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Links between sleep brain waves and blood sugar control.

Links between sleep brain waves and blood sugar control.

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Diabetes is a disorder that makes it difficult for the body to regulate blood sugar levels.

When the body stops generating or responding to the hormone insulin, which controls blood glucose (sugar), blood glucose levels rise too high.

Poor sleep quality and higher blood sugar levels are related, according to research. A recent study has discovered that certain deep sleep brain waves are connected to the control of blood sugar levels.

The researchers hypothesise that elevating particular deep-sleep brain waves could lower the incidence of type 2 diabetes.

More than 6% of the world’s population currently has diabetes, which is on the rise globally. The American Diabetes Association estimates that 37.3 million Americans, or 11.3% of the population, have diabetes, with more than 35.4 million of those having type 2 diabetes.

96 million Americans aged 18 and older had prediabetes in 2019, which is a condition in which blood glucose (sugar) levels are increased but not high enough to be classified as diabetes.

The risk factor for type 2 diabetes, prediabetes, frequently has no symptoms and can go unnoticed for a very long time.

To lower the chance of acquiring type 2 diabetes, the National Institutes of Health recommend many lifestyle modifications, including:

  • if a person is overweight, reducing 5–7% of their body weight and maintaining that weight loss
  • getting up to 30 minutes of exercise five times each week
  • consuming fewer servings and making an effort to consume nutritious foods the majority of the time.

What connection exists between sleep and diabetes?

Numerous studies have connected poor blood glucose control and sleep issues. Raised blood glucose levels and a higher risk of type 2 diabetes are all linked to inadequate sleep length, poor sleep quality, and sleep disorders such insomnia and sleep apnea.

Now, a study has postulated a mechanism through which deep sleep is associated with lower blood glucose levels and contends that sleep quality rather than quantity is a better predictor of blood glucose levels.

Researchers discovered a connection between some deep sleep brain waves and better blood sugar regulation the next day.

According to the study, which was published in Cell Reports Medicine, deep sleep enhances the body’s sensitivity to insulin by stimulating the parasympathetic nervous system, leading to better blood sugar regulation.

According to study co-author and researcher Vyoma D. Shah of the Centre for Human Sleep Science, “the association with blood glucose control appears to be strongly explained by a link between deep sleep oscillations and specific alteration in insulin sensitivity, rather than insulin synthesis, storage, or secretion.”

The study noted that “the causal chain by which this occurs in humans is still unexplored.”

Brainwaves suggest a metabolic connection

Although she was not engaged in this study, Fiona McLoone, a research communications officer at Diabetes UK, commented:

“This study gives us more information about how the brain regulates blood glucose levels while we sleep; however, more research is required to determine whether assistance with improving sleep could benefit those who have type 2 diabetes or are at risk for developing it.”

Previous studies have suggested that decreased glucose metabolism is related to a shortening of slow-wave, or deep, sleep.

In a laboratory experiment, it was discovered that healthy young people’ insulin sensitivity significantly decreased when slow-wave sleep was inhibited, which in turn reduced glucose tolerance and raised the chance of developing diabetes.

Researchers found that clusters of strong wave ripples from the hippocampus, which happen during non-REM sleep, caused a drop in blood sugar levels in the rats within 10 minutes.

In the current investigation, the researchers first examined 647 people’s nocturnal polysomnography results as well as their next-morning glucose and insulin readings. They subsequently conducted their trials once more on a different 1,996 subjects.

They were looking to see if coupled non-REM spindles the night before were linked to better peripheral blood glucose levels the next day.

Other variables known to affect blood glucose management, such as age, gender, race, body mass index (BMI), hypertension, quantity of sleep, and sleep quality, were accounted for in both groups.

They discovered that the coupling of slow waves and sleep spindles during deep sleep was connected to better blood glucose regulation the next morning.

How could REM sleep affect blood sugar?

The parasympathetic nervous system’s activity, according to the authors, may be the cause of the influence on blood glucose.

They discovered that deep sleep activated this area of the nervous system, causing the body to become more sensitive to insulin, causing the body to absorb more glucose from the bloodstream into cells, so reducing blood sugar.

As Shah commented that the results of our study are not applicable to all deep sleep in general, but rather to the coupling (nearly simultaneous or time-locked occurrence) of slow oscillations and spindles in deep sleep, despite the fact that there are numerous techniques that can alter brain waves during sleep, including electrical, audio stimulation, and better sleep hygiene to increase the ease of falling asleep and the likelihood of staying asleep.

