Tag Archives: diabetes

Vitamin D supplement & reducing diabetes risk

For our readers interested in the ongoing research on vitamin D and in light of our previous post on the growing diabetes epidemic I felt that this latest news would be of interest; Researchers working at Tufts Medical Center in Boston, under the direction of Professor Anastassios Pittas, published just such a randomized controlled trial in the American Journal of Clinical Nutrition. Their research group reported that 2,000 IU/day of vitamin D, given for 12 weeks, significantly improved pancreatic function in mildly overweight adults with pre-diabetes.

Unfortunately, the lead author, Dr. Joanna Mitri, did not comment on the low dose of vitamin D they used, 2,000 IU/day, which only increased vitamin D levels from 8 to 12 nmol/l (24-30 ng/ml). In spite of the low dose and short length of their study, they found their principal outcome, a measurement of pancreatic function, increased by 300 in the vitamin D group but fell by 126 in the placebo group.

View the abstract here:

Effects of vitamin D and calcium supplementation on pancreatic β cell function, insulin sensitivity, and glycemia in adults at high risk of diabetes: the Calcium and Vitamin D for Diabetes Mellitus (CaDDM) randomized controlled trial. Am J Clin Nutr 2011 ajcn.011684; First published online June 29, 2011. doi:10.3945/ajcn.111.011684

Related posts:

1. Diabetes is reversible
2. Vitamin D should be higher in people taking osteoporosis drugs

 

 

 

 

 

 

 

 

 

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Diabetes is reversible!

One of the fastest growing health problems facing us is diabetes. A brief look at the statistics (from Diabetes UK) for the UK clearly reflects a worrying trend with the year on year prevalence of diabetes on the steady increase. The chart below, constructed from figures readily available from Diabetes UK clearly shows the trend.

While diabetics should never radically change their treatment plan on their own, fascinating new results have just been published showing how powerful diet can be in influencing this growing health crises. Researchers from Newcastle University have clearly shown that a strict low calorie diet can actually reverse the condition by normalizing blood glucose levels, reducing cholesterol levels and even stimulate the pancreas’s insulin producing cells (beta cells) to return to normal!

However, this was a small-scale study and involved just 11 people; 9 men and 2 women. The participants followed a very low energy (calorie) diet based on a special liquid diet formula along with 3 portions of non-starchy vegetables so that the total daily energy intake was about 600 kcal. They were also encouraged to drink around 2 liters of water a day and avoid all sugary or high-energy drinks.

At the end of the 8-week diet trial the study demonstrates that the twin defects of beta cell failure and insulin resistance that underlie type 2 diabetes can be reversed by the very low energy diet alone. Over the trial the average blood glucose levels of those involved fell from 9.2mmol/l to 5.7mmol/l.

While this study involved a drastic dietary change and can’t be considered as a gold standard for managing type-2 diabetes on a daily basis it does dramatically highlight the importance of diet and the power of modifying it. With 50% of diet control diabetics requiring insulin injections after 10 years of diagnosis long term management through diet modification and exercise would be the most sensible way forward for the UK type-2 diabetic population and especially for those with pre-diabetic or borderline test results. The full study was published in the June issue of the journal Diabetologia.

More on the growing prevalence of diabetes

Read Sugar Rush published in the Economist online. The number of adults with diabetes more than doubled between 1980 and 2008, according to a new study led by Professor Majid Ezzati of Imperial College London and Goodarz Danaei at Harvard University and published in the Lancet…

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Sugar, gout and metabolic syndrome

Consumption of sugar sweetened soft drinks and fructose is strongly associated with an increased risk of gout in men. This was the finding of a study published in the British Medical Journal back in 2008. Gout is a joint disease which causes extreme pain and swelling. It is most common in men aged 40 and older. It is caused by excess uric acid in the blood (hyperuricaemia) which leads to uric acid crystals collecting around the joints.

In the United States, levels of gout have doubled over the last few decades, which coincided with a substantial increase in the consumption of soft drinks and fructose (a simple sugar and the only carbohydrate known to increase uric acid levels). Conventional dietary recommendations for gout have focused on the restriction of purines (found in high levels in meat and meat products, especially liver and kidney) and alcohol but with no restriction of sugar sweetened soft drinks.

With this in mind, researchers in the US and Canada examined the relation between intake of sugar sweetened soft drinks and fructose and the risk of gout. They followed over 46,000 men aged 40 years and over with no history of gout. The men completed regular questionnaires on their intake of more than 130 foods and beverages, including sugar sweetened soft drinks and diet soft drinks, over a period of 12 years. Different types of fruits and fruit juices (high in natural fructose) were also assessed.

At the start of the study, and every two years thereafter, information on weight, regular use of medications and medical conditions were also recorded. Gout was diagnosed according to American College of Rheumatology criteria. During 12 years of follow-up, the researchers documented 755 newly diagnosed cases of gout. The risk of gout increased with increasing intake of sugar sweetened soft drinks. The risk was significantly increased with an intake level of 5-6 servings per week and the risk was 85% higher among men who consumed two or more servings of sugar-sweetened soft drinks per day compared to those who consumed less than one serving per month. These associations were independent of other risk factors for gout such as body mass index, age, diuretic use, high blood pressure, alcohol intake, and dietary factors.

Diet soft drinks were not associated with the risk of gout.

Fruit juice and fructose rich fruits (apples and oranges) were associated with a higher risk of gout. However, the authors stress that this finding needs to be balanced against the benefit of fruit and vegetable intake to prevent other chronic disorders like high blood pressure, coronary heart disease, stroke and certain types of cancer.

In conclusion, the 2008 findings provide evidence that consumption of sugar sweetened soft drinks and fructose is strongly associated with an increased risk of gout, say the authors. Furthermore, fructose rich fruits and fruit juices may also increase the risk. In contrast, diet soft drinks were not associated with the risk of gout.

To bring this article more up to date, fructose does now appear to be closely associated with a number of uric acid related disorders that include high blood pressure, fatty liver, generalised inflammation, elevated blood fats (lipids) as well as the growing epidemic of abdominal obesity and type-II diabetes.

Adopting a low glycaemic style diet would appear to be the way forward for many who have become habitual sugar and fructose consumers; not only will it reduce the problems associated with gout this dietary approach will minimise the growing problem of metabolic syndrome.

Further reading

Hypothesis: Could Excessive Fructose Intake and Uric Acid Cause Type 2 Diabetes?

Pre-diabetes; what can be done?

Hi GI foods and heart disease

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Burning Feet Syndrome

Burning Feet

During my last BBC Cornwall phone-in on Sunday 20th July a lady called complaining of burning feet. This is not an uncommon problem and plagues many people, especially those 50 and over. Sadly, its not a condition that is managed very well.
It is important to remember that burning feet may be the only symptom of a more complex underlying cause and should not be ignored. Among the many causes undiagnosed or poorly controlled diabetes is one of the commonest causes. In this case the pain is due to a nerve condition known as a peripheral neuropathy. I would urge all burning feet sufferers to get a simple blood glucose check – may pharmacies can perform this while you wait.
Below are a few more causes of burning feet;
• Fungal foot infections
• Poorly fitting shoes
• Vitamin B12 deficiency (pernicious anaemia)
• Circulatory problems
• Chronic smoking or alcohol use
• Organ disease; kidney or liver
• Glandular problems; thyroid
For most the most common symptom is a burning or stinging pain in the feet that is sometimes accompanied by redness and occasionally swelling.
Studies into burning feet have revealed some interesting findings. In cases of diabetic nerve damage the pain appears to come not only from the nerve problem itself but also from the reduced circulation that accompanies it.

This image to the left (image credit: NASA) clearly shows the cold foot (dark colours) detected by thermography. As you are looking at the picture, its the foot on the left (the patients right foot) that is dark, almost black in colour. This indicates a region of low temperature. Compare this to the other foot and you will see the difference. The reduced circulation appears to be closely associated with the nerve damage. Because nerve pain (neuropathic pain) is such a problem research has been focused on this subject for many years. Not only is neuropathic pain is one of the most difficult types of chronic pain to treat and relief is often unsatisfactory or short-term. Since medical treatment options are limited, doctors often prescribe a combination of therapies in an attempt to relieve symptoms. It can be associated with many conditions including Multiple Sclerosis (MS), stroke, cancer, spinal cord injury, physical trauma, post-herpetic neuralgia (shingles), and peripheral neuropathy resulting from diabetes. To read about some interesting clinical trials being performed click here.
Treatment options
Because the nerve pain is perceived in the brain but the circulatory aspect is affecting the foot itself we need to focus attention both centrally and locally. The diagram to the right shows how it all connects.

The foot nerves are connected via the spinal cord to the brain where the messages are converted into the feeling of pain. Our brain then “maps” this feeling of pain to the region where the signals are coming from – the foot. Hence we feel pain in the foot but perceive it in the brain!
I have found that a cream called Alikeine Red offers great relief from the local circulatory aspect of the burning foot syndrome. Not only does it keep the skin healthy and supple but it can help balance the circulation.
From the vitamin point of view I tend to recommend a months course of vitamin B12 in the biologically active form known as methylcobalamin and taken as a suckable tablet rather than a simple tablet or capsule that is swallowed. The suckable form allows the B12 to be absorbed through the mouth membranes. This is a good way to get it into your system especially it absorption from the stomach is in question.
For those who are not on blood thinning drugs an additional boost to the peripheral circulation can be obtained using the combination of Ginkgo (80mg twice a day withn food) and vitamin E 400iu (1 capsule per day with food) I have also had some success using electroacupuncture. This is defiantly worth a try and may help “re-set” the level of central (brain) sensitivity which in turn can ease some of the nerve pain symptoms.

Further reading
The Neuropathy Trust, a worldwide Charity (1071228) that was founded in 1998 by Andrew Keen to provide a lifeline to people affected by Peripheral Neuropathy (PN) and Neuropathic Pain (NeP).
Vitamin B12 deficiency
Journal abstract regarding Vitamin E being effective in chemotherapy induced neuropathy

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