ROADTOAD..Diabetics info{by medical doctors}

[David Wilson]

http://www.pcrm.org/health/Preventive_Medicine/diabetes.html


Raodtoad, this info was sourced from the Physicians for Responsible Medicine website.
These people are doctors, you're welcome to reject the info, but how do you explain disagreement between scientists....is it possible YOUR current doctor is uninformed?


Diet and Diabetes

In diabetes, the cells of the body cannot get the sugar they need. Glucose, a simple sugar, is the body’s main fuel. It is present in the blood, but in diabetics it cannot get into the cells where it is needed. When diabetes starts in childhood (insulin-dependent diabetes), it is due to an in adequate supply of insulin, the hormone which ushers sugar into the cells of the body. Without insulin, the cell membranes keep sugar out. This form of diabetes is also called Type I or childhood-onset diabetes. When diabetes begins in adulthood (non-insulin-dependent diabetes), it is not due to an inadequate supply of insulin. There is plenty of insulin in the bloodstream, but the cells do not respond readily to it. Sugar cannot easily get into the cells, and it backs up in the bloodstream. This form is also called Type II or adult-onset diabetes. In the short run, diabetics may experience episodes of labored breathing, vomiting, and dehydration. In the long run, diabetics are at risk for heart disease, kidney problems, disorders of vision, and other difficulties.

The old approach to diabetes was to focus on eliminating refined sugars and foods that turned into sugars—starches, breads, fruits, etc.—from the diet. The rationale was based on the fact that diabetics’ urine contains sugar. Unfortunately, with all of the complex carbohydrates eliminated, fat and protein are all that is left in the diet.

The new approach focuses more attention on fat. Fat is a problem for diabetics. The more fat there is in the diet, the harder time insulin has in getting sugar into the cell. Exactly why this occurs is not clear. But what is clear is that minimizing fat intake and reducing body fat help insulin do its job much better. Modern diabetic treatment programs drastically reduce meats, high-fat dairy products, and oils. At the same time, they increase grains, legumes, and vegetables.

One study found that 21 of 23 patients on oral medications and 13 of 17 patients on insulin were able to get off of their medications after 26 days on a near-vegetarian diet and exercise program.1 During two- and three-year follow-ups, most diabetics treated with this regimen have retained their gains.2 The dietary changes are simple, but profound, and they work. Low-fat, vegetarian diets are ideal for diabetics.


There is a second essential component to managing diabetes. Through regular exercise, the need for insulin injections can often be reduced, and oral medications often become unnecessary. This holds true not only for people with non-insulin-dependent diabetes, but also to some extent for those with insulin-dependent diabetes. Exercising muscles have a voracious appetite for fuel. When an individual is engaged in regular aerobic exercise, the sugar is able to enter the cells without the need for as much, or perhaps any, insulin.
While people with non-insulin-dependent diabetes can often eliminate medications when their weight is reduced and foods and exercise are better controlled, those with insulin-dependence will always need a source of insulin. The cause of insulin-dependent diabetes remains elusive. Several recent studies have implicated cow’s milk consumption as a possible contributor.3,4 When milk consumption patterns were examined across various nations, there was a very strong correlation with the incidence of insulin-dependent diabetes. It may be that milk proteins cause an autoimmune reaction in which the body mistakenly attacks its own insulin-producing cells. Even so, a good diet and regular exercise can minimize the amount of insulin these diabetics require. This is especially important given their tendency toward complications, heart disease, and other blood vessel problems that are much more common in diabetics. So it is doubly important to keep fit and to keep dietary fat to a minimum.
Diabetics are shortchanged by the diet most doctors give them. The typical American Diabetes Association (ADA) diet is still high in fat. The ADA diet limits the amount of butter, eggs, and so forth, but it contains about 300 milligrams of cholesterol per day and about 30 percent fat.
This fact sheet is not intended as a comprehensive program for diabetes. If you have diabetes, consult your doctor and tailor a program for your needs. But it is important to recognize that, for many, diabetes is a disease that need never occur. In most cases, diabetics can manage their disease much better with a food plan that gets most of its calories from complex carbohydrates while minimizing fats. At the same time, regular, vigorous exercise helps insulin work optimally.

