Evidence of insulin resistance and changes in blood sugar linked to type 2 diabetes can be measured more than a decade before the disease occurs, new research confirms. The findings suggest that diabetes prevention efforts that focus on people with prediabetes may come too late to make a big difference.
The findings were presented today at the 69th Scientific Sessions of the American Diabetes Association in New Orleans, and they also appear in the latest online issue of the journal The Lancet. Researchers followed more than 6,500 British civil servants without diabetes for up to 13 years, during which time they repeatedly measured insulin sensitivity and fasting and non-fasting glucose levels.
During an average follow-up of 10 years, 505 of the study participants developed type 2 diabetes. The study showed a steady upward trajectory in metabolic changes in participants who did not develop diabetes. In contrast, these changes tended to occur at different periods in those who did go on to have diabetes, and these changes were often abrupt.
Timeline to Type 2 Diabetes
Specifically, the findings revealed:
* A steady trend in fasting glucose as early as 13 years prior to the diagnosis of type 2 diabetes, with fasting glucose levels rising rapidly three years before diagnosis
* Glucose levels after eating (post-meal glucose) began to increase rapidly starting three years prior to diagnosis
* Insulin sensitivity began to decline steeply five years before diagnosis
* Beta-cell function — a measure of insulin production — began to increase three to four years prior to diagnosis, as the pancreas tried to compensate for increases in blood glucose by producing more insulin. Insulin production dropped precipitously in the three years prior to a diagnosis of type 2 diabetes.
“The main addition of this study is that it shows for the first time a clear picture of the timeline to diabetes,” study co-author Daniel R. Witte, MD, of the University College London . Witte says the timeline suggests three distinct phases in the progression to diabetes, which may require different disease prevention strategies.
During the first phase, which occurs six or more years before diagnosis, glucose levels remain relatively stable but insulin resistance increases along with insulin secretion. “This is the time when relatively straightforward lifestyle changes, like increasing physical activity, changing diet, and reducing obesity, could have the biggest impact,” he says.
The second phase of progression to disease is characterized by increased beta-cell activity as the pancreas produces more insulin to compensate for insulin resistance. Witte says prevention efforts during this period may require more aggressive lifestyle intervention along with blood-sugar regulating medications like metformin.
During the final phase toward progression, which Witte refers to as the unstable phase, insulin production drops and blood glucose levels rise dramatically and rapidly. The study suggests that people who are generally considered to have prediabetes are in this final phase or close to it.
“We hypothesize that prevention would be more effective before this unstable period, but more research is needed to identify people at this stage of disease development.”
This is an ongoing series on health care system “memes” that continue to permeate our debate, even when evidence shows them to be false. The introductory post contains links to all entries.
For better or for worse, whenever many are asked about how they would help control the cost of the health-care system, tort reform always seems to be one of the first things offered as a solution.
The argument goes that doctors, afraid of being sued, order lots of extra tests and procedures to protect themselves. This is known as defensive medicine. Tort reform assumes that if we put a cap on the damages plaintiffs can win, then filing cases will be less attractive, fewer claims will be made, insurance companies will save money, malpractice premiums will come down, doctors will feel safer and will practice less defensive medicine, and health-care spending will go way down.
Ergo, tort reform = cost control.
Let’s start with some basics. How much does the malpractice system really cost in the U.S.? The most recent, comprehensive estimate, which was published in Health Affairs in December, estimated that medical liability system costs were about $55.6 billion in 2008 dollars, or about 2.4 percent of all U.S. health-care spending. Some of that was indemnity payments, and some of it was the cost of components like lawyers, judges, etc.; most of this, however, or about $47 billion, was defensive medicine. So yes, that is real money, and it theoretically could be reduced.
The question is, will tort reform do that?
That’s actually an answerable question. You could look at areas where tort reform has already happened and see how things have changed. For instance, we could look at Texas, where non-economic damages on malpractice lawsuits were capped at $250,000 about eight years ago. You might remember when Rick Perry and Newt Gingrich said:
Texas, for example, has adopted approaches to controlling health-care costs while improving choice, advancing quality of care and expanding coverage. Consider the successful 2003 tort reform.