The connection might not be direct

The researchers issue a warning that their results do not prove a causal link between better blood glucose regulation and deep sleep. They do, however, offer a theory as to how the link occurred.

According to Shah, “based on a seminal study in rats that inspired this study, it is plausible that during sleep, hippocampal sharp wave ripples which we index by measuring slow oscillation-spindle coupling in this study send a signal to a relay station called the lateral septum, which in turn modulates blood glucose levels.”

The authors also make the case that monitoring brain waves during deep sleep could be a non-invasive way to determine how well someone is controlling their blood sugar.

What will the upcoming research focus be?

We learned from Shah that “our findings are the first to demonstrate an association between these particular deep sleep brain waves (slow oscillation-spindle coupling) and glucose regulation, reiterating the significance of sleep in the clinical management of hyperglycemia.”

“We hope this study paves the way for future research that can better understand the causal mechanisms underlying these associations, and eventually, develop therapeutics to enhance slow-oscillation spindle coupling during sleep, to better control blood sugar levels,” she continued.

She also outlined possible areas for further study, such as measuring glucose levels at various times and examining whether slow oscillation and spindle coupling may be used to change glucose regulation or vice versa.

However, as McLoone cautioned, “Some people are more at risk of developing type 2 diabetes than others, and getting a good night’s sleep is an essential component of good health, but currently the best evidence for reducing the risk of developing type 2 diabetes involves eating a healthy, balanced diet and keeping active.”

REFERENCES:

For Diabetes medications that have been suggested by doctors worldwide are available here https://mygenericpharmacy.com/index.php?therapy=13

Cardiovascular benefits in elderly from antidiabetic drugs.

Cardiovascular benefits in elderly from antidiabetic drugs.

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Researchers found that some types of diabetes medications can lower the risk of heart illnesses when coupled with other diabetic medications in a trial including older military veterans.

According to experts, heart health problems are widespread in diabetics, thus a larger segment of the population may benefit from the research. Drugs for GLP1, DPP4, and SGLT2 were used in the trial.

According to a study published today in the Annals of Internal Medicine, some diabetic drugs may reduce the risk of cardiovascular events when combined with other diabetes treatments.

Researchers compared conventional diabetes treatment plans to three key classes of diabetes medications: GLP1, DPP4, and SGLT2.

Recent clinical trials for novel diabetes medicines, the researchers noted:

  • tested the medications only against a placebo, not in competition with one another
  • only tested on individuals with heart disease when examining the cardiovascular benefits

The best pharmaceutical class for lowering the risk of cardiovascular disease, even in those without a history of the condition, was something the researchers sought to determine.

They claimed that when compared to DPP4 treatments, GLP1 therapies lowered the risk of adverse cardiovascular events and hospitalisations for heart failure.

Compared to DPP4 medications, SGLT2 therapies did not lower the number of hospitalisations for heart failure or cardiovascular events.

Information about the diabetic drug study

Between 2001 and 2016, the researchers examined the medical records of approximately 100,000 veterans who had been prescribed diabetes drugs including metformin, insulin, or sulfonylurea.

Then, one of the three more recent drugs—GLP1, DPP4, or SGLT2—was introduced. Following up was done until 2019.

Agonists of the GLP1 receptor included:

  • Exenatide
  • Liraglutide
  • Semaglutide

Inhibitors of SGLT2 included:

  • Empagliflozin
  • Dapagliflozin
  • Canagliflozin

Among the DPP4 inhibitors were:

  • Alogliptin
  • Linagliptin
  • Saxagliptin
  • Sitagliptin

Participants’ median ages ranged from 67 to 8.5 years, and their median time with diabetes was 8.5 years.

The results revealed:

When compared to DPP4 inhibitors, GLP1 reception agonists have a 20% lower incidence of significant adverse cardiovascular events and heart failure hospitalisations in persons with type 2 diabetes who have never had a heart condition. The risk reduction amounts to around three fewer heart failure episodes, strokes, or fatalities per 1,000 patients using the drug for a year.

When compared to DPP4 inhibitors, SGLT2 inhibitors did not lower hospitalisations for heart failure and cardiovascular events.

