Weight, Weight Don't Tell Me!

Actos and Intramyocellular Fat

2010-04-19T08:42:00.000-07:00

Lipotoxicity in muscle

The Journal of Clinical Endocrinology and Metabolism April 2010, 95(4). 1916-1923 published research on Intramyocellular muscle fat in Diabetes 2.

Pioglitazone (Actos) was given to 24 patients with diabetes 2 and treated for 4 months.

Fat was measured with magnetic resonance
Muscle biopsy was done to measure fat as well,
Muscle biopsy done to check level of fat toxic products.
Studies were done to show how insulin resistance improved with a decrease in fat inside the cells.
Toxic products were measured and showed a decrease as the fat left the cells.

This indicated that Actos improved insulin resistance and took fat and fat toxicity metabolites out of the all the muscle cells of the body. All this indicated better control of glucose and quite likely a reduction in complications.

Weight and Lovgevity

2010-03-18T11:11:00.000-07:00

So hard to lose weight, so what to do to live a long healthy life?

The Mayo Clinic had two articles, one in February and one in March that addressed the issue. One of the studies addressed middle aged men with known or suspected coronary artery disease. Men only in two Veterans Administration Hospitals, one in Washington, DC the other in Palo Alto, California, were followed for twenty four years.

No weight changes of note but as long as they retained a high degree of fitness they had increased longevity.

The second had men with the metabolic syndrome, famous for that particular belly fat from the “Brown fat” that accumulates in the upper abdomen. These men had also had abnormal EKGs. The presence of that EKG predicted increased mortality. Presumably fitness would have helped according to the first study.

Mayo Clin Proc. 2010;85(3):239-246 and 2010;85(2):115-121.

Faced with these clinical observations in my practice in 1990, I not only preached fitness but the use of l-arginine. With that singular change we began the march to a slimmer, healthier and comfortable longevity. With Byetta the weight has dropped even more. Our patients, men and women, have literally lost tons of weight.

It’s your time.

Dr. Joe

Taking Care of Diabetes Outside the Doctor’s Office

2010-01-13T14:54:00.000-08:00

There is a new, very good service that deals with real life and how to deal with it when you have diabetes. Now is a good time to give it a look - just when you might be giving up on those New Year's Resolutions.

http://www.diabetesoutside.com/

It is done by a woman, Amy Gonsalves, who has lived with her diabetes for over two decades. She is a Boot Camp Instructor no less and she just completed her first marathon. But the major part is she knows how to live normally.

I know her personally. You would love to know her personally because she also knows how to have fun in life. She’s smart. She’s tough. She’s cool. Take a look at her site. It just may be your time.

Dr. Joe

Cardiometabolic Risk of Antipsychotic Medications in Youth

2009-11-23T15:38:00.000-08:00

Cardiometabolic Risk of Antipsychotic Medications in Youth
JAMA Oct 28, 2009 Pg.1765-1773

Many of us, who see people with metabolic syndrome, particularly in young people, have been startled by the sharp rise in new patients who seem to have been started on antipsychotic medication. Many others who are no longer considered “youths” have similar problems.

The Cardiometabolic Syndrome (AKA METABOLIC SYNDROME, DYSMETABOLIC SYNDRONE, and SYNDROME X) is now regarded to be much more of a clinical problem than just prediabetes since the pre-atherosclerotic component is much worse and more dangerous for early death than previously thought.

The weight changes were most striking. 10% to 36% transitioned to overweight or obese within 11 weeks. These changes were not felt to be due worsening psychiatric disorders. The concern is that youths with this weight and metabolic status will accelerate the cardiometabolic syndrome and its complications. The medications involved in this study include,

Risperidone

Quetiapine (Seroquel)

Abilify (Aripiprazole)

Zyprexa

Ziprasidone This was part of the project because it is in the same class but there were not enough people to get statistically significant results.

To trade a serious psychiatric illness for another serious chronic disease is quite a decision. It is something to seriously think about.

We have done very well with the use of Byetta for reversal of the weight loss and well as reversing the metabolic syndrome. We have been using the Byetta for metabolic weight loss before this present announcement.

http://www.medicalnewstoday.com/articles/169396.php
Dr. Joe

Retinal Changes in Pre-diabetes, Pre-hypertension

2008-09-23T08:12:00.001-07:00

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Diabetes Care October 2007, page 2708-2715 reported that new technologies are now picking up the retinal changes in the back of the eye that diagnose prediabetes and pre-hypertension.

We know that these two problems begin long before symptoms or signs of the disease. In the past we would consider this a victory for “strategic health” but little treatment to reverse this was suggested.

Now we confirm these advancing diseases with the wave form analysis with the CardioVascular Profiler and begin treatment with ProArgi 9 plus immediately. The ProArgi9 plus reverses all the vascular problems of both diseases actually reversing both disorders as far as the vascular component is concerned.

This is not a cure, but a reversal. Diabetes is a multi-metabolic problem and with time different treatments will be needed. At least you will not be in the bad patch the group in Seattle was in when the diagnosis of their diabetes was first made when they had their heart attack.

Bariatric Surgery - A Cure for Diabetes?

2008-09-18T14:18:00.001-07:00

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The September 18, 2008 medical newspaper Endocrine Today had on their front page, Bariatric Surgery – a cure for diabetes?

I have been involved with people needing to consider this type of surgery for their diabetes and other severe problems relating to their metabolism since 1965. The initial success in the first year has again given many people a reason to consider that new technology and understanding of the pathogenesis of diabetes might get better success that in the past.