So what happened to costs of care after that law was put in place? Public Citizen analyzed just that (pdf) using data from the Dartmouth Atlas of Health Care (Selected Medicare Reimbursement Measures):
Texas is blue, the nation is red, and the law went into place at the dotted line. If anything, Texas’s Medicare spending seems to have gone up faster than the nation’s since 2003. Hardly a persuasive argument for tort reform = cost control.
Another thing you could do is compare areas with high and low malpractice premiums, and see whether doctors practice differently. Guess what? Someone did. In the same issue of Health Affairs, another study showed that tort reform, which might lead to a 10 percent reduction in malpractice premiums (not small), which might translate into a health-care spending reduction of 0.1 percent. Let me show you that in a chart:
If the pie represents our total health-care spending, then the blue wedge is defensive medicine. Not as big as you thought, likely. But the red sliver, which I pulled out for easier viewing, is what we could expect to see in savings from tort reform.
I’m not going to disagree that the malpractice system needs fixing. Likely, too many claims are filed that have no merit. In addition, many more are never brought to trial that absolutely do. I completely support efforts at malpractice reform.
But it’s not the solution to our high health-care spending. Tort reform does not equal cost control.
Cysteine-rich protein reverses weight loss in lung cancer patients receiving chemotherapy or radiotherapy.
Hamilton Regional Cancer Centre, Hamilton, Ontario.
Cysteine-Rich Protein Prevents Weight Loss in Lung Cancer Patients:
A Promising Intervention Study
MONTREAL, Jan. 17, 2008 /PRNewswire-FirstCall/ – Immunotec Inc. (TSX-V: IMM) announced today the successful completion of a multi-center randomized, double-blind clinical trial on cancer-related weight loss (cachexia) in lung cancer patients which was performed in collaboration with various Canadian clinical centers (x) . The research concluded that patients treated with IMN 1207 showed significant increases in body weight (Tozer et al.Antioxidants & Redox Signaling (2008) 10:395-402). Immunotec also announced the initiation of a follow-up study to confirm the positive results.
The massive loss of body weight and muscle mass in advanced cancer patients is typically associated with psychological stress, financial burden and a decreased quality of life. Until now there have been no dietary interventions known to satisfactorily prevent this process.
Immunotec’s new study included 66 patients with advanced lung cancer receiving state of the art chemotherapy or radiotherapy. The patients had already suffered significant involuntary weight- loss prior to treatment. During a six month treatment period the patients were given either casein, a protein supplement low in cysteine which is widely used in clinical nutrition (“placebo”) or IMN 1207, a specially-prepared glutathione enhancing cysteine-rich whey protein isolate supplied by Immunotec Inc. The results showed that patients in the placebo group continued to lose weight whereas patients treated with IMN 1207 showed a significant increase in body weight. Incidentally, these patients also showed an increase in strength and quality of life parameters. This study showed for the first time that cancer-related weight loss (cachexia) can be prevented by a single source of protein. Dr. Gerald Batist, Chair, Department of Oncology, McGill University stated “Having been involved in the early mechanistic studies of the therapeutic use of whey proteins, I’m pleased to see this particular formulation being tested in the clinic. The data to date encourage additional and expanded clinical trials”. Dr. Wulf Droge, Senior Vice-President Research & Development at Immunotec Inc. emphasized that the results of this first trial should be viewed with cautious optimism. A second trial has been initiated to confirm the results.
Among other questions, this clinical trial also addressed the controversy about antioxidant use in chemotherapy. Since radiotherapy and many types of chemotherapy work by raising levels of oxidative stress and free radical formation to destroy cancer cells, oncologists have voiced concern that treatment of the patient with antioxidants may “protect” the cancer from the toxic effects of the therapy. If this were the case, antioxidants could even be expected to shorten the life span of the patients. Immunotec’s study now showed that this was clearly not the case with IMN 1207. Based on his earlier work at his laboratory at the National Cancer Research Center of Germany (DKFZ) in Heidelberg, Dr. Droge was reasonably confident that supplementation with a critical precursor of the major cellular antioxidant glutathione, would actually improve the condition of the patients, most probably by ameliorating adverse effects of these therapies on the patients’ healthy tissues. The results of this new study suggest that this is true. The antioxidant glutathione is distinct from other antioxidants including the popular antioxidant vitamins A, C, and E which are widely used as nutritional supplements. Glutathione is involved in the removal of reactive oxygen species and other potential toxic compounds through special biochemical processes and can reach relatively high and beneficial concentrations in cells and tissues depending on the availability of its biosynthetic precursor cysteine.