Dr. Kathleen Dungan, an endocrinologist at The Ohio State University Wexner Medical Centre, said that therapy should focus on effectiveness in reaching and maintaining treatment objectives for glucose and weight management.

As a result, she said, “some GLP1-based therapies have greater potential to help patients achieve these goals than SGLT2i or DPP-4 inhibitors.” The complexity and method of administration, patient desire, other co-occurring illnesses, side effects, and cost are all person-centered aspects that may be more significant.

Dungan stated that “some limitations [of this study] prevent our ability to directly apply the findings to usual care.” These include a brief follow-up period, a lack of demographic diversity, missing or incomplete data, and nonrandom prescribing patterns, any of which could affect the study findings.

He told us, “This study provides important information on using two classes of diabetes medications, especially for people without known cardiovascular disease.”

The significance of the diabetic medication research

People with diabetes have a younger average age of onset and a twofold increased risk of heart disease. According to the Centres for Disease Control and Prevention, having diabetes increases your risk of developing heart disease.

Additionally, elevated blood pressure, “bad” cholesterol, and triglyceride levels are more prevalent among diabetics. These ailments can make you more likely to experience a cardiovascular incident.

Dr. Sanjay Bhojraj, an interventional cardiologist at Providence Mission Hospital in California, remarked, “This study is a superb example of the new convergence of therapeutics for diabetes and cardiovascular diseases.”

“In the past, the cardiology community has mainly refrained from optimizing diabetic drugs either out of worry over medication-related problems or out of fear of alienating other treating physicians. Primary prevention studies like this one are an appeal to cardiologists to finally enter the fray and treat diabetes like we treat cholesterol or deal with quitting smoking.”

According to Bhojraj, “Now we have real-world data, in a [veterans] population, suggesting a significant decrease in major adverse cardiovascular events using GLP-1 receptor antagonists in patients who have diabetes without prior [cardiovascular disease],” she said. This could help the doctor decide which class of diabetic medication to add to standard-of-care treatment regimens to reduce cardiovascular risk.

It’s interesting to note that both the GLP-1 and SGLT-2 medication classes had positive treatment outcomes in the whole group of individuals undergoing primary and secondary prevention.

The bottom line, the cardiology community needs to take action and incorporate glucose optimization into our treatment strategies, according to Bhojraj, “if we truly want to protect our patients from serious adverse cardiovascular events.”

Treating coexisting conditions common with diabetes

According to a 2019 study, nearly 75% of patients had at least one other chronic health condition when they received a type 2 diabetes diagnosis. 44% of people have two or more conditions.

Diabetes and a number of other common comorbid illnesses include:

  • obesity
  • dyslipidemia
  • blood pressure is high.
  • heart condition
  • renal illness
  • mental health conditions
  • sleep problems
  • cancer

According to Dr. Minisha Sood, an endocrinologist at Lenox Hill Hospital in New York, “Generally speaking, a GLP1 RA is preferred over an SGLT-2 for the weight benefit in patients with diabetes and obesity – two conditions which overlap more often than not.”

But she added, “This study also reveals another advantage of selecting a GLP1 over an SGLT-2 in patients without cardiovascular disease.”

These medications can help with other comorbid conditions as well, experts point out.

Dr. Rigved Tadwalkar, a cardiologist at Providence Saint John’s Health Centre in California, said, “This research is encouraging and supports a growing body of evidence that these medications have multiple beneficial effects.”

“GLP-1 receptor agonists are currently being used to treat obesity off-label, according to the literature. He informed us that SGLT2 inhibitors are also licensed to treat chronic renal disease and heart failure.”

REFERENCES:

For Alzheimer’s disease medications that have been suggested by doctors worldwide are available here https://mygenericpharmacy.com/index.php?therapy=11

Reduce the Dementia risk by strict blood pressure control.

Reduce the Dementia risk by strict blood pressure control.

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The effects of intensive versus routine hypertension treatment on brain lesions were examined by researchers at the University of Texas Health Science Centre in San Antonio.

The researchers discovered that intensive therapy that maintains blood pressure within normal bounds is associated with a slowed progression of lesions using data from a previous study.

The study results could influence treatment strategies for hypertensive patients to lower the likelihood of lesions that can result in diminished cognitive performance with further research and trials.

Millions of people have hypertension, which can lead to strokes and brain lesions and compromise brain health.