References
1. Brand JC, Snow BJ, Nabhan GP, Truswell AS. Plasma glucose and insulin responses to traditional Pima Indian meals. Am J Clin Nutr 1990; 51(3):416-20.
2. Barnard RJ, Massey MR, Cherny S, O’Brien LT, Pritikin N. Long-term use of a high-complex-carbohydrate, high-fiber, low-fat diet and exercise in the treatment of NIDDM patients, Diabetes Care 1983;6(3):268-73.
3. Scott FW. Cow milk and insulin-dependent diabetes mellitus: is there a relationship? Am J Clin Nutr 1990;51:489-91.
4. Karjalainen J, Martin JM, Knip M, et al. A bovine albumin peptide as a possible trigger of insulin-dependent diabetes mellitus. N Engl J Med 1992;327:302-7.
10/27/98

 

[ImpyTimpy]

... Have you read the report?????

Well Dave, I congratulate you on self contradicting your own statements yet again... Let's see.. From your previous thread:

by Dave Wilson
Why don't you only change your breakfast to...2 pieces of raw fruit.....don't change anything else, if there are no complications, gradually increase your fruit consumption...

Yet this old study mentions increase in vegetables (which are naturally low in carbohydrates and fat) and reduction in meats as a possible help for diabetics. Nothing is mentioned about FRUIT which you were telling Roadtoad to eat as much of as he could.

Funnily enough, this "eat more veggies" is NOTHING new (no wonder, the text uses references from 10 years ago). Diabetics are already told to watch their diets (usually get special diets they need to follow) and increase their exercise levels. The insulin is given WHEN those things fail to bring diabetes under control.

Finally, the study uses an EXTREMELY small sample. I seriously question their findings...

 

[David Wilson]

The new approach focuses more attention on fat. Fat is a problem for diabetics. The more fat there is in the diet, the harder time insulin has in getting sugar into the cell. Exactly why this occurs is not clear. But what is clear is that minimizing fat intake and reducing body fat help insulin do its job much better.



This is the message i'm trying to get across...FAT, is the major problem.

My advice to RT, about locating a Fit for Life sympathetic doctor and experimenting with a "gradual" increase of fruit stands.
Plus the deep breathing, and exercise...more exercise and reduce stress...all factors combined "may" work.....avoiding it and you have what you got, Diabetes ABSOLUTELY.

 

[MRC_Hans]

In diabetes, the cells of the body cannot get the sugar they need. Glucose, a simple sugar, is the body’s main fuel. It is present in the blood, but in diabetics it cannot get into the cells where it is needed. When diabetes starts in childhood (insulin-dependent diabetes), it is due to an in adequate supply of insulin, the hormone which ushers sugar into the cells of the body. Without insulin, the cell membranes keep sugar out. This form of diabetes is also called Type I or childhood-onset diabetes.

The description of Type I Diabetes is fairly precise, except that it should be noted that some patients do not produce insulin at all.

When diabetes begins in adulthood (non-insulin-dependent diabetes), it is not due to an inadequate supply of insulin. There is plenty of insulin in the bloodstream, but the cells do not respond readily to it. Sugar cannot easily get into the cells, and it backs up in the bloodstream. This form is also called Type II or adult-onset diabetes.

This description of Type II diabetes is highly inadequate. Type II DIabetes is really a number of different diseases, but is usually characterized by BOTH insulin deficience and lack of response to insulin.

The old approach to diabetes was to focus on eliminating refined sugars and foods that turned into sugars—starches, breads, fruits, etc.—from the diet. The rationale was based on the fact that diabetics’ urine contains sugar. Unfortunately, with all of the complex carbohydrates eliminated, fat and protein are all that is left in the diet.

This refers to the pre-insulin (i.e. pre 1930) approach. The reason for that approach was that high blood-clucose (hypergluceamia) is very harmful to the body. It not only left fat and protein, but actually increased it. This is not healthy in the long run, but without glucose fuel, the patient starved to death otherwise.

The new approach focuses more attention on fat. Fat is a problem for diabetics. The more fat there is in the diet, the harder time insulin has in getting sugar into the cell. Exactly why this occurs is not clear. But what is clear is that minimizing fat intake and reducing body fat help insulin do its job much better. Modern diabetic treatment programs drastically reduce meats, high-fat dairy products, and oils. At the same time, they increase grains, legumes, and vegetables.

Modern dietary treatment aims at a moderate fat intake, reducing or maintaining a normal body weight (BMI), and exercise. Exactly what is recommended for everybody!

One study found that 21 of 23 patients on oral medications and 13 of 17 patients on insulin were able to get off of their medications after 26 days on a near-vegetarian diet and exercise program.1 During two- and three-year follow-ups, most diabetics treated with this regimen have retained their gains.2 The dietary changes are simple, but profound, and they work. Low-fat, vegetarian diets are ideal for diabetics.

This can be true, provided we are talking about Type II patients that formerly were overweight and lacked exercise. For type I patients, diet and exercise cannot replace medication, but it can improve their regulation and decrease the risk of long-term effects.

There is a second essential component to managing diabetes. Through regular exercise, the need for insulin injections can often be reduced, and oral medications often become unnecessary. This holds true not only for people with non-insulin-dependent diabetes, but also to some extent for those with insulin-dependent diabetes. Exercising muscles have a voracious appetite for fuel. When an individual is engaged in regular aerobic exercise, the sugar is able to enter the cells without the need for as much, or perhaps any, insulin.
While people with non-insulin-dependent diabetes can often eliminate medications when their weight is reduced and foods and exercise are better controlled, those with insulin-dependence will always need a source of insulin. The cause of insulin-dependent diabetes remains elusive. Several recent studies have implicated cow’s milk consumption as a possible contributor.3,4 When milk consumption patterns were examined across various nations, there was a very strong correlation with the incidence of insulin-dependent diabetes. It may be that milk proteins cause an autoimmune reaction in which the body mistakenly attacks its own insulin-producing cells. Even so, a good diet and regular exercise can minimize the amount of insulin these diabetics require. This is especially important given their tendency toward complications, heart disease, and other blood vessel problems that are much more common in diabetics. So it is doubly important to keep fit and to keep dietary fat to a minimum.
Diabetics are shortchanged by the diet most doctors give them. The typical American Diabetes Association (ADA) diet is still high in fat. The ADA diet limits the amount of butter, eggs, and so forth, but it contains about 300 milligrams of cholesterol per day and about 30 percent fat.
This fact sheet is not intended as a comprehensive program for diabetes. If you have diabetes, consult your doctor and tailor a program for your needs. But it is important to recognize that, for many, diabetes is a disease that need never occur. In most cases, diabetics can manage their disease much better with a food plan that gets most of its calories from complex carbohydrates while minimizing fats. At the same time, regular, vigorous exercise helps insulin work optimally.

This part is secteric. Surely a more rigorous diet and exercise regimen wont hurt anybody, but the assersion that exercise can give immidiate lowering of Blood Glucose is dead wrong: The problem for the diabetic is exactly that the body is unable to process glucose. Without something to alleviate that problem, extra exercise will only lead to exthausion.

All in all, there is little new and little interesting in your post. And the interesting parts are not new. And the new parts are not interesting.

Hans

 

[Seelie]

Low-fat, vegetarian diets are ideal for diabetics.

I respectfully, wholeheartedly disagree. I have Type 2 diabetes, and this is my perspective.

From age 12 to age 30, I ate a low-fat vegetarian diet. I was quite anal about it, specifically because my mother's side of the family ran strong with heart conditions and Type 2 diabetes.

At age 28, I suddenly experienced a sudden (and nearly violent) weight gain, accompanied by a host of other symptoms that crept up on me over time. I continued to see my doctor, who continued to advise me to eat my low to non fat vegetarian diet. I ate fresh veggies and fruits, pastas and rice, beans, etc in measured amounts. I was ~sure~ I was doing the "healthy thing".

By the time I was thirty, I was 80-90 pounds overweight, in a constant state of lethargy, my hands and feet felt numb all the time. my vision started deteriorating, my kidneys started to succumb to infections constantly. Enough was enough ... I went to another doctor for a second opinion. Indeed, onset of Type 2 diabetes had occured in force, and nothing about my diet was helping. He immediately placed me on a protein rich, light carb and sugar diet (not Atkins )

Within 3 months I shed 40 - 50 pounds, I have energy, my vision is no longer blurring, no more symptoms whatsoever ... my sugar levels are at an appropriate place and (besides sinusitis occasionally ) I feel great and people tell me I look great ... the best I have in a very long time. I don't really exercise, though I should ... I'm lucky enough to be able to manage my diabetes purely by diet alone at this point, though I imagine things may change as I get older and circumstances change.

I eat meat, have no care on whether or not something has fat, and manage my carb and pure sugar intake, and all is well. It's a dietary change that will have to last the rest of my life ... but better to give up cookies and chocolate and pasta than to go back to the way I was.

Now, I know this is purely anecdotal. I also know that my diabetes is Type 2 and not Type 1. However, I do want to express that there is no one true right answer for a diabetic ... Get a bunch of healthy diabetics together, and we'll run the gamut of treatment plans. Some of us will be on meat diets, some of veggie diets, some on no diet at all ... some will be on meds, some not, some on exercise plans of varying types. It's an odd, touchy, simplistic yet oh so not simple disease, and to say one specific treatment plan or diet is "ideal" for a diabetic doesn't help them in the least ... because there's not ...

So anywho ... don't mind me ... carry on with the debate

 

[MRC_Hans]

Seelie: Congratulations on your recovery and well-managed condition. Type I is comparatively simple, in a way preferable, if it wasnt for the normally early onset, because it is fairly simple (not easy, but simple) to manage (all you need is insulin). Type II has many different manifestations and can be a bitch to manage.

Hans

 

[Frostbite]

My father has had Type A diabetes for the last 35 years or so and is one of the oldest cases of diabetes in Canada. His health is still top-notch and, although he suffered some minor problems with his kidneys and eyes a decade ago due to problems in keeping his blood sugar low, he has since recovered from these side effects. The people you see who get blind or get their limbs amputated are the ones who have kept their sugar levels too high for too long to keep themselves from falling below normal levels into a hippoglycemic state which resembles someone being drunk. A good diet, regular exercise and an accurate control of blood sugar levels is all it takes to live long for a Type A diabetic.

 

[sickstan]

[BRaodtoad, this info was sourced from the Physicians for Responsible Medicine website.
[/B]

The Physicians for Responsible Medicine are a pro-vegetarian advocacy group. I have as much skepticism of their opinions as I have of the Atkins people.

 

[Roadtoad]

First chance I've had to check this thread out.

Thanks, David, for the info. Just a bit of info about what we're currently doing.

My wife usually buys lots of vegetables for me to snack on, as this is first of all cheaper than M&Ms (in both senses of the word), and I've also got lots of purified, clear water which I drink throughout the day. (Usually, I'm drinking nearly a gallon a day.) This may be a bit much, but that's what I usually do.

Also, I'm supposed to be exercising daily for a minimum of 30 minutes, (in this case, I use a treadmill), though with my injury from work, that's been a bit difficult. That should be resuming in force very shortly, possibly with longer duration. I'm also going to start adding weight training, as has been recommended by my Dr., which should build up lean muscle mass, and work towards cutting back on body fat, (though you never really lose fat cells, do you?) The idea is to try and increase my metabolism rate, and burn off the sugars. Hopefully, this will work. (Fingers crossed...)

We've become very careful about what we eat around this house. We have a new yogurt maker, which we use frequently to make plain, nonfat, unsweetened yogurt. This seems to have a positive effect on my sugars when I eat it, so we'll give it a shot. I've also been checking around about artificial sweeteners, as some create byproducts in the bloodstream which can be even more hazardous than the sugar you're already not supposed to be eating. One book I read suggested I quit using aspartame, but I haven't seen any more information about the stuff, or what it does inside your body. Is there more information?

I'm also taking a daily multivitamin supplement, as well as Mevacor for high cholesterol. My wife has also cut back severely on the fats in our diets, and when she does use them, she uses extra-virgin olive oil, and a canola oil. We're constantly checking the backs of bottles and cans and boxes for hidden fats, which aren't usually evident. And, yes, I've cut way back on some of my favorite foods: bagels, donuts, cheesecake... (Hey, I'm a truck driver! How can I drive without my donuts!)

Anyway, it's great hearing from others what they're doing, and what's working for them. Something more to work with. I keep telling my kids to stay active, and watch what they eat. Maybe they'll listen. This disease just plain sucks.