About IMN 1207 from Immunotec Research (Immunocal plus)
IMN 1207 is a cysteine-rich protein. It is the research formulation of the undenatured whey protein Immunocal(R)/HMS 90(R), a dietary natural health supplement, developed and marketed worldwide by Immunotec during the past 12 years. Immunocal(R)/HMS 90 is a precursor of the major cellular antioxidant glutathione, an element important in maintaining a strong
About Immunotec Inc.
Immunotec is engaged primarily in the development and marketing of natural health products, dietary supplements, food, vitamins and personal care products, many of which are manufactured on its behalf by third parties. Immunotec’s products are distributed and sold in Canada and the United States through a network marketing system and in other countries through exclusive distributorship agreements. Immunotec’s investment in this study is another manifestation of its ongoing commitment to research and development. http://www.immunotec.com.
x Montreal General Hospital (McGill University teaching hospital) Montreal , Quebec , Canada
x Cross Cancer Institute, Alberta Cancer Board (University of Alberta affiliate) Edmonton , Alberta Canada
x Jewish General Hospital (McGill University teaching hospital) Montreal Quebec,Canada
x Juravinski Cancer Centre (McMaster University and Hamilton Health Sciences affiliate) Hamilton , Ontario,Canada .
x Allan Blair Cancer Centre (a division of Saskatchewan Cancer Foundation) Regina , Saskatchewan , Canada .
PMID: 18158761 [PubMed - in process]
See the actual report:
8 Home Remedies That Actually Work
Find out the science behind common DIY treatments for hiccups, warts and more
By Brynn Mannino Posted February 08, 2011 from WomansDay.com
Nobody is naysaying the wonders of modern medicine—what would we do without a medication like penicillin to treat infections? But, as it turns out, everyday items have secret curing powers, too. Next time you don’t want to fork over money to get a common wart removed, consider using duct tape. Already popped two aspirin but can’t get rid of the headache? A pencil could do the trick. Below, get medical explanations behind a few bizarre—albeit brilliant—MacGyver-esque home remedies.
Duct Tape to Remove Warts
In 2002, a group of doctors compared duct tape’s effectiveness with liquid nitrogen in removing warts. After two months of wearing duct tape on a daily basis and using a pumice stone about once a week to exfoliate the dead skin, 85 percent of patients’ warts were gone, whereas freezing only removed 60 percent. “The question is whether there is something in the chemical adhesive itself, or if the occlusion (suffocation) causes the destruction of the wart,” says New York City–based dermatologist, Robin Blum, MD. “The other thinking is that the duct tape causes irritation, which stimulates our body’s immune cells to attack the wart.” Photo: Thinkstock
Vapor Rub to Cure Nail Fungus
While there are no studies to prove coating infected toenails with vapor rub once or twice a day is an effective treatment for nail fungus, a basic Internet search results in a number of personal testaments to the medicinal ointment’s fungus-killing powers. “I’ve heard many patients say that vapor rub does help, but I’m not exactly sure why,” Dr. Blum admits. While some argue it’s the menthol in the balm that kills the fungus and others say it’s the smothering effect of the thick gel, if used consistently, vapor rub has been shown to get rid of not just the fungus, but the infected toenail, too, which will turn black and eventually fall off. When the new nail grows in, it should be fungus-free. Photo: Thinkstock
Oatmeal to Soothe Eczema
“This is absolutely true, as oats have anti-inflammatory properties,” Dr. Blum says. Whether it’s used as a paste or poured into a bath, most experts recommend choosing colloidal (finely ground) oatmeal and soaking the affected area for at least 15 minutes. In addition to reducing inflammation, oats are thought to have an antihistamine effect, Dr. Blum says. By lowering levels of histamine, which triggers inflammation as part of the immune system’s recovery response, she explains, oats prevent or reduce the redness. Photo: Thinkstock
Yogurt to Cure Bad Breath
Bad breath comes from a number of places, the two most common being the mouth and the stomach. The neutralizing powers of yogurt and other probiotics treat the latter cause. “Yogurt shouldn’t have any effect at all on the bacteria that live on the tongue because it’s not there long enough,” says Robert Meltzer, MD, a New York City–based gastroenterologist and attending physician at Lenox Hill Hospital. However, it likely has a neutralizing effect on the acid that resides anywhere between the mouth and the stomach, including the back of the throat and the esophagus, he explains. “I think almost any milk product or food that contains live cultures would have the same effect.” While yogurt can get rid of bad breath that results from gastrological conditions, like acid reflux, it won’t have any real effect on bad breath that is the product of gum, liver or lung disease, says Ohio-based dentist Matthew Messina, DDS. Photo: Thinkstock