An aggressive blood pressure regimen can slow the growth of white matter lesions in the brain, according to a recent study headed by UT Health San Antonio.

In contrast to patients with systolic blood pressure readings of 140 mm Hg, the researchers compared the MRI scans of individuals who maintained blood pressure levels below 120 mm Hg.

What is considered hypertension?

Millions of Americans suffer from the medical disease known as hypertension, sometimes known as high blood pressure. Nearly half of American adults have hypertension, which the Centres for Disease Control and Prevention claim contributed to more than 670,000 deaths in 2020.

Blood vessel damage and other health issues can result from high blood pressure. Heart attacks and strokes are two conditions brought on by hypertension.

The following blood pressure ranges are described by the American Heart Association:

For individuals, a normal blood pressure reading is defined as an upper number (systolic) less than 120 over a lower number (diastolic) of 80 mm Hg.

  • Blood pressure that is elevated is 120 to 129 over 80 or less.
  • Hypertension in stage 1 is defined as 130-139 above 80-89.
  • 140 over 90 or higher indicates stage 2 hypertension.

When the systolic and/or diastolic values exceed 180 and 120 respectively, a hypertension crisis ensues.

As the cardiologist, Dr. Kershaw Patel points out in the Houston Methodist podcast On Health, “When we talk about high blood pressure, we must realise it affects not just the heart, but also the brain, the kidneys, and other organs in the body.”

Although doctors frequently prescribe prescription drugs to treat high blood pressure, patients can also try to lower or normalise their blood pressure by making changes to their lifestyle.

Dr. Patel stated that lifestyle changes and then drugs are commonly used to manage high blood pressure. And it really comes down to two-thirds lifestyle and one-third medicine. By adjusting a few aspects of our lifestyle, we can significantly lower our blood pressure.

Blood pressure can be normalised by giving up smoking, consuming less alcohol, exercising, eating a low-sodium diet, and eating more fruits and vegetables.

lowering one’s blood pressure to 120

The American Academy of Family Physicians’ (AAFP) standard of care for hypertensive patients is to lower their systolic blood pressure to 140 mm Hg. This goal lowers the risk of cardiovascular death, according to the AAFP.

To assess the effect on white matter lesions (WMLs), the UT Health San Antonio researchers compared the normal treatment target to a more rigorous therapy. The goal of the rigorous treatment program was to lower participants’ systolic blood pressure to under 120 mm Hg.

The researchers examined data from 458 participants using information from the Systolic Blood Pressure Intervention Trial (SPRINT), which tracked participants for 4 years. Participants in the study were “aged 50 years or older with hypertension and without diabetes or a history of stroke,” according to the study’s authors.

At the start and conclusion of their trials, the researchers matched each participant’s treatment to their MRI images. They were searching for WMLs, a type of injury to the brain’s white matter that can result in cognitive impairment.

Treatment that is intensive lessens brain damage

According to the study’s findings, the intensive treatment group’s WML volume progression and fractional anisotropy (FA) declines were slower than those of the conventional treatment group.

The FA result is noteworthy since it represents a “measure of connectivity in the brain.” The right splenium, right tapetum, and left anterior corona radiata are a few of the brain areas that saw slower WML growth.

The study also demonstrates that aggressive blood pressure management may be able to maintain some myelin structure, which, according to the scientists, “ultimately slows the progression of injury patterns associated with dementia.”

According to research author Dr. Tanweer Rashid, who works with the Biggs Institute at UT Health San Antonio, “our study shows that specific areas have greater benefit, representing sensitive regions to track in future trials evaluating small-vessel disease.”

How white matter is impacted by blood pressure?

The study’s findings were discussed by Dr. Arun Manmadhan, a cardiovascular disease expert at Columbia University Irving Medical Centre in New York City.

“White matter lesions are abnormally damaged regions of tissue in the white matter of the brain. According to Dr. Manmadhan, they are frequently brought on by anomalies in the tiny blood arteries that provide oxygen and nutrients to the brain.”

Dr. Manmadhan provided more information on the study’s findings, namely how blood pressure may affect WMLs.

“The current report, which is a SPRINT-MIND substudy, examined the impact of stringent blood pressure management on changes in the brain’s white matter as determined by MRI.”