 

[Supercharts]

I have recently been discovered to be a Type II. I've always avoided sweets, take my coffee black and eat quite a bit of protein.
My fasting level was 160 so the 'doctor' said I was diabetic.
My Cholestrol is 355, I smoke, drink and stay out late. I love bacon. I do not exercise. Strokes run in my family. But my weight is perfect for my age and height. I drink a 6-pack, minimum, every day. [Normally Bud, but Tiger when I can get it. I may move to Mich low carb but it tastes like water.] I do daily weight lifting with barbells - mostly bicepts and tricepts.

I am confused about how to manage my diabetes. B&N has many books on the subject and each seems to have a different method of control.

At present I hope I die of a massive heart attack rather than have a stroke, be put in a nursing home, and dribble for 30 years.

The 'doctor' is an idiot. Recent immigrant. Told me to visit CVS (Pharmacy) to check out the meters and lancets and find one I liked. [Big help doc!]

I love fruit but hate asparagus and broccoli. I never put beans in my chili. I can exist for days on hamburger and lobster.

Anyone recommend a book on managing type II diabetes?

 

[Roadtoad]

I have recently been discovered to be a Type II. I've always avoided sweets, take my coffee black and eat quite a bit of protein.
My fasting level was 160 so the 'doctor' said I was diabetic.
My Cholestrol is 355, I smoke, drink and stay out late. I love bacon. I do not exercise. Strokes run in my family. But my weight is perfect for my age and height. I drink a 6-pack, minimum, every day. [Normally Bud, but Tiger when I can get it. I may move to Mich low carb but it tastes like water.] I do daily weight lifting with barbells - mostly bicepts and tricepts.

I am confused about how to manage my diabetes. B&N has many books on the subject and each seems to have a different method of control.

At present I hope I die of a massive heart attack rather than have a stroke, be put in a nursing home, and dribble for 30 years.

The 'doctor' is an idiot. Recent immigrant. Told me to visit CVS (Pharmacy) to check out the meters and lancets and find one I liked. [Big help doc!]

I love fruit but hate asparagus and broccoli. I never put beans in my chili. I can exist for days on hamburger and lobster.

Anyone recommend a book on managing type II diabetes?

The first thing the doctors told me was that there is no one way to control it. (Four years of basic science, three years med school, and an internship... The doctor looks at my mangled arm after my load shifted and asks "Where does it hurt?" DUH!)

The meter I use is the One Touch Profile. One drop, and it's accurate within 5 points, plus or minus. A friend of ours is using one that you touch to your arm, rather than sticking your finger with the lancet. It's supposed to be more comfortable, so that may be something you want to consider.

You may not want to hear this, but you need to eat more vegetables. Lots of them, ideally raw. That's what's worked for me, primarily the cruciferous types, but just keep in mind that any time you make a change, you need to really watch your blood glucose levels closely, and talk to your doctor about it. Sounds as if you don't trust this guy. The only thing I can tell you is get another doctor you DO trust, and do it soon. You are going to get to know this guy real well, and your health is on the line, not his.

You're also going to need to get your cholesterol down, because that's a contributing factor to your diabetes, from what I've been told. I wound up taking Mevacor, though there are other meds you can take which would help. I'd ask my pharmacist, which is what I wound up doing, and working around the various options to find the one that works best.

When I was diagnosed, my wife cut way back on red meat, and on the few occasions when we had it, she trimmed even more of the fat off than the store did. Also, she broiled the meats, rather than frying them, so there was less saturated fat. She's quite talented in the kitchen, so a skinned chicken breast broiled with basil and thyme is actually quite good. I'd suggest you invest in some good cookbooks, ideally about Mediterranean cooking, since they don't seem to use as much fat or oil. (Though there's one dish, called in English "The Imam Fainted," which sounds so good, I just might sacrifice a few points on my fasting score just to try it...)

My work has always been pretty physical, so exercise for me was always a given, but the ideal they tell me is 30 minutes of aerobic exercise a day. I also used to smoke (two pack a day habit), and ten years after quitting, I STILL WANT A DRAG! You have got to quit smoking. Period. I know it's addictive. But if you'd rather have your stroke, go ahead and keep on smoking. Your choice, Amigo.

I've caught some good advice here so far. I'm just adding on what I've found... Stay tuned...