A Spoonful of Sugar to Cure Hiccups
In 1971, Edgar Engelman, MD, conducted a study to find out if a spoonful of sugar really is an effective cure for hiccups. He assembled a group of 20 patients who had been experiencing intractable hiccups for more than six hours, eight of whom had had them anywhere from a full day to six weeks. Each of the test subjects was given one teaspoon of white granulated sugar to swallow dry, and for 19 of the 20 hiccup patients, the cure was immediate. André Dubois, MD, a gastroenterologist in Bethesda, Maryland, noted in The Doctors Book of Home Remedies that “the sugar is probably acting in the mouth to modify the nervous impulses that would otherwise tell the muscles in the diaphragm to contract spasmodically.” Photo: iStockphoto
Bite a Pencil to Cure a Headache
While doctors aren’t sure why we do it, clenching our teeth is a common side effect of stress. According to Fred Sheftell, MD, director of the New England Center for Headache in Stamford, Connecticut, when we clench up, we strain the muscle that connects the jaw to the temples, which can trigger a tension headache. By placing a pencil between our teeth—but not biting down—we relax our jaw muscles, which eradicates tension and reduces pain. Just remember, the remedy really only applies to tension headaches—not migraines or headaches caused by sinus pressure, etc. Photo: Thinkstock
Olives for Motion Sickness
According to the National Library of Medicine, there are a number of symptoms that present themselves as a result of motion sickness, including increased salivation, which is the body’s way of protecting the teeth from the high doses of acid accompanied by vomit. Enter olives, which contain tannins that, when released in the mouth, work to dry saliva—first eliminating the symptom and then the body’s instinct to follow suit. However, the treatment is only effective during the early stages of nausea, when the salivation changes first appear. Photo: Thinkstock
Gargle Salt Water for a Sore Throat
When you were a kid and had a sore throat, your mom likely made you gargle warm water with salt in it…and she was definitely on to something. According to Douglas Hoffman MD, PhD, author of the website The Medical Consumer’s Advocate, a sore throat is an inflammatory response of the infected tissues, and the salt helps draw out the excess fluid to temporarily decrease swelling and the pain it causes. Most remedies call for a ratio of 1 tablespoon salt to 8 ounces of water, but it’s always better to opt for more salt rather than less. Just keep in mind that you are treating the symptoms—not the illness. As Dr. Hoffman notes on his website: “The relief is very real, but also tends to be short-lived, since the gargle has done nothing to remove the cause of the sore throat.” Photo: Thinkstock
Here are the top Metabolism Boosting Foods
1. Water! A new study seems to indicate that drinking water actually speeds up weight loss and boost metabolism. Researchers in Germany found that subjects of the study increased their metabolic rates (the rate at which calories are burned) by 30 percent after drinking approximately 17 ounces of water. Water is also a natural appetite suppressant that banishes bloat as it flushes out sodium and toxins. Drinking enough water will also help keep you from mistaking thirst for hunger. So drink up! Make sure that you are starting your day with a big big glass of water and drink throughout the day not just all at one time.
2. Green Tea! Studies show that green tea extracts boost metabolism and may aid in weight loss. This mood-enhancing tea has also been reported to contain anti-cancer properties and help prevent heart disease. It’s also a trendy drink among weight-conscious celebrities. You may Have already seen my green tea articles but this may be one really fantastic herb and it tastes nice too!
3. Soup! Eat less and burn fat faster by having a bowl of soup as an appetizer or a snack. According to a Penn State University study, soup is a super appetite suppressant because it’s made up of a hunger-satisfying combination of liquids and solids. In the study, women chose one of three 270-calorie snacks before lunch. Women who had chicken and rice soup as a snack consumed a n average of 100 fewer calories than those in the study who opted for a chicken and rice casserole or the casserole and a glass of water. I used to joke that soup is not a meal but it really dies fill you for very few calories and remember that when you eat a food with a lot of taste it really will satisfy.
