Low Levels of Vitamin D Don't Put Older Women at Greater Risk for Type 2 Diabetes

(Reuters Health) - Low levels of vitamin D don't put older women at greater risk for type 2 diabetes, a large study of U.S. women suggests.
The findings may further temper the enthusiasm for vitamin D that built up in recent years, as studies linked it to lower risks of everything from diabetes, to severe asthma, heart disease, certain cancers and depression.
The problem with those studies is that they were observational -- which means that researchers simply looked at people's vitamin D intake, or their blood levels of the vitamin, and whether or not they developed a given health condition.
Those types of studies cannot prove that vitamin D was the reason for any lower disease risk.
"You can't make dietary recommendations based on observational studies," said Dr. Jennifer G. Robinson, a professor of epidemiology and medicine at the University of Iowa and the lead researcher on the new study.
In an interview, she pointed to the recent report on vitamin D from the Institute of Medicine (IOM), an independent scientific body that advises the U.S. government. The report said the evidence didn't show that vitamin D has any health benefits beyond building and maintaining strong bones.
It also said average Americans already have vitamin D blood levels at or above the amount that's needed for good bone health.
The new study, published online by the journal Diabetes Care, involved women participating in the Women's Health Initiative, a large government project that looked at the health effects of hormone therapy, diet changes, and vitamin D and calcium supplements on women age 50 and older.
Of 5,140 women who were free of type 2 diabetes at the start of the trial, 6 percent developed the disorder over an average of 7 years.
Robinson's team found no clear link between the women's blood levels of vitamin D at the outset and their risk of developing type 2 diabetes later on.
Initially, there was some evidence of an association. But it disappeared when the researchers accounted for factors like body weight, exercise levels and certain diet habits, like fiber intake -- which are key in the risk of developing type 2 diabetes.
"Look at how you get vitamin D," Robinson said. She noted that the main sources include sun exposure, fatty fish like salmon and mackerel, and vitamin D-fortified dairy products. "People who get those things are a lot different from people who don't."
And it's those factors, Robinson said, that may account for the link between vitamin D and lower diabetes risk researchers thought they had found in older studies.
Still, the current study, like past ones, was observational -- so it doesn't disprove a role for vitamin D in diabetes risk. So-called randomized studies are what's needed to prove whether the vitamin curbs disease risks, Robinson pointed out.
In that type of trial, participants are randomly assigned to different treatment groups, which helps ensure the results are accurate and not just an effect of chance.

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Treatment with Pioglitazone Able to Halt The Progression of Impaired Glucose Tolerance

Treatment with pioglitazone (Actos) was able to halt the progression of impaired glucose tolerance to type 2 diabetes in a majority of patients, a randomized trial found.
After a mean follow-up of 2.2 years, 5% of patients with impaired glucose tolerance treated with Actos had developed diabetes, compared with 16.7% of those on placebo, according to Ralph A. DeFronzo, MD, of the University of Texas in San Antonio, as reported in the March 24 New England Journal of Medicine.
For more information please visit the original diabetes network at http://www.diabetes.net

Diabetes roughly doubles the risk of having a heart attack or stroke

Diabetes roughly doubles the risk of having a heart attack or stroke but it
triples the odds of dying of kidney disease and of dying from infection.
Pooled data from 97 studies enabled the researchers to point out that 40% of
820,000 people with raised blood sugar levels died from non vascular causes.
The findings are the first to be documented from comprehensive reports on
non-cardiovascular causes of death in people with diabetes.
Diabetes increases the risks of dying from cancers like ovarian, pancreatic,
colorectal, breast, bladder, and lung.
It also raises the risk of dying from Alzheimer's disease, chronic
obstructive pulmonary disease (COPD), falls, nervous system disorders,
digestive disorder, suicide and liver disease, to name a few.
That people with diabetes live a shorter life is not something new. But
Spyros Mezitis, MD, an endocrinologist at Lenox Hill Hospital in New York
City said an increased association with cancer and non-cancerous disease
with diabetes is something to give attention to.
Edward Giovannucci, MD, ScD, a professor in the departments of nutrition and
epidemiology at Harvard School of Public Health in Boston said the result
emphasizes the importance of continued work on why diabetes increases cancer
risk.
Besides smoking, and lack of physical activity, related problems such as
diabetes are likely to be close to importance as smoking for cancer risk.
Giovannucci was the lead author of a consensus statement jointly published
by the American Cancer Society and the American Diabetes Association in 2010