I get to see people in their second year after surgery. Many have new metabolic problems in the area of vitamins (especially vitamin D) and most dreaded of all, the return of diabetes and weight gain.

The Chief Medical Editor of this publication, Alan Garber, MD included his perspective at the end of the article noting the durability of the antidiabetic effect remains uncertain. He noted the observation that when diabetes is diagnosed there is a progressive loss of beta cells, the cells that produce insulin. Thus in my experience as well as Alan’s, we have only delayed diabetes, not denied its presence.

Water Bottles and Diabetes 2

2008-09-17T08:43:00.001-07:00

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Plastic water bottles, food containers, baby bottles and water containers contain bisphenol A, a chemical that suppresses a hormone that protects humans from heart attacks and diabetes 2.

Hundreds of studies have shown bisphenol A’s toxicity in developing tissue and tissue function. Reproductive problems, certain cancers and asthma have been shown to cause problems in lab animals.

Bisphenol A leeches from food and beverage containers and has been found in 93% of the urine samples in test patients. In the body it mimics estrogen and prevents natural estrogens from attaching to the estrogen site. When this happens in mice they become obese and insulin resistant.

Testing of fat tissue from bisphenol A affected humans reports suppression of the protective hormone adiponectin. Adiponectin protects against heart attacks and type 2 diabetes. Similar studies in mice indicate effects on the beta cells that create insulin resistance. This may well be a reason for children and adolescents’ obesity and early diabetes.

Environmental Health Perspective August 14, 2008.
Science News 9.29.2007
Science News 9.13.2008

Soft Drinks

2008-01-28T17:04:00.001-08:00

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Acomplia for Weight Loss

2008-01-12T08:17:00.001-08:00

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Living Long on Less

2007-11-24T08:46:00.000-08:00

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Dr. Joe refers to material from Science News March 10, 2007, Vol. 171, Page 147.

Viruses Cause Obesity

2007-10-04T16:48:00.000-07:00

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Weight Loss, Knee Pain

2007-10-03T07:12:00.000-07:00

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Low HDL & Increased Triglycerides

2007-09-10T08:54:00.001-07:00

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Calcium and Vitamin D

2007-09-04T11:09:00.000-07:00

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Risk Factors in the Obese

2007-07-18T07:59:00.000-07:00

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DNA, Obesity and Diabetes 2

2007-05-27T07:40:00.000-07:00

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Of the Fit and the Fat

2007-05-24T06:25:00.000-07:00

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Visceral Fat Testing

2007-05-16T06:57:00.000-07:00

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Cortisone Response in Men & Women

2007-05-14T09:20:00.000-07:00

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Public Concern About Obesity

2007-04-30T07:15:00.000-07:00

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Rimonabant

2007-03-03T07:10:00.000-08:00

The two year results JAMA 2006 2;295(7):761-75 of treatment with 20 mg/d of rimonabant plus diet promoted modest but sustained weight loss as well as favorable changes in cardiometabolic risk factors. At year 1, compared with the placebo group, the rimonabant 20 mg group produced greater mean reductions in weight (–6.3 kg; P<.001) and waist circumference (–6.1 cm; P<.001).

The rimonabant 20 mg group also produced greater changes in levels of triglycerides (% change, –5.3; P<.001) and increases in HDL cholesterol (% change, 12.6; P<.001), as compared with placebo. Subsequently, the weight loss achieved during year 1 was maintained during year 2 in the patients continuing to receive rimonabant 20 mg.

A limitation of the study, pointed out by the authors was the limited data in minority groups, with the population predominantly white female.

Body Shape Predicts Disease

2007-02-26T11:19:00.000-08:00

We have heard of the perils of body shape causing disease, Apple vs. Pear and the like, but now we have real science behind it. Accuracy of Anthropometric indicators of Obesity to Predict Cardiovascular Risk, J of Clinical Endocrinology and Metabolism 92:589-594, 2007.

This is a European study that uses all the same testing as we have in the office. The focus previously was detecting tendency for disease with blood testing. Now we have the simplicity of the body shape able to do what is needed to start therapy.

Our Regional Tissue Analysis and the Lateral vertebral analysis are sufficiently able to define diagnosis for 6 major disorders. The Cardiovascular Profiler defines the diagnosis for 6 different disorders. Sure we back it up with additional testing but this enables us to be far leaner on blood letting.

It’s your time.

Weight Loss Prevents Diabetes Type 2

2007-02-01T07:37:00.000-08:00

The Diabetes Prevention Program has convincingly shown that weight loss programs will prevent diabetes type 2. Diabetes Care Vol 29, #9. 9.2006, pg 2102-2107.

For every 2.2 lbs of weight loss there was a 16% decrease in the chance of getting diabetes. Decrease in fat consumed and increase in physical activity accounted for the weight loss. Increased physical activity helped sustain the weight loss.

About 25% of the participants did not reach the weight loss goal at one year but did achieve the goal of a 44% drop in the incidence of diabetes.

Preparation for Bariatric surgery

2006-11-05T07:17:00.000-08:00

Click here to listen to Dr. Joe's message about Preparation for Bariatric surgery. (1:22 minutes)

Rimonabant for Weight Loss

2006-10-23T08:58:00.000-07:00

Click here to listen to Dr. Joe's Weight Loss E-News. (3:40 min.)