4. Grapefruit! The grapefruit diet is not a myth. Researchers at Scripps Clinic found that participants who ate half a grapefruit with each meal in a 12-week period lost an average of 3.6 pounds. The study indicates that the unique chemical properties in this vitamin C-packed citrus fruit reduce insulin levels, which promotes weight loss and boost metabolism. NOTE: If you are taking medication, check with your doctor about any potentially adverse interactions with grapefruit. Grapefruit, because of the soft peel is a nice alternative to an apple of orange and study after study of the last 30 years has shown that it can really help burn fat.
5. Apples and Pears! Overweight women who ate the equivalent of three small apples or pears a day lost more weight on a low-calorie diet than women who didn’t add fruit to their diet, according to re searchers from the State University of Rio de Janeiro. Fruit eaters also ate fewer calories overall. So next time you need to satisfy a sugar craving, reach for this low-calorie, high-fiber snack. You’ll feel full longer and eat less.
6. Broccoli! Study after study links calcium and weight loss. Broccoli is not only high in calcium, but also loaded with vitamin C, which boosts calcium absorption. This member of the nutritious cabbage family also has plenty of vitamin A, folate and fiber. And, at just 20-calories per cup, this weight-loss superfood not only fights fat but also contains powerful phytochemicals that boost your immunity and protect against disease.
7. Low-Fat Yogurt! Dairy products can boost weight loss efforts, according to a study in the April issue of Obesity Research. People on a reduced-calorie diet who included three to four servings of dairy foods lost significantly more weight than those who ate a low-dairy diet containing the same number of calories. Low-fat yogurt is a rich source of weight-loss-friendly calcium, providing about 450 mg (about half the recommended daily allowance for women ages 19-50) per 8-ounce serving, as well as 12 grams of protein. As far as superfood go Yogurt is right there. It includes calcium, protein and a ton of other nutrients as well as good bacteria and probiotics for you digestive tract.
8. Lean Turkey! Rev up your fat-burning engine with this bodybuilder favorite. Countless studies have shown that protein can help boost metabolism, lose fat and build lean muscle tissue so you burn more calories. A 3-ounce serving of boneless, skinless lean turkey breast weighs in at 120 calories and provides 26 grams of appetite-curbing protein, 1 gram of fat and 0 grams of saturated fat. With the price of chicken going up and up these days Turkey has become a great alternative. Remember that Turkey is a little tougher than chicken and the taste is a little different but it is not just for Thanksgiving and Christmas anymore.
9. Oatmeal! This heart-healthy favorite ranks high on the good carb list, because it’s a good source of cholesterol-fighting, fat-soluble fiber (7 grams per 3/4-cup serving) that keeps you full and provides you with the energy you need to make the most of your workouts. Just be sure to choose steel cut or rolled oats, not instant oatmeal, to get your full dose of vitamins, minerals and fiber. For many years now Pro Bodybuilders have relied on Oatmeal as a staple of their breakfast, it is amazingly high in nutrients.
10. Hot Peppers! Eating hot peppers can speed up and boost metabolism and cool your cravings, researchers at Laval University in Canada found. Here’s why: Capsaicin (a chemical found in jalapeno and cayenne peppers) temporarily stimulates your body to release more stress hormones, which speeds up your metabolism and causes you to burn more calories.
Here’s how these 10 fat-blasting superstars help you lose weight
Each of these healthy weight-loss boosters fills you up and keeps you full longer on fewer calories.
Water-rich fresh fruits, veggies and soup dilute the calories in your food and allow you to eat more without breaking the calorie bank.
High-fiber fruit, vegetables and nutritious whole grains keep your digestive system on track and steady insulin levels, which prevents fat storage.
Lean meat boosts metabolism and burns calories because it take more energy to digest than other foods.
Another Good way to raise your metabolism is to try a new diet that cycles your calories with some on day and other days off of your diet. This is a new style diet that works great, the name, Fat Loss 4 Idiots. Check out the review that I have done of the diet that is really built to boost metabolism.
Sheri Strykowski is a freelance journalist who specializes in health, fitness and lifestyle. Her articles have appeared in The Chicago Tribune, Lerner newspapers and National Safety Council publications. Tell us all your Metabolism Boosting Foods in the comments below.