For more information about from the original diabetes network please visit Diabetes.net

If you are some close to you would like more information about diabetes treatment please visit American Diabetes Therapy Centers

A 50-year-old with diabetes can expect to die six years earlier than a nondiabetic peer

Diabetes not only doubles vascular death risk but also substantially raises risk of death from non vascular causes, including cancer and infectious disease, researchers found.
A 50-year-old with diabetes can expect to die six years earlier than a non diabetic peer, with non vascular deaths accounting for about 40% of the survival difference, John Danesh, MSc, DPhil, of the University of Cambridge, England, and colleagues in the Emerging Risk Factors Collaboration reported.
By comparison, smoking takes about seven years off life expectancy, the group noted.
Their patient-level pooled analysis of 820,900 individuals across 97 prospective studies appeared in the March 3 issue of the New England Journal of Medicine.
The magnitude of both the study and the risks highlights how serious and complicated diabetes is, commented Richard Bergenstal, MD, of the International Diabetes Center at Park Nicollet in Minneapolis, Minn., and immediate past president of the American Diabetes Association.
"We should be taking a broader view of diabetes," he told MedPage Today. "We sometimes get completely wrapped up in the metabolism of the A1c and the glucose and we forget about the associated effects on quality of life and depression and other consequences."
The researchers examined 12.3 million person-years of mortality follow-up for individuals without a history of vascular disease at enrollment in the 97 studies. The baseline diabetes prevalence was 6%.
Those with diabetes were 80% more likely to die from any cause during the study periods, after adjustment for age, sex, smoking status, and body mass index (95% confidence interval 1.71 to 1.90).
Vascular disease took top place as a cause of death, followed by cancer.
Not surprisingly, diabetes patients carried a 2.32-fold higher adjusted risk of death from vascular causes than their nondiabetic counterparts (95% CI 2.11 to 2.56).
But they were also at significantly elevated risk of death from cancer (adjusted HR 1.25, 95% CI 1.19 to 1.31) and from other nonvascular, noncancer causes (adjusted HR 1.73, 95% CI 1.62 to 1.85).
Diabetes moderately increased risk of death from the following as well:
* Cancers of the liver, pancreas, ovary, colorectum, lung, bladder, and breast
* Renal disease
* Liver disease
* Pneumonia and other infectious diseases
* Mental disorders
* Nonhepatic digestive diseases
* External causes
* Intentional self-harm
* Nervous-system disorders
* Chronic obstructive pulmonary disease
Links with kidney, digestive, and infectious disease could reflect nephropathy, fatty liver disease, and suppression of cellular immunity from diabetes, the researchers suggested.
The greater risk of injury-related deaths could be related to end-organ complications, such as neuropathy and eye disease, or episodes of hypoglycemia, they added.
The elevated mortality risk with diabetes appeared independent of blood pressure, lipids, the inflammatory marker C-reactive protein, fibrinogen, alcohol use, kidney function, and socioeconomic status.
Fasting glucose or glycosylated hemoglobin, though, appeared to account for some of the mortality risk of diabetes, as adjustment for these factors "considerably" attenuated the excess risk associated with diabetes.
Each 18 mg/dL higher fasting glucose level above 100 mg/dL was associated with a 5% higher risk of death from cancer, 13% higher risk of vascular death, and 10% higher risk of death from other causes -- for a 10% overall higher risk of death from any cause, all statistically significant.
Fasting glucose levels in the 70 to 100 mg/dL range were not significantly associated with death.
These findings support a direct impact of hyperglycemia on mortality risk, Danesh's group argued.
A consensus statement from the ADA and American Cancer Society last year cautioned that it wasn't clear whether the elevated cancer risk seen with diabetes is direct or due to shared risk factors or other indirect factors.
Bergenstal warned that this is still the case.
"We still can't say if it's the glucose or something associated with the hypoglycemia," he told MedPage Today, noting that the study did not control for diet, activity, and many other potentially confounding factors.
However, he agreed with the researchers that the findings reinforce the need for people with diabetes to get appropriate cancer screening tests on a regular basis.
"We should be taking a broader view of diabetes," he said. "We need to be supporting the patient in improving metabolic parameters but also looking at their whole life experience."
Primary source: New England Journal of Medicine
Source reference:
Emerging Risk Factors Collaboration "Diabetes mellitus, fasting glucose, and risk of cause-specific death" N Engl J Med 2011; 364: 829-841.