 

[Roadtoad]

Heard a couple of things that sounded interesting, but I'm not sufficiently versed in matters medical to know if it's the real deal. Could someone pass on info if it's available?

(1.) I was told that 1/2 tsp of cinnamon a day is supposed to help control your blood sugar. I've never heard this before, and it sounds suspect, but has anyone else heard about this, and what's the source?

(2.) I've also heard that certain artificial sweeteners will cause your blood sugars to rise, but again, no source on this. (Supposedly, this includes saccharine and aspartame.) Any info?

Thanks.

 

[sickstan]

Heard a couple of things that sounded interesting, but I'm not sufficiently versed in matters medical to know if it's the real deal. Could someone pass on info if it's available?

(1.) I was told that 1/2 tsp of cinnamon a day is supposed to help control your blood sugar. I've never heard this before, and it sounds suspect, but has anyone else heard about this, and what's the source?

(2.) I've also heard that certain artificial sweeteners will cause your blood sugars to rise, but again, no source on this. (Supposedly, this includes saccharine and aspartame.) Any info?

Rest assured, the above two statements are patently ridiculous. I've reviewed literature regarding artificial sweeteners, mostly phenylalanine, and none of them have such effects. If cinnamon were even allegedly supposed to help control blood sugar, people would be selling capsules for $50 for a bottle of 30 by now.

Some research suggests chromium picolinate supplementation improves glycemic control, but it appears that much of its effects was appreciated in corticosteroid-induced hyperglycemia. A literature review in a 1998 American Family Practitioner did not find any double-blind, placebo-controlled trial supporting chromium supplementation as a safe, useful adjunct in diabetic control.

 

[sickstan]

I have recently been discovered to be a Type II. I've always avoided sweets, take my coffee black and eat quite a bit of protein.
My fasting level was 160 so the 'doctor' said I was diabetic.
My Cholestrol is 355, I smoke, drink and stay out late. I love bacon. I do not exercise. Strokes run in my family. But my weight is perfect for my age and height. I drink a 6-pack, minimum, every day. [Normally Bud, but Tiger when I can get it. I may move to Mich low carb but it tastes like water.] I do daily weight lifting with barbells - mostly bicepts and tricepts.

I am confused about how to manage my diabetes. B&N has many books on the subject and each seems to have a different method of control.

At present I hope I die of a massive heart attack rather than have a stroke, be put in a nursing home, and dribble for 30 years.

The 'doctor' is an idiot. Recent immigrant. Told me to visit CVS (Pharmacy) to check out the meters and lancets and find one I liked. [Big help doc!]

I love fruit but hate asparagus and broccoli. I never put beans in my chili. I can exist for days on hamburger and lobster.

Anyone recommend a book on managing type II diabetes?

Well, let me address your post point-by-point.

1. Diabetes is a multifactorial disease. There are genetic , dietary, and body composition factors. I am sure there are many more -- putative risk factors abound. Nobody said you caused your diabetes. If your weight is normal for your age/height/gender, then obesity is not a factor. We have to chalk this up to genetics and possibly diet.

2. It's not necessarily sweets that cause diabetes. Complex carbohydrates in the diet can also cause type II diabetes. It is the most common cause of diabetes in people who grew up in third world countries, where a majority of the calories consumed come from carbohydrates. But---! fat can also cause diabetes by increasing obesity. I recommend (interject your miracle restrictive diet protest at the end, please) a diet balanced roughly equally between fat, carbohydrate, and sodium that is restricted to maintain or lose weight slowly.

3. You're drinking too much. You might not die of a massive heart attack or stroke, but by turning yellow and having your belly distend like a pregnant woman, with huge hemorrhoids and little wasted stick arms and gynecomastia (man boobs) bleeding to death from an esophageal varix. All from liver cirrhosis. Or even worse, you could start losing huge amounts of weight and find out you have liver cancer and about 2 months to live.

4. Your doctor is an idiot. We know that measuring spot serum glucose levels do not correlate with prevention of microvascular complications of type II diabetes. You should have a blood test (needle in the vein and tube of blood off to the lab) every 3-4 months. This measures glycosylated hemoglobin (HbA1c), which is a measure of the percentage of hemoblobin that has been chemically affected by glucose. Because the life of a red blood cell is ~120 days, this % approximates your control for the last 3-4 months. I would try to keep this number below 7%.

