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Diabetes As physicians, we must be aptly prepared to address risk factors facing our diabetic patients. Trial results reveal intensive diabetes treatment aimed at normalizing long-term glucose control decreases risks, such as nonfatal myocardial infarctions, nonfatal strokes and fatal cardiovascular events. A diet comprised of low-GI starchy foods showed lowered glucose and insulin responses throughout the day—and improvement in the lipid profile and capacity for fibrinolysis, suggesting a therapeutic potential. Review current research and medical articles on diabetes to stay informed. Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women: 2007 Update.pdf
This 2007 update provides the
most current clinical
recommendations for the prevention
of CVD in women 20 years of age and
is based on a systematic search of
the highest-quality science,
interpreted by experts in the fields
of cardiology, epidemiology, family
medicine, gynecology, internal
medicine, neurology, nursing, public
health, statistics, and surgery.
These guidelines cover the primary
and secondary prevention of chronic
atherosclerotic vascular diseases.
More acute management of vascular
disease in the periprocedural or
immediate posthospital settings and
of valvular heart disease is covered
in other AHA guidelines. Management
of heart failure, atrial
fibrillation for stroke prevention,
and CVD risk factors during
pregnancy is beyond the scope of the
present document.
At a
major Alzheimer's Association
meeting in Madrid, researchers
behind the Veterans Administration
Puget Sound Health Care System
experiment in Seattle and other
experts are making a strong case
that diabetes hammers not just the
body but the mind. Indeed, it may be
a precursor to Alzheimer's. As blood
sugar control gets worse in
diabetics, Alzheimer's risk climbs
astronomically, one study found.
This
study demonstrated that aging men
with obesity and the metabolic
syndrome have a significant decrease
in total serum testosterone levels
compared to aging, metabolically
healthy men. These data suggest that
the well established association
between erectile dysfunction and
pre-diabetes/diabetes (particularly
in obese pre-diabetic/diabetic
patients) may involve a hormonal
component. Lowering Dietary Glycemic Load for Weight Control and Cardiovascular Health: A Matter of Quality.pdf
This
study concludes that although
significant differences in
neurohormonal responses to different
types of carbohydrates have long
been recognized, until recently this
knowledge has not been
comprehensively and systematically
applied to the study of diet and CVD
in populations or to the development
of food-composition tables in
guiding dietary practice. Prevalence of Hypogonadism in Males Aged at Least 45 Years: The HIM study.pdf
According to this study, based on TT
concentration, the prevalence of
hypogonadism in men reporting to
primary care offices was estimated
to be 38.7%. The medical conditions
that occurred significantly more
frequently among hypogonadal men
than eugonadal men included
increased BMI, hypertension,
hyperlipidaemia, diabetes, and
asthma or COPD. As men age, they are
susceptible to conditions that share
many of the same symptoms similar to
hypogonadism. The presence of these
conditions may, in effect, mask
underlying hypogonadism and
negatively impact quality of life. Low Serum Testosterone and Mortality in Male Veterans.pdf
This
study used a clinical database to
identify men older than 40 years
with repeated testosterone levels
obtained from October 1, 1994 to
December 31, 1999, and without
diagnosed prostate cancer. It
concluded that low testosterone
levels were associated with
increased mortality in male
veterans. Further prospective
studies are needed to examine the
association between low testosterone
levels and mortality. GE Healthcare Announces Most Extensive Body Composition Reference Database in China.pdf
GE
Healthcare, a unit of General
Electric Company (NYSE: GE),
announced that the company has
developed the most extensive body
composition reference database to
evaluate total body composition in
Chinese women. The reference
database provides improved
confidence for Chinese physicians in
evaluating clinical conditions such
as obesity, eating disorders,
diseases that cause muscle wasting,
and conditions that may increase the
risk of diabetes and heart disease.
The new reference database was
presented at the 27th
Annual Meeting of the American
Society for Bone and Mineral
Research meeting in Nashville, TN
September 23-27.
