Does Diabetes Drug Pioglitazone Prevent Dementia?

Nobody knows. A recent report out of Germany suggests that pioglitazone does prevent dementia, but it’s not a very strong linkage. If it works, I wonder if it’s simply related to better control of blood sugar, which could be accomplished with a variety of means. Pioglitazone (aka Actos) is a type 2 diabetes drug in the TZD class. You could call it an “insulin sensitizer.”

The best popular press report I’ve seen is at Bloomberg.

German researchers went fishing for associations in a huge database of patients and drug usage. Their formal report hasn’t even been published yet. A five-year study was recently initiated to further investigate the possibility that piogoitazone prevents dementia. I doubt this will pan out.

Steve Parker, M.D.

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Does Skipping Breakfast Affect Weight Loss?

It didn’t in this 16-week study. I don’t know what they ate nor how many calories. 

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Recipe: Eggs, Bacon, and Honeydew Melon

 

Bacon, eggs, black coffee, and Cholula hot sauce. A caveman wouldn't recognized any of this except for eggs.
Bacon, eggs, black coffee, and Cholula hot sauce

If you follow nutrition science literature, you’ll see periodic references to “processed meats” like bacon contributing to increased risk of cardiovascular disease, cancer, or premature death. I think the associations are pretty weak. Health-conscious cautious people aren’t going to go hog-wild on processed meats. I don’t. We may never have a definitive science-based resolution of the issue.

If you want to control the degree of processing in your bacon, make your own. The recipe at the link includes pink salt (sodium nitrite), maple syrup, and dark brown sugar. Many other recipes are available. My understanding is that sodium nitrite is a preservative and gives bacon meat that pink color. (Does it contribute to flavor?) If you’re not storing your bacon for a long time, you may not need the pink salt.

In any case, I thoroughly enjoyed three strips of bacon with my eggs recently. Mine was the Kirkland brand from Costco was $3.80/pound (USD). Two slices provide 80 calories (uncooked) and zero grams of carb although, if I recall correctly, it was honey-cured bacon.

Ingredients:

3 large eggs

3 strips of bacon, standard thin slices

Salt and pepper to taste

1/2 cup raw honeydew melon, cubed

Instructions:

Fry the bacon over medium or medium-high heat. If there’s too much grease leftover in the pan after cooking, poor out what you don’t want, for later use or drizzle over your dog’s dry kibble food. Leave a little grease in the pan so your eggs don’t stick. Then fry your eggs over medium heat. Enjoy with raw honeydew, which will cleanse your palate after eating bacon.

You can pay a lot more than $3.80 a pound for bacon
You can pay a lot more than $3.80 a pound for bacon

Servings: One

Nutritional Analysis per Serving: (from FitDay.com)

63 % fat

10 % carbohydrate

26 % protein

319 calories

9 carb grams

1 fiber grams

8 digestible carb grams

845 mg sodium

423 mg potassium

Prominent features: high in B12, riboflavin, selenium, protein, pantothenic acid, and phosphorus. Although this is low in calories, it’s adequately satiating because of the rich protein and fat content. The calorie count will be higher by 50 if you eat all the bacon grease.

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How To Put Out a Grease Fire

Of all the things I cook, bacon is the most likely to end up causing a grease fire. Imagine pouring excess bacon grease out of the frying pan and a little grease dribbles onto the outside of the pan. You set the pan back down on a hot burner, then the excitement starts.

How do you put out a grease fire? I knew water wouldn’t do the trick; my first thought was pour salt on it. That’s wrong! About.com says to simply smother it by putting a metal lid on the pan and turn off the heat. If you can’t find the fitted lid, use a cookie sheet. Fire won’t burn without a supply of oxygen. You could pour baking soda on the fire, but it takes a lotWikihow has more info on putting out a grease fire, mentioning a dry chemical fire extinguisher as a last resort if you’re going to handle the fire yourself. Think safety first.

Grease fire? Put a lid on it and turn off heat. If that fails, try a LOT of baking soda. Or fire extinguisher.

Grease fire? Put a lid on it and turn off heat. If that fails, try a LOT of baking soda. Or fire extinguisher.

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Sitagliptin May Increase Risk of Heart Failure

JACC has the details. Sitagliptin is a DPP-4 inhibitor used to treat type 2 diabetes. It’s sold in the U.S. as Januvia. Note that the alleged higher risk of heart failure is in patients who had a history of prior heart failure. Research findings like this are not always dependable or reproducible. It bears watching, especially if you’re a heart patient.

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Multinational Study Suggests Insulin Pump Better Than Multiple Daily Injections for Inadequatedly-Controlled Type 2 Diabetes

Lancet has the details. I’ve only read the abstract, so don’t know much about the actual research. Study subjects were sub-optimally controlled (HgbA1c of 8-12%) on multiple daily injections; that’s why they were considered for pump therapy. They were randomized to pump or continued multiple daily injections. What I can’t tell – and it matters – is whether the multiple injection group underwent changes in their management or whether they were told to “just keep doing what your were doing” (which wasn’t working well).

 

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Metformin Works Twice as Well in Blacks as Whites

Diabetes Self-Management has some of the details.

The implication is that the genetically determined physiology of black diabetics is different from whites. There could be other explanations, admittedly.

Here’s why I bring this to your attention. You don’t see me review many scientific articles involving mice, rats, pigs, or rabbits. I take care of human patients. I suspect there are too many genetic differences between us and them that clinically pertinent studies are rare. If you read my blogs carefully, you’ll also note I often hesitate to generalize clinical study results from one ethnic group to others. The different black/white responses to metformin validates my approach.

Type 2 diabetes in whites and blacks may not be the same disease, and it could be different in Asians, Australian aborigines, and North American Native Americans.

You may also be starting to understand why there’s so much confusion about which diabetic drugs are the best. We have 12 different classes of drugs now; what’s best for me may not be best for you.

Steve Parker, M.D.

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