5. It is good to keep your physical activity level up, but this also probably increases your appetite. Try cutting down on your caloric intake overall (same food, less of it) and maintaining your activity level.

6. Be sure to browse through books and check the bibliography. Avoid books that are heavy in rhetoric from either the Ornish, Pritikin, or Atkins camps.

7. A growing body of evidence points to the utility of metformin as initial monotherapy for type II diabetes. We are moving away from sulfonylureas because the potential for hypoglycemia and the undesired hyperinsulinemia effects, which can lead to dyslipidemias like you have.

Hope that helps

 

[MRC_Hans]

There is some info here: www.diabetes.com

Hans

 

[Roadtoad]

Huge help! Thanks, Hans!

(Thanks, also, David Wilson, for starting this thread!)

 

[Roadtoad]

More on Diabetes:

By LAURAN NEERGAARD, AP Medical Writer

WASHINGTON - Losing your memory in old age sometimes may have nothing to do with Alzheimer's and lots to do with blood sugar.

So suggests new research that found people who don't process blood sugar normally — a silent, pre-diabetic condition — are likely to suffer poor memory and even a shrinkage of the brain region crucial for recall.

The good news: If the small study from New York University is confirmed, simple diet and exercise could help many people protect their brains from the fogged memory associated with aging.

Maybe the threat of memory loss — an oft-cited fear among aging baby boomers — will provide the final push for people to take those steps, says lead researcher Dr. Antonio Convit.

"That's a great motivator to stay off the calories and stay off the couch," he said.

For every Alzheimer's patient, there are eight older people who suffer enough memory loss to significantly harm their quality of life yet have no dementia-causing disease, says Convit, an NYU psychiatry professor who set out to uncover the causes.

Blood sugar was a natural suspect because scientists have long known that diabetics are at higher-than-normal risk for memory problems, possibly because diabetes harms blood vessels that supply the brain, heart and other organs.

The new study, published Monday in the Proceedings of the National Academy of Sciences, found that people's memory may be harmed long before they ever develop full-fledged diabetes — and that it's a problem of fuel, not plumbing.

Convit studied 30 non-diabetic middle-age and elderly people. He measured how they performed on several memory tests; how quickly they metabolized blood sugar after a meal; and, using MRI scans, the size of the hippocampus, the brain region responsible for recent memory.

The slower those outwardly healthy people metabolized blood sugar, the worse their memory was — and the smaller their hippocampus was, Convit found.

Unlike most other tissues that have multiple fuel sources, the brain depends on blood sugar for almost all its energy, Convit explained. The longer that glucose stays in the bloodstream instead of being metabolized into body tissues, the less fuel the brain has to store memories.

Convit's research found no specific threshold at which memory automatically worsened. Instead it was a spectrum: The slower glucose metabolism, the worse people did.

Once that metabolism reaches certain levels, it becomes a condition called "impaired glucose tolerance" or pre-diabetes, thought to afflict 16 million Americans. It strikes mostly in middle age, although people of any age who are overweight and sedentary are at risk — and Americans are getting fatter every year. Without treatment, pre-diabetes usually turns into full-fledged diabetes, which in turn brings deadly heart attacks, kidney failure and numerous other ailments.

Why did only the memory-crucial hippocampus seem harmed? Previous animal and human research shows it's the region most likely damaged by any brain insult, Convit said. Conversely, it's also a very adjustable region, with the potential for some recovery if people bring their blood sugar under control, he said.

Convit's study sheds important light on yet another risk of bad blood sugar, said Dr. Fran Kaufman, president of the American Diabetes Association.

She cautioned that it was a small study that requires confirmation before doctors test glucose solely for memory complaints.

But if confirmed, the same advice for lowering people's overall diabetes risk — drop a few pounds and do exercise as simple as walking 30 minutes a day — apparently would help protect people's brains, too, Kaufman said.

Meanwhile, the diabetes association already recommends pre-diabetes testing for everyone 45 or older, and for younger people who are significantly overweight and have one other risk factor: a diabetic relative; bad cholesterol; high blood pressure; diabetes during pregnancy or gave birth to a baby bigger than 9 pounds; or belong to a racial minority group.

 

[xouper]

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