Posted in diabetes, Health, news

Diabetes Again Linked to Pancreatic Cancer

Another study highlights the risk between high blood sugar and pancreatic cancer.

Researchers from Kangbuk Samsung Hospital in Seoul found as study participants’ blood sugar rose so did their incidence of pancreatic cancer.  Some theories behind one getting cancer could be the following:

  • A virus causes a pancreas to decrease its insulin producing capabilities and this same virus may be culprit in future cancer
  • One with a high sugar diet may be over consuming what the pancreas can handle and the overwork puts one at risk of cancer

According to the CDC, 30.3 million people in the US have diabetes, and at least 100 million Americans suffer from pre-diabetes or diabetes.

Previously the 7th leading killer of Americans, diabetes affects so many people that it has now become third leading cause of death in the US.  A study in 2017 found 12% of deaths in the US is caused by diabetes, trailing behind heart disease and cancer, ranked at #1 and #2.

What is Diabetes?

Diabetes is a disease in which the body doesn’t utilize and metabolize sugar properly.  When we consume food, its broken down into proteins, nutrients, fats, water, and sugar. These components are necessary for cell growth and function.  They get absorbed in the small intestine and make it to the blood stream.   In order for a cell to utilize sugar, it needs the hormone insulin to help guide it in.  It’s similar to a key that fits in the keyhole of the “door” of the cell, opening it up so sugar can enter.  Insulin is produced in the pancreas, an organ that receives signals when one eats to release insulin in preparation of the sugar load coming down the pike.

Diabetes Explained

So I imagine our mouth like a waiting room, the blood stream like a hallway, and the cells of the body the rooms along the hallway.  Insulin is the key to open the cells’ “doors” allowing sugar to enter.  If the sugar does not get in, it stays in the bloodstream “hallway” and doesn’t feed the cell.  Weight loss occurs, and individuals may become more thirsty as the sugar in the blood makes it fairly osmotic, something the body wants to neutralize, reduce.  The kidneys are going to want dump the excess sugar, so to do so, one would urinate more, again causing thirst.  So when a diabetic loses weight, urinates more frequently and becomes thirsty, you now understand why.

Complications of Diabetes

Cardiovascular disease – Sugar is sticky, so it can easily add to atherosclerotic plaques.

Blindness – high sugar content draws in water to neutralize and small blood vessels in the eye can only take so much fluid before they burst.  Moreover, high blood sugar weakens blood vessels.

Kidney disease – the kidneys work overtime to eliminate the excess sugar. Moreover, sugar laden blood isn’t the healthiest when they themselves need nourishment.

Infections – pathogens love sugar. Its food for them.  Moreover blood laden with sugar doesn’t allow immune cells to work in the most opportune environment.

Neuropathy – nerves don’t receive adequate blood supply due to the diabetes-damaged blood flow and vessels, hence they become dull or hypersensitive causing diabetics to have numbness or pain.

Dementia – as with the heart and other organs, the brain needs healthy blood and flow.  Diabetes has been found to increase risk of Alzheimer’s as well.

Type I vs. Type II Diabetes

Type I Diabetes, previously called insulin dependent or Juvenile diabetes, occurs when the pancreas doesn’t produce insulin, possibly from the immune system destroying the cells that produce the hormone. When this occurs there is rapid weight loss and death could occur if the cells don’t get the sugar they need.  Insulin has to be administered regularly.

Type II Diabetes, previously called non-insulin dependent or adult-onset diabetes,  occurs in those who began with a fully functioning pancreas but as they age the pancreas produces less insulin, called insulin deficiency, or the insulin produced meets resistance.  This is the fastest growing type of diabetes in both children and adults.

What is insulin resistance?

Insulin resistance, if using our hallway and door analogy, is as if someone is pushing against the door the insulin is trying to unlock. As we know, those with obesity are at higher risk for diabetes, hence fat can increase insulin resistance.  It’s also been associated with an increase in heart disease.

Blood sugar numbers

If your fasting blood sugar (glucose) is greater than 126 mg/dl, or your non fasting blood sugar is greater than 200 mg/dl, you may be considered diabetic.  Pre-diabetes occurs when the fasting blood sugar is between 100 and 125 mg/dl.  If ignored, and the sugar rises, pre-diabetics may go on to develop diabetes.

 

dmp-blood-sugar-levels-chart

SOURCE DIABETESMEALPLANS.COM

Preventing/Controlling Diabetes

1/3 of American adults are currently pre-diabetic.  Experts predict 1/3 of US Adults will be diabetic by the year 2050.  Although genetics plays a big role, decreasing ones sugar intake and maintaining an active lifestyle can help ward of diabetes.

Foods high in sugar and carbohydrates increase one’s risk, so a diet rich in vegetables and lean meats is preferred.

For more information, visit http://www.diabetes.org/.

What are the risk factors for pancreatic cancer?

Known risk factors for pancreatic cancer include:

  • Older individuals
  • Male (though women are affected as well)
  • Diabetes
  • Alcohol use
  • Chronic pancreatitis
  • Genetics
  • African-American descent
  • Ashkenazi Jewish descent
  • Obesity
  • High fat diet
  • Hepatitis B
  • H. pylori infection
  • BRCA1 or BRCA2 mutations
     

    Can Diet Soda CAUSE Diabetes?

Artificial sweeteners have been linked to diabetes and diabetes is a risk factor for pancreatic cancer.  Their relationship to pancreatic cancer, however, still remains controversial.

 

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

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Posted in diabetes, food, Health, news

Leftover Pasta May Be Better For Diabetics than Freshly Made

Pasta is usually a no-no for those with high blood sugar as it has a high glycemic index. But researchers reveal a trick to allow those with diabetes to enjoy the popular dish:  cooling and then reheating it the next day.

Express.co.uk reports the following:

 ……eating cooled or reheated pasta can help reduce the rise of blood glucose levels, according to an experiment led by the University of Surrey’s Dr Denise Robertson and TV doctor Chris van Tulleken.
This is because when starch is cooked in water and then cooled, it changes shape.
The new structure is resistant to enzymes in the body so can’t be digested, becoming what is known as ‘resistant starch’.
When regular starch becomes resistant starch, most of the sugars it contains aren’t released in the gut, meaning the body will take in fewer calories from the same food.

When study authors tested their theory, they found cooled and reheated pasta did not cause the same spike in blood sugar as freshly made pasta.  There was still a surge in blood sugar, but not as much.

What is resistant starch?

There are four classifications of resistant starch.

resistant starch 1.jpg

Resistant starches get their name by being “resistant” to digestion.  They are carbohydrates that don’t get broken down as easily and act like fiber. The less they are digested, the less their “sugar” can enter the blood stream (diabetes explained below).  Starches that are cooled and then reheated undergo changes in their carbohydrate composition, rendering them less vulnerable to enzymatic breakdown.

Foods with resistant starches are found to be more beneficial when it comes to  insulin sensitivity and gut health.  They include:

  • Legumes
  • Oats
  • Green Bananas
  • Whole grains
  • Cooked and cooled rice and potatoes

 

resistant-starch-1024x986.jpg

 

What is Diabetes?

Diabetes is a disease in which the body doesn’t utilize and metabolize sugar properly.  When we consume food, its broken down into proteins, nutrients, fats, water, and sugar. These components are necessary for cell growth and function.  They get absorbed in the small intestine and make it to the blood stream.   In order for a cell to utilize sugar, it needs the hormone insulin to help guide it in.  It’s similar to a key that fits in the keyhole of the “door” of the cell, opening it up so sugar can enter.  Insulin is produced in the pancreas, an organ that receives signals when one eats to release insulin in preparation of the sugar load coming down the pike.

Diabetes Explained

So I imagine our mouth like a waiting room, the blood stream like a hallway, and the cells of the body the rooms along the hallway.  Insulin is the key to open the cells’ “doors” allowing sugar to enter.  If the sugar does not get in, it stays in the bloodstream “hallway” and doesn’t feed the cell.  Weight loss occurs, and individuals may become more thirsty as the sugar in the blood makes it fairly osmotic, something the body wants to neutralize, reduce.  The kidneys are going to want dump the excess sugar, so to do so, one would urinate more, again causing thirst.  So when a diabetic loses weight, urinates more frequently and becomes thirsty, you now understand why.

Complications of Diabetes

Cardiovascular disease – Sugar is sticky, so it can easily add to atherosclerotic plaques.

Blindness – high sugar content draws in water to neutralize and small blood vessels in the eye can only take so much fluid before they burst.  Moreover, high blood sugar weakens blood vessels.

Kidney disease – the kidneys work overtime to eliminate the excess sugar. Moreover, sugar laden blood isn’t the healthiest when they themselves need nourishment.

Infections – pathogens love sugar. Its food for them.  Moreover blood laden with sugar doesn’t allow immune cells to work in the most opportune environment.

Neuropathy – nerves don’t receive adequate blood supply due to the diabetes-damaged blood flow and vessels, hence they become dull or hypersensitive causing diabetics to have numbness or pain.

Dementia – as with the heart and other organs, the brain needs healthy blood and flow.  Diabetes has been found to increase risk of Alzheimer’s as well.

Type I vs. Type II Diabetes

Type I Diabetes, previously called insulin dependent or Juvenile diabetes, occurs when the pancreas doesn’t produce insulin, possibly from the immune system destroying the cells that produce the hormone. When this occurs there is rapid weight loss and death could occur if the cells don’t get the sugar they need.  Insulin has to be administered regularly.

Type II Diabetes, previously called non-insulin dependent or adult-onset diabetes,  occurs in those who began with a fully functioning pancreas but as they age the pancreas produces less insulin, called insulin deficiency, or the insulin produced meets resistance.  This is the fastest growing type of diabetes in both children and adults.

What is insulin resistance?

Insulin resistance, if using our hallway and door analogy, is as if someone is pushing against the door the insulin is trying to unlock. As we know, those with obesity are at higher risk for diabetes, hence fat can increase insulin resistance.  It’s also been associated with an increase in heart disease.

Blood sugar numbers

If your fasting blood sugar (glucose) is greater than 126 mg/dl, or your non fasting blood sugar is greater than 200 mg/dl, you may be considered diabetic.  Pre-diabetes occurs when the fasting blood sugar is between 100 and 125 mg/dl.  If ignored, and the sugar rises, pre-diabetics may go on to develop diabetes.

 

dmp-blood-sugar-levels-chart

SOURCE DIABETESMEALPLANS.COM

Preventing/Controlling Diabetes

1/3 of American adults are currently pre-diabetic.  Experts predict 1/3 of US Adults will be diabetic by the year 2050.  Although genetics plays a big role, decreasing ones sugar intake and maintaining an active lifestyle can help ward of diabetes.

Foods high in sugar and carbohydrates increase one’s risk, so a diet rich in vegetables and lean meats is preferred.

For more information, visit http://www.diabetes.org/.

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

 

 

Posted in diabetes, Health, medications, news

Genital Gangrene Linked to Newer Class of Diabetes Medications

The FDA has issued a warning for the class of diabetic medications, the sodium-glucose cotransporter-2 (SGLT2) inhibitors, following reports of Fournier’s gangrene, or necrotizing fasciitis of the perineum.

SGLT2 inhibitors are sometimes used to lower blood sugar in diabetics.  They work by preventing the body from reabsorbing glucose (sugar), forcing it to be excreted in the urine.

 

SGLT_kidneys-621x248

Image from Sirona Biochem

 

Medscape lists the common drugs in this class:

  • Canagliflozin (InvokanaInvokamet, Invokamet XR; Janssen)
  • Dapagliflozin (FarxigaXigduo XRQtern, AstraZeneca)
  • Empagliflozin (JardianceGlyxambi, Synjardy, Synjardy XR; Boehringer Ingelheim/Eli Lilly)
  • Ertugliflozin (Steglatro, Segluromet, Stelujan; Merck)

 

12 cases had been reported to the FDA, seven of which were men, and five were women, all having had taken an SGLT2 inhibitor. One died, despite treatment.

Last summer, Liu et al published a study in Scientific Reports suggesting an “increased risk of genital infections with SGLT2 inhibitors.”

Symptoms of Fournier’s gangrene may begin with fever, pain, redness or swelling that may occur behind and around the area of the genitalia.  Then necrotizing fasciitis ensues when the infection spreads rapidly across (and killing) the fascia, fibrous tissue that surrounds the muscles and organs.  Anyone experiencing any of the above symptoms must see a medical provider immediately.

The FDA reports the following:

Patients should seek medical attention immediately if you experience any symptoms of tenderness, redness, or swelling of the genitals or the area from the genitals back to the rectum, and have a fever above 100.4 F or a general feeling of being unwell. These symptoms can worsen quickly, so it is important to seek treatment right away.
Health care professionals should assess patients for Fournier’s gangrene if they present with the symptoms described above. If suspected, start treatment immediately with broad-spectrum antibiotics and surgical debridement if necessary. Discontinue the SGLT2 inhibitor, closely monitor blood glucose levels, and provide appropriate alternative therapy for glycemic control.
Fournier’s gangrene is an extremely rare but life-threatening bacterial infection of the tissue under the skin that surrounds muscles, nerves, fat, and blood vessels of the perineum. The bacteria usually get into the body through a cut or break in the skin, where they quickly spread and destroy the tissue they infect. Having diabetes is a risk factor for developing Fournier’s gangrene; however, this condition is still rare among diabetic patients. Overall published literature about the occurrence of Fournier’s gangrene for men and women is very limited. Publications report that Fournier’s gangrene occurs in 1.6 out of 100,000 males annually in the U.S., and most frequently occurs in males 50-79 years (3.3 out of 100,000).1-3 In our case series, however, we observed events in both women and men.
In the five years from March 2013 to May 2018, we identified 12 cases of Fournier’s gangrene in patients taking an SGLT2 inhibitor. This number includes only reports submitted to FDA* and found in the medical literature,4-6 so there may be additional cases about which we are unaware. In 2017, an estimated 1.7 million patients received a dispensed prescription for an SGLT2 inhibitor from U.S. outpatient retail pharmacies.7Although most cases of Fournier’s gangrene have previously been reported in men, our 12 cases included 7 men and 5 women. Fournier’s gangrene developed within several months of the patients starting an SGLT2 inhibitor and the drug was stopped in most cases. All 12 patients were hospitalized and required surgery. Some patients required multiple disfiguring surgeries, some developed complications, and one patient died. In comparison, only six cases of Fournier’s gangrene (all in men) were identified in review of other antidiabetic drug classes over a period of more than 30 years.

This is a developing story.

 

dw sketch.jpg

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada