Diabetes: A 21st Century Scourge - The Facts and Figures

The causes of diabetes and how it ravages the body is sobering. The shocking reality of diabetes is that despite all of the medical advances and its worldwide prevalence it continues on a skyward rise into the stratosphere. As if that is not sobering enough the facts listed below will help bring the point home.

• Nearly 26 million children and adults in the United States (nearly 8.5 % of the population) have diabetes
• 79 million Americans are thought to be prediabetic
• 1.9 million Americans are diagnosed with diabetes every year
• Nearly 10% of the entire U.S. population has diabetes, including over 25% of seniors
• As many as 1 in 3 American adults will have diabetes in 2050 if present trends continue
• The economic cost of diagnosed diabetes in the U.S. is $245 billion per year
• 1.9 million Americans aged 20 years or older are newly diagnosed with diabetes                each year (5,205/day)
• Compared to non-Hispanic whites the risk of diagnosed is 1.2 times higher among Asian Americans, 1.7 times higher among Hispanic Americans, and 1.8 times higher among African Americans
• Diabetes is the primary cause of death  for 71,382 Americans each year
• Diabetes contributes to the death of 231,404 Americans annually (combining death certificates that list diabetes as the primary and a contributing cause of death)
• $245 billion annually attributable to diagnosed diabetes, including $176  billion in direct costs and $69 billion in indirect costs (disability, work loss, premature mortality)
• People with diagnosed diabetes have health care costs 2.3 times higher than what expenditures would be in the absence of diabetes
• About 60% to 70% of people with diabetes have mild to severe forms of neuropathy
• More than 60% of nontraumatic lower-limb amputations occur in people with diabetes
• About 65,700 nontraumatic lower-limb  amputations are performed in people with diabetes annually (180/day)
• Diabetes is the leading cause of kidney failure, accounting for 44% of all new cases of kidney failure
• Adults with diabetes have heart disease death rates about 2 to 4 times higher than adults without diabetes, and the risk for stroke is 2 to 4 times higher among people with diabetes
• Diabetes is the leading cause of new cases of blindness among adults aged 20–74 years
• The prevalence of diagnosed diabetes in the U.S. increased by 128% from 1988 to 2008
• Diabetes kills more Americans every year than AIDS and breast cancer combined

 In the next few articles in this series we will strike a happier tone by covering some of the ways diabetes can be mitigated or reversed. There is plenty of hope and good news so there is no need to despair despite the statistics. We will also discuss the psychology of diabetes and its effect on the lives of those that have it and the people who help care for them.

Diabetes: A 21st Century Scourge - The Ravages of Diabetes Continued

Uncontrolled blood sugar levels is the calling card of Type II diabetes that eventually leads to circulatory issues that are life changing. Foot ulcers, peripheral nerve damage and the accompanying pain, and blindness can result when blood vessels are weakened by the inflammatory action of unregulated blood sugar. Nightmarish as those conditions may be the complications of diabetes can worsen overtime leading to renal failure, heart attacks and stroke.

Diabetic Nephropathy

Silently and slowly high blood glucose levels damages the kidneys of diabetics and pre-diabetics which takes its toll. The kidneys help filter the blood and flush the body of unwanted toxins. Overtime high sugar levels cause the thickening and scarring of nephrons. The process eventually leads to renal (kidney) failure. To make matters worse it can take anywhere from 5 – 10 years before the symptoms of acute kidney damage are experienced. Some of the symptoms include nausea with vomiting, swelling of the legs, headaches, chronic fatigue, and poor appetite. Kidney damage is a leading cause of death in diabetics. As it is kidney function can be a direct correlation to the quality of a person’s life.

Strokes

High blood glucose levels create all sorts of negative domino effects in the body. One part of the domino effect is the scarring and deterioration of blood vessels that occur. The body attempts to repair these blood vessels that are constantly under attack. In doing so the material used to make the repairs “builds up” in the blood vessels creating blockages. Sometimes these blockages occur in arteries and blood vessels that supply blood to brain. When the blockages are severe enough a stroke soon follows. The result of the stroke could lead to paralysis, speech loss, inability to coordinate movement or even death. Smaller strokes could lead to dementia or senility.

Heart Attacks

Diabetes and cardiovascular diseases seem to go hand in hand. Primarily because of the circulatory issues created by having diabetes in the first place. From there it becomes much easier for cardiovascular disease to gain a foothold especially if poor lifestyle habits and predisposition to these diseases exist. Diabetics experience heart attacks more frequently than non-diabetics. Diabetics are also twice as likely to die following a heart attack as non-diabetics.

The Story of Cholesterol: A Supplemental on Supplementals

In the last article (which was supposed to be the last article in this series) we covered the miraculous and beneficial effects of CoQ10 on heart health and energy. If you or a loved one ever had a heart attack CoQ10 supplementation is a must. 

As far as supplements go the story is a bit more involved than just CoQ10 as wonderful as it is. There are a few other supplements that can greatly improve cardiovascular health and increase energy in the process. The news gets even better when you consider that, along with CoQ10, anyone can benefit from a boost of energy and vitality when the following supplements are added to a healthy lifestyle. Just as before in the previous article it is necessary to point out that nothing written here should be construed as medical advice and that any supplemental regimen should be discussed with your trusted (and open minded) healthcare professional. With that caveat established let's take a look at some of the other supplements that you may or may not be familiar with.

D Ribose

We are energetic beings and our bodies need plenty of energy. ATP (adenosine triphosphate) is how our body gets things done energetically speaking. One of the main constituents of ATP is D-ribose. No D-ribose means there can be no way to produce ATP. Without ATP there can be no energy. D-ribose is generated by the body mostly on the as-needed basis and there is no way to store it. This is an important factor to consider because when tissues are under stress they cannot produce D-ribose and thus the body is robbed of energy. The combination of poor heart function leading to oxygen deprivation and the inability to produce energy can leave you feeling quite poor in deed.

A prominent German physiologist by the name of Heinz-Gerd Zimmer established a connection between heart function and D-ribose. He found that people who had hearts deprived of nutrients and oxygen sometimes due to blockages fared better when given D-ribose.  Zimmer also found that the administration of D-ribose had restorative powers for energy and helped bring about normal diastolic heart function. In a 1992 clinical study D-ribose was also shown to have increased the ability to do exercise in patients that had severe coronary artery disease.

Magnesium

One of the main culprits of poor cardiovascular health is actually the inability to properly absorb calcium which is found in plentiful amounts in most western diets. When calcium is ill-absorbed it remains in the blood stream longer where it has a greater chance to interact with free radicals increasing the rate of calcification that often occurs in arteries and other blood vessels. At this point blockages are sure to happen given enough time. This is where magnesium comes in to help. Magnesium, along with vitamin D, helps to convert calcium into a more absorbable form before it calcifies keeping blood vessels clear. If that was not important, or impressive, enough magnesium is also great at keeping platelets from aggregating (sticking together) and forming blood clots while it also acts as a vascular dilator reducing blood pressure. It should be noted that people suffering from renal insufficiencies should not supplement with magnesium without medical guidance.

B Vitamin Complex (especially B5)

B vitamins in and of themselves provides the body with massive, sustained energy over a significant amount of time and that is simply awesome. For the sake of this article, however, we will cover vitamin B5 specifically in a slightly different light. Many people are unaware of the vital role B5 (also known as pantothenic acid) plays in limiting inflammation and oxidation of cholesterol. No less than 28 clinical studies have shown that vitamin B5 produced positive results regarding triglyceride levels and LDL cholesterol levels while increasing HDL levels. A literature review was conducted by Dr. Mark Houston and published in Progress in Cardiovascular Diseases helped establish pantothenic acid’s importance in cardiovascular health. The literature demonstrated after only four months of B5 supplementation total cholesterol was reduced by 15%, LDL cholesterol by 20% and triglycerides by 32.9% while increasing HDL by 8.4%. He also noted that studies of longer duration showed continued improvement in participants over the initial four month successes. Reduce inflammation and you reduce cholesterol…period!

We long to live lives enriched by the fragrance of energy and productivity radiating from every pore. Sometimes, however, devastating health conditions such a heart attack can rob us of that ability leaving one disturbed and down trodden. The beauty of nature and life is that even if we find ourselves in this lowered state of affairs we do not have to dwell there. An out is often provided if we look carefully and thoughtfully at our circumstances. There are, of course, many more supplements that could be considered but this is a healthy start (pun intended). Proper supplementation of the right nutrients can be the difference between slumming in the doldrums and soaring with the eagles after an adverse cardiovascular event. This article should serve as a great catalyst for conversation between you and your trusted healthcare provider.

Sources for this article include:

The Great Cholesterol Myth (Bowden and Sinatra)

The Story of Cholesterol: Energy, CoQ10 and Statins

We have reached the point where the discussion turns to the practical side of things. Once the thinking is done we must put into practice what we have learned. Right off the top the need for a disclaimer is paramount: Nothing in this article should be construed as advice on dietary or supplemental modalities. You should consult your physician or a trusted health care provider for your specific needs. In the interest of stimulating a great conversation between you and your health care provider the words that follow should be your guide.

The miracle of Coenzyme Q10 (CoQ10)

One of the main issues surrounding statin drugs is how it inhibits the production of a key enzyme known as CoQ10. Devastating adverse health effects have been associated with CoQ10 deficiencies and has been recognized by some parts of the medical community in the U.S. and more widely in Europe and the Far East. Many people are familiar with the term “CoQ10” but do not have a firm grasp of what it is and how vital it is to our hearts so let’s discuss it.  

CoQ10 is a powerful vitamin-like substance produced by virtually every cell in the body. It has many functions that prove to be vitally important to the body. One of those functions is converting our food into fuel for our cells to use. When we eat good, wholesome foods and CoQ10 is present in the cells in adequate supplies our energy levels rise. The science of the process in which CoQ10 does its work is actually intriguing but we will skip the detailed lesson and just say without it we would have a hard time getting much of anything done. Because the heart is such a dense muscle that is always active it is one of the top CoQ10 producers in the body and rightfully so. Beating on average 2.5 billion times during a person’s life the heart requires a wealth of energy. Statins interfere with the production of some enzymes including CoQ10 robbing the heart of significant amounts of energy. To add insult to injury as we age we tend to produce less and less of this powerful enzyme naturally setting us up for exponential energy lose and poor cardiovascular production.

Another function of this miracle enzyme is blood pressure modification. It has proven itself to be an awesome way to reduce blood pressure without harmful side effects. A meta-analysis of clinical trials conducted in 2007 by F.L. Rosenfeldt et al (Coenzyme Q10 in the treatment of hypertension…) found overwhelming, across the board evidence that significant reductions in blood pressure took place among test subjects taking the supplement when compared to the control group (who did not take CoQ10 at all). Since 1974 doctors in Japan have prescribed CoQ10 to patients who experience congenital heart failure. Further studies in the U.S. showed a marked increase of heart function and vitality in people suffering from severe (class III and class IV) cardiomyopathy. These were people who were given just a year or two to live because they were that sick until CoQ10 supplementation began.

In addition, CoQ10 is a wonderful antioxidant. Oxidative stress, especially as it relates to LDL cholesterol, is a major cardiovascular concern. Remember that cholesterol in and of itself is not the boogey man but oxidized pattern B LDL cholesterol is. Coenzyme Q10 steps in and helps to prevent oxidation of patter B LDL helping to stop the type of cardiovascular stress that plague so many people. A healthy non-inflammation inducing eating plan along with CoQ10 supplementation can make all the difference in having excellent heart health especially if the person is experiencing poor cardiovascular health at the moment.

Where to find it

Typically CoQ10 tends to be found most prevalently in the organ meat of animals such as the kidneys, liver and heart. This is the most natural way to get it from outside your own body. The problem is enzymes tend to breakdown very readily when exposed to high heat even for short periods of time. The alternative to consuming organ meat (especially if you are vegetarian) has to be in the form of a supplement.

CoQ10 supplements are out there but it is imperative you can trust the source. There is no need to consume anything that is of low quality in the hopes that it will be beneficial. High quality CoQ10 that is readily bioavailable is a must. Seek advice from a knowledgeable source when determining what you might like to use.  

In Conclusion

There is a distinct correlation between CoQ10 deficiency and poor, sometimes fatal, heart function. So much so that the evidence of years of studies should be splattered across the headlines daily warning us about the deficiency and how to overcome it through supplementation. Medically speaking it is a very cheap and efficient way to reduce mortality and morbidity from cardiovascular issues especially in comparison to drugs and surgery that both carry ill side effects while draining personal and institutional coffers worldwide.

Originally this was supposed to be the last article in the series but there are other nutrients that should be discussed that would be of great benefit to cardiovascular health. With that thought in mind one or two additional articles may be necessary for the sake of thoroughness.

Sources: The Great Cholesterol Myth (Bowden and Sinatra)

Multivitamin Use Absurd and Dangerous? I Think Not Part I

Do you remember Christmas as a child with that jolly red nosed Santa who most kids idolized in every sense of the word? Or maybe for you it was the tooth fairy, the great pumpkin or even Peter Cottontail. Any or all of these myths seemed to be real to us and for some the realization that they don't exist was quite the shock. Banished to the realm of make believe our childhood idols went and now some would have us believe another one of our cherished beliefs (that is actually a fact) should be relegated to the same place we put St. Nick and the others.

Recently several studies were analyzed that purport to firmly establish the "fact" that multivitamin supplementation is at best useless and at worst detrimental to your health to the point of causing harm. Harm from vitamins? Let us explore the article and the studies it cites in an effort to keep vitamin supplementation out of the realm of make believe.

The Researchers

Eliseo Guallar and his colleagues recently analyzed three studies and came to a shocking conclusion. They have stated, unequivocally, that multivitamin supplementation has no clear benefit and could prove harmful to your health. The group of researchers went on to say that multivitamins should not be used in the prevention of chronic disease and that "enough is enough" when it comes to the silly people who erroneously use these vitamins (emphasis mine). After you get past the initial shock that vitamin supplementation is harmful or useless and wrestle with the condescending tone of the abstract written by the researchers you are left to ponder things that you have held to be true: that vitamins are good for you. Should vitamins head off to the island of misfit beliefs with the rest of our childhood idols? Intuitively you know the answer but let us spell a few things out for the sake of clarity and sound reasoning.

The conclusion of these researchers has been published in the Annals of Internal Medicine and is chock full of assumptions. One of these assumptions provided by Guallar et al is that the average western style diet provides adequate nourishment to the masses to the point that vitamin and mineral supplementation is unnecessary. Surely, there are a percentage of westerners who eat pretty healthy by consuming clean, pure water and either natural or organic foods while limiting processed foods but this does not pertain to the vast majority especially in America. In addition, due to soil depletion and over-farming mineral and vitamin levels in fruits, vegetables and grains have been on a decline for decades.

Aside from the assumption let us to take a look at what really lies at the heart of the matter for the people who take great interest in their health. An analysis of the three studies is appropriate and fundamental so we can understand what the researchers saw and what the newspapers, online publishers and television programs failed to report.

The Studies

Three studies were cited by the researchers and here is where we really have to pay attention which is unfortunate. It is unfortunate because there is a sense among most people in the general public that studies are impartial, truthful and therefore should be taken as gospel. Since the word gospel literally means "good news" some of these studies should be taken as the anti-gospel. Let us review

Cardiovascular Disease and Cancer Study

The first study mentioned in the article is the "Vitamin and Mineral Supplements in the Primary Prevention of Cardiovascular Disease and Cancer". I know it's a mouthful but bear with me. Researchers in this study wanted to establish whether cardiovascular issues and cancer was actually preventable through supplementation. It appears to be a noble endeavor on the surface even with flawed results (an explanation on why it is not noble will present itself a little later). It was acknowledged that the results of this study did not pertain to individuals with nutrient deficiencies or others that would be considered high risk. The article cited above would have you believe the results of this trial pertained to everyone. When you consider that most people are nutrient deficient the article becomes just plain misleading.

At one point in the analysis of the trial the researchers had to admit that the study was actually set up to measure results in a drug trial not a nutrient trial which may skew the data. In addition, it was noted that the difference between examining optimal levels of a nutrient intake and "normal" levels may have established a different result. In other words studying minimum nutrient supplementation may not be in the best interest of the general public. Then the question becomes "Why do the study in this way if the results do not apply to most people"? Great question!

Cognitive Function in Men

This study was a misnomer from the very start. Called "Long Term Multivitamin Supplementation and Cognitive Function in Men: A Randomized Trial"  it looked at a very particular group of men: doctors. The importance of this will become clear in a moment. The intent of this study was to assess cognitive function in men and whether multivitamin supplementation would improve it. The conclusion was that multivitamin supplementation does not improve cognitive function or prevent dementia.

There are three interesting points to consider regarding this study. The first is that physicians were studied and this poses a problem. It has been long established that people who pursue academics have a lowered risk of developing dementia. Secondly, most older physicians generally eat very healthy and are able to afford the best, most nutritious foods. Proper nourishment combined with a high level of education diminishes the likelihood of developing dementia which is a great thing but it makes you wonder why this study was used to attack multivitamin use. There was not much of any chance to see any improvements from multivitamin use because of the group of men that were studied. The third, and perhaps the most disturbing aspect of this study was the fact that actual dementia or any cognitive dysfunction was never tested for. None of the participants were assessed for any level of dementia either before, during or after. How do you purport that something does not work (multivitamins) if you never test for the dysfunction you are looking to improve (cognition)?

Trial to Assess Chelation Therapy

This study set out to assess whether or not high doses of vitamins and minerals help prevent a another occurrence of a second myocardial infarction (heart attack). Two things of import to note for this one.

The first is that the people studied had a high incidence non-adherence. This is a fancy way of saying more than enough people failed to do what was requested of them ultimately affecting the data collected. In addition, the participant dropout rate was also high. It becomes a difficult task to honestly document and extract accurate information to convey to the public when so many people involved in the study fail to comply with the instructions or complete the program. It puzzles me that Eliseo Guallar and his colleagues used this study or any of the previously mentioned ones to attack vitamins and minerals.

The Story of Cholesterol: Our Immune Systems

On a daily basis our immune systems are constantly under pressure to perform a symphony of life saving duties. Multiple levels of specialized cells and chemicals orchestrate tasks like carry messages, serve as lookouts and summon killer cells. Pathogens, inflammation, even poorly digested food make demands for the attention of our often overburdened immune systems but the indignity does not stop there for some of us. Cholesterol lowering has been the "go to" treatment for many people with the unfortunate side effect of a suppressed immune system for many.

How suppression happens

It was mentioned in a previous article that one of the few benefits of statin drugs is that it reduces inflammation in the body and indeed it does. The problem is how it goes about achieving this "accomplishment". Your immune systems is a complex work of art. A significant part of the artwork involves being able to point out infection causing pathogens to the rest of the immune system. This is accomplished by creating inflammation with a chemical known as NF-kB. We must remember that inflammation, in and of itself, is not necessarily a bad thing. Without it our bodies would suffer greatly from a lack of an alarm system (inflammation) when burglarized by infection causing materials. Problems with inflammation arises when it becomes rampant and chronic due to what we do to ourselves through certain foods, drugs or environmental exposures.

Statin drugs inhibits our bodies from making NF-kB, the chief burglar alarm of the body, by the same process in which it inhibits production of CoQ10. At first thought it would seem like a good idea to lower inflammation and by most natural standards it is. It becomes problematic when it is done with a drug that ultimately makes the immune system weaker and less responsive.

Why is NF-kB suppression a big deal?

Would it surprise you to know that some pathogens like E. Coli and Salmonella actually proliferate by suppressing the body's ability to produce NF-kB? With no alarm they can terrorize the body. There are viruses that can do the same thing or can even increase the alarm rate which causes an over response and overwhelms the system. The point is that manipulating the process to produce NF-kB generally leads to adverse or undesired results.

It is also important to point out that low cholesterol levels put people at increased risk of acquiring and dying from infections. Cholesterol itself (specifically LDL the so-called "bad cholesterol") is noted for being able to disarm 90% of toxic bacterial pathogens. Infections can take hold of the body whether cholesterol levels fall too low or through suppression of NF-kB production. In 1992 a review of 19 studies of more than 68,000 deaths found that those with low cholesterol died from respiratory and gastrointestinal infections in higher numbers than those with what is generally considered normal to high cholesterol. In addition, a study that began in 1977 called MRFIT found that men with cholesterol levels at or below 160 were four times as likely to die from AIDS as men whose levels were above 260.

The bottom line

Manipulating the immune system to prevent it from doing all or part of it's job usually leads to disastrous outcomes. Medical science has done it for years whether it be intentionally (think organ transplants) or unintentionally you can never be sure of the results. One thing is sure and that is wherever a compromised immune system exist there will be a pathogen waiting to exploit it. At that point the question becomes one of survival.

Sources include:

The Great Cholesterol Myth (Bowden and Sinatra)

The Story of Cholesterol: The Statin Drug Nightmare Part I

We have steadily climbed to the point of discussing a class of drugs known as statins. These very powerful and costly medications has reached the height of pharmaceutical popularity. Essentially a sub-industry within an industry statin drugs account for $31 billion of annual sales alone. It is estimated from sales that a staggering 15 million Americans are currently on these cholesterol lowering drugs. All the while the majority of them are suffering from side effects that range from slightly annoying to absolutely debilitating. These side effects include impaired cognitive function, sexual dysfunction, increased risk of diabetes and heart disease, lethargy and low vitamin D levels (with its associated adverse health effects when vitamin D deficiencies occur).

The history of mankind has been filled with many medical oddities that now look completely absurd to us. As far back as 1500 BC mercury was used for whatever ailed you. During the 19^th century the chief ingredient in cough syrup was heroin. And who can forget bloodletting used by the Greeks and the rest of the world right up to the 19^th century. While all of this might elicit a chuckle or two as we think of how silly “those people” were for believing in that stuff history will chuckle at us when statin drug use is reviewed for the amusement of our more enlightened descendants.

One of the many issues that surrounds the use of statin drugs is the yet unproven hypothesis that blood cholesterol is a key contributor to heart disease. You read that correctly: Cholesterol being the chief contributor to heart disease is a yet unproven hypothesis. In fact almost all studies concerning the relationship between heart disease and cholesterol either points to another culprit (e.g. inflammation), exonerates cholesterol or both. During the late ‘80’s a Dr. Russell Smith wrote a two volume review of literature associated with heart disease and diet called Diet, Blood Cholesterol and Coronary Heart Disease: A Critical Review of the Literature. It took over 600 pages of research for him to state that in the vast majority of studies reviewed there was no difference in the number of deaths between people who reduced their cholesterol and those that did not. This point will become more important as we move along.

In 1991 Dr. Smith teamed up with Dr. Edward Pinckney, the editor of four medical journals, to publish a book called The Cholesterol Conspiracy. In the book they summarized studies conducted with cholesterol lowering drugs and concluded that these drug were effective at lowering cholesterol but not deaths. Of the eight randomized and blinded trials that met their standard for study six had participants where the rate of death among the group being treated with cholesterol lowering drugs was the same or higher than the control group. That’s not very promising but it gets worse. They also looked at sixteen studies looking at reducing cholesterol using a drug and diet approach. What they found was that the death rate from all-causes in the treatment group and control was the same. In addition, the rate of death from coronary heart disease was the same or greater among the treatment group in fifteen of the sixteen trials. Yes, you read that correctly. What the good doctors demonstrated, essentially, is that there was zero benefit to lowering cholesterol when it comes to preventing adverse coronary events including death. Outside of a very narrow group of people (white males at least 48 years old who have already had one heart attack) statins have proven to have no benefit but they have proven to be extremely toxic. Part II of the statin nightmare will address specific issues that statins cause in the body.

Sources include:

The Great Cholesterol Myth

The Cholesterol Conspiracy