Older than 2. Gestational diabetes with past pregnancy. Having given birth to a child weighing over 9 pounds. Diagnosis of pre- diabetes. Women who have gestational diabetes are at increased risk of developing type 2 diabetes after their pregnancy. They should be screened for diabetes 6 - 1. Symptoms. Type 2 diabetes usually begins gradually and progresses slowly. Symptoms in adults include: Excessive thirst. Increased urination. Fatigue. Blurred vision. Random finding (plus pi) - The best part of parenting (so far)? Helping your kids overcome things you struggled with. It’s at least in the top 5. Last Saturday my daughter came home from dance class—something she normally loves—and seemed upset. A bit of prodding led to the cause: a girl in her dance class told her she was “as fat as a hippopotamus.” My first reaction (note to self: probably not the right one) was to laugh out loud, given that my daughter is probably in the 1. I’m worried she’s too skinny! Of course I realized quickly the “facts” were irrelevant in this case. Her body habitus was moot. But her feelings were hurt, and as we all know this wouldn’t be last time someone said something to her—true or untrue—that would hurt her feelings. She was shocked, “Like what, daddy?” I gave example after example. She was amazed—and relieved, I suspect—to know that she wasn’t alone and that I was able to shrug it off after temporarily being upset by it. I even told her about folks posting videos on You. Tube specifically attacking me. So, when our little talk was over she asked if she could see one of the videos I alluded to. I was a bit hesitant, if only for some of the language used when folks rant against my existence (if she’s going to learn choice 4- letter words in earnest, it should be from me after all), but I figured it was a good idea. She could actually see for herself that people say mean things about her dad and he’s still, more or less, ok. Which brings me to the point of this quasi- post. Even if you watched the earlier version of the talk, if you find this question interesting—what is the case for restricting saturated fat (SFA) intake—it’s worth watching this version. I find this particular topic especially interesting because I think it highlights the challenge we all have, myself included, in setting aside bias when confronted with new information. What do I mean by that (i. Certainly in this presentation I try to make the case that the continually falling recommendations for SFA—from 1. In fact, such recommendations likely do harm, courtesy of the “substitution effect,” i. PUFA)—that likely cause greater metabolic derangement. However, some readers may interpret the data I present to mean it’s perfectly safe to consume, say, 2. SFA. I realize I may have to turn in my keto- club card, but I am convinced that a subset of the population—I don’t know how large or small, because my “N” is too small—are not better served by mainlining SFA, even in the complete absence of carbohydrates (i. This leads me to believe some people are not genetically equipped to thrive in prolonged nutritional ketosis. In one particularly interesting case, a patient in self- prescribed nutritional ketosis presented to me with an LDL- P of more than 3. L (i. e., more particles than could be measured by the NMR machine so the report simply said “> 3,5. L”) despite feeling, performing, and looking great. Based on his through- the- roof desmosterol and cholanstanol levels, and a curb- side consult from the Godfather I mean Dr. Tom Dayspring, I decided to try an experiment. You see, the logical thing to do in this setting would have been to start two drugs immediately (a potent statin to address the hypersynthesis and ezetimibe to address the hyperabsorption) or tell him to abandon ketosis altogether. But this patient was adamant about staying in ketosis given the other benefits, though obviously worried about the long- term coronary implications. So, we agreed that for a 3 month trial period he would reduce SFA to an average of 2. Parenthetically, we also reduced his omega- 3 PUFA given very high RBC EPA and DHA levels. So, on balance, he consumed about the same number of calories and even total quantity of fat, but his distribution of fat intake changed and he heavily swapped out SFA for MUFA. The result? His LDL- P fell from > 3,5. L to about 1,3. 00 nmol/L (about 5. CRP fell from 2. 9 mg/L to < 0. L (and for the lipoprotein cognoscenti, both desmosterol and cholanstanol fell). Pretty cool, huh? So, my point is this: while I believe the population- based guidelines for SFA are not supported by a standard of science I consider acceptable, it does not imply I believe SFA is uniformly safe at all levels for all individuals. Some of you may be wondering about me. It turns out I’m in the group (recall: I have no idea how large or small this group is) that seems to do well—at least by the tools we have available to assess risk—with large amounts of SFA in my diet, if and when I elect to. Even when I was in ketosis, eating 4,0. SFA alone) my biomarkers—cardiovascular, insulin resistance, inflammation—were excellent. Better than they ever were or even are today. Though, my point still stands: there are some people who do not appear able to safely consume massive amounts of SFA. One last point I’ll make on this highly charged topic. I realize there is a contingent within the LCHF community who argue that traditional biomarkers of coronary risk—such as LDL- C or its superior cousin LDL- P—“don’t matter” if one is on a low carb or ketogenic diet. I guess time will tell. But I am not convinced, at least not yet. So if you’re following such a diet, and your LDL- P goes through the roof, I’d urge you to consider a variation of the diet.(Note: If you post your NMR results, please understand I will not comment on them.)This presentation has nothing to do with nutrition but is, nevertheless, a topic I’m pretty obsessed with: how do we achieve cost containment on healthcare in the United States? Most problems that have been heavily politicized suffer a common problem: they fail to distinguish between what is desirable in a resource unconstrained world (e. Hope you enjoy the departure from the usual topics. Pi Day. The math geeks in the audience will appreciate that yesterday, March 1. Normally, March 1. Yesterday, however, being the pi day in 2. If you’re a watch geek, in addition to being a math geek–yes, I realize this is not a huge club–the beauty of a perpetual calendar (a type of watch that shows time, month, date, and year inclusive of leap years), made it a really fun day! Because at 9: 2. 6 and 5. After capturing this wonderful moment in time, I sent the picture, below, to my watch mentor (also a math geek; yes I just wrote the words “watch” and “mentor” next to each other). He loved it, but his response was priceless: “Peter, don’t ever show this to any woman you have the slightest interest in. I dig it.”Good thing my days of trying to impress the ladies are far in the rear view mirror. Parting shot: I did a follow up podcast with Tim Ferriss a few weeks ago. It’s episode #6. 5 which is available on i. Tunes. This was my first time doing the strange format of just talking by myself. Feedback appreciated if this should morph into something I do quasi- regularly on the blog.
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