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

The Center for Disease Control 2011 Diabetes Facts

The Center for Disease Control 2011 Diabetes Fact Sheet reports:
The number of people with diabetes is rising and by 2050 1 in 3 people could have diabetes if current trends don’t change.

26 million adult Americans have diabetes and 79 million more have prediabetes.

In 2010 1.9 million people were newly diagnosed with diabetes.

About 215,000 Americans under age 20 have diabetes.

Diabetes is a major cause of heart disease and stroke.

Among U.S. residents aged 65 years and older, 10.9 million, or 26.9% had diabetes in 2010.

For more information:American Diabetes Therapy Centers - Roseville

Americans and Diabetes Grown to Nearly 26 Million

The number of Americans with diabetes has grown to nearly 26 million and an estimated one-third of all U.S. adults over 20 now have prediabetes, according to figures released Wednesday by the Centers for Disease Control and Prevention <http://www.foxnews.com/topics/health/medicine/center-for-disease-control.ht
m>  (CDC).  This means that the Artificial Pancreas System will have
application for more people than originally projected.
Read more:
http://www.foxnews.com/health/2011/01/26/cdc-nearly-million-americans-diabet
<http://www.foxnews.com/health/2011/01/26/cdc-nearly-million-americans-diabetes-adults-risk/>

Diabetes Therapy Centers - Consider These Good Foods

Good Foods:

Oatmeal
Studies have shown that eating a diet rich in whole grains and high-fiber foods may reduce the risk of diabetes by between 35 and 42 percent. An excellent source of both is heart-healthy oatmeal: It's packed with soluble fiber, which slows the absorption of glucose from food in the stomach — keeping blood-sugar levels under control. Top oatmeal with 1 to 2 tablespoons of chopped pecans, almonds, or walnuts to add protein and healthy fat, which stabilize blood sugars further. Plus, the nuts add great crunch and flavor to your morning meal.
Fish
Another outstanding source of lean protein is fresh fish. Choose an environmentally friendly variety like catfish, cod, or tilapia; all are mild-flavored, white-fleshed fish that can be healthfully prepared by baking, grilling, or roasting. Pair fish with the high-quality carbs found in vegetables, lentils, or beans for another balanced meal combination that will keep your blood sugar from rising
Nonfat Yogurt
Fat-free yogurt naturally contains both high-quality carbohydrates and protein, making it an excellent food for slowing or preventing an unhealthy rise in blood sugar. Studies also show that a diet high in calcium from yogurt and other calcium-rich foods is associated with a reduced risk of type 2 diabetes. Be sure to stick to low-fat or nonfat brands; Greek nonfat yogurt is my favorite choice because it has twice as much protein as regular nonfat yogurt.
Almonds
Unsalted almonds provide a healthy, low-carb mix of monounsaturated fats plus magnesium, which is believed to be instrumental in carbohydrate metabolism. A large study out of Harvard University found that high daily magnesium intake reduced the risk of developing diabetes by 33 percent. Therefore, including more magnesium-rich foods like almonds, pumpkin seeds, spinach, and Swiss chard in your diet is a smart move.
Nonstarchy Vegetables
Chock-full of vitamins, minerals, and fiber, nonstarchy vegetables (such as broccoli, spinach, mushrooms, and peppers) are an ideal source of high-quality carbohydrates. Because these low-calorie, nutrient-dense veggies have a low-impact on blood sugar, they're an integral component of your diabetes food plan. For most people (including those looking to lose weight), this is one food group that's okay to eat as much as you like!
Egg Whites
Rich in high-quality lean protein and low in carbs, egg whites are another healthy choice for controlling or preventing type 2 diabetes. One large egg white contains about 16 calories and 4 g of high-quality, filling protein, making egg whites a perfect food for blood sugar control, not to mention weight-loss or maintenance.
Avocado
Avocado is high in monounsaturated fats, which are generally considered among the healthiest of fats. Researchers have found that a diet high in monounsaturated fats and low in low-quality carbs may improve insulin sensitivity. Monounsaturated fats also improve heart health—an especially important benefit for diabetics, who are at increased risk for heart disease and stroke. Add a few thin slices of avocado to your sandwiches in place of mayonnaise, or mash a ripe tomatoes with cilantro, lime juice, and diced tomatoes for a delicious guacamole dip.  If you don't like avocado, try to use it as a spread.