April 29, 2017

Diabetes and Your Teeth

There are many tips for reducing the teeth problems and four signs you may have a problem.

Diabetes puts you at risk for dental problems. It hurts your ability to fight bacteria in your mouth. Having high blood sugar encourages bacteria to grow and contributes to gum disease. You may have gum disease if you have:
  • Gums that are red, sore, bleeding, or swollen, or that pull away from your teeth
  • Loose teeth
  • Chronic bad breath
  • An irregular bite or dentures that don't fit well
Tips to help you have a healthy mouth:
Control Diabetes to Keep Your Smile - Well controlled diabetes will help you keep your mouth healthy. If you have poorly controlled or high blood glucose, you have a higher chance of dry mouth, gum disease, tooth loss, and fungal infections like thrush. Since infections can also make your blood glucose levels rise, your diabetes may become harder to control. Keeping your mouth healthy can help you manage your blood glucose.

See Your Dentist Regularly - People with diabetes are more likely to have oral infections. You should get dental checkups at least twice a year. Let your dentist know you have diabetes and what medicines you take. Regular checkups and professional cleanings can help keep a mouth healthy. Your dentist can teach you the best ways to care for your teeth and gums at home.

Keep Plaque at Bay - Sticky plaque -- food, saliva, and bacteria -- starts to form on your teeth after you eat, releasing acids that attack tooth enamel. Untreated plaque turns into tartar, which builds under gum lines and is hard to remove with flossing. The longer it stays on your teeth, the more harmful it is. Bacteria in plaque causes inflammation and leads to gum disease. High blood glucose can make gum disease worse.

Brush Daily, Brush Right - When you brush your teeth twice a day, it not only keeps your breath fresh, but it also helps rid your mouth of bacteria that makes up plaque and can lead to infections. To brush properly, point your bristles at a 45-degree angle against your gums. Use gentle back-and-forth strokes all over your teeth -- in front, in back, and on chewing surfaces -- for two minutes. If holding a toothbrush is hard for you, try an electric toothbrush. Also, brush your gums and tongue.

Floss Every Day - It helps control plaque. Floss can reach where a toothbrush can't, like between the teeth. Do it every day, and use floss and interdental cleaners that carry the American Dental Association (ADA) seal. Ask your dentist for tips if you're not sure how to floss. Like everything else, it gets easier with practice.

Rinse - Use an anti-bacterial mouthwash every day. It freshens your breath, gets debris out of your mouth, and helps ward off gum disease and plaque buildup. Talk to your doctor or dentist about the best rinse for you.

Take Care of Your Dentures - Loose-fitting or poorly maintained dentures can lead to gum irritation and infections. It's important to talk to your dentist about any changes in the fit of your dentures. When you have diabetes, you are at a higher risk of fungal infections like thrush. Poorly maintained dentures can contribute to thrush, too. Remove and clean your dentures daily to help lower your risk of infection.

Toss the Tobacco - Tobacco products -- cigarettes, cigars, smokeless tobacco, and pipes -- are bad for anyone's mouth. But if you have diabetes and you smoke, you have even higher odds of developing gum disease. Tobacco can damage tissue and cause receding gums. It can also speed up bone and tissue loss. Motivate yourself to quit. List your reasons for quitting, set a date, and get the support of family and friends.

Prepare for Oral Surgery - Well-controlled blood sugar reduces your chance of infection and speeds healing. If you need oral surgery, tell your dentist and surgeon you have diabetes beforehand. Your doctor may recommend that you wait to have surgery until your blood sugars are under control

4 Steps to Protect Your Health - The same steps that ensure a healthy mouth also help you manage your diabetes.
  • Eat a healthy diet.
  • Don't smoke.
  • Keep up with your diabetes medications.
  • See your dentist regularly to lower your of a serious problem.
Know the Warning Signs - Regular dental checkups are important because your dentist can spot gum disease even when you don't have any pain or symptoms. But you should examine your teeth and gums yourself for early signs of trouble. Infections can move fast. If you notice redness, swelling, bleeding, loose teeth, dry mouth, pain, or any other symptoms that worry you, talk to your dentist right away

April 28, 2017

Diabetes Organizations Contribute to Complications

Yes, I am making this accusation and it makes sense to me. Why else would people of importance in the American Diabetes Association (ADA) and the American Association of Clinical Endocrinologists (AACE) speak so confidently about type 2 diabetes not needing to test regularly and to rely on their A1c results only.

