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Diabetes and ALA
- Thread starter Temple
- Start date
T
The Shadow
Guest
ummm..the doc ain't gonna know shit about it.
Do a search - I posted a good article on ALa a few weeks back and it mentioned benefits for diabetics....I see no reason for dr. supervision - just keep a glucometer close
Do a search - I posted a good article on ALa a few weeks back and it mentioned benefits for diabetics....I see no reason for dr. supervision - just keep a glucometer close
search.....what's that????
I just like watching you type, hun.
I do remember the article and will dig it up, I think I even printed that one which is probably what made me think of the ALA for him in the first place.
Actually what I think is going on is a 65 year old man who needs but refuses to taked injections.....
I just like watching you type, hun.
I do remember the article and will dig it up, I think I even printed that one which is probably what made me think of the ALA for him in the first place.
Actually what I think is going on is a 65 year old man who needs but refuses to taked injections.....
T
The Shadow
Guest
Try it.....it might save his life...seriously.
A good guy on the anablic board is encapsulating 500 mg caps for like .20 each - that's a steal.
A good guy on the anablic board is encapsulating 500 mg caps for like .20 each - that's a steal.
Temple01--I am going to forward you an email I sent my dad recently--I've been researching ALA for a while wrt the diabetes thing--I did alot of explaining and gave alot of references. His doc is really cool and has Type II as well so when he showed it to him--his doc said he had been researching also and they (my dad and doc) are going to start using together!
Beware it's a long email and may have some unrelated crap in it but links to lots of studies and lots of explaining--seriously I could write a book on this stuff. Let me know if you want any more specifics after you read the email.
Beware it's a long email and may have some unrelated crap in it but links to lots of studies and lots of explaining--seriously I could write a book on this stuff. Let me know if you want any more specifics after you read the email.
If he's Type I diabetic, he needs his insulin or he's a dead man walking who is going to die a relatively slow painful death (blindness, kidney failure, limb amputation, heart attack, etc.).
ALA isn't going to solve his primary problem. Glycemic control is the only answer and inadequate glycemic control is the primary reason behind diabetes related morbidity and mortality.
Exercise is the only additional way to dispose of glucose independent of insulin and/or in an insulin resistant state, but he still needs insulin.
W6
ALA isn't going to solve his primary problem. Glycemic control is the only answer and inadequate glycemic control is the primary reason behind diabetes related morbidity and mortality.
Exercise is the only additional way to dispose of glucose independent of insulin and/or in an insulin resistant state, but he still needs insulin.
W6
I wholeheartedly agree with the weight loss, except that the diabetic meds makes it difficult for both Type I and IIs to lose wt. I do credit Metformin enough to say it is one of the few that seems to assist in dropping pounds gained from getting on the meds in the first place and it does help to control type II but is still limited and causes other complications if you have high blood pressure, chol, etc.
Diabetes (both types) runs high on both sides of my family which is why I research it so much and search for options. The ALA is so much better than the meds out there IMO. Not only does it dispose of the glucose efficiently, it also helps diabetic related complications (slow healing, numbness, etc.) and does not cause elevation in the other bad stuff mentioned above. Although if he does get a script--again, IMO should try the Metformin first (w/docs ok) over the other meds available.
Diabetes (both types) runs high on both sides of my family which is why I research it so much and search for options. The ALA is so much better than the meds out there IMO. Not only does it dispose of the glucose efficiently, it also helps diabetic related complications (slow healing, numbness, etc.) and does not cause elevation in the other bad stuff mentioned above. Although if he does get a script--again, IMO should try the Metformin first (w/docs ok) over the other meds available.
I also would not recommend using ALA to prop up the faulty lifestyle habits that lead to the diabetes in the first place. MOST type 2 diabetes can be very well controlled if caught early and corrective lifestyle measures are taken. Metformin would be my first choice for a prescription, but ALA would come a close second. It's anti-ox/liver protective effects are possibly beneficial to many people (even those without overt diabetes).
Here's an editorial I just came across in this week's British Medical Journal....I thought it might interest Pryncess and other people interested in the prevention and management of type 2 diabetes:
Prevention and cure of type 2 diabetes
Weight loss is the key to controlling the diabetes epidemic
The Department of Health has published the first part of the national service framework defining standards of care for
people with diabetes. The substance of how these standards will be achieved is now awaited. Type
2 diabetes, however, is reaching epidemic proportions, and epidemics are seldom controlled unless their causes are
addressed. Obesity is strongly and causally linked to type 2 diabetes. Recent data suggest that the prevention of
diabetes is feasible if weight management is addressed adequately in individuals at high risk. More controversially,
weight management also has the potential to make a significant impact in those with established type 2 diabetes.
The most common definition of obesity is a body mass index greater than 30 kg/m2. In the nurses' health study the risk of type 2 diabetes in women with an index of
29-31 was 28-fold increased compared with women with an index lower than 22, and an index greater than 35 carried a 93-fold increased risk.1
The overall prevalence of self reported diabetes in the United States has reached 7.3%, and 15% in people over 60 years of age, driven by epidemic obesity.2 There
is no room for complacency in the United Kingdom. The prevalence of known and new type 2 diabetes, detected by oral glucose tolerance test, was 20% in
Europeans, 22% in Afro-Caribbeans, and 33% in Pakistanis in urban Manchester.3 Obesity and physical inactivity were the principal factors associated with
diabetes, and waist circumference, a measure of intra-abdominal fat, was the strongest predictor of glucose tolerance. Similarly, obesity related diabetes in childhood,
already common worldwide, has now reached the United Kingdom.4
So, could we prevent type 2 diabetes? In a prospective study of 84 941 female nurses followed for 16 years, a combination of five modifiable risk factors related to
dietary behaviour, physical activity, weight, and cigarette smoking was identified that was associated with a remarkable 91% reduction in the risk of developing
diabetes.5 Even with a family history of diabetes the risk reduction was 88%. In theory, therefore, most diabetes could be preventable, largely irrespective of genetic
background.
Two pioneering studies show that this is feasible. In the Finnish diabetes prevention study weight loss in overweight subjects with impaired glucose tolerance,
averaging just 3-4 kg over 4 years, led to a 58% reduction in incident diabetes.6 A similar result was achieved by the diabetes prevention programme in the United
States, in which lifestyle intervention involving exercise and dietary change in subjects with impaired glucose tolerance reduced incident diabetes by 58%.7
The mechanism of prevention of diabetes probably entails changes in both dietary behaviour and physical activity, for which weight loss is a surrogate indicator.
Whatever the mechanism the message is that much could be done to prevent diabetes in individuals at high risk. If theory is to be put into practice in the United
Kingdom, however, where few general practitioners see a role for primary care in the prevention of diabetes,8 a substantially increased awareness of risk factors
such as obesity and impaired glucose tolerance is needed. A bigger obstacle still is that lifestyle and body weight are far from being under voluntary control, and so
prevention of diabetes requires sustained cultural change.
The success of the diabetes prevention studies begs a controversial question: should we put greater emphasis on weight loss for patients with new diabetes? The
traditional dogma (not strongly evidence based) is that people with diabetes cannot lose weight and so this is futile. However, the regular support of a dietitian,
practical help with physical activity, and behavioural change at home and at work are the central tenets of successful weight management and are absent from
diabetes care. The most thought provoking data on improved glycaemic control, and sometimes remission of diabetes, through restriction of calories come from
morbidly obese individuals undergoing bariatric surgery.9 Although this remedy can hardly be advocated widely, the data show how diabetes can be controlled and
sometimes cured by major reductions in caloric intake. Weight loss, therefore, of at least 5-10% would be a logical goal, alongside standard glycaemic and
cardiovascular targets, for many overweight people with diabetes. This would slow progression, reduce insulin requirements, allow withdrawal of treatment for some,
and, most importantly, reduce mortality.10 Experience shows, however, that this is often beyond the reach of older patients; it may be more realistic for younger
newly diagnosed patients, given appropriate support, and perhaps judicious use of anti-obesity drugs. Much remains to be learned about the treatment of this disease.
Testing times lie ahead for this national service framework. Epidemic type 2 diabetes demands more than a reiteration of the established glycaemic and
cardiovascular targets on a grand scale. While the goal of a cure for type 2 diabetes remains some way off for most patients, prevention of diabetes and slowing of
the natural history of the disease are clearly feasible. We should act on this important new evidence.
Jonathan Pinkney, senior lecturer.
University Department of Medicine, Diabetes and Endocrinology Research Group, Clinical Sciences Centre, University Hospital Aintree, Liverpool L9 7AL [email protected]
1.
Colditz G, Willett WC, Stampfer MJ, Manson JE, Hennekens CH, Arky RA, et al. Weight as a risk factor for clinical diabetes in women. Am J Epidemiol
1990; 132: 501-513[Abstract].
2.
Mokdad AH, Bowman BA, Ford ES, Vinicor F, Marks JS, Koplan JP. The continuing epidemics of obesity and diabetes in the United States. JAMA 2001;
286: 1195-2000[Medline].
3.
Riste L, Khan F, Cruickshank K. High prevalence of type 2 diabetes in all ethnic groups, including Europeans, in a British inner city: relative poverty, history,
inactivity, or 21st century Europe? Diabetes Care 2001; 24: 1377-1383[Abstract/Full Text].
4.
Drake AJ, Smith A, Betts PR, Crowne EC, Shield J. Type 2 diabetes in obese white children. Arch Dis Child 2002; 86: 207-208[Abstract/Full Text].
5.
Hu FB, Manson JE, Stampfer MJ, Colditz G, Liu S, Solomon CG, et al. Diet, lifetyle, and the risk of type 2 diabetes mellitus in women. N Engl J Med 2001;
345: 790-797[Abstract/Full Text].
6.
Tuomilehto J, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, et al. Finnish Diabetes Prevention Study
Group. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001; 344:
1343-1350[Abstract/Full Text].
7.
Diabetes Prevention Program Research Group. Reduction of the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002;
346: 393-403[Abstract/Full Text].
8.
Wylie G, Hungin APS, Neely J. Impaired glucose tolerance; qualitative and quantitative study of general practitioners' knowledge and perceptions. BMJ 2002;
324: 1190-1196[Abstract/Full Text].
9.
Pinkney JH, Sjostrom CD, Gale EAM. Should surgeons treat diabetes in severely obese people? Lancet 2001; 357: 1357-1359[Medline].
10.
Lean ME, Powrie JK, Anderson AS, Garthwaite PH. Obesity, weight loss and prognosis in type 2 diabetes. Diabet Med 1990; 7: 228-233[Medline].
Prevention and cure of type 2 diabetes
Weight loss is the key to controlling the diabetes epidemic
The Department of Health has published the first part of the national service framework defining standards of care for
people with diabetes. The substance of how these standards will be achieved is now awaited. Type
2 diabetes, however, is reaching epidemic proportions, and epidemics are seldom controlled unless their causes are
addressed. Obesity is strongly and causally linked to type 2 diabetes. Recent data suggest that the prevention of
diabetes is feasible if weight management is addressed adequately in individuals at high risk. More controversially,
weight management also has the potential to make a significant impact in those with established type 2 diabetes.
The most common definition of obesity is a body mass index greater than 30 kg/m2. In the nurses' health study the risk of type 2 diabetes in women with an index of
29-31 was 28-fold increased compared with women with an index lower than 22, and an index greater than 35 carried a 93-fold increased risk.1
The overall prevalence of self reported diabetes in the United States has reached 7.3%, and 15% in people over 60 years of age, driven by epidemic obesity.2 There
is no room for complacency in the United Kingdom. The prevalence of known and new type 2 diabetes, detected by oral glucose tolerance test, was 20% in
Europeans, 22% in Afro-Caribbeans, and 33% in Pakistanis in urban Manchester.3 Obesity and physical inactivity were the principal factors associated with
diabetes, and waist circumference, a measure of intra-abdominal fat, was the strongest predictor of glucose tolerance. Similarly, obesity related diabetes in childhood,
already common worldwide, has now reached the United Kingdom.4
So, could we prevent type 2 diabetes? In a prospective study of 84 941 female nurses followed for 16 years, a combination of five modifiable risk factors related to
dietary behaviour, physical activity, weight, and cigarette smoking was identified that was associated with a remarkable 91% reduction in the risk of developing
diabetes.5 Even with a family history of diabetes the risk reduction was 88%. In theory, therefore, most diabetes could be preventable, largely irrespective of genetic
background.
Two pioneering studies show that this is feasible. In the Finnish diabetes prevention study weight loss in overweight subjects with impaired glucose tolerance,
averaging just 3-4 kg over 4 years, led to a 58% reduction in incident diabetes.6 A similar result was achieved by the diabetes prevention programme in the United
States, in which lifestyle intervention involving exercise and dietary change in subjects with impaired glucose tolerance reduced incident diabetes by 58%.7
The mechanism of prevention of diabetes probably entails changes in both dietary behaviour and physical activity, for which weight loss is a surrogate indicator.
Whatever the mechanism the message is that much could be done to prevent diabetes in individuals at high risk. If theory is to be put into practice in the United
Kingdom, however, where few general practitioners see a role for primary care in the prevention of diabetes,8 a substantially increased awareness of risk factors
such as obesity and impaired glucose tolerance is needed. A bigger obstacle still is that lifestyle and body weight are far from being under voluntary control, and so
prevention of diabetes requires sustained cultural change.
The success of the diabetes prevention studies begs a controversial question: should we put greater emphasis on weight loss for patients with new diabetes? The
traditional dogma (not strongly evidence based) is that people with diabetes cannot lose weight and so this is futile. However, the regular support of a dietitian,
practical help with physical activity, and behavioural change at home and at work are the central tenets of successful weight management and are absent from
diabetes care. The most thought provoking data on improved glycaemic control, and sometimes remission of diabetes, through restriction of calories come from
morbidly obese individuals undergoing bariatric surgery.9 Although this remedy can hardly be advocated widely, the data show how diabetes can be controlled and
sometimes cured by major reductions in caloric intake. Weight loss, therefore, of at least 5-10% would be a logical goal, alongside standard glycaemic and
cardiovascular targets, for many overweight people with diabetes. This would slow progression, reduce insulin requirements, allow withdrawal of treatment for some,
and, most importantly, reduce mortality.10 Experience shows, however, that this is often beyond the reach of older patients; it may be more realistic for younger
newly diagnosed patients, given appropriate support, and perhaps judicious use of anti-obesity drugs. Much remains to be learned about the treatment of this disease.
Testing times lie ahead for this national service framework. Epidemic type 2 diabetes demands more than a reiteration of the established glycaemic and
cardiovascular targets on a grand scale. While the goal of a cure for type 2 diabetes remains some way off for most patients, prevention of diabetes and slowing of
the natural history of the disease are clearly feasible. We should act on this important new evidence.
Jonathan Pinkney, senior lecturer.
University Department of Medicine, Diabetes and Endocrinology Research Group, Clinical Sciences Centre, University Hospital Aintree, Liverpool L9 7AL [email protected]
1.
Colditz G, Willett WC, Stampfer MJ, Manson JE, Hennekens CH, Arky RA, et al. Weight as a risk factor for clinical diabetes in women. Am J Epidemiol
1990; 132: 501-513[Abstract].
2.
Mokdad AH, Bowman BA, Ford ES, Vinicor F, Marks JS, Koplan JP. The continuing epidemics of obesity and diabetes in the United States. JAMA 2001;
286: 1195-2000[Medline].
3.
Riste L, Khan F, Cruickshank K. High prevalence of type 2 diabetes in all ethnic groups, including Europeans, in a British inner city: relative poverty, history,
inactivity, or 21st century Europe? Diabetes Care 2001; 24: 1377-1383[Abstract/Full Text].
4.
Drake AJ, Smith A, Betts PR, Crowne EC, Shield J. Type 2 diabetes in obese white children. Arch Dis Child 2002; 86: 207-208[Abstract/Full Text].
5.
Hu FB, Manson JE, Stampfer MJ, Colditz G, Liu S, Solomon CG, et al. Diet, lifetyle, and the risk of type 2 diabetes mellitus in women. N Engl J Med 2001;
345: 790-797[Abstract/Full Text].
6.
Tuomilehto J, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, et al. Finnish Diabetes Prevention Study
Group. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001; 344:
1343-1350[Abstract/Full Text].
7.
Diabetes Prevention Program Research Group. Reduction of the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002;
346: 393-403[Abstract/Full Text].
8.
Wylie G, Hungin APS, Neely J. Impaired glucose tolerance; qualitative and quantitative study of general practitioners' knowledge and perceptions. BMJ 2002;
324: 1190-1196[Abstract/Full Text].
9.
Pinkney JH, Sjostrom CD, Gale EAM. Should surgeons treat diabetes in severely obese people? Lancet 2001; 357: 1357-1359[Medline].
10.
Lean ME, Powrie JK, Anderson AS, Garthwaite PH. Obesity, weight loss and prognosis in type 2 diabetes. Diabet Med 1990; 7: 228-233[Medline].
In most cases, obesity is the cause of Type II diabetes, but yet instead of weight-loss as the primary tool, what do we do? Use drugs to try and force more glucose in, instead of decreasing insulin resistance with weight-loss and increasing glucose uptake and utilization with exercise. Go figure.
Fact is we're dealing with a group of people that overeat and don't like to exercise and/or be physically active. Thus, we try and solve the problem with pharmacology rather than behavioral modification. It only prolongs the inevitable.
W6
Fact is we're dealing with a group of people that overeat and don't like to exercise and/or be physically active. Thus, we try and solve the problem with pharmacology rather than behavioral modification. It only prolongs the inevitable.
W6
T
The Shadow
Guest
...true - treating symptoms and not the actual cause...
This statement is a little too stereotyped and overall just harsh IMO--
Fact is we're dealing with a group of people that overeat and don't like to exercise and/or be physically active. Thus, we try and solve the problem with pharmacology rather than behavioral modification. It only prolongs the inevitable.
Sometimes it is the case but sometimes it's just that people don't know about eating right--does the surgeon general emphasize low glycemic carbs or the dangers of refined bread, rice, cereal etc. No--I know plenty of people with type II that are not obese (a couple that aren't even overweight) and just as many who are physically active. Still overall they have damaged their system as a whole.
I am with you about the pharmacology part--I hate that my dad takes diabetes pills which drives his cholesterol up which drives up the bad enzymes in his liver--freakin redicoulous process. I just think the ALA can help take away the drug part while fixing whatever it was bad eating or obesity or inactivity that lead to the problem in the first place. The disease took a lifetime to develop in the first place--you can't just say well start eating and exercising right today and it'll go away--some people don't even have that many years left!
My point is there isn't an easy fix but and the meds will lead to further complication; weight loss or life style change is a valid means of decreasing the resistance and sometimes even, reversing the condition but there's an inbetween time that must be accounted for, what are they supposed to do until the healthy changes start to do some good, you can't just ignore that.
MS--I forwarded an email to you as well--I was hoping the author of the article could give me references for the studies proving weight loss for a diabetic is not any harder--I also asked if this was his opinion, someone else's opinion or a proven statement. He said it was his opinion based on things he read--I asked him for references to those things so we'll see. If he's right I would love to know the methods they tested with and the ones that worked best.
Fact is we're dealing with a group of people that overeat and don't like to exercise and/or be physically active. Thus, we try and solve the problem with pharmacology rather than behavioral modification. It only prolongs the inevitable.
Sometimes it is the case but sometimes it's just that people don't know about eating right--does the surgeon general emphasize low glycemic carbs or the dangers of refined bread, rice, cereal etc. No--I know plenty of people with type II that are not obese (a couple that aren't even overweight) and just as many who are physically active. Still overall they have damaged their system as a whole.
I am with you about the pharmacology part--I hate that my dad takes diabetes pills which drives his cholesterol up which drives up the bad enzymes in his liver--freakin redicoulous process. I just think the ALA can help take away the drug part while fixing whatever it was bad eating or obesity or inactivity that lead to the problem in the first place. The disease took a lifetime to develop in the first place--you can't just say well start eating and exercising right today and it'll go away--some people don't even have that many years left!
My point is there isn't an easy fix but and the meds will lead to further complication; weight loss or life style change is a valid means of decreasing the resistance and sometimes even, reversing the condition but there's an inbetween time that must be accounted for, what are they supposed to do until the healthy changes start to do some good, you can't just ignore that.
MS--I forwarded an email to you as well--I was hoping the author of the article could give me references for the studies proving weight loss for a diabetic is not any harder--I also asked if this was his opinion, someone else's opinion or a proven statement. He said it was his opinion based on things he read--I asked him for references to those things so we'll see. If he's right I would love to know the methods they tested with and the ones that worked best.
While there are certainly non-obese Type II diabetics and those that are genetically predisposed and develop Type II when exposed to a Western diet, I think if you really look hard at Americans in general, you'll find that I'm not being overly harsh or stereotyping. They are the cause of their own problems.
Aside from drugs, the only way around insulin resistance is aggressive physical activity in the form of high intensity exercise several times a week. Most Type IIs have plenty of GLUT-4 protein around, they just can't mobilize it through insulin dependent pathways. This only leaves one option and that is exercise stimulated GLUT-4 mobilization, and walking or a light jog isn't going to do it.
Type II diabetes (obese type, and some develop insulin resistance before they are even obese just from a Western diet), is a function of "no where else to put the energy". Its really pretty simple, when the barrel (fat cell and muscle) is full, the fat runs over and results in a wide range of metabolic problems. The only way to make more room is to burn off the fat and use the glucose. Once the insulin dependent pathway is dysfunctional, then the exercise pathway is the only one left unless someone is really lacking GLUT-4 protein.
W6
Aside from drugs, the only way around insulin resistance is aggressive physical activity in the form of high intensity exercise several times a week. Most Type IIs have plenty of GLUT-4 protein around, they just can't mobilize it through insulin dependent pathways. This only leaves one option and that is exercise stimulated GLUT-4 mobilization, and walking or a light jog isn't going to do it.
Type II diabetes (obese type, and some develop insulin resistance before they are even obese just from a Western diet), is a function of "no where else to put the energy". Its really pretty simple, when the barrel (fat cell and muscle) is full, the fat runs over and results in a wide range of metabolic problems. The only way to make more room is to burn off the fat and use the glucose. Once the insulin dependent pathway is dysfunctional, then the exercise pathway is the only one left unless someone is really lacking GLUT-4 protein.
W6
Pryncess, I received you email and commend your efforts. I don't think anyone would say that it's not HARDER for diabeteics to lose weight than non-diabetics. It's harder as long as insulin resistance continues, but even then it's not impossible. It's just that getting anyone (diabetic or not) to follow a sensible reduced calorie low GI diet and participate in regular exercise is much too hard for most GPs to attempt. Much easier to prescribe drugs. Let's not forget that drugs and surgery are what modern doctors are predominantly trained for. We know for sure from other (non human) animal models of type 2 diabetes that if you control their food intake and force them to exercise, the insulin resistance goes away as they lose weight. Same as humans. So the question really is, how to motivate and educate someone with type 2 to make those lifestyle changes (which are damned hard...let's face it) rather than just swallow a pill. That editorial quite rightly pointed out that lifestyle interventions are more likely to be effective in younger diabetics, and that making the crucial lifestyle changes in older age is much less likely to happen. I guess you have to be realistic in what you can achieve with lifestyle modifications, and when it's appropriate to use drugs instead. ALA as part of a drug program is a good idea (though maybe not in combo with metformin). ALA may also help control blood glucose levels while a diabetic in in transition to making those lifestyle changes. But eventually the diabetic will need to control their glucose with good diet and exercise if they want to get off the meds. There are possibly other (more controversial) benefits of drugs like ALA for increasing lifespan or at least decreasing the incidence of chronic degenerative diseases of western society, but these fall under the category of preventative medicine and are unproven. Personally I prefer preventative medicine, but that doesn't help someone who's already got problems.
I don't think it's helpful trying to blame the diabetic for their condition. That doesn't help anyone. But at the same time I think it is wrong for the diabetic to attempt to place the blame on someone else! There can't really be that many people in western countries that don't know that they shouldn't over eat, they should avoid refined sugars, reduce saturated fats, eat fresh fruits and veggies, and exercise more. Just like smokers can no longer claim ignorance when they get lung cancer, or alcoholics when their liver packs in. I do agree however, that the public needs to be more clearly warned about the possible glycemic impact of the foods they eat so they don't automatically think that 'fat-free' means the same thing as 'OK to eat as much as you want'.
I don't think it's helpful trying to blame the diabetic for their condition. That doesn't help anyone. But at the same time I think it is wrong for the diabetic to attempt to place the blame on someone else! There can't really be that many people in western countries that don't know that they shouldn't over eat, they should avoid refined sugars, reduce saturated fats, eat fresh fruits and veggies, and exercise more. Just like smokers can no longer claim ignorance when they get lung cancer, or alcoholics when their liver packs in. I do agree however, that the public needs to be more clearly warned about the possible glycemic impact of the foods they eat so they don't automatically think that 'fat-free' means the same thing as 'OK to eat as much as you want'.
Hmmm must be the week for type 2 diabetes editorials! Here's another one from the New Zealand Medical Journal. I particularly like their method of testing for glucose intolerance 2 hours after someone has their 50th birthday big fatty sweet pig-out!!:
"Screening for type 2 diabetes
Tim Kenealey and colleagues’ excellent article on screening for type 2 diabetes gives good guidance to general practitioners and wisely leaves
options open to initiate an early therapeutic opportunity1.
As advocated for more than twenty years an excellent chance to estimate residual beta cell reserve function is when the patient turns fifty years
of age. They can then be advised to have a really very large three course mid day birthday dinner (possibly with other older brothers and
sisters?). They present at the laboratory exactly two hours after the meal has been finished. This time suits most people and laboratories.
Values returned over 7.0mmol/L will suggest beta cell reserves less than 30% rather than the more likely 50% expected in the average New
Zealander.
An oral glucose tolerance test giving 2 hour values 7.8 – 11mmol/L will allow a diagnosis of impaired glucose tolerance, always a forerunner of
diabetes and low levels of beta cell residual capacity. Two hour values over 11.0mmol/L on the OGTT make an “official” diagnosis of type 2
diabetes.1 In the United Kingdom there is usually a period of twelve years from onset to diagnosis.
Such two hour values relate much better to functioning residual beta cell mass, to future cardiovascular disease and to all cause mortality than
do fasting blood glucose values alone – a late diagnostic feature.
Diabetes NZ Inc, the Federation of thirty seven voluntary societies representing the 105 000 people with diabetes strongly supports earliest
possible diagnosis set out in the Pricewaterhouse Coopers report of 2001.
Two other key issues emerge in respect to the widespread loss by midlife or earlier of non renewable beta cell function in so many people in
New Zealand. It is now accepted that the earliest diagnosis is cost effective. Evidence for this has been reviewed. It is also now accepted
that 150 minutes of active exercise weekly and four visits yearly for dietetic advice on weight management and reduction of saturated fat intake
prevents diabetes. Our high New Zealand weight and animal fat levels were not designed for the beta cells or liver enzymes of our huntergather
ancestors.
Five fold increases in animal fat ingestion increases insulin demand and often body mass index and, unless modified, accelerate B cell
destruction.
This 50% prevention of progression to diabetes with the above lifestyle changes is exciting but a less well known finding of the last five years.
Let us all now initiate action and do something modern about diabetes in our country."
Sue Benny,
Diabetes Health Promoter.
Professor D W Beaven,
Prof Emeritus,
Diabetes Life Education and Patron Diabetes NZ,
Christchurch.
"Screening for type 2 diabetes
Tim Kenealey and colleagues’ excellent article on screening for type 2 diabetes gives good guidance to general practitioners and wisely leaves
options open to initiate an early therapeutic opportunity1.
As advocated for more than twenty years an excellent chance to estimate residual beta cell reserve function is when the patient turns fifty years
of age. They can then be advised to have a really very large three course mid day birthday dinner (possibly with other older brothers and
sisters?). They present at the laboratory exactly two hours after the meal has been finished. This time suits most people and laboratories.
Values returned over 7.0mmol/L will suggest beta cell reserves less than 30% rather than the more likely 50% expected in the average New
Zealander.
An oral glucose tolerance test giving 2 hour values 7.8 – 11mmol/L will allow a diagnosis of impaired glucose tolerance, always a forerunner of
diabetes and low levels of beta cell residual capacity. Two hour values over 11.0mmol/L on the OGTT make an “official” diagnosis of type 2
diabetes.1 In the United Kingdom there is usually a period of twelve years from onset to diagnosis.
Such two hour values relate much better to functioning residual beta cell mass, to future cardiovascular disease and to all cause mortality than
do fasting blood glucose values alone – a late diagnostic feature.
Diabetes NZ Inc, the Federation of thirty seven voluntary societies representing the 105 000 people with diabetes strongly supports earliest
possible diagnosis set out in the Pricewaterhouse Coopers report of 2001.
Two other key issues emerge in respect to the widespread loss by midlife or earlier of non renewable beta cell function in so many people in
New Zealand. It is now accepted that the earliest diagnosis is cost effective. Evidence for this has been reviewed. It is also now accepted
that 150 minutes of active exercise weekly and four visits yearly for dietetic advice on weight management and reduction of saturated fat intake
prevents diabetes. Our high New Zealand weight and animal fat levels were not designed for the beta cells or liver enzymes of our huntergather
ancestors.
Five fold increases in animal fat ingestion increases insulin demand and often body mass index and, unless modified, accelerate B cell
destruction.
This 50% prevention of progression to diabetes with the above lifestyle changes is exciting but a less well known finding of the last five years.
Let us all now initiate action and do something modern about diabetes in our country."
Sue Benny,
Diabetes Health Promoter.
Professor D W Beaven,
Prof Emeritus,
Diabetes Life Education and Patron Diabetes NZ,
Christchurch.
That is a good article--seriously I wish they would test and diagnose insulin resistance instead of waiting until it becomes diabetes and better yet, really take the time to educate people before while the damage is still minimal.
Another big problem (seriously, although you may laugh) is because the disease usually occurs later in life and has really only been an epidemic for the last ten years give or take--it almost seems like a myth to the person. I mean, when did talk of insulin resistance really start, not that long ago. The elders in my family (second generation too, doesn't help) never heard of diabetes when they were younger and rarely before their doctor diagnosed them with it. Both of my grandmothers (1 Type I, the other Type II and recently deceased) thought it was a crock. "What do these young doctors know; how can food I've been eating all my life be bad-would've killed me years ago if that was the truth." They would hear nothing of it and both of them are (were) surprisingly active and under 20lbs overweight so the doctor telling them to drop some pounds and be more active was essentially interpreted as he was saying they were fat and lazy.
It is like was said about smoking--the person has to decide to take control, unfortunately though the timeless mentality of I'm sick doc, give me something to help is stuck--I am very pro preventative measures. People should be asking doc how can I improve my health not what do you have that'll make me feel better. Would've, should've, could've--it will take a while to catch on and believe me the government is starting to. Obesity related deseases (to include diabetes) have for the first time ever come in with medical costs greater than smoking related diseases and while the number of people who smoke is decreasing, the number of people with unhealthy eating habits and growing waistlines is at an all time high--the amount of cash the gov't has had to contribute towards treating these diseases has lead to them to make weight loss efforts a tax deductable expense--they will begin preaching more because it is costing them more.
Hopefully will at least keep some of the folks in our generation from the same fate. Unfortunately, I think the generations before us will not get the message in time--I have to keep telling my dad that having a coke while taking the Metformin IS a bad thing and eventually make it so the Metformin doesn't even help--he still thinks the opposite, the Metformin allows him to drink the coke ("not as much" is the best I get "but I can have a coke or two a day"). And he is VERY intellegent and active but still he's a good 30lbs overweight and just doesn't get it--he thinks that is his normal weight, yeah maybe 30 years ago when he had alot more muscle. I send him articles all the time--to tell him stuff the doctor won't and to scare him--he did a good job scaring himself recently, overdid his eating much more than the metformin could counter--said it felt like his body was shutting down, thought he was going to slip into a coma--he's been listening alot better since then and the fact that his doc backed me up on alot of stuff helped.
BTW--I agree the ALA and the Metformin is overkill, I sent my dad the supp, keto strips and directions and gave him instructions should he enter ketosis--also made him discuss with his doc. I think the doc is going to try it first, taking one less dose of the metformin daily and replacing w/the ALA (yeah his doc is type II also). Anyway the studies are very convincing, if anyone wants the stuff I sent to Temple01 just let me know-they are links to many real studies, not someones opinion--cold hard facts always work best for me.
Another big problem (seriously, although you may laugh) is because the disease usually occurs later in life and has really only been an epidemic for the last ten years give or take--it almost seems like a myth to the person. I mean, when did talk of insulin resistance really start, not that long ago. The elders in my family (second generation too, doesn't help) never heard of diabetes when they were younger and rarely before their doctor diagnosed them with it. Both of my grandmothers (1 Type I, the other Type II and recently deceased) thought it was a crock. "What do these young doctors know; how can food I've been eating all my life be bad-would've killed me years ago if that was the truth." They would hear nothing of it and both of them are (were) surprisingly active and under 20lbs overweight so the doctor telling them to drop some pounds and be more active was essentially interpreted as he was saying they were fat and lazy.
It is like was said about smoking--the person has to decide to take control, unfortunately though the timeless mentality of I'm sick doc, give me something to help is stuck--I am very pro preventative measures. People should be asking doc how can I improve my health not what do you have that'll make me feel better. Would've, should've, could've--it will take a while to catch on and believe me the government is starting to. Obesity related deseases (to include diabetes) have for the first time ever come in with medical costs greater than smoking related diseases and while the number of people who smoke is decreasing, the number of people with unhealthy eating habits and growing waistlines is at an all time high--the amount of cash the gov't has had to contribute towards treating these diseases has lead to them to make weight loss efforts a tax deductable expense--they will begin preaching more because it is costing them more.
Hopefully will at least keep some of the folks in our generation from the same fate. Unfortunately, I think the generations before us will not get the message in time--I have to keep telling my dad that having a coke while taking the Metformin IS a bad thing and eventually make it so the Metformin doesn't even help--he still thinks the opposite, the Metformin allows him to drink the coke ("not as much" is the best I get "but I can have a coke or two a day"). And he is VERY intellegent and active but still he's a good 30lbs overweight and just doesn't get it--he thinks that is his normal weight, yeah maybe 30 years ago when he had alot more muscle. I send him articles all the time--to tell him stuff the doctor won't and to scare him--he did a good job scaring himself recently, overdid his eating much more than the metformin could counter--said it felt like his body was shutting down, thought he was going to slip into a coma--he's been listening alot better since then and the fact that his doc backed me up on alot of stuff helped.
BTW--I agree the ALA and the Metformin is overkill, I sent my dad the supp, keto strips and directions and gave him instructions should he enter ketosis--also made him discuss with his doc. I think the doc is going to try it first, taking one less dose of the metformin daily and replacing w/the ALA (yeah his doc is type II also). Anyway the studies are very convincing, if anyone wants the stuff I sent to Temple01 just let me know-they are links to many real studies, not someones opinion--cold hard facts always work best for me.
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