According to Dr. Manmadhan, the results here point to a potential benefit of tight blood pressure control in slowing the development and progression of white matter lesions, which are linked to a higher risk of dementia and cognitive decline.

Overall, according to Dr. Manmadhan, the study is an asset to the field of hypertension.

This study “adds to the already substantial body of literature that managing blood pressure is very important for not only preventing cardiovascular events but also in maintaining memory and cognition,” the author added.

REFERENCES:

For Dementia disease medications that have been suggested by doctors worldwide are available here https://mygenericpharmacy.com/index.php?cPath=77_478

Is Covid-19 linked to a rising risk of developing diabetes?

Is Covid-19 linked to a rising risk of developing diabetes?

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The question of whether or not viral infections can raise the chance of getting diabetes has been the subject of research for some time.

The virus that causes COVID-19, SARS-CoV-2, has now prompted scientists to investigate whether diabetes risk can be raised by SARS-CoV-2 infection.

According to recent data, the COVID-19 pandemic may have contributed to a 3-5% rise in the overall disease burden of diabetes in the Canadian population.

In order to prevent further injury to those who have been harmed, this evidence supports requests for greater observation of blood sugar levels in COVID-19 survivors.

The complete impact on the health of the worldwide population has not yet been fully appreciated, although the COVID-19 pandemic has so far caused close to 7 million fatalities, according to the World Health Organisation (WHO).

COVID-19 and diabetes association

This is not the first time that research has drawn attention to a possible connection between diabetes and SARS-CoV-2 infection.

American retrospective cohort research that was published in the BMJ in May 2021 showed that people who become infected have a considerably higher risk of diabetes. A prior article in Nature demonstrated an increased likelihood of metabolic diseases, including diabetes, being diagnosed after an illness.

The ability of SARS-CoV-2 to infect human pancreatic cells—which produce insulin and are harmed and eventually destroyed in diabetics—was proven later that year in a study published in the journal Cell Metabolism. The loss of these cells could potentially be caused by infection, suggesting a potential underlying mechanism to explain the relationship.

Since then, cohort studies have indicated a greater incidence rate of type 2 diabetes, but not type 1 diabetes, after infection. One such study was reported in Diabetologia. Another retrospective cohort study employing Veterans Health Administration data, which was published in Diabetes Care, revealed that males, but not women, saw a rise in the incidence of all diabetes diagnoses following SARS-CoV-2 infection.

Children are more likely to be diagnosed with type 1 diabetes than adults are, according to a cohort study that was published in PLOS One. The risk of type 1 diabetes diagnosis after infection was also found to be higher in American Indian/Alaskan Native, Asian/Pacific Islander, and Black populations.

Diabetes is 22% more likely to develop

Now, a study involving 629,935 persons, with an average age of 32, has found that men who tested positive for SARS-COV-2 between January 1, 2020, and December 31, 2021, had a 22% higher risk of developing diabetes in the eight months after infection than men who hadn’t been exposed.

Based on age, sex, and date of infection, researchers matched pairings of individuals with a confirmed case of COVID-19 and those who hadn’t, using data from the British Columbia COVID-19 Cohort, a database of SARS-CoV-2 infection in British Columbia, Canada.

When the results were stratified by the severity of the disease, researchers discovered that those who had COVID-19 when they were admitted to the hospital had a 2.4-fold increased risk of developing diabetes compared to those who hadn’t been infected, and those who were admitted to intensive care had a 3.29-fold increased risk.

When these cases were taken into account, the data revealed that women were also more likely to acquire diabetes following infection with SARS-CoV-2, albeit this tendency was not significant when only moderate cases were taken into account.

The scientists were unable to differentiate between type 1 and type 2 diabetes using the data they had access to since this link was only discovered for non-insulin-dependent diabetes.

Risk of diabetes with viral infections

It is unclear precisely how SARS-CoV-2 infection causes these long-term consequences, as it is with other long-term side effects. It is not the first time that a viral infection has been connected to a higher chance of acquiring diabetes, but the mechanisms underlying the association are still unknown.

The effect of Coxsackievirus B infection on the risk of type 1 diabetes has been extensively investigated, along with the effects of mumps, rubella, and cytomegalovirus, according to Dr. Fares Qeadan, associate professor of biostatistics at Loyola University Chicago who was not involved in the study.