Dr. Robert Ratner, past chief scientific and medical officer of the American Diabetes Association and Alan J. Garber, M.D., Ph.D., Professor of Medicine, Biochemistry & Molecular Biology, and Molecular & Cellular Biology at Baylor College of Medicine, Houston, Texas are both recipients of money from Big Pharma. I also have to wonder if they also receive large sums of money from Big Food, Big Agriculture, and Big Chemical. These two doctors and others within these organizations received big sums of money to limit what most patients can do. To date we have not heard from the new officers in the ADA or AACE.

This is why they insist that we do not test to make the complications happen. This in turn is a favor to the rest of the doctors to give them patients to treat. It is a shame that the insurance industry has to go along with the pronouncements of these doctors, but they are in the business of showing a profit. Therefore, their leaders are more than happy to limit testing supplies. What they do not realize is that the complications will cause greater expenses in the future than the test strips will cost now.

This is part of the reason I have such a dislike for the people in the ADA and the AACE that are in a position to influence guidelines and position statements. This in turn affects most of the actions of other healthcare professionals in the American Association of Diabetes Educators (AADE) and the Academy of Nutrition and Dietetics (AND). This is also the reason most of their members do not talk about testing or promote testing.

This leaves people with type 2 diabetes who cannot afford extra test strips, managing their diabetes in the dark without the means to use testing supplies that will aid them in more efficient diabetes management. These patients will not be able to determine the most reliable time to test postprandial and often find it impossible to test in pairs to help them decide how a meal affects their blood glucose levels. Those of us that have been able to do this have found that we are better able to manage our diabetes.

We have found that by reducing the number of carbohydrates consumed, we are better able to manage our diabetes. Yet both members of the AADE and AND continue to promote carbohydrates and reduced fat and this makes diabetes management more difficult for most people with diabetes. Yes, the ADA has opened the door for low carbohydrate consumption, but the members of these organizations have yet to put this into practice. Maybe the officers have accepted this, but the general membership still follows the old guidelines and the two organizations have not produced new position statements to affirm to the membership the acceptance of anything but the prior guidelines.

All of this creates an uphill battle for people with diabetes that desire to manage diabetes at a level to prevent complications. It is still possible, but takes more effort and education, which most with type 2 diabetes do not receive. Most are required to self-educate to be able to manage their diabetes.

April 27, 2017

Diabetes, Type 1 and 2 Confusion

Other bloggers are writing about this, and I am now writing about the topic – the ADA mess up in titling of the types of diabetes.

  1. The ADA titles diabetes to blur the lines for the general population
  2. The ADA objective in the titles is to satisfy Big Pharma and Big Food
  3. The ADA aim is to obscure the real causes of the different diabetes types

The ADA mission:
  • is to secure donations to extend their employment
  • ingratiate themselves with their true “constituents” (#2 above)
  • is not to serve people with diabetes

The titles have gone through several different titles:
  • IDDM: Insulin dependent diabetes mellitus
  • NIDDM: Non-insulin dependent diabetes mellitus

The current titles include the following:
  • Type 1 diabetes
  • Type 2 diabetes
  • Pre-diabetes – while discussed it is not an official ADA classification
  • LADA - Latent autoimmune diabetes in adults – Generally discussed as a part of Type 1
  • MODY - Maturity-Onset Diabetes of the Young – Presently there are six or seven types of MODY based on the genetic location

Those with Type 2, as we know, typically over produce insulin for many years.
Why would someone who over-produces insulin, NEED insulin? For two reasons:
  1. The poor lifestyle advice that leads to the need for huge insulin production, leads to insulin resistance, leading to the need for even more insulin to do the same job. And,
  2. After years of this insulin over-production, the pancreas “wears out,” or insulin producing cells are destroyed. Therefore, insulin becomes necessary to be injected.

That is not all that is happening. People with Type 1 are often told from childhood to “eat like every other child and just cover with enough insulin.” Here is the thing…the diet for the average child in America is leading to obesity and Type 2 (previously never seen in children). Therefore, it’s not good for ANY child!! After years of following this poor dietary advice and using large doses of injectable insulin, those with Type 1 will begin to become overweight and insulin resistant.

What is at the heart of it? Poor dietary advice. The right dietary advice (if applied early enough) can often keep those with Type 2 from becoming insulin dependent. In fact, when adopting a healthy lifestyle, many people with Type 2 are able to manage their diabetes without medication. The right dietary advice will also keep those with Type 1 from becoming insulin resistant. It can help both Types to maintain a healthy weight.

I think there needs to be a reclassification of diabetes Types as well, but with emphasis on cause. If we identify diabetes Types by cause, the focus on treatment will be clear.
  • Type 1 diabetes should be classified as “autoimmune” diabetes (not reversible, yet), insulin needed.
  • Type 2 diabetes should be classified as a “lifestyle” diabetes (preventable AND reversible). In fact, the esteemed Dr. Robert Lustig, world renowned Pediatric Endocrinologist and obesity specialist, recently quipped that Type 2 should be called a “processed food disease.” If we classify Type 2 in this way, it would put the focus on using lifestyle to treat and reverse Type 2 diabetes. The majority of lifestyle management would be directed toward diet, with the other factors being things such as exercise, proper sleep, stress control, and balancing hormones.

Some might balk at calling Type 2 a “lifestyle” disorder, saying that it is strongly genetic. I feel your pain. I do find that I must work much harder than many of my healthy eating friends to keep my blood sugar and weight regulated. But, as the saying goes, “genetics loads the gun but environment pulls the trigger.” In other words, we can’t change what we have inherited. But we can do our best with what we have been handed…it doesn’t have to rule us or be our destiny. Through great effort, and by adopting a healthy lifestyle immediately upon diagnosis, many people have been able to achieve non-diabetic health markers for several years.

So why is the right dietary advice so elusive? As I have said before…diabetes is big business. And there are a lot of organizations and people in the business of diabetes. Unfortunately, there is much money to be made when people are sick.
Please, don’t line the pockets of organizations that are increasing their bank accounts on the very advice that increases your drug dependence and your waistline.

April 26, 2017

Metformin, Aging, and Comorbidities

According to the American Diabetes Association, over 29 million Americans have diabetes, with 11.8 million of the patient population being over the age of 65. Approximately 1.4 million Americans a year are diagnosed with diabetes, and those diagnosed with type 2 diabetes or prediabetes are likely to be started on first-line therapy with metformin. Although a concern of vitamin B12 deficiency is associated with metformin, it is still a choice drug due to its efficacy and limited side effects and may now have additional benefits for diabetes patients.

A study was recently released in the Journal of Diabetes and its Complications that aimed to “…assess the heterogeneity of metformin’s co-development of ARCs (age-related comorbidities) among healthy older adults with T2D” and focused on the prospect of the development of cardiovascular disease, cancer, depression, dementia, and frailty-related disease (FRD). The study population originated from the Veterans Administration Electronic records between the years of 2002-2012 and included men who were age 65 or older, had diagnosis of type 2 diabetes but were naïve to glucose-lowering medication treatment prior to 2003, had one or more outpatient visits per year, and were not diagnosed with any ARC at the beginning of the study period.

The study excluded patients with liver and kidney disease due to metformin’s contraindication in these disease states of increased risk of developing lactic acidosis. Glucose-lowering medications used in the study were: sulfonylureas (glipizide, glyburide, glimepiride, etc), biguanides (metformin), mheglitinides (repaglinide, nateglinide), and alpha-glucosidase inhibitors (acarbose, miglitol, vogilbose). Study subjects were further divided into metformin users (more than 180 days of a prescription for metformin) or non-metformin users who were on any of the other included study medications.

The analysis identified four advanced-related comorbidity trajectory classes that included both metformin and non-users. The majority of the study patients fell into the healthy class, meaning they had a lower chance of developing ARCs. After nine years of the study, metformin was found to have an absolute risk reduction of 2.5% in likelihood of cancer diagnosis (p= 0.02), 6.1% reduction in cardiovascular disease (p= less than 0.01), 5.0% reduction in FRD (p= less than 0.01), and 0.14% reduction in dementia (p= less than 0.01). Consequently, the patients who were classified as non-users of metformin had an approximate increase of 2.8% in likelihood of cancer diagnosis, 6.7% increase in cardiovascular disease, 6.2% increase in FRD, and a 1% increase in depression.

The second most populated class consisted of patients who had the highest risk of developing cardiovascular disease. Metformin non-users had an increase of 74.5% (p less than 0.01) in cardiovascular disease (up from 47.1% in year one of the study) as well as significant increases in likelihood of cancer diagnosis (p less than 0.01), depression (p less than 0.01), dementia (p less than<0 .01="" 0.01="" 1="" 23.6="" 40.1="" 44.4="" 45.5="" 48.2="" 48.6="" 64.7="" a="" above="" across="" all="" an="" and="" arcs="" as="" associated="" being="" both="" by="" cancer="" cardiovascular="" category="" class="" classes.="" classes="" compared="" consequently="" consisted="" decrease="" decreased="" decreases="" depression.="" developing="" diagnosis="" disease="" effect="" final="" followed="" four="" frd.="" frd="" from="" furthermore="" greatest="" had="" high="" highest="" impact="" in="" increase="" increased="" less="" likelihood="" metformin="" mortality="" most="" non-users="" occurrence="" of="" p="" patients="" rate="" reduction="" risk="" seen="" significant="" similarly="" spectrum="" than="" the="" third="" to="" trends="" up="" use="" users.="" users="" was="" well="" who="" with="" year="">

Metformin use was found to reduce the development of ARCs, with significant reduction in patients who are at risk for a particular condition. Limits of this study include the observational design that could lead to bias due to the possibility of unobserved events and confounders, the all-male cohort, and lack of data concerning other medications study participants were taking during the 9-year course observed. This study opens up further potential investigation to confirm the benefit of metformin in reduction of ARCs. Possible beneficial studies would include women as well as looking into the effects of long-term use of glucose-lowering medications used alone or in combination.

April 25, 2017

People with Diabetes Need Life Insurance

Because I have life insurance and have not needed to purchase more, I do not know a lot about life insurance. I do know that many of us with type 2 diabetes and even many with type 1 diabetes have a very difficult time obtaining life insurance. A good person, Matt L. Schmidt has given me information about life insurance.

While I firmly believe in term life; however, Matt has presented me information that makes me doubt my wisdom. In addition, I had purchased a Non-guaranteed Universal Life policy in the late 1980's that I became very unhappy with and thought to cancel, but then I talked with another agent for the same company and this agent was able to convert the policy to another type of policy.

Matt provided me some information on Guaranteed Universal Life Insurance which I find interesting. So I will quote from the information provided, as I could easily make a mess of the information. “Guaranteed Universal Life is often called “No Lapse” or “Secondary Guarantee Universal Life” in the insurance industry.

Let’s look at the Pros and Cons of this life insurance product:
  1. Premiums can be level for lifetime. You can select the age they want the death benefit guaranteed to, whether it is age 90, 95, 100, 105, 115 or 121….
  2. The length of premium payments can be structured according to your preferences.
  3. Interest rate volatility does not affect premium payments.
  4. This product is inexpensive as a permanent life insurance product compared to other products, as the premium is calculated to maintain a level premium payment until death.
  5. Comparisons of this product among insurance carriers are relatively easy as there are not many components to the plan.