Scientists Believe Type 3 Diabetes Uncovered.pdf
After
discovering that insulin and its
related proteins are produced in the
brain and that reduced levels of
both contribute to Alzheimer’s,
scientists believe they may have
found a new type of Diabetes.
This
review details what is currently
known about insulin, insulin-like
growth factor type I (IGF-I) and
IGF-II proteins and their
corresponding receptors in the
brain, and delineates the major
controversies pertaining to
alterations in the expression and
function of these molecules in AD.
According to this article, for more
than 30 years, type 1 and type 2
diabetes have been viewed as
different disorders. Type 1 has been
cast as an autoimmune disease, and
the association of type 1 diabetes
with HLA genotype has been
thoroughly studied. New research has
suggested that a shift in the
diabetes paradigm may be coming. The
“accelerator hypothesis” is a
relatively new interpretation of
diabetes.
According to Mary Ann Banerji, MD,
associate professor of medicine and
endocrinology at SUNY Downstate
Medical Center in Brooklyn, N.Y.,
abdominal obesity may be a better
marker of insulin resistance
syndrome than other indicators such
as BMI and weight. Banerji spoke
about obesity and its association
with insulin resistance syndrome at
the 65th
Scientific Sessions of the American
Diabetes Association.
This
article discusses how intensive
therapy should begin as early as
possible to reduce the risk of
long-term complications of type 1
diabetes, according to the latest
results from the Diabetes Control
and Complications Trial. The new
Diabetes Control and Complications
Trial (DCCT) results demonstrated
that intensive diabetes treatment
aimed at normalizing long-term
glucose control decreased the risk
of nonfatal myocardial infarctions,
nonfatal strokes and fatal
cardiovascular events. Diabetes Management Remains Suboptimal: Even Academic Centers Neglect Curbing Risk Ractors.pdf
The
potential complications associated
with the treatment of Diabetes
require aggressive management by
medical professionals. This article
discusses concerns about the need
for doctors to do a better job of
addressing their Diabetic patients’
risk factors. Midlife Cardiovascular Risk Factors and Risk of Dementia in Late Life.pdf
The
aim of this study was to evaluate if
midlife cardiovascular risk factors
are associated with risk of
late-life dementia in a large,
diverse cohort. It concluded that
the presence of multiple
cardiovascular risk factors at
midlife substantially increases risk
of late-life dementia in a dose
dependent manner.
Insulin-Like Growth Factor-1 as a
Vascular Protective Factor.pdf Frequent Occurrence of Hypogonadotropic Hypogonadism in Type 2 Diabetes.pdf
Type
2 diabetes is associated with lower
total testosterone levels in
cross-sectional studies. However, it
is not known whether the defect is
primary or secondary. This article
concludes that hypogonadotropic
hypogonadism occurs commonly in type
2 diabetes.
Review of the Book The Sexy
Years: Discover the Hormone
Connection: The Secret to Fabulous
Sex, Great Health, and Vitality, for
Women and Men.pdf Low Androgenization Index in Elderly Women and Elderly Men with Alzheimer's Disease.pdf
The
authors of this study investigated
whether testosterone levels and
testosterone availability differ
between older lean subjects with and
without Alzheimer's disease (AD).
Sex hormone binding globulin (SHBG)
and estradiol levels were higher,
whereas the free androgenization
index (FAI) was lower, in lean
subjects with AD than in lean
subjects without AD. Factors
involved in the increase of SHBG
secretion could have an important
role in the lower testosterone
availability of subjects with AD. Diet Composition and the Risk of Type 2 Diabetes: Epidemiological and Clinical Evidence.pdf
This
article concludes that new emphasis
on prevention by multiple lifestyle
modifications, including moderate
changes in the composition of the
habitual diet, might limit the
dramatic increase in incidence of
type 2 diabetes envisaged worldwide. The Paradox of the Insulin/IGF-1 Signaling Pathway in Longevity.pdf
This
review focuses on the downstream
cascade of events in the insulin and
IGF-1 signaling to identify specific
pathways that are relevant to human
longevity. Diabetes Mellitus and Risk of Dementia in the Kungsholmen Project: A 6-Year Follow-up Study.pdf
The
authors of this study investigated
the relationship between diabetes
mellitus and risk of dementia,
Alzheimer disease (AD), and vascular
dementia (VaD). They concluded that
diabetes mellitus increases the risk
of dementia, and VaD in particular,
in very old people. The risk for
dementia and VaD is especially high
when diabetes mellitus occurs
together with severe systolic
hypertension or heart disease. Relationship of Walking to Mortality Among US Adults with Diabetes.pdf
This
study concluded that walking was
associated with lower mortality
across a diverse spectrum of adults
with diabetes. One death per year
may be preventable for every 61
people who could be persuaded to
walk at least 2 h/wk. Insulin Resistance and Prostate Cancer Risk.pdf
In
this study, the associations between
prostate cancer risk and insulin
sensitivity or resistance were
independent of total caloric intake
and serum levels of insulin-like
growth factors, sex hormones, and
sex hormone-binding globulin.
Because of the retrospective design
of this study, the role of insulin
resistance in prostate cancer needs
to be confirmed in prospective
studies.
A Diet Rich in Coconut Oil Reduces
Diurnal Postprandial Variations in
Circulating Tissue Plasminogen
Activator Antigen and Fasting
Lipoprotein (a) Compared with a Diet
Rich in Unsaturated Fat in Women.pdf Lifetime Risk for Diabetes Mellitus in the United States.pdf
This
study concluded that for individuals
born in the United States in 2000,
the lifetime probability of being
diagnosed with diabetes mellitus is
substantial. Primary prevention of
diabetes and its complications are
important public health priorities. Overweight, Obesity, and Cancer Risk.pdf
According to this article, in
addition to an increase in the risk
of cardiovascular disease and type
II diabetes, the evidence summarized
here shows that excess body weight
is directly associated with risk of
cancer at several organ sites,
including colon, breast (in
postmenopausal women), endometrium,
oesophagus, and kidney.
This
study concludes that recombinant
human growth hormone (rhGH) has a
beneficial effect on metabolism in
patients who are severely burned.
Hyperglycemia, however, is apt to
occur and water, Na(+), Cl(-)
retention are suggested. Fifty
patients were studied. The Influence of Recombinant Human Growth Hormones on the Systemic Metabolism After Severe Burn.pdf
The
conclusion of this study involving
twenty-four burn patients was that a
small dose of recombinant human
growth hormone could promote
systemic protein synthesis with no
side effects on blood glucose
levels. Hormone Replacement Therapy, Insulin Sensitivity, and Abdominal Obesity in Postmenopausal Women.pdf
The authors concluded that
postmenopausal women taking oral
estrogen or those taking a
combination of estrogen and HRT are
more insulin-resistant than women
not on HRT, even when women are of
comparable total and abdominal
adiposity. This study concluded that low-dose GH treatment combined with dietary restriction resulted not only in a decrease of visceral fat but also in an increase of muscle mass with a consequent improvement of the insulin resistance observed in obese type 2 diabetic patients.Nam, S.Y., Kim, K.R., Cha, B.S., Song, Y.D., Lim, S.K., Lee, H.C., et al. (2001). Low-dose growth hormone treatment combined with diet restriction decreases insulin resistance by reducing visceral fat and increasing muscle mass in obese type 2 diabetic patients [Electronic version]. International Journal of Obesity and Related Metabolic Disorders, 25(8), 1101-1107. Retrieved January 19, 2006.
This
study concludes that long-term
rhGH-replacement therapy in GH
deficiency adults induced a
significant deterioration in glucose
tolerance, profound changes in
kinetics of C-peptide, and insulin
and prehepatic insulin secretion,
despite an increase in lean body
mass and a reduction of fat mass.
Therefore, rhGH treatment may
precipitate diabetes in some
patients already susceptible to the
disorder. Consequences of the Diabetic Status on the Oxidant/Antioxidant Balance.pdf
The
aim of this paper was to review the
consequences of the diabetic status
on the oxidant/antioxidant balance.