Researchers have also looked into the potential roles of inflammation, insulin resistance, and impacts on pancreatic cells in the relationship between hepatitis C virus infection and the risk of type 2 diabetes.

In conclusion, viral infections have been linked to a higher risk of developing both type 1 and type 2 diabetes. The evidence for type 1 diabetes is stronger and includes a wider range of viruses, but the data for type 2 diabetes is more limited and mostly concentrates on particular viral diseases like the hepatitis C virus. Dr. Fares Qeadan stated that more study is required to pinpoint the precise processes by which viral infections influence the onset of diabetes and to create preventative measures.

Diabetes or long COVID, which is it?

As the clinical characterisation of long-COVID is still being developed, experts cautioned that it was a complicated topic to determine whether the onset of diabetes following infection with SARS-CoV-2 might be regarded a symptom of long-COVID.

Dr. Morgan Birabaharan, a physician and virus researcher from the University of California, San Diego’s Division of Infectious Diseases and Global Public Health who was not involved in the study, stated:

The onset of diabetes may fall within the category of protracted COVID, which is used to characterise a variety of symptoms and illnesses that appear after the acute phase of SARS-CoV-2 infection (>30 days).

To classify what side effects of SARS-CoV-2 infection are ‘long COVID’ vs. some other process, he said, “is difficult because we are still trying to understand the pathophysiology of long COVID, whether it be persistent viremia, dysregulated immune response, or some other phenomenon.”

This most recent article backed suggestions for aggressive management of this, saying that the population-level effects of a rise in diabetes cases caused by the COVID-19 pandemic could also be considerable.

In any case, Dr. Qeadan said, “Recognising the potential link between SARS-CoV-2 infection and the onset of diabetes is important for healthcare professionals as it highlights the need for careful monitoring of blood glucose levels and early intervention in people who have had COVID-19.”

“This can help lessen the long-term effects of diabetes on the affected individuals and reduce the overall burden on healthcare systems,” he continued.

After COVID, diabetic symptoms

Increased thirst and hunger, frequent urination, unexplained weight loss, exhaustion, and hazy eyesight are all typical early indicators of diabetes, according to Ricordi.

If you had COVID-19 and any of these symptoms, it would be worthwhile to request a diabetic screening from your doctor, especially if you have risk factors or a family history of the disease.

One should see their primary care physician if any of these symptoms or indicators are present, according to Ricordi.

The conclusion

An increased risk of diabetes has been linked with COVID-19, according to recent research. Diabetes may be another factor contributing to extended COVID, according to the study. Endocrinologists think COVID-19 may harm the pancreas and affect how it releases insulin, though additional research is required to fully understand the association.

REFERENCES:

For Diabetes medications that have been suggested by doctors worldwide are available here https://mygenericpharmacy.com/index.php?therapy=13

Can Bariatric surgery treat people with obesity & diabetes?

Can Bariatric surgery treat people with obesity & diabetes?

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Diabetes is a chronic disease that can cause nerve damage among other long-term problems. One method of weight loss is bariatric surgery, which may be necessary for some obese people.

According to a recent study, bariatric surgery may benefit those who have type 2 diabetes by reducing peripheral neuropathy. To assist patients in maintaining a healthy body weight, doctors employ a range of strategies. Bariatric surgery may be advantageous for those who are obese.

To fully comprehend the advantages of bariatric surgery, researchers are still working. How bariatric surgery might affect particular diabetic problems is one topic of investigation.

An investigation of the effects of bariatric surgery on diabetic complications in obese patients was recently published in Diabetologia.

Researchers saw stabilisation of retinopathy and cardiac autonomic neuropathy as well as improved peripheral neuropathy.

long-term impact of diabetes

Diabetes is a persistent disease. It has to do with how well the body can use glucose (sugar) for energy and the hormone insulin.

Diabetes has a number of long-term problems that might develop if it is not well managed. For instance, peripheral neuropathy, which is nerve damage that affects the feet, legs, arms, and hands, is one problem.

Another is retinopathy, which eventually harms the eyes and impairs vision. The nerves that govern the heart are also damaged in cardiac autonomic neuropathy. These damage areas may result in poor health and a lower quality of life.

Dr. Denise Pate, a board-certified medical professional and Medical Director at Medical Offices of Manhattan who was not engaged in the current study, provided additional details regarding the harm peripheral neuropathy causes:

