Category Archives: Diabetes Complications

Does Type 2 Diabetes Cause Alzheimer’s Dementia?

dementia, memory loss, Mediterranean diet, low-carb diet, glycemic index, dementia memory loss

“More basic research is critical.”

Several scientific studies, but not all, link type 2 diabetes with Alzheimer’s disease. Some go so far as to say Alzheimer’s is type 3 diabetes.

My Twitter feed brought to my attention a scientific article I thought would clarify the relationships between diabetes, carbohydrate consumption, and Alzheimer’s dementia (full text).

It didn’t.

Click the full text link to read all about insulin, amylin, insulin degrading enzyme, amyloid–β, and other factors that might explain the relationship between type 2 diabetes and Alzheimer’s dementia. You’ll also find a comprehensive annotated list of the scientific studies investigating the link between diabetes and Alzheimer’s.

Bottom line: We still don’t know the fundamental cause of Alzheimer’s disease. A cure and highly effective preventive measures are far in the future.

Action Plan For You

You may be able to reduce your risk of Alzheimer’s disease by:

  • avoiding type 2 diabetes
  • preventing progression of prediabetes to diabetes
  • avoiding obesity
  • exercising regularly
  • eating a Mediterranean-style diet

Carbohydrate restriction helps many folks prevent or resolve obesity, prediabetes, and type 2 diabetes.

Steve Parker, M.D.

Reference: Schilling, Melissa. Unraveling Alzheimer’s: Making Sense of the Relationship Between Diabetes and Alzheimer’s Disease. Journal of Alzheimer’s Disease, 51 (2016): 961-977.

LCHF Mediterranean diet

LCHF Mediterranean diet

 

 

 

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Intensive Program Extended Lifespan By Eight Years in Type 2 Diabetes

"I don't mind dying. I just don't want to be there when it happens."  --Woody Allen

“I don’t mind dying. I just don’t want to be there when it happens.” –Woody Allen

MedPageToday has some details:

“Type-2 diabetics lived nearly 8 years longer when treated with an intensive, multifactorial approach that employed behavioral and pharmacological interventions.

The 160 patients with type-2 diabetes mellitus and microalbuminuria, now followed for 21 years, received either conventional or intensified therapy.

Thirty-eight intensive-therapy patients died during the follow-up period compared with 55 conventional-therapy patient deaths during the same time. This translated to a median survival period 7.9 years longer for the intensive-therapy cohort, as well as a median delay of 8.1 years to a first cardiovascular event, the investigators reported in the journal Diabetologia.

“The outcome of our study is very encouraging and emphasizes the need for early and intensified treatment of multiple modifiable risk factors for a poor prognosis of patients with type 2 diabetes,” said lead study author Peter Gaede, MD, of the University of Southern Denmark in Odense, in a statement.”

Source: Intensive Program Extends Lifespan in T2D Patients | Medpage Today

Study participants were northern Europeans (Danes) who had small amounts of protein (albumin) in their urine and were mostly in their 50s when this long-term study started.

Medical intervention included diet changes, drugs for diabetes/blood pressure/lipids, and exercise. Therapy for the intensive therapy group was “target-driven, with stepwise implementation of both behavioral and pharmacological treatment following a structured approach.”

If you’re a researcher and want to test how my diabetes diets would perform in a study like this, contact me for a discount on books.

Steve Parker, M.D.

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Diabetes-related vision loss growing worldwide 

Photo of the retina at the back of the eyeball

Photo of the retina at the back of the eyeball

After near-sightedness, diabetes affecting the eyes (aka diabetic retinopathy) is the leading cause of impaired vision in adults. The key to preventing retinopathy is strict control of blood sugars, especially early in the course of diabetes. Controlling blood pressure and not smoking are of secondary importance.

MNT has the details on the global increase in retinopathy:

“The worldwide burden of diabetes-related vision loss is growing alarmingly. Over 2 decades from 1990-2010, the number of people worldwide with diabetes-related blindness or visual impairment rose by an alarming 27 percent and 64 percent, respectively. In 2010, 1 in every 52 people had vision loss and 1 in every 39 people were blind due to diabetic retinopathy – where the retina is damaged by diabetes.

The researchers suggest poor control of blood glucose and inadequate access to eye health services in many parts of the world are contributing to the growing global burden of diabetes-related vision loss.

These figures are the result of an analysis by a global consortium, who recently published their work online in the journal Diabetes Care.

As the number of people living with diabetes worldwide grows, so does the chance that more people will develop diabetic retinopathy and suffer subsequent vision loss, especially if they do not receive or adhere to the care they need.Diabetic retinopathy is a disease of the retina that damages sight as a result of chronic high blood sugar in diabetes. The high sugar damages the delicate blood vessels in the retina – the light-sensitive layer of tissue that lines the back of the eye.”

Source: Diabetes-related vision loss growing worldwide – Medical News Today

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Bariatric Surgery Reduces Microvascular Complications of Type 2 Diabetes

bariatric surgery, Steve Parker MD

Band Gastric Bypass Surgery (not the only type of gastric bypass): very successful at “curing” T2 diabetes if you survive the operation

Folks with T2 diabetes who undergo weight-loss surgery (bariatric surgery) often see a reversal or remission of their diabetes. The reversal doesn’t always last.

