All posts by Vijay

Are we treating type 2 diabetes right?

I am planning to write series of blog posts on what is diabetes , how do we get , prevention, treatment and so on . In this blog post lets see what is Type 2 diabetes and its consequences

Diabetes Mellitus Type 2 or adult on-set diabetes is a metabolic disorder that is characterized by hyperglycemia i.e. high blood sugar in the context of insulin resistance. Pictures worth more than words given below picture will explain difference between normal people and people with diabetesim-1

Symptoms

im-2

Diabetic Epidemic

Due to urbanization and fast moving world diabetic become epidemic due to following reasons

  • Fast food / high sugar items accessibility at ease and cheap
  • Lack of physical activity
  • environmental and other economic factors
  • Genetic i.e. family history

home

  • Diabetes, heart disease and stroke cost $237 Billion in loss on national income during 2005 –2015 (WHO)
  • 25% family income devotes to diabetic are for single diabetic family member
  • Premature deaths +5 million / year
  • diabetic patient dies every 6 sec while 2 new patients are diagnosed
  • Accumulated lifetime cost of diabetes
    • 20-30% – control & monitor
    • 70-80% – Complications
    • Medicines – ???

so based on above picture now you will understand the magnitude and public health crises we are facing .

How do we get diabetes?

  • Change in standards of diagnosis[1997 ADA lowered the per se standard for diagnosing diabetes from a fasting blood glucose level of 140 mg/dL to 126 mg/dL]
  • Insulin resistance
  • Obesity
    • too much deposit of white adipose tissue associated with obesity
    • insufficient mass of functional beta cells
    • glucagon
  • gastric emptying
  • Genetic family tree

in my next blog post we can see how do we get diabetes in detail.

Insulin resistance causes type 2 diabetes

As per my previous post here I am writing follow up post on how people will become diabetes.

Insulin resistance was the most important factor people will become diabetes, lets dig deeper how and why treatment of diabetes might be wrong. lets run through simple case for example if get hurt in leg and you will get swelling around that area and you also get little fever so to treat this case what will be treatment option i.e. you will take pills for hurt or reduce swelling or fever the correct treatment will be to understand the root cause and treatment. so have to take treatment for hurt not for fever !!!

bottom line was that treatment for real cause not for symptom

since the body auto immune system fight against all hurts we get into via various means.

how this will resonate into treatment of diabetes ?

real culprit for diabetes was Insulin resistance nothing else, so lets find out more on this.

Insulin is peptide hormone produced by beta cells in pancreas, its regulates the metabolism of carbohydrates and fats by promoting the absorption of glucose from the blood to muscles and fat tissues, this also causing fat to be stored rather than used for energy.

Insulin resistant [IR] is a condition in which cells fail to respond to the normal actions of the hormone insulin

insulin-resistance

    • exposure to excess nutrients causes cells to produce excess reactive oxygen species which in turn shutdown insulin signaling
    • Mitochondria were overloaded with energy i.e. excess nutrients , particularly free fatty acids causes IR
    • suppressing free fatty acids levels restores insulin sensitivity in obese & T2DM
    • if cell takes up more energy than it burns energy accumulates typically in the form of fatty acid metabolites in cytoplasm this causes IR

Hormonal-Obesity-theory-step-2

The bottom line is this – high levels of insulin cause insulin resistance.

 

how do we get excess nutrients to tissues ?

Consuming energy in excess of what the body can constructively use

Fat tissue main work was to accumulate circulating energy excess to keep away from damaging other tissues , once it started accumulating  over the period of time it begins to do its job less efficiently

Increase in energy in cause IR in parallel with fat gain so to speak the weight gain  that’s the very reason for type 2 diabetic patients hard for them to loose weight .

so from the above to treat the diabetic patient should target how to reduce  insulin only not to reduce the blood sugar , people who practice long term calorie restriction for life extension have very low fasting insulin & glucose  suggesting high insulin sensitivity

Big fat mistake behind 40 years of dietary advice

on Feb I was travelled to UK for Startup training program there I have found that in article written in “The Independent” on 10th Feb by Cahal Millmo on dietary advice given to Britons that healthy diet should be limit saturated fat to just a tenth of daily calorie intake , given below was the image snap I took it from my Nexus 5

 

IMG_20150210_085054

As I was writing earlier here, here and here  about the myth created by academic and industry lobbyist now slowly accepting truth and started publishing accepting thesis. these dietary guideline issued by ADA/ AHA and other parts of the world started followed and now ever reacting over the truth , more over to convince doctors and dietitians about this truth is becoming much harder  since they read / follow their curriculum after all , how do we change this ? please share you guys thought as well.

Sweet truth numbers were wrong

On sep 19th there was an article written in Times of india news paper about “Diet, Exercise reduce diabetes heart disease by 75% study” as shown below image

IMG_20140919_094551

did you guys find any mistakes ?  its not easy to find out though , OK  let me tell you what is there was box with title SWEET TRUTH in that the numbers provided for diabetes and pre-diabetes were wrong i.e. its flipped, the actual number will be as follows

62.4 million people has diabetes

77.2 million people have pre-diabetes

Ref: ICMR-INDIAB study 2011.

I have contacted the author to correct that mistake at least in online version of it  on that day itself via email but still now I haven’t got any reply from her. why I am bring this here means this case was a typical example of media’s ignorance and dump wrong / unverified information to public , media should be more responsible than ever before.