In
this study, GH therapy resulted in
increased insulin resistance during
hypoglycemia, without changes in the
counterregulatory hormonal
responses, serum IGFBP-1, or serum
FFA.
This
study concludes that a diet
characterized by low-GI starchy
foods lowers the glucose and insulin
responses throughout the day and
improves the lipid profile and
capacity for fibrinolysis,
suggesting a therapeutic potential
in diabetes.
Long-Term Effects of Growth Hormone
Therapy on Intermediary Metabolism
and Insulin Sensitivity in
Hypopituitary Adults.pdf
This
study concludes that menopausal
status and type 2 diabetes are
associated with impaired
microvascular reactivity. HRT
substantially improves microvascular
reactivity in postmenopausal healthy
women. In contrast, the effect of
HRT on the microvascular reactivity
of postmenopausal diabetic women is
less apparent. However, the use of
HRT among women with diabetes is
associated with lower sICAM levels,
suggesting an attenuation in
endothelial activation.
This
study concludes that the ultimate
effect of GH therapy upon
cardiovascular mortality remains to
be determined and may be
dose-related.
This
trial has demonstrated that GH can
favorably affect some of the
multiple perturbations associated
with abdominal/visceral obesity.
This includes a reduction in
abdominal/visceral obesity, an
improved insulin sensitivity, and
favorable effects on lipoprotein
metabolism and diastolic blood
pressure.
The
purpose of this study was to prove
whether stimulating collagen type I
synthesis would be accompanied by a
deposition of collagen type I in the
skin. It examined twenty growth
hormone-deficient hypopituitary
patients for twelve months.
This
study concludes that diabetics with
dementia rarely have AD except as a
component of mixed dementia. Apo-E
genotyping showed only average E4
allele frequency in diabetics
compared with the high E4 frequency
found in AD patients. However, mixed
dementia in diabetics may be
associated with the E4 allele,
suggesting that close control of
diabetes may be particularly
important for those with E4 since
they may be more likely than others
to develop both diseases.
The
authors of this study conclude that
short term low dose
rhGH treatment of GH-deficient
adults induces a
temporary state of mild
glucose intolerance,
hyperinsulinemia, insulin
resistance, and raised
NEFA levels at 1 week. By 3 months,
these metabolic
disturbances had returned
to baseline for a persisting modest
hyperinsulinemia.
Whether this hyperinsulinemia will
last over the longer
term and/or has distant
detrimental metabolic consequences
in the
individual must await further
studies.
This
study investigated the potential
pituitary origin of gonadal
insufficiency in hemochromatosis.
Gonadotropin secretion was studied
in seven patients with
hemochromatosis and hypogonadism,
before and after chronic pulsatile
GnRH therapy. It was concluded that
hypogonadism in hemochromatosis is
due to pituitary lesions.
This
study examined endocrine functions
at baseline and after TRH and LHRH
stimulation in a group of 7 young
male patients with genetic
hemochromatosis (HE) without liver
damage (i.e. fibrosis and
cirrhosis). In five patients
endocrine re-evaluations after
complete iron depletion was also
performed. Mechanism of Growth Hormone-Induced Postprandial Carbohydrate Intolerance in Humans.pdf
In
this study, the decrease in
postprandial glucose uptake did not
appear to be mediated by a change in
substrate uptake since postprandial
plasma concentrations and forearm
balance of lactate, free fatty
acids, and ketone bodies did not
differ in the presence and absence
of growth hormone excess.
In
this study, IGF-1 levels were
examined in a man with hypothalamic
growth hormone-deficiency before and
during the first six days of
treatment with daily growth hormone
injections.
This
study examined the effect of iron
depletion on reproductive function
in a 37-yr-old man with
hypogonadotropic hypogonadism due to
idiopathic hemochromatosis. It was
concluded that phlebotomy alone may
be adequate treatment for
hypogonadotropic hypogonadism in men
with hemochromatosis.
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