In either case, bariatric surgery does seem to reduce the risk if microvascular complications, namely retinopathy (eye disease), neuropathy (nerve pain or numbness), and nephropathy (kidney disease).

The conclusion of a recent study:

“Our results indicate that remission of type 2 diabetes after bariatric surgery confers benefits for risk of incident microvascular disease even if patients eventually experience a relapse of their type 2 diabetes. This provides support for a legacy effect of bariatric surgery, where even a transient period of surgically induced type 2 diabetes remission is associated with lower long-term microvascular disease risk.”

Source: Long-term Microvascular Disease Outcomes in Patients With Type 2 Diabetes After Bariatric Surgery: Evidence for the Legacy Effect of Surgery | Diabetes Care

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What’s the Deal With Hypoglycemia Unawareness?

Some people with diabetes, particularly after having the condition for many years, lose the ability to detect hypoglycemia—low blood sugar—just by the way they feel. This “hypoglycemia unawareness” is obviously more dangerous than being able to detect and treat hypoglycemia early on. Blood sugar levels may continue to fall and reach a life-threatening degree. Hypoglycemia unawareness can be caused by impairment of the nervous system (autonomic neuropathy) or by beta blocker drugs prescribed for high blood pressure or heart disease. People with hypoglycemia unawareness need to check blood sugars more frequently, particularly if driving a car or operating dangerous machinery.

How Is Hypoglycemia Treated?

Folks who can indeed perceive signs or symptoms of hypoglycemia usually won’t notice them until their blood sugar is under 65 mg/dl (36 mmol/l).

If you have diabetes, your personal physician and other healthcare team members should teach you how to recognize and manage hypoglycemia. Immediate early stage treatment involves ingestion of glucose as the preferred treatment—15 to 20 grams. You can get glucose tablets or paste at your local pharmacy without a prescription. Other carbohydrates will also work: six fl oz (180 ml) sweetened fruit juice, 12 fl oz (360 ml) milk, four tsp (20 ml) table sugar mixed in water, four fl oz (120 ml) soda pop, candy, etc. Fifteen to 30 grams of glucose or other carbohydrate should do the trick. Hypoglycemic symptoms respond within 20 minutes.

If level of consciousness is diminished such that the person cannot safely swallow, he’ll need a glucagon injection. Non-medical people can be trained to give the injection under the skin or into a muscle. Ask your doctor if you’re at risk for severe hypoglycemia. If so, ask him for a prescription so you can get an emergency glucagon kit from a pharmacy.

Steve Parker, M.D.

low-carb mediterranean diet

Front cover of book

 

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Elevated Fasting Blood Sugar Linked to Pancreatic Cancer

A recent meta-analysis found that elevated fasting blood glucose levels, even in the prediabetic range, are associated with higher risk of developing pancreatic cancer. This is important because you can take action today to lower your fasting blood sugar level, which may lower your risk of pancreatic cancer over the long-term. The researchers conclude that…

“Every 0.56 mmol/L [10 mg/dl] increase in fasting blood glucose is associated with a 14% increase in the rate of pancreatic cancer.”

In the developed world, your risk of getting an invasive cancer is roughly one in four. Pancreatic cancer is the most lethal. Surgery is the way to cure it, but at the time of diagnosis only two in 10 patients are candidates for surgery because the cancer has already spread. Pancreatic cancer is the fourth leading cause of cancer death in the USA and the fifth in the UK. Nevertheless, pancreas cancer is not terribly common; the US has 50,000 new cases annually. As a hospitalist, I run across one or two new cases of pancreas cancer every year.

We’ve known for years that type 2 diabetes is linked to pancreatic cancer, with diabetics having twice the risk of nondiabetics.

What if you have elevated fasting blood sugars? There’s no proof that reducing them to the normal range will reduce your risk of pancreatic cancer. But if it were me, that’s what I’d shoot for.

Other that type 2 diabetes and prediabetes, some other risk factors for pancreas cancer are:

  • heredity
  • smoking
  • sedentary lifestyle
  • body mass index over 30 (obesity in other words)

You can alter most of those risk factors. Why not get started now?

Steve Parker, M.D.

PS: If you’re not sure if your fasting blood sugar’s elevated, click here.

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Breaking News! Obesity Can Cut Years Off Your Life

Are you tired of this stock photo yet?

Are you tired of this stock photo yet?

MedPageToday has the details. A quote:

In a computer modeling study, very obese men lost just over 8 years of life compared with normal-weight men, and very obese women lost as many as 6 years, Steven Grover, PhD, of McGill University, and colleagues reported online in the Lancet Diabetes and Endocrinology.

They also found that very obese men and women (defined as a body mass index [BMI] of 35 and higher) lost about 19 years of healthy life, defined as living free of chronic disease such as diabetes and cardiovascular disease.

Note that “very obese” in this context has a specific definition: body mass index 35 or higher. Calculate yours.

The number of life years lost to obesity and disease were highest for those who were very obese in young adulthood and presumably stayed obese for years. In other words, becoming very obese at age 60 is not as dangerous as at 25.

I first got interested in weight loss in the 1990s when I had an office-based primary care medical practice. It was obvious that many of the medical problems I was treating were related to years of obesity. Believe me, you’re much better off preventing those problems via diet and exercise.

Click for The Lancet study abstract.

Steve Parker, M.D.

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Filed under Diabetes Complications, Heart Disease, Longevity, Overweight and Obesity