  1. This product may not have any cash value, unlike alternative permanent life insurance products.
  2. Although premiums may be lower than whole life insurance or other permanent insurance products, they will generally be higher than term insurance.
  3. The greatest con of guaranteed universal life is that the timeliness of premium payments is critical to maintain the guaranteed level premium. Other policies that contain cash value can provide a source within the policy to cover the required premium to maintain the death benefit, however, a missed or late premium payment can jeopardize the guaranteed premium feature resulting in a policy without a guaranteed premium. An individual has to maintain timely payments, or the guarantees of the policy could be altered. Unquote

If you are like myself, age 60 or older, you’ve had term life insurance in the past, and it has since expired, or your term policy is getting ready to expire. If this is the situation you are in, you’ve probably received a notice that your rates are about to skyrocket. Your next policy should be your last policy, as it becomes increasingly difficult to re-qualify as you age and your health is not guaranteed to remain insurable

Despite the implication of its name, guaranteed universal life insurance (GUL) is not whole life insurance. But, it is designed to last your entire life. It does not build cash value, allowing you to keep your monthly payments low, and does not carry the expensive management fees of whole life. It is also much better than regular universal life in which the premium continues to rise and can become very expensive.

Term life insurance is the ideal solution for those in good health to secure coverage into their 80s. But, if you are in your late 60s or early 70s and still pondering whether or not to buy a term life policy or another term life policy, you are approaching a cutoff where term life will no longer be viable (or even accessible, for that matter).

Here’s why I'm suggesting a guaranteed universal life over a non-guaranteed universal life:
  • Your cost of insurance will not change, even as you get older or if your health changes.
  • Your coverage isn’t tied to an investment. You pay for the life insurance protection only, just like term life insurance.
  • You aren’t pouring extra money into your policy. Trust the financial experts on this–you’re better off putting your money into a savings, or perhaps paying down your mortgage.
  • You will pay less up front. Guaranteed universal life insurance is a fraction of the cost of non-guaranteed universal life.
  • You don’t run the risk of losing coverage from unfavorable investments or changes in the market.

I don't sell insurance, but if you are looking for life insurance, I suggest reading or looking at this http://www.diabeteslifesolutions.com .

April 24, 2017

Avocados May Help Treat Metabolic Syndrome

A new review of studies looking at the health effects of avocados finds that there is "satisfactory clinical evidence" that the fruit can help to treat metabolic syndrome.

Metabolic syndrome is defined as a cluster of risk factors that can raise the risk of other health conditions, such as type 2 diabetes, heart disease, and stroke.
Risk factors include abdominal obesity, low levels of high-density lipoprotein (HDL) cholesterol - or "good" cholesterol - high triglyceride levels, high blood pressure, and high fasting blood sugar.

The presence of at least three of these risk factors warrants a diagnosis of metabolic syndrome. According to the American Heart Association, metabolic syndrome affects around 23 percent of adults in the United States.

Adopting a healthful diet is considered one of the best ways to prevent or treat metabolic syndrome. The new review - recently published in the journal Phytotherapy Research - suggests that avocados should form a part of this diet.

Avocados are a fruit from the avocado tree, or Persea americana, which is native to Mexico and Central and South America.

A number of studies have documented the possible health benefits of avocado. A study reported by Medical News Today in 2014, for example, found that eating half an avocado with lunch may aid weight loss, while more recent research linked the fruit to reduced levels of low-density lipoprotein (LDL) cholesterol, known as "bad" cholesterol.

These benefits have been attributed to the bioactive components of avocados, which include carotenoids, fatty acids, minerals such as calcium, iron, and zinc, and vitamins A, B, C, and E.

For their review, co-author Hossein Hosseinzadeh, of Mashhad University of Medical Sciences in Iran, and colleagues set out to determine how these components might help to combat the risk factors of metabolic syndrome.

Avocado has strongest effect on cholesterol levels. To reach their findings, the researchers analyzed the results of various in vivo, in vitro, and clinical studies that investigated the effects of avocado on metabolic health.

Hosseinzadeh and colleagues found that the fruit has the strongest impact on lipid levels - that is, levels of HDL cholesterol, LDL cholesterol, total cholesterol, and triglycerides.

As an example, the team points to one study of 67 adults, of whom 30 had a healthy lipid profile and 37 had mild hypercholesterolemia. After adhering to an avocado-enriched diet for 1 week, both groups showed significant reductions in total and LDL cholesterol and triglyceride levels.

"The reported mechanism of this effect was regulating of the hydrolysis of certain lipoproteins and their selective uptake and metabolism by different tissues such as liver and pancreas," explain the authors.

"Another possible mechanism could be related to the marked proliferation of the liver smooth endoplasmic reticulum which is known to be associated with induction of enzymes involved in lipid biosynthesis."

An 'herbal dietary supplement' can help treat metabolic syndrome. The review also uncovered evidence that avocado is beneficial for weight loss. The researchers cite one study that found overweight or obese adults who ate one avocado every day for 6 weeks experienced significant decreases in body weight, body mass index (BMI), and the percentage of body fat.

Additionally, the team identified a number of studies associating avocado intake with reductions in blood pressure among patients with hypertension, and evidence suggests that the fruit might also help to reduce atherosclerosis - the narrowing or hardening of arteries caused by a buildup of plaque.

Notably, Hosseinzadeh and colleagues found that it is not just the flesh of the avocado that can benefit metabolic health - the peel, seed, and leaves of the fruit may also help.

One study published in 2014, for example, found that a daily dose of oil extracted from avocado leaves led to reductions in total and LDL cholesterol and blood pressure.

Overall, the researchers conclude that avocado may be effective for the treatment of risk factors associated with metabolic syndrome, though further research is warranted. They write: "In this review article, satisfactory clinical evidence suggested that avocado can be used as herbal dietary supplements for treatment of different components of [metabolic syndrome].

Although, avocado like other herbal products is safe and generally better tolerated than synthetic medications, there is limited scientific evidence to evaluate different side effects because of contaminants, or interactions with drugs. Besides, further studies need to be accomplished on the metabolic effects of different parts of avocado for other possible mechanisms."

April 23, 2017

Insulin Resistance May Cause Cognitive Decline

Many of us that have had insulin resistance and no longer have it because we are on medications or have adapted our lifestyles to overcome this are fortunate. While we may have some cognitive problems, we are likely not having continued cognitive decline.

Executive function, memory is particularly vulnerable to the effects of insulin resistance, researchers say. Insulin resistance, caused in part by obesity and physical inactivity, is also linked to a more rapid decline in cognitive performance, new research suggests.

A new Tel Aviv University study published in the Journal of Alzheimer's Disease finds that insulin resistance, caused in part by obesity and physical inactivity, is also linked to a more rapid decline in cognitive performance. According to the research, both diabetic and non-diabetic subjects with insulin resistance experienced accelerated cognitive decline in executive function and memory.

The study was led jointly by Prof. David Tanne and Prof. Uri Goldbourt and conducted by Dr. Miri Lutski, all of TAU's Sackler School of Medicine.

"These are exciting findings because they may help to identify a group of individuals at increased risk of cognitive decline and dementia in older age," says Prof. Tanne. "We know that insulin resistance can be prevented and treated by lifestyle changes and certain insulin-sensitizing drugs. Exercising, maintaining a balanced and healthy diet, and watching your weight will help you prevent insulin resistance and, as a result, protect your brain as you get older."

Insulin resistance is a condition in which cells fail to respond normally to the hormone insulin. The resistance prevents muscle, fat, and liver cells from easily absorbing glucose. As a result, the body requires higher levels of insulin to usher glucose into its cells. Without sufficient insulin, excess glucose builds up in the bloodstream, leading to prediabetes, diabetes, and other serious health disorders.

The scientists followed a group of nearly 500 patients with existing cardiovascular disease for more than two decades. They first assessed the patients' baseline insulin resistance using the homeostasis model assessment (HOMA), calculated using fasting blood glucose and fasting insulin levels. Cognitive functions were assessed with a computerized battery of tests that examined memory, executive function, visual spatial processing, and attention. The follow-up assessments were conducted 15 years after the start of the study, then again five years after that.

The study found that individuals who placed in the top quarter of the HOMA index were at an increased risk for poor cognitive performance and accelerated cognitive decline compared to those in the remaining three-quarters of the HOMA index. Adjusting for established cardiovascular risk factors and potentially confounding factors did not diminish these associations.

"This study lends support for more research to test the cognitive benefits of interventions such as exercise, diet, and medications that improve insulin resistance in order to prevent dementia," says Prof. Tanne. The team is currently studying the vascular and non-vascular mechanisms by which insulin resistance may affect cognition.