For more information about diabetes please visit Diabetes.net "The Original Diabetes Network"

Diabetes Therapy Treatment Day - American Diabates Therapy Centers

Treatments begin in the morning and continue for 6 hours, allowing the patient to leave shortly after lunch.  The six hours are spent with the patient reading, watching TV, working on a computer or any other non-stressful pastime.  The patient can walk around but should generally be in the chair while being treated.

The following picture depicts a man being treated. 

The machine on the left (a standard sports medicine metabolic measurement machine)  measures the metabolism of a patient. The patient breathes normally into the machine, and it calculates the carbohydrate and lipid metabolism of the patient.  Diabetic patients cannot metabolize sugars, but with CAT, they are able to normalize their metabolism and this machine shows that normalization process.   It is exciting to see a patient change from unable to burn sugars to using them as do non-diabetic people.

Patients are able to see their metabolism restored to normal healthy levels. Software in the computer tracks the benefits to the patient and provides the data necessary for billing.

The Bionica pump is on the armrest table to the left.  It is about the size of a video cassette.  It is a unique type of infusion device that delivers pulses of insulin in a special way with unique pressures so that the liver of the patient prepares the rest of the body for metabolizing carbohydrates.  (This is how the enzymes are made by the liver).

The Bionica pump thus mimics the stimulation that a non-diabetic liver receives.  Once the   liver is properly stimulated, the entire body then burns carbohydrates again, and the disease process of diabetes is stopped and in many ways reversed.

All of this equipment is fully FDA cleared (or sometimes called "approved" even though the FDA does not "approve" anything) and is manufactured in a U.S. FDA certified manufacturing facility.

All of this equipment has been tested and used for years.  In over 100,000 treatments, there has never been a reported adverse reaction, side effect, injury or claim.  There has never been a recall of this equipment or any reason to suspect that it will not work.

Exactly what takes place on a treatment day?

1. When the patient comes into the clinic a short review of their week takes place, looking for anything out of the ordinary.  The improvement in health which CAT causes is noted. Their blood pressure, heart rate and weight are recorded.  Any complications which are being measured are recorded (such as heart function improvement, kidney test improvement, neuropathy reversal, wound healing, etc.)

2. The patient sits in the chair, and a small IV is started.  The patient's blood sugar level is checked to make sure that the insulin being given will not be too great an amount.  (The blood sugar is kept a little higher than normal to insure that no hypoglycemia takes place.  This does not hurt the patient).   If the blood sugar is too low for treatment the patient is given a glucose drink.

3. The prior treatment parameters are reviewed and the patient breathes into the Metabolic Measurement cart to record the metabolism levels of the patient.  (These levels will quickly increase when the treatment is given.)

4. One hour of insulin pulses are given.  These pulses mimic normal pancreas stimulation of the liver to produce the enzymes necessary for proper resting metabolism.  The amount of insulin is not much more than the normal amount given to a diabetic person.  However, if the patient is insulin resistant, then as the treatment days progress that insulin resistance will reduce.

5. The patient is given glucose drinks throughout the treatment which is the second "signal" that is provided to the liver.  (when a non-diabetic person eats a meal with carbohydrates it stimulates the liver and is one of the signals that causes the pancreas to secret bursts of insulin every 4 to 6 minutes).

(Note: With the two signals to the liver, the oral glucose and the pulses of insulin which stay pulses due to the nature of the Bionica pump, the liver then "turns on" certain enzymes and "produces" more enzymes, all of which are needed to restore proper metabolism.  This happens no matter how sick or impaired the patient).

6. After one hour of pulses are given with the presence of glucose, the pateint waits an hour for their bodies to adjust.  This cycle is repeated two more times (for a total of 3 one hour infusion treatments and 3 one hour rests periods).  There is no pain or discomfort associated with the treatment or the breathing test other than a small IV which does not bother the patient.

7. Several times during the process the patient breathes into the Metabolic Measurement machine to track their progress (which always happens) and to insure that the right amount of insulin and glucose is being administered.  The patient's blood glucose levels are checked frequently to make sure that they do not become hypoglycemic from insulin.  If their blood sugar goes down, additional glucose drink is given.

8. After the last rest period, the checking of the blood sugar level and another Metabolic Measurement the patient is free to go home.   The patient is encouraged to consume solid foods as soon as possible after the treatment.  The patient is encouraged to have a normal meal for dinner, and to do some light exercise, while monitoring their blood sugar.

Obviously, the Staff is doing much of the work, calculating the amounts of insulin, glucose and metabolic outcomes.  This adjustment continues for a few months while the patient "gets their life back" and all of the changes take place.

The more ill the patient when they start, the more dramatic the outcomes, since the patient can show more improvement when they are really ill.  No patient is too ill for treatment.

How often do patients require treatment?  The majority of patients like to be treated once a week. They can tell when their energy level goes down, and can sense when complications of diabetes come back.  Thus, they are happy to come into the clinic once a week.

Occasionally a patient will miss a treatment, and nothing dramatic happens.  However, a second missing of treatment will cause most patients to feel "diabetic" again.  (Most diabetic people do not realize how badly they feel with diabetes, as they adjust and adapt to their condition over a period of years).

Accordingly, patients want to be treated regularly and maintain their energy levels as they regain their former abilities.

All of the clinical trials which showed the stopping and reversal of diabetes complications were based upon a "once a week" treatment regimen.  During these trials, an occasional treatment would be missed without known adverse result.  However, some patients elect to be treated once every 2 weeks if their metabolism remains normalized with this treatment schedule.

What do I do before coming?  Patients will be told to reduce their long acting insulin the night before.  Also, they should not have low blood sugar levels prior to treatment.

There are a number of things that happen as a patient gets better.  Over the first 3 to 6 months many of the patient's medicines will have to be adjusted (as their bodies become more responsive and more normal).  Some medicine, such as blood pressure medications, may become unnecessary after a few months of treatment.

Basically, if a medication relates to wellness, heart function, blood pressure, or pain, it will need to be adjusted as the patient changes to more normal metabolism.  However, this is just common sense and nothing unusual in the adjustment should occur.

For more information about American Diabetes Therapy Center or Treatment American Diabetes Therapy Centers

Do you know that about 125,000 Americans under the age of 21 have diabetes?

Glucose Control of Diabetes May Not Be of Benefit - Sacramento Roseville Folsom

Hospital physicians are joining other practitioners who agree that intensive glucose control of diabetes may not be of benefit. While wildly out of control blood glucose is always a threat, tight control may just starve the patient. Heart patients should not too tightly control their diabetes as it is associated with more heart attacks. No Gain With Intensive Glucose Control in ICU. Please view or download complimentary source below.
Clinical Guideline - American College of Physicians American Diabetes Therapy Centers