Medical Myths: IBS myths and facts

Medical Myths: IBS myths and facts

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This edition of Medical Myths explores common misconceptions regarding irritable bowel syndrome (IBS). We discuss common misconceptions about IBS, including what causes it and what to know about diet and exercise modifications.

Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder that affects around 11% of adults worldwide.
Symptoms include:
Abdominal pain
Excess gas
Bloating
Sudden, urgent need to use the bathroom
Changing bowel habits.
While relatively common, IBS is often misunderstood. To help us dispel some prevalent myths about this condition.

We know what causes IBS
Dairy products and spicy foods are examples of foods that may cause symptoms, but they are not the cause of the illness. However, he pointed out that bacteria like Campylobacter jejuni can cause post-infectious IBS.

Stress causes IBS
Recent studies have revealed that mental stress levels affect the makeup of gut bacteria and are crucial in IBS through the gut-brain axis. Dr. However, according to Farhadi, stress levels are typically comparable for those who have IBS and those who do not, suggesting that stress management practices may have a greater impact on an individual’s likelihood of developing IBS symptoms than stress levels alone. I discussed a study in my book on IBS that revealed an increase in mast cells in the gut of a stressed-out individual. He clarified that stress alters the gut’s morphology to make it more susceptible to stress, in addition to increasing the release of hormones and mediators in the gut.

This implies that your gut does not function the same as it did before you went through that stressful time. Stress-related IBS symptoms can therefore persist after the stress has subsided. Furthermore, he noted that IBS patients frequently experience this. Dr. Farhadi also shared the results of a study he did, which indicated a correlation between fewer IBS symptoms and a subjective sense of well-being. IBS symptoms may also be influenced by psychological, social, and genetic factors, according to earlier research.

Doctors only diagnose IBS via ‘fancy tests’
Dr. Farhadi informed us that a simple diagnostic test can identify IBS. In five years, physicians can diagnose IBS with 97 percent accuracy if the proper clinical criteria are followed. That level of accuracy is unmatched in the medical field by any other test. The Rome IV criteria is used to diagnose IBS. According to Dr. Jackson, patients with IBS should experience symptoms of abdominal pain at least once a week on average, along with a change in the frequency or form of their stools and/or a decrease in or worsening of their abdominal pain after defecating. IBS comes in different varieties; you might primarily experience constipation, diarrhea, or a combination of both. Bloating is another common symptom among patients, but she noted that this symptom is not necessary for the diagnosis to be made.

IBS is curable
IBS can be treated in a variety of ways, utilizing a combination of prescription drugs and individualized lifestyle modifications. Dr. Farhadi stated, “I can assure you that in the vast majority of cases, management is very cheap and simple: fiber, probiotics, reassurance, and exercise.”. As Dr. Farhadi puts it, taking medication can be a trial-and-error process. However, when combined with other treatments, it can help reduce the symptoms brought on by IBS. Dr. Dot Farhadi pointed out that there is ultimately no treatment for IBS, and that sometimes medication is just like a band-aid solution for symptom relief. I have to fill prescriptions for drugs again, such as antibiotics to treat bacterial overgrowth. In the end, IBS cannot be cured.

IBS is uncommon, does not affect the quality of life
According to Dr. Jackson, IBS is frequently a chronic, crippling, and widespread disorder of the gut-brain interaction. She noted that it is 10–15% common in North America and that higher healthcare expenses are linked to it. It can also have a major negative impact on a patient’s quality of life. IBS patients stated in one study that they would forgo 10–15 years of their life expectancy in exchange for an immediate cure, highlighting the detrimental effects of the illness.

All types of exercise help IBS
Exercise does help with IBS in some cases, according to Dr. Farhadi, but not all forms of exercise are the same. Exercise that is competitive causes stress rather than reducing it. He pointed out that the same is true for weightlifting in the gym: you need to be extremely aware of the type of weight you’re lifting as well as the way you’re pushing and pulling on different muscles. Additionally, he mentioned that after running for extended periods, many runners experience diarrhea, or “runner’s run.”. He cautioned that as a result, extended running sessions may exacerbate IBS symptoms.

Meditation helps
Research is ongoing, but some studies point to meditation as a potential treatment for IBS symptoms. According to Dr. Jackson, research on the brain-gut-microbiome axis and its connection to IBS is still ongoing. It has been demonstrated that gut-directed psychotherapies help reduce IBS symptoms. She also mentioned that research on the benefits of mindfulness and meditation has demonstrated how the brain’s ability to regulate how we perceive and interpret signals from our gut may help alleviate the symptoms of IBS. That being said, individuals may benefit from different forms of meditation in different ways.

Dr. Farhadi suggests mindless meditation, which involves walking the same route for 30 minutes a day until one becomes so bored that they stop observing their surroundings, though it might not be effective for everyone. That’s a contemplative stroll where you both meditate. Rebooting your system is a stress reliever. But a lot of practice is required. According to him, after a year, you might spend one minute of the fifteen you’re attempting to be in that zone.

Cutting out lactose helps
There is no clear correlation between lactose intolerance and IBS, even though many IBS patients report having a milk intolerance, according to a recent review. It is conceivable that someone with IBS may also be lactose intolerant, given that approximately two-thirds of the world’s population is intolerant to lactose. This suggests that avoiding dairy products could aid in the relief of gastrointestinal complaints.

According to Dr. Jackson, many IBS patients try to reduce their symptoms by avoiding particular foods because they believe that eating causes their symptoms. To identify trigger foods, an elimination diet entails cutting out some foods from your regular diet and then gradually adding them back. The low-FODMAPS diet has been researched the most for IBS. FODMAP foods may cause patients with IBS to experience increased gas and distension as well as the onset of symptoms related to meals. She clarified that although dairy is a high FODMAP food and maybe a trigger for some people, it is not always the case. A gastrointestinal dietician, if one is available, can assist you in navigating the often confusing world of food options.

Natural treatments work for IBS
There has been some indication that using natural remedies like cardamom and peppermint oil can help relieve the symptoms of gastric ulcers and IBS. Natural remedies may not work for everyone, though, as there hasn’t been much research done on them. According to Dr. Farhadi, black cardamom seeds and spearmint are gut-muscle relaxants that may help with symptoms. As long as the natural remedies aren’t overly potent, people can try these and other options. He continued, “People have been using many herbal remedies for thousands of years with no problems.”. However, consulting a physician is always advised before beginning a new course of treatment.

Fasting relieves IBS
Let’s say you own an engine and it is experiencing trouble. You now switch it off. Dr. Farhadi said, “Of course, as long as it’s off, you might not have any problems, but how long can you keep it off?”. Therefore, you may experience fewer symptoms each day if you cut down on how often you eat—maybe from three to two times a day. It might be useful, but it’s not always the best course of action, he clarified. He did, however, add that fasting is beneficial for other things, like memory and weight loss.

Fiber helps IBS
Fiber may be helpful if a patient has chronic constipation, according to Dr. Farhadi. However, too much fiber can cause bloating due to an overabundance of gas in the stomach. To prevent this, Dr. Farhadi suggested ingesting fiber in the form of a spoonful of probiotic-rich Greek yogurt combined with a pinch of water-soluble fiber, or psyllium.

There is an IBS diet
According to Dr. Farhadi, there isn’t a particular diet for IBS. Diets are dynamic in addition to being personalized. While on vacation, one person might be able to consume coffee, but during finals, they might have trouble doing so. He said that just as no one diet works for everyone, no one diet works for everyone all the time.

Reference:
https://www.medicalnewstoday.com/articles/medical-myths-ibs-myths-and-facts#12.-There-is-an-IBS-diet

Medications that have been suggested by doctors worldwide are available here
https://mygenericpharmacy.com/index.php?therapy=43

Medical Myths: All about psoriasis

Medical Myths: All about psoriasis

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Psoriasis Awareness Month is in August. In light of this, misconceptions about psoriasis will be confronted in the most recent episode of Medical Myths. We will talk about treatments, diet, hygiene, and other things.

One rather common immune-mediated skin condition is psoriasis. It results in the skin becoming flaky and crusty in certain areas, usually the knees, scalp, elbows, and back. On light skin, these patches appear red, and on dark skin, they may appear violet or purple. It is challenging to determine the precise prevalence of psoriasis worldwide. On the other hand, a 2020 study discovered that the prevalence ranges from 0.14 percent in East Asia to 1.99% in Australasia. Psoriasis can have an impact on a person’s quality of life and general well-being in addition to its physical symptoms. In a similar vein, stigma affects some psoriasis sufferers.

According to the authors of one study, stigmatizing attitudes toward people who have psoriasis are common in the US. Public awareness campaigns and medical student education programs could lessen the stigma associated with psoriasis sufferers. In light of this, we address some enduring misconceptions about psoriasis and enlist the assistance of two specialists to refute them. The first one is David Chandler, the CEO of the UK’s Psoriasis and Psoriatic Arthritis Alliance. The second is Dominic Urmston, who works for the Psoriasis Association in the United Kingdom as the manager of patient advocacy and communications.

Psoriasis is contagious
This is a widespread myth, but it is still just that a myth. As Chandler clarified, psoriasis is not contagious. It’s an autoimmune disease where the body overproduces skin cells due to an improper immune response. It cannot be spread by direct contact between people, sharing of bodily fluids (such as kissing), or food or beverages. Additionally, it cannot be acquired by people in close quarters in public places like saunas or swimming pools.

Psoriasis is just dry skin
No, Chandler said, there’s a lot more to it than that. The normal skin turnover cycle is approximately every 28 days, but in psoriasis, it can occur as quickly as 4-5 days. The skin structure changes much more quickly. This rapid turnaround has prevented the skin cells from maturing. They accumulate into thick scales that the body is unable to normally shed. Furthermore, blood vessels also shift and migrate toward the surface, Chandler added, making the areas that are scraped bleed and turn extremely red and painful. Psoriasis can be crippling in more severe cases when it causes the skin to break and bleed, according to Urmston. Psoriasis on the hands or feet can make daily tasks challenging, and psoriasis on the buttocks or groin can make simple tasks like sitting down or using the restroom uncomfortable.

There is only one type of psoriasis
Many people believe that there is only one type of psoriasis and that it is always present. It is not the case, though. Chandler clarified that large plaque psoriasis, which has typical thick silvery scales, is the most prevalent type. Other forms include guttate psoriasis, which is sometimes referred to as raindrop psoriasis due to the tear-shaped scaly patches. Only areas that come into contact with other body parts, like the groin, underarms, or armpits, can develop inverse psoriasis. Erythrodermic psoriasis: This rare kind of psoriasis causes a rash that peels over a large portion of the body. Pustular psoriasis: This kind typically affects the hands and feet and causes pus-filled bumps to appear.

Psoriasis results from poor hygiene
In Urmston’s words, having psoriasis does not indicate poor personal hygiene. Chandler agreed, no, really not. Psoriasis sufferers actually usually have to be meticulous when it comes to self-care because their skin is so sensitive and dry that it requires attention all the time. Additionally, he clarified that individuals with psoriasis frequently need to apply their treatments twice daily, which means that people will have to spend a lot of time managing it, especially in areas like the scalp, because if it is ignored, it will rapidly become extremely difficult to manage.

Doctors can cure psoriasis
This is untrue as well because there isn’t a treatment for psoriasis at this time. But, as Chandler pointed out, scientists are still learning more about the illness, and this new knowledge might eventually result in a treatment. Crucially, psoriasis can be effectively managed and treated, as Urmston noted, and dermatologists and physicians can provide a variety of treatment alternatives.

Psoriasis only affects the skin
Although psoriasis primarily affects the skin, it affects more than just the skin. Psoriasis is not limited to the skin. According to Urmston, psoriatic arthritis is an inflammatory form of arthritis that affects the joints and is thought to develop in 6–42 percent of individuals with psoriasis. It frequently affects the knees, hands, and feet joints, as well as the lower back and heel, which are places where tendons join to the bone. Psoriasis can affect a person’s mental health in addition to their physical health. According to Urmston, those who have psoriasis are also more likely to suffer from anxiety, depression, low self-esteem, and low confidence, all of which can have a serious influence.

No treatments can relieve psoriasis
It is a myth that there are no treatment options, even though there is no cure. Depending on how severe a person’s psoriasis is, there are a variety of treatments that can help, according to Chandler. These include ointments, gels, foams, and topical (applied) creams. Along with disease-modifying medications that come in tablet and injectable form, light therapy is also utilized. Each of these methods has different advantages and disadvantages. Since psoriasis is a lifelong chronic condition, a patient’s treatment plan may need to be modified over time in collaboration with their physician. A physician is usually the one who prescribes topical (applied to the skin) treatments in a variety of formulations (creams, ointments, and gels) for the majority of psoriasis patients. A dermatologist can recommend additional treatment options, such as UV light therapy, tablet and injection treatments if the patient’s psoriasis is more severe or if different topical treatments don’t work.

Psoriasis only affects adults
Psoriasis can affect children and, very infrequently, newborns, even though it is most frequently observed in adults. It typically begins in adolescence and lasts a lifetime, according to Chandler. According to Urmston, MNT, there appear to be two “peaks” in the onset period: in the late teens to early 30s and in the 50–60 age range.

Psoriasis is the same as eczema
Even though psoriasis and eczema share similar primary symptoms, they are two very different conditions. As Chandler clarified, psoriasis is not based on an allergic reaction, whereas eczema frequently is. Additionally, eczema is more prevalent in young children and goes away with time. On the other hand, psoriasis is less common in kids and usually lasts a lifetime. According to Urmston, they also typically affect different parts of the body. Psoriasis typically manifests on the outside of the elbows and knees as well as on the scalp, while eczema typically appears inside the crook of the elbow and knee. In general, psoriasis and eczema have distinct underlying mechanisms.

Eczema is a skin condition that can be caused by environmental, genetic, or other factors; psoriasis is an autoimmune condition. Nonetheless, there exist certain indications indicating eczema may also be an autoimmune disorder. Urmston made a significant statement: “For both conditions, early initiation of the most appropriate treatment pathway necessitates a diagnosis from a qualified healthcare professional.

Changing your diet can cure psoriasis
Chandler told MNT that there is no proof that a specific diet can treat psoriasis. Since psoriasis tends to “wax and wane,” many people may link dietary adjustments to improvement; however, this could just be a coincidental occurrence. He did, however, add that maintaining a healthy weight, exercising frequently, and adhering to a balanced diet are all generally sound recommendations for general wellbeing.

As of right now, solid research has not been done to connect any particular dietary modification to a reduction in the symptoms of psoriasis. Since obesity, alcoholism, and smoking have been shown to exacerbate psoriasis symptoms, leading a healthy lifestyle that includes regular exercise and a nutritious, balanced diet can help manage psoriasis. Although it cannot be cured, psoriasis can be managed. To start treatment as soon as possible, anyone who thinks they may have psoriasis should consult a physician. Like with all medical conditions, scientists are still looking into potential approaches to better control the symptoms. Maybe one day, scientists will also find a treatment.

Medical myths: All about diabetes

Medical myths: All about diabetes

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Globally, diabetes is becoming increasingly prevalent, as are the myths and misconceptions that surround it. Here, we discuss 11 of these repeated untruths.

Approximately 10% of Americans currently suffer from diabetes. Over 422 million people worldwide are afflicted by the illness. Diabetes is a common term, but the biological mechanisms underlying it are complicated, and symptoms can vary. Half-truths abound because it’s both common and complex. Regrettably, a few of the misconceptions debunked in this piece contribute to the stigma surrounding diabetes. It is crucial to refute these lies just for that reason. First, we will define diabetes in brief and discuss the distinctions between type 1, type 2, and gestational diabetes, the three most prevalent types of the disease.

The autoimmune condition known as type 1 diabetes is characterized by an attack on the insulin-producing pancreatic cells by the immune system. Compared to type 2 diabetes, it usually manifests earlier in life. Type 2 diabetes is characterized by insufficient insulin production, impaired insulin sensitivity, or both. At least 90 percent of people with diabetes in the U. S. possess type 2. As the name implies, gestational diabetes happens during pregnancy. Pregnancy increases the body’s need for insulin. When the body is unable to meet these new requirements, gestational diabetes develops. Even though gestational diabetes typically disappears after delivery, there is a chance that it will recur in subsequent pregnancies and that type 2 diabetes will manifest later in life.

Eating sugar causes diabetes
Diabetes is not directly brought on by sugar consumption. However eating a diet high in sugar can result in obesity and overweight, which are risk factors for type 2 diabetes. This is a widespread misconception, which makes sense given that blood sugar levels are crucial in the development of diabetes. However, sugar by itself is not a causative agent. As usual, the story is complicated, but it seems that regular soda consumption is associated with a higher risk of type 2 diabetes. Drinking soda has been associated with a higher risk of developing the disease, even after adjusting for energy intake and body mass index (BMI), according to a large 2013 study. Regarding other beverages, like fruit juices and artificially sweetened beverages, the study did not discover this correlation. Why some people develop type 1 diabetes and others do not is still a mystery to scientists. Nutrition is not a risk factor, though.

Diabetes is not serious
Maybe because diabetes is so prevalent, some people don’t think it’s a serious illness. This is untrue. Diabetes has no known treatment, and improper diabetes management can lead to some negative outcomes. Heart disease, nerve damage, kidney damage, blindness, skin disorders, and hearing loss are among the complications. In the United States in 2018, diabetes was the primary cause of 84,946 deaths. S. According to estimates from the World Health Organization, 11.6 million deaths worldwide in 2016 were attributed to diabetes.

Diabetes only affects people with obesity
Type 2 diabetes and gestational diabetes can affect individuals of any weight, but being overweight or obese increases the risk of developing the disease. According to information from the 2020 National Diabetes Statistic Report published by the Centers for Disease Control and Prevention (CDC), 11% of persons in the U.S. are not obese or overweight.
Type 1 diabetes has no association with body weight.

Obesity always leads to diabetes
Obesity raises the risk of diabetes, but the condition is not always caused by obesity. The CDC reports that approximately 39.8% of adults U.S. are obese, whereas 13% have diabetes.

People with diabetes cannot eat sugar
People with diabetes indeed need to closely monitor their carbohydrate intake and manage their diets. They may still include treats, though. According to the American Diabetes Association, the key to enjoying sweets is to limit your intake to special occasions and concentrate your meals on healthier options. To maintain stable blood sugar levels, people with diabetes must carefully schedule their meals and snacks. Another misconception is that individuals with diabetes must consume particular diabetes-friendly foods. These goods can still elevate blood sugar levels, and they are frequently more costly.

Diabetes always leads to blindness and amputation
Fortunately, this is untrue. Diabetes does not always result in blindness or amputations, even though it can in certain situations. Furthermore, these results are uncommon in people who take good care of their condition. According to the CDC, 11.7 percent of adult diabetics have some degree of visual impairment. About 0.56% of diabetics in the United States have lower-extremity amputations. S. Some risk factors that raise the possibility of developing complications related to diabetes have been identified by experts. These include smoking, being overweight or obese, not exercising, having high blood pressure, and having high cholesterol.

People with diabetes should not drive
A diabetes diagnosis does not always imply that a person should give up driving. The American Diabetes Association explains in a position statement on driving and diabetes: Most people with diabetes operate motor vehicles safely without creating any meaningful risk of injury to themselves or others. But they also clarify that individuals should be assessed individually if there are any concerns. As stated by the U.S. Department of Transportation: Diabetics can drive unless their condition prevents them from doing so. These include vision issues or dangerously low blood glucose levels. You should collaborate closely with your diabetes healthcare team to determine whether diabetes impairs your driving ability if you are dealing with complications related to your diabetes.

Prediabetes always leads to diabetes
Within the U.S. 88 million adults, or one in three, are thought to have prediabetes. Blood sugar levels that are higher than average but not quite high enough to be considered diabetes is known as prediabetes. Type 2 diabetes can develop from prediabetes if it is not treated. It is not a given, though. A shift in lifestyle can reverse the trend. Diabetes can be stopped in its tracks with a more nutritious diet and regular physical activity.

People with diabetes cannot be active
Again, this is not accurate. As a matter of fact, exercise plays a big part in managing diabetes. Exercise lowers blood pressure and promotes weight loss, which lowers the risk of complications. It may also improve how well the body uses insulin. However, exercise has various effects on blood sugar levels; sometimes it rises and sometimes it lowers. As stated by Diabetes UK Even though you consume the same foods and engage in the same activities on certain days, your blood sugar levels might behave differently than you would anticipate. Additionally, they provide advice on controlling blood sugar levels while exercising, including taking notes on how your blood sugar behaves and showing them to your doctor. This can direct any necessary adjustments to insulin. Those who are susceptible to hypoglycemia should always have fast-acting carbohydrates on hand. Put on a diabetes identification so that others can assist you if necessary.

You can ‘catch’ diabetes
This is a myth. Pathogens do not cause diabetes, so someone cannot pass it to someone else. Doctors classify it as a noncommunicable disease.

Some natural products cure diabetes
Diabetes currently has no known treatment. It is untrue to say that a product can treat diabetes. Many herbal or natural products are ineffective or even harmful; diabetes co . uk explains: It is often argued that using natural therapies could reduce blood sugars to dangerously low levels and raise the risk of other diabetes complications because certain herbs, vitamins, and supplements may interact with diabetes medications (including insulin) and increase their hypoglycemic effects. Diabetes is a complicated yet widespread illness. Dispelling myths as we come across them is crucial as their ubiquity rises.

Lung Cancer and Treatment Options: A Guide for Pharmacists

Lung Cancer and Treatment Options: A Guide for Pharmacists

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One of the main causes of death in the world is lung cancer. Smokers have a significantly increased risk of developing lung cancer, though it can also strike nonsmokers. ¹ In the United States, 230,000 people were expected to receive a lung cancer diagnosis in 2023; in the lifetime of an individual, 1 in 16 men and 1 in 17 women will receive a lung cancer diagnosis.

Lung cancer is difficult to diagnose in its early stages because it rarely exhibits symptoms until the disease has progressed. Chest pain, coughing up blood, hoarseness, shortness of breath, and wheezing are a few of these symptoms that may be present. Patients may experience additional symptoms, such as headaches, weight loss, appetite loss, and swelling in the face or neck, as the disease progresses.

Small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) are the two main subtypes of lung cancer. Less common than NSCLC, SCLC usually affects people who have smoked heavily for years. Large cell carcinoma, adenocarcinoma, and squamous cell carcinoma are all included in NSCLC.

First- or second-hand smoke exposure, as well as prior radiation therapy (particularly to the chest) for a prior diagnosis, are risk factors for lung cancer. Lung cancer risk may increase with exposure to cancer-causing agents, such as carcinogens such as nickel, chromium, asbestos, and arsenic. Finally, it has been established that a family history of lung cancer contributes to the disease’s development.

Imaging tests are commonly used in the diagnosis process, and lung cancer cells may also be detected through sputum cytology. While thoracentesis can examine the fluid surrounding the lungs to determine whether it is malignant, a biopsy is an additional method to examine the cells that are proliferating in the lungs. 1, 3.

Patients with lung cancer may receive palliative care in addition to radiation, chemotherapy, targeted therapy, immunotherapy, and other treatments. Wedge resection, segmental resection, lobectomy, and pneumonectomy are possible surgical options.

REFERENCES:
https://www.mayoclinic.org/diseases-conditions/lung-cancer/symptoms-causes/syc-20374620
https://www.lung.org/lung-health-diseases/lung-disease-lookup/lung-cancer/symptoms-diagnosis/how-is-lung-cancer-diagnosed
https://www.cancer.gov/about-cancer/treatment/types/targeted-therapies
https://www.cancer.gov/about-cancer/treatment/types/targeted-therapies/approved-drug-list#targeted-therapy-approved-for-lung-cancer

Updated Cardiovascular Guidelines for Individuals with HIV Expand Statin Eligibility

Updated Cardiovascular Guidelines for Individuals with HIV Expand Statin Eligibility

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In the United States, about 1.2 million people are HIV positive. 1 Patients with HIV are living longer thanks to the development of contemporary antiretroviral therapy. Nearly two-thirds of HIV-positive people in the US were predicted to be 45 years of age or older in 2021. 2 Treatment of co-morbid conditions must be addressed as the HIV population ages, even though antiretroviral therapy that permanently suppresses HIV replication is of the utmost importance. Statin drugs for HIV, heart disease, stroke, and cholesterol management.

It is well known from research that those living with HIV have an increased risk of heart disease. For instance, research has shown that this patient population has a 20–100% increased risk of myocardial infarction. 3 Unfortunately, even with HIV under control, this risk remains. Research is still ongoing to determine the mechanisms underlying the elevated risk of cardiovascular disease. Nonetheless, current theories include immunological activation and persistent inflammation; depletion of CD4-positive cells; exposure to toxic, older antiretroviral therapies; and conventional risk factors like diabetes, smoking, and unhealthy eating patterns. Before recently, there was no particular advice available for HIV patients on how to prevent cardiovascular events. Now that the results of the REPRIEVE trial (NCT03455390) have been released, medical professionals have access to data unique to this significant patient population.

7769 people with HIV infection between the ages of 40 and 75 who were receiving antiretroviral therapy and had a low-to-moderate risk of cardiovascular disease were enrolled in the phase 3 Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE)4. A placebo or 4 mg of daily pitavastatin calcium (Livalo; Kowa) was administered at random as a form of treatment. Pitavastatin calcium was selected due to its incompatibility with medications utilized in antiretroviral therapy.

According to a time-to-event analysis, the main outcome was the occurrence of a major adverse cardiovascular event (MACE), which included peripheral arterial ischemia, myocardial infarction, hospitalization for unstable angina, stroke, revascularization of a peripheral artery or coronary carotid, cardiovascular death, and death from an unknown cause. A composite of a fatality from any cause or a MACE was a significant secondary outcome.

Thirty-one percent were women, 65 percent were non-White, and the median age was 50 years. The median screening CD4-positive count was 621 cells/mm3, and the median screening low-density lipoprotein cholesterol (LDL-C) level was 108 mg/dL. At the time of the report, 83% of participants were still in follow-up, with 74.8 percent of the pitavastatin group and 71% of the placebo group still receiving their randomized treatment. The median 10-year Atherosclerotic Cardiovascular Disease risk score was 4.5 percent. In the pitavastatin and placebo groups, the rates of treatment discontinuation due to adverse events were 2 points 1 percent and 1 point 2 percent, respectively.

After a median of five years, the trial was terminated early for efficacy because the pitavastatin group experienced a twenty-one percent reduction in MACE and a thirty-five percent reduction in MACE or death. Antiretroviral medication plus statins may be even more beneficial in lowering the risk of cardiovascular disease. Even though the results are unique to pitavastatin, other statins might offer comparable protection.

The Department of Health and Human Services/National Institutes of Health HIV Clinical Guidelines updated their recommendation to include that all individuals with HIV who are between the ages of 40 and 75 and have a risk of atherosclerotic cardiovascular disease of at least five percent should receive a moderate-intensity statin due to the trial’s efficacy. 5 The majority of people living with HIV can benefit from starting a moderate-intensity statin between the ages of 40 and 75, as nearly two-thirds of those living with HIV are at least 45 years old.

Regardless of the practice setting, pharmacists are especially qualified to assist in putting these recommendations into practice. Enhancing patient health is a shared responsibility among those working in primary care, inpatient, retail, and HIV-focused clinical settings, among others. Proactive chart reviews to ensure appropriate statin use are already standard practice in many of these settings; the patient population that qualifies has simply grown. In other contexts, the payment for medication therapy management may serve as a catalyst for the adoption of statins in this patient population.

Pharmacists can discuss statin use with patients at every interaction, including admission and refills, and can help with the right statin selection when necessary. As the second most prescribed class of drugs, antilipidemic agents require special handling from pharmacists when it comes to insurance claims, formulary substitutions, and appropriate counseling. This may make it possible to switch to a better option or start taking a statin with ease.

When selecting the appropriate statin, it’s important to understand the pharmacokinetics of both antiretrovirals and statins to look for any potential side effects that might be mitigated. The commercially available statins are listed in tables 15, 7, and 25, 7 below according to how much they lower LDL. Based on data from REPRIEVE, guidelines recommend 10 mg of rosuvastatin, 4 mg of pitavastatin, and 20 mg of atorvastatin as the recommended statins and dosages. Consequently, a list of potential drug interactions between them and commonly used antiretrovirals is available.

HIV-positive people live longer and are more likely to experience cardiovascular events. The recent release of REPRIEVE data has impacted the revision of guidelines to include a broader use of statins. The majority of HIV patients are now advised to take a moderate-intensity statin, and pharmacists are well-positioned to assist in putting these new guidelines into practice and helping their patients’ cardiovascular outcomes.

REFERENCES
https://clinicalinfo.hiv.gov/en/guidelines/adult-and-adolescent-arv
https://stacks.cdc.gov/view/cdc/156513
https://dx.doi.org/10.15620/cdc:123251

Curing Cancer: Newer Treatments to Keep an Eye On

Curing Cancer: Newer Treatments to Keep an Eye On

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Although there isn’t a cure for cancer at this time, scientists are looking into some novel treatments that could one day transform the way the disease is treated, such as vaccines and gene editing. A class of diseases known as cancer is distinguished by abnormal cell growth. These cells can invade various bodily tissues, which can cause major health issues. After heart disease, cancer is the second most common cause of death in the United States, according to the Centers for Disease Control and Prevention (CDC). Is there a real treatment for cancer at the moment, though?

On the other hand, recent advancements in technology and medicine have made newer cancer treatments possible, which are helping us get closer to a cure. We’ll look at these new therapies and their potential implications for cancer care in the following sections. Continue reading to learn more.

Will we ever cure cancer?

The distinction between a cure and remission must be made to respond to the question, “Is there a cure for cancer? If so, how close are we?. A full recovery from cancer indicates that all signs of the disease have been removed from the body and that recurrence is unlikely. Remission. Remission denotes a decrease in or complete absence of cancerous signs. A person in remission may exhibit little to no physical evidence of cancerous cells. Generally speaking, there are two types of remission: a complete remission, in which the cancer is not showing any symptoms. a partial remission, in which there is still cancer present but the tumor has shrunk. Cancer cells can reappear in the body even after they have completely disappeared.

This implies that the cancer may return. If this occurs, it usually does so in the first five years following therapy. Even though some medical professionals might refer to cancer as “cured” if it doesn’t recur within five years, cancer is never really cured because it can always return. This is why most medical professionals will refer to a patient as being “in remission” rather than “cured.”. We will be looking at novel and cutting-edge cancer treatments in this article. These more recent therapies can be administered in addition to or instead of more traditional cancer treatments like radiation and chemotherapy. Now let’s get started.

Immunotherapy

Cancer immunotherapy is a type of treatment that helps the immune system fight cancer cells. The immune system is made up of various organs, cells, and tissues that help the body fight off outside invaders, including:

bacteria, viruses, parasites…
However, cancer cells are a part of us and aren’t seen by our bodies as invaders. Because of this, the immune system may need help identifying them. There are several ways to provide this help.

Vaccines

Most likely, when you consider vaccinations, you consider them concerning the prevention of infectious diseases such as COVID-19, measles, and the flu. Certain vaccines, however, can aid in the prevention or even treatment of specific cancers. For instance, the human papillomavirus (HPV) vaccine offers defense against a variety of HPV strains that can result in throat, cervix, and anus cancers. Furthermore, a chronic hepatitis B virus infection, which can result in liver cancer, is avoided by receiving the hepatitis B vaccine. The vaccine known as Bacillus Calmette-Geurin (BCG) is typically administered to treat tuberculosis, but it can also be used in the treatment of bladder cancer. During this treatment, a catheter delivers BCG directly to the bladder, stimulating the body’s immune system to target and destroy bladder cancer cells.

Additionally, scientists are working to develop a vaccine that directly supports the immune system’s defense against cancer. Typically, the surface of cancer cells contains molecules absent from healthy cells. These molecules may be included in a vaccine that improves the immune system’s ability to identify and eliminate cancer cells. The Food and Drug Administration (FDA) has only approved one vaccine to treat cancer thus far. Sipuleucel-T, also known as Provenge, is a medication used to treat advanced prostate cancer in patients who have not responded to prior therapies. The fact that this vaccine is customized makes it special. After being extracted from the body, immune cells are altered in a lab to identify prostate cancer cells. After that, they are reinjected into the body to support the immune system’s search for and elimination of cancerous cells. A review from 2021 states that scientists are now in the process of creating and evaluating novel vaccinations to treat specific forms of cancer. The National Cancer Institute (NCI) states that these vaccines are occasionally tested in conjunction with approved cancer medications.

Some examples of cancers with vaccines that have been or are currently being tested are:

Pancreatic cancer
Melanoma
Non-small cell lung cancer (NSCLC)
Breast cancer
Multiple myeloma

T-cell therapy

One type of immune cell is the T-cell. They function to eliminate external invaders that your immune system has identified. These cells are taken out of the body and sent to a lab for T-cell therapy. The cells that exhibit the highest degree of reactivity against cancerous cells are isolated and cultured in vast quantities. Then, your body receives another injection of these T-cells. CAR T-cell therapy is a particular kind of T-cell therapy. T-cells are taken out and altered to have a receptor added to their surface during treatment. When cancer cells are reintroduced into your body, this aids the T-cells’ ability to identify and eliminate them more effectively. Six CAR T-cell therapies have received FDA approval as of this writing. These are used to treat blood cancers, such as multiple myeloma and certain forms of leukemias and lymphomas.

In general, CAR T-cell therapy is advised in cases where prior cancer therapies have failed. It has some potentially dangerous side effects, but it can also help patients with cancers that are difficult to treat. Cytokine release syndrome (CRS) is one of these. This occurs when a significant amount of chemicals known as cytokines are released into the bloodstream by the freshly reintroduced T-cells. The immune system may go into overdrive as a result. Following CAR T-cell therapy, major neurological side effects such as seizures and confusion have also been reported. Clinical trials are underway to investigate the potential applications of this therapy for other cancer types, such as solid tumors, which can present challenges for CAR T-cell penetration. Additionally, researchers are looking into more effective ways to control the side effects of CAR T-cell therapy.

Monoclonal antibodies

The B cell, another kind of immune cell, produces antibodies, which are proteins. They can attach to antigens, which are particular targets that they can recognize. T lymphocytes can locate and eliminate antigens once an antibody has bound to them. Antibodies that recognize antigens typically found on the surface of cancer cells are produced in large quantities as part of monoclonal antibody (mAb) therapy. Once inside the body, they can assist in identifying and eliminating cancer cells. Many types of mAbs have been developed for cancer therapy. Some examples include:

Alemtuzumab (Campath). This mAb binds selectively to a protein that is highly expressed on the surface of both T and B cell lymphocytes. By targeting this specific protein, both the T and B cells are marked for destruction, which helps your body get rid of any cancer-containing cells.

Trastuzumab (Herceptin). This mAb is specific for HER2, a protein found on some breast cancer cells, and promotes their growth. Trastuzumab binds to HER2, which blocks its activity. This stops or slows the growth of breast cancer cells.

Blinatumomab (Blincyto). Given that it contains two distinct mAbs, this therapy is regarded as both a T-cell therapy and a mAb. One adheres to the cells of the cancer, and the other to the cells of the immune system. This combines the two cell types and makes the cancer cells vulnerable to immune system attack. It is presently used to treat acute lymphocytic leukemia and medications akin to it are being created to treat conditions like myeloma.

Additionally, monoclonal antibodies can be linked to chemotherapy medications or radioactive particles. We refer to these as conjugated mAbs. These cancer-fighting agents can be delivered straight to cancer cells because the antibodies are specific for antigens on cancer cells.

Ibritumomab tiuxetan (Zevalin).Zevalin, or ibritumomab tiuxetan. Because this mAb has a radioactive particle attached to it, when the antibody binds, radioactivity can be delivered straight to the cancer cells. It is applied to treat certain non-Hodgkin lymphoma types. Emtansine (ado-trastuzumab) (Kadcyla). There is a chemotherapy drug attached to this antibody. The medication is released into the cancer cells by the antibody once it has been attached. Certain forms of breast cancer are treated with it.

Virotherapy

As a normal part of their life cycle, many virus species kill their host cell. This makes viruses a promising cancer treatment option. The use of viruses to specifically destroy cancer cells is known as virotherapy. Oncolytic viruses are the type of viruses used in virotherapy. They have undergone genetic modification so they can only replicate and target cancer cells. According to the NCI, antigens linked to cancer are released when an oncolytic virus destroys a cancer cell. Following their binding to these antigens, antibodies can start an immune reaction. Although multiple viruses are being investigated by researchers for this kind of treatment, only one has received approval thus far. It is a modified form of the herpes virus known as talimogene laherparepvec (T-VEC). It is used to treat skin cancer caused by melanoma that is not surgically treatable.

Oncolytic viruses are still being researched as a potential cancer treatment. A review published in 2020 examined research on oncolytic viruses conducted between 2000 and 2020. There were 97 distinct clinical trials identified, the majority of which were phase 1. Melanoma and digestive cancers were the most common cancer types targeted by virotherapy. The most studied oncolytic virus was a modified adenovirus. Only 7 of the studies included information on the levels of tumor-specific immune response, according to the reviewers.

Hormone therapy

Hormones are naturally produced by the body and function as messengers between the various tissues and cells in your body. They support the regulation of numerous bodily processes. Certain hormone levels can have an impact on the growth of certain cancers. For this reason, hormone therapy employs medication to prevent hormone production. Certain types of cancer cells can have their growth and survival impacted by changes in hormone levels. These cancers can grow more slowly if a necessary hormone is blocked or its level is lowered. Prostate, uterine, and breast cancers are occasionally treated with hormone therapy. It frequently serves as a supplement to other cancer treatments like targeted therapy or chemotherapy.

Nanoparticles

Nanoparticles are extremely small particles, much smaller than a cell. Because of their size, they can move around the body and interact with various biological molecules and cells. In particular, nanoparticles hold great promise for drug delivery in the treatment of cancer. Nanoparticles have the potential to be used in drug delivery systems that can target cancer cells and penetrate tissue barriers, like the blood-brain barrier. This could reduce side effects and increase the efficacy of cancer treatments.

Additionally, nanoparticles might have an impact on the immune system. In a 2020 study, immune cells were trained to mount an attack against cancer cells using a nanoparticle-based system in mice. Additionally, this strategy increased the efficacy of immune checkpoint inhibitor therapy. The FDA has approved several nanoparticle-based delivery systems for the treatment of cancer, even though the kinds of nanoparticle therapy we just covered are still in the research and development stage. These systems use nanoparticles to more effectively deliver cancer drugs. A few cancer medications that might make use of a nanoparticle-based delivery system are doxorubicin (Doxil) and paclitaxel (Abraxane).

There are currently clinical trials underway for additional nanoparticle-based cancer treatments. A list of ongoing clinical trials using nanoparticles to treat cancer is available on the U. S. Clinical Trials, National Library of Medicine. There are representations of numerous cancers, such as lung, prostate, and breast cancers.

In summary, there is presently no conclusive treatment for cancer. There is always a chance that cancer may recur, even in cases where a patient has experienced complete remission. Still, scientists are working hard to create fresher, more potent cancer therapies. Hormone therapy, immunotherapies such as monoclonal antibodies, CAR T-cell therapy, and cancer vaccines are some of the treatments that are currently being used in addition to more traditional cancer therapies. Nanoparticles and gene editing, particularly with the CRISPR system, are other important research areas. Even though these technologies are still in the early phases of development, preliminary research and testing have produced encouraging outcomes.

REFERENCES:
https://www.healthline.com/health/is-there-a-cure-for-cancer#resources

Medications that have been suggested by doctors worldwide are available here

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Low magnesium levels lead to an increased risk of chronic diseases.

Low magnesium levels lead to an increased risk of chronic diseases.

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Because it lowers the risk of DNA damage and chronic degenerative disorders, a diet high in magnesium is beneficial for human health according to a recent Australian study. Researchers at the University of South Australia examined blood samples from 172 middle-aged adults. They discovered a significant correlation between elevated levels of the genotoxic amino acid homocysteine and low magnesium levels. Because of the harm this toxic combination causes to the body’s genes, individuals are more vulnerable to diabetes, gastrointestinal disorders, cancers, Alzheimer’s and Parkinson’s disease, and other illnesses. Foods high in magnesium, such as whole grains, dark green leafy vegetables, nuts, beans, and dark chocolate, support the body’s ability to create energy, maintain healthy teeth and bones, control blood pressure and sugar levels, and support the healthy operation of the heart, muscles, and kidneys.

A low magnesium intake (less than 300 mg per day), according to UniSA molecular biologist Dr. Permal Deo, can raise the risk of many diseases; however, its function in preventing DNA damage in humans has not yet been thoroughly investigated. According to co-author Professor Michael Fenech, a persistent magnesium deficiency is likely to impair the body’s capacity to generate energy and power cells, hastening the aging process of tissue and increasing the risk of developing some diseases at an earlier age. The fourth most common mineral in the human body is magnesium. It is needed as a co-factor by over 600 enzymes and as a trigger for nearly 200 vital bodily functions. Finding the ideal magnesium dietary intake—whether from food or supplements and how it might affect the development or course of cancer and other chronic illnesses are the next steps, according to Prof. Fenech.

Even after controlling for age and gender, our research revealed a clear link between elevated DNA damage and blood magnesium levels below 18 mg/L. Measurements of blood levels of magnesium, homocysteine (Hcy), folate, and vitamin B12 revealed a positive correlation between magnesium and vitamin B12 and an inverse relationship between magnesium and Hcy.

This suggests that homocysteine toxicity, which is exacerbated in cases of folate and vitamin B12 deficiency, increases the levels of magnesium in the blood to dangerous levels. Symptoms of magnesium deficiency include tremors, twitches, and cramping in the muscles. In severe cases, a deficiency may even result in convulsions or seizures. Researchers think that these symptoms are brought on by increased calcium entry into nerve cells, which causes the muscle nerves to become overexcited or hyper-stimulated.

Numerous symptoms, such as hypocalcemia, hypokalaemia, and cardiac and neurological problems, can be brought on by magnesium deficiency. The body uses magnesium for numerous functions in every organ and cell, and a chronic low magnesium state has been linked to some chronic diseases, such as diabetes, hypertension, coronary heart disease, and osteoporosis. We frequently hear less about magnesium and more about other electrolytes like calcium, potassium, and sodium.

However, magnesium, like these other electrolytes, is essential to our metabolism and general well-being. It is particularly crucial for the heart’s electrical conduction system and nervous system. Hypomagnesemia, or low or inadequate magnesium levels, can result in some issues. Certain ones are more severe than others. We’ll talk about this condition’s symptoms, causes, diagnosis, and treatment here. Different body parts may experience a variety of symptoms due to low magnesium levels. Numerous symptoms are related to issues with electrical conduction in the heart and nervous system.

Hypomagnesemia can cause a variety of symptoms, such as weakness, exhaustion, tremors or twitches in the muscles, cramping in the heart, palpitations or arrhythmias, numbness, seizures, confusion, or mood swings. Low magnesium is frequently linked to low levels of other crucial electrolytes. Particularly common are low calcium and potassium levels. This is because there are common causes for low levels of these electrolytes. Magnesium is necessary for every organ in the body, but it is especially important for the heart, muscles, and kidneys. It also plays a role in the synthesis of bones and teeth. Many processes in the body require magnesium. This encompasses the bodily chemical and physical processes known as metabolism that transform or utilize energy. Low magnesium can cause symptoms to appear when the body’s magnesium levels fall below normal.

REFERENCES:

https://medlineplus.gov/ency/article/000315.htm
https://www.goodrx.com/conditions/magnesium-deficiency/hypomagnesemia-magnesium-deficiency
https://www.healthline.com/nutrition/magnesium-deficiency-symptoms#twitches-cramps

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In Conversation: Can diet and exercise reverse prediabetes?

In Conversation: Can diet and exercise reverse prediabetes?

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A person with prediabetes has a higher chance of developing type 2 diabetes as a warning sign. Prediabetes can cause long-term harm, including to the heart and blood vessels if left untreated. But can it be reversed? Can diet and exercise modifications help achieve this? Type 2 diabetes, in particular, is fast emerging as one of the most difficult health issues of the twenty-first century. It is also anticipated that 380 million people globally will receive a diabetes diagnosis by 2025. Diabetes management and treatment are increasingly important because it is a risk factor for many other diseases and chronic health conditions, including stroke, kidney disease, cardiovascular disease, and blindness, to name a few.

However, many people are thought to be in a precursor stage known as prediabetes before they go on to develop type 2 diabetes. This medical condition is characterized by blood sugar levels that are higher than normal but not high enough to be classified as type 2 diabetes. However, a significant risk factor for type 2 diabetes is prediabetes. The numbers of individuals with prediabetes provide a clear picture when it comes to scaling this issue: more than one in three individuals in the U.S. S. along with the U.K. have been identified as prediabetic. Therefore, if prediabetes is considered an early warning sign of type 2 diabetes, what steps can people take to reverse the course of this condition? Is it not possible to reverse this condition with significant lifestyle changes?

On our May podcast, “In Conversation: Can diet and exercise help reverse prediabetes?” Dr. Thomas Barber, an associate clinical professor at Warwick Medical School and consultant endocrinologist at University Hospitals Coventry and Warwickshire, joined Dr. Hilary Guite and me. Additionally, Healthline Media and Medical News Today Managing Editor Angela Chao shared her personal story of reversing her diagnosis of prediabetes and the lifestyle changes she made to maintain it. An unusual case: In Angela’s instance, few medical professionals would have thought that her blood sugar levels were cause for concern. She is not thin, youthful, and energetic like most people with prediabetes or those at risk of getting diabetes. She did, however, admit that at the time she led a fairly sedentary lifestyle.

She said that because my readings were so low on the spectrum, I don’t even think my primary care physician at the time talked to me about it beyond providing the range and the diagnosis. She did, however, add that some doctors and her medical friends seemed concerned about the changes to the cutoff point for readings that qualified as prediabetes. Being diagnosed with prediabetes: In my opinion, receiving the diagnosis was a bit of a wake-up call. Whether or not the threshold has changed, “You need to increase your exercise level; you need to make some changes to your lifestyle to get back to a healthy range.

How to measure prediabetes
According to Dr. Barber, the diagnosis of diabetes and prediabetes was previously made using fasting glucose readings or a conventional glucose tolerance test. In this test, participants were given 75 grams of a sugar-filled beverage, and their blood sugar levels were monitored for the following two hours. Additionally, the definition of prediabetes is constantly changing and may vary from nation to nation. Definitions vary amongst societies and prestigious organizations. And the most important thing to remember, in my opinion, is that there is a continuum when it comes to diabetes and prediabetes, Dr. Barber stated. Should we choose the U. S. along with the U. K. For instance, there are variations in the thresholds and units of measurement applied when diagnosing prediabetes.

As you point out, there are various units, which makes it a little confusing. However, in essence, in the U. K. for glucose, we use millimoles per liter, and in the U.S. S. milligrams per deciliter, to be exact. We typically use millimoles per mole in clinical settings these days, and we have for a while, according to Dr. Barber. He went on, “I think that further complicating matters is the hemoglobin A1C, which has two different percentage units—one that we have historically used and the other that is now replaced by millimoles per mole. Dr. According to Barber, glucose is a continuous variable rather than a discrete measure. He clarified that while everyone can agree on what is elevated and what is normal, there are kind of disagreements about everything in between. The World Health Organization approved hemoglobin A1C as a test for diabetes a few years ago. While additional glucose readings can be useful, Dr. Barber stated that medical professionals primarily rely on A1C in current clinical practice. About prediabetes in the U.S. K, he said, this is based on an A1C range of 39 to 47 mmol per mol, with 39 corresponding to an A1C of 5 points 7 percent.

Anything that raises the hemoglobin A1C level above 48 millimoles per mole, or 60.5 percent, is statistically defined as diabetes. He stated that to diagnose type 2 diabetes, we should ideally have at least two of those readings that are elevated. When Angela was diagnosed, her A1C was 5 points8 percent, and anything above 5 points7 was considered prediabetes. Dr. Barber reminded us that, in the United States, Angela’s readings would not have been regarded as prediabetes and that, in recent years, the diagnostic criteria for diabetes have gradually decreased. K. at the time, since the values were extremely near to normal and not quite below the cut-off. Usually, prediabetes shows no symptoms at all. But occasionally, people might get frequent thirst, wake up in the middle of the night to urinate, experience blood sugar spikes, or have energy slumps.

Prediabetes is frequently asymptomatic, so many people who are diagnosed with it may have had it for months or even years. Furthermore, it can easily go unreported unless people are tested for it, according to Dr. Barber.

Angela recounted her own experience:
I most definitely didn’t experience a variety of symptoms. But drinking water was something I was definitely already doing quite a bit of the time. I therefore found it difficult to determine whether anything was changing. Low blood sugar, particularly if she went for prolonged periods without eating, was something she did notice before the diagnosis. Over the years, she said, there has been a consistent pattern of significant fluctuations in her blood sugar levels, which she could feel physically. She can, however, fast trouble-free for more than 16 hours now because of certain lifestyle adjustments. Sugar surges and falls may be considered preemptive indicators of diabetes. According to Dr. Dot Barber, prediabetes is a general term that can refer to either elevated fasting glucose or elevated postprandial glucose. Dr. Dot Barber stated that fluctuations in blood sugar levels, or glycemia, were often observed in the context of insulin resistance. Glucose levels tend to rise a little higher than they should, he explained, because the beta cells can’t produce enough insulin, for example, or the insulin isn’t as effective after a meal.

The main difference, I suppose, is that most of the time we are unaware of this when it comes to prediabetes because the majority of patients actually do not. monitor their blood glucose, he said, noting that people might not notice these changes physically if blood sugar levels are not closely monitored throughout the day. It makes perfect sense that as you lead a healthier lifestyle, lose weight, and reverse prediabetes, your blood sugar levels will stabilize. He mentioned Angela’s description of the changes she saw and said that the insulin becomes more effective and can handle the fluctuations in glycemia better.

Who is most at risk of developing prediabetes?
Obesity, having a high body mass index, and being overweight are some of the most well-known risk factors for type 2 diabetes. Additionally, as we age, our vulnerability increases. And the reason for that is that as we age, the beta cells and insulin receptors can no longer function as well, and insulin itself becomes slightly less effective. Accordingly, as we age, our chance of having prediabetes and diabetes rises, according to Dr. Barber. Dr. Barber added that eating a diet heavy in high-glycemic foods and sugary drinks, as well as stress, can all raise risk. Conversely, he asserted that a diet low in simple carbohydrates and high in fiber can delay the onset of dysglycemia. Being sedentary means spending most of the day sitting or lying down, especially when it comes to watching TV, which is, in my opinion, the least sedentary activity that can increase risk. Sedentary behavior raises the risk of insulin resistance, a condition that increases the likelihood of prediabetes and type 2 diabetes. Genetics and ethnic origin are other factors to consider.

Dr. Barber presented the results of a recent investigation they carried out in the U.S. K. which revealed that, at a BMI of 23.9%, individuals of South Asian ethnicity had the same risk of developing diabetes as did white people at 30. In contrast, Angela’s risk was increased by her family history. My mother, a retired medical doctor, had warned me since I was a teenager about the slight family history of type 2 diabetes on my father’s side. She also mentioned that everyone on that side of the family was thin and had no weight problems. Dr. According to Barber, diabetes is frequently attributed to lifestyle decisions, but many people are unaware that it is a hereditary disorder. According to him, patients with a strong family history may not always exhibit the characteristics of type 2 diabetes, such as obesity, middle age, male gender, and large abdomen. That’s the idea that most people with type 2 diabetes have of the typical person. He added that, as you point out, Angela defies all of those stereotypes about what that entails. Dr. Barber also emphasized that having a genetic predisposition to diabetes at birth can result in dysglycemia even in the absence of those other factors. More than 40 genes and gene mutations have been found to increase your risk of developing type 2 diabetes. Additionally, he added, that even though each effect alone is rather weak, adding them all together can have a cumulative effect.

Lifestyle changes to reverse prediabetes
Through a combination of intermittent fasting, a balanced diet with an increased amount of lower-glycemic index foods and complex carbohydrates, and significantly increased physical activity, Angela was able to reverse her diabetes. She added that she did not make any significant dietary changes and that she also worked with a personal trainer on weight and resistance training. She advised against strict dieting, keto, and quick, drastic changes that aren’t long-term. Dr. Barber conceded that while this approach obviously worked for Angela, it might not be feasible for many others to make such drastic life changes and that doing so can be challenging. We are aware that rigorous lifestyle interventions that emphasize food, exercise, weight loss, and other factors can significantly aid in preventing type 2 diabetes, or at least postponing its onset, according to Dr. Barber. In my opinion, it serves as a kind of early warning system that indicates when a person needs to make a lifestyle change. And it has to be beneficial if it inspires or motivates people to alter [their] way of life, he added.

Why building muscle is important
Angela’s BMI was already low, so losing weight would not have been a wise course of action. I was diagnosed with a sedentary lifestyle behavior [issue] because I could not afford to lose weight. Without a doubt, I wasn’t working out frequently. She recalled, “I was working [in] very high-stress, high-demanding journalism jobs, covering disasters, traveling, breaking news, you name it.”. Strength training is a useful tool for improving insulin sensitivity and reducing insulin resistance. Dr. According to Barber, the benefits of cardiometabolism may be mediated by the act of exercising and the release of myokines from muscles. In fact, having more muscle mass can increase your metabolic rate overall, which will help you maintain your current weight. He went on to say that burning fat and oxidizing it through exercise also helps because your muscles use this energy source.

Moving throughout the day
Regular exercise, not just intense exercise, has been demonstrated in studies to help stabilize blood sugar and enhance blood sugar management. Although working up a sweat on a treadmill or running a 5k is certainly a form of exercise, Dr. Barber stated that the real message when it comes to fitness should be avoiding inactivity. We are aware that standing up increases caloric expenditure and is therefore beneficial to health. It’s even better if you’re moving around, he said. Additionally, some intriguing studies have examined ways to modify sedentary behavior, such as getting up every hour or every 30 minutes, taking short walks, and performing squats in a room corner. He went on to say that they demonstrated how just that amount of activity throughout the day can have transformative effects on glucose levels.

What it actually means to be active: You don’t have to run on a treadmill or scale Mount Everest. All you have to do is get up occasionally and move around. And that will now significantly improve your metabolic health on its own.

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Diabetes-related health complications can lower life expectancy

Diabetes-related health complications can lower life expectancy

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530 million adults worldwide are estimated to have diabetes. Individuals diagnosed with diabetes mellitus are more susceptible to various health complications. Multiple long-term conditions (MLTCs) are health complications related to diabetes that affect more than one person. Imperial College London researchers have discovered that diabetes not only causes MLTCs to occur 15–20 years earlier, but it also drastically shortens the life expectancy of those who have the disease. Approximately 529 million individuals worldwide are estimated by researchers to have diabetes, with 90–95 percent of those cases being type 2 diabetes.

Serious complications such as heart disease, nerve damage, kidney disease, gum disease, dementia, mood disorders, and eye issues are more common in people with diabetes. Multiple long-term conditions (MLTCs) are the terms used to describe the presence of multiple complications in a person with diabetes. According to recent research from Imperial College London in the United Kingdom, diabetes not only causes MLTCs to occur 15–20 years earlier, but it also drastically shortens the life expectancy of those who have the disease. The study was just released in the Nature Medicine journal.

Diabetes patients with several chronic conditions by the age of 50 Researchers examined medical records from more than 46 million U.S. K. utilizing the National Bridges to Health Segmentation Dataset, adults aged 20 and above. Over 3 million individuals in the research had diabetes mellitus, whether it be type 1 or type 2, or another type. After analysis, researchers discovered that roughly one-third of study participants with diabetes had at least three MLTCs by the time they were 50 years old. On the other hand, people without diabetes did not develop three MLTCs until they were 65 to 70 years old.

Researchers also discovered that individuals with diabetes had an average onset age of 66–67 years for at least two MLTCs. Furthermore, a person’s levels of MLTCs would be more severe as they age if they were diagnosed with diabetes at a younger age. One of the most difficult global population health risks has emerged to be multiple long-term conditions, Edward W. Gregg, PhD, as well as the School of Population Health at RCSI University of Medicine and Health Science in Ireland.

Age has been the main cause, and while longer lifespans do play a role, it is not the whole story. We’ve confirmed that this is a serious problem that still shows up in early and middle adulthood,” he said. When Gregg and his team examined specific MLTCs, the most prevalent conditions they observed were depression, asthma, osteoarthritis, and hypertension. People of all ages and genders were observed to have these conditions. Although the link between diabetes and MLTCs was expected, we were surprised by the breadth and depth of the findings, i.e. e. the prevalence of having 3, 4, or 5+ conditions and their comparatively early age of onset, according to Gregg. Hypertension and coronary heart disease were expected. On the other hand, there were no associations with asthma or osteoarthritis. It was surprising that a significant proportion of young adults would also have diabetes, even though the link to depression was expected.

4 years of life lost for each co-occurring condition
The number of years that diabetes patients lost as a result of MLTCs was another area of study for the researchers. Researchers discovered that individuals with more MLTCs lived with them for fewer years and passed away sooner than those without MLTCs. Researchers discovered, for instance, that individuals with diabetes who had three MLTCs lived roughly ten years with them and five years less than the overall population, whereas individuals with diabetes who had at least five MLTCs lived five years with them and passed away six years sooner than those without MLTCs. Gregg and his colleagues also discovered a higher number of life years spent and lost in young adults with diabetes who suffer from MLTCs. For instance, compared to people without MLTCs, a person with diabetes and MLTCs lost roughly 4 years of life by the time they were 40. According to Gregg, “It might be a sign that these conditions are more severe when they arise in young adulthood. However, chronic illnesses typically worsen disability and shorten life expectancy over time, so we must find strategies to prevent people from developing these conditions at an early age. Diabetes can be prevented in many ways, and delaying its onset can help prevent the development of other conditions.

Furthermore, the researcher noted that diabetes is also highly manageable and can reduce the development of MLTCs with good control. The next stages involve determining, creating, and evaluating the effectiveness of interventions that can stop MLTCs from developing or getting worse. Pouya Shafipour, MD, a board-certified family and obesity medicine physician at Providence Saint John’s Health Center in Santa Monica, California, told MNT he was not surprised by the study’s findings and asked why so many conditions co-occur with diabetes. Shafipour clarified, “This is something we expected because the state of insulin resistance in the body starts way before someone is diagnosed with diabetes. They frequently have fatty livers and insulin resistance, and that’s when the body’s damage to all of the organs really begins. Diabetes increases the risk of several conditions, including atherosclerotic heart disease, cerebrovascular disease (CVD), stroke, retinopathy, neuropathy, and kidney disease,” he continued. As a result, it was not at all surprising because the ailment actually affects the entire body.

In addition, Yu-Ming Ni, MD, a board-certified cardiologist and lipidologist at Fountain Valley, California’s MemorialCare Heart and Vascular Institute at Orange Coast Medical Center, concurred with MNT’s assessment. Diabetes affects a wide range of conditions, according to Ni. We are discussing an issue with the body’s metabolism of sugar. It has an impact on more than just blood sugar levels. It has an all-encompassing effect on how your body functions physically and how well your organs function. From a cardiac perspective, we frequently consider heart disease to include conditions like high blood pressure, coronary artery disease, and the risk of heart attack and stroke,” he said. All of this is related to diabetes; it is not only a direct result of diabetes’s impact on organ and blood vessel function, but it also occurs in tandem with diabetes as a result of underlying metabolic issues, particularly obesity. Therefore, I do not find the study’s conclusions surprising. It merely emphasizes how seriously long-term diabetes exposure can impact your health in a variety of ways.

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New treatment may stop and potentially reverse some nerve damage in MS

New treatment may stop and potentially reverse some nerve damage in MS

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The neurological condition known as multiple sclerosis (MS) is a chronic illness that can cause paralysis, vision loss, and muscle weakness. It happens when the myelin sheath, which envelops and shields nerve cells, is attacked by the immune system. Current therapies seek to inhibit the immune system to stop additional nerve cell damage. A new study has produced a therapy that may be able to reverse the damage caused by multiple sclerosis and even help regenerate myelin.

The autoimmune disease known as multiple sclerosis (MS) causes the immune system to target and destroy the nerve cells’ myelin sheath. People in their 20s to 40s are the most common age range to experience it. The myelin sheath is attacked by immune cells, which results in inflammation and blocks the flow of nerve impulses throughout the body. This can cause neurological symptoms, such as fatigue, vertigo, bowel and bladder issues, muscle weakness, numbness, tingling, and pain, mobility issues, and vision loss.

Current therapies can alleviate symptoms, lessen the frequency and intensity of relapses, and slow the disease’s progression all while there is currently no known cure. Current treatments for MS work by targeting the immune system, which reduces the likelihood that the immune system will attack the protective myelin coating around nerves. Now, researchers have developed a treatment that can help regenerate myelin around nerve cells, potentially reversing the damage caused by MS. However, we also need to figure out how to fix the myelin that has already been harmed.

Restoring the protective sheath of nerve cells
Cells known as oligodendrocytes produce the myelin sheath that envelops and shields nerve cells. Myelin sheath damage cannot be repaired in an MS patient because these cells are lost in the disease. Regenerating myelin and activating oligodendrocytes have not always been successful in animal studies. A study on mice indicates that improving myelin production could be accomplished through an epigenetic strategy. A recently developed drug called PIPE-307 blocks the M1R receptor, allowing the oligodendrocyte precursor cells (OPCs) to differentiate into oligodendrocytes that can then form new myelin sheaths. The OPCs fail to differentiate into oligodendrocytes in people with MS. The researchers used this toxin from the venom of a green mamba snake to identify and locate this receptor protein on OPCs. Once the drug’s receptor had been identified and demonstrated to be able to block it, the researchers tested the drug’s effectiveness in vitro using isolated OPCs.

The medication caused the OPCs to develop into oligodendrocytes and start myelinating neighboring nerve axons because it blocked the M1R receptor more effectively than other medications. Additionally, because it could pass through the blood-brain barrier, it might be able to repair damaged brain nerve cells. After researching the biology of remyelination, we have developed a precise therapy to activate it, which is the first of a new class of MS therapies. Ten years ago, we found a way for the body to regenerate its myelin in response to the appropriate molecular signal, reversing the effects of MS.

Animal and phase 1 human trials show promise
Using slices of mouse brain tissue, the researchers conducted additional in vitro experiments and discovered that PIPE-307 enhanced the myelination of nerve cell axons. The drug was then given orally to mice (MOG-EAE mice) that had been genetically engineered to develop inflammatory demyelination as a model for multiple sclerosis. The mice not only displayed enhanced nerve cell myelination, but they also regained some of their lost functionality. This research, which used human tissue and animals, indicates that PIPE-307 has the potential to be used as a myelin repair treatment. Because PIPE-307 was well tolerated and had no negative effects in a phase 1 trial in healthy people, the researchers are moving on to a phase 2 trial to determine whether it is an effective treatment in people with MS. But to truly know whether this medication will be effective, we must see the outcomes of clinical trials involving MS patients.

Early progress could give hope to MS patients
With differing degrees of success, other medications, such as the first-generation antihistamine clemastine, have been studied as possible myelin repair therapies. The news release quoted Ari Green, MD, co-author of the paper and chief of the division of Neuroimmunology and Glial Biology in the UCSF Department of Neurology, as saying: “Clemastine is not a targeted drug, affecting several different pathways in the body.”. However, we quickly observed that its pharmacology with muscarinic receptors may lead to the development of more effective restorative treatments for MS patients.

Furthermore, their results imply that PIPE-307 is more successful in myelin restoration and M1R receptor blocking. It is still very early, though, and the recently started phase 2 trial will need to demonstrate that the medication is both safe and effective to take, with no serious side effects. As Astbury concluded, there is a critical need for efficient treatments for MS patients. Over 150,000 MS patients reside in the United States. K., and many of them lack access to any kind of care. We hope to see a cocktail of medications in the future that can stop immunological reactions, restore myelin, and shield nerves from additional harm. If additional trials prove fruitful, PIPE-307 might be included in that mix.

REFERENCES:

https://www.aol.com/treatment-may-stop-potentially-reverse-144117447.html

https://www.hopkinsmedicine.org/news/articles/2024/02/tipping-the-balance-in-ms#:~:text=Although%20there%20currently%20is%20no,MS%2Dlike%20symptoms%20in%20mice.

https://www.medicalnewstoday.com/articles/new-treatment-may-stop-potentially-reverse-nerve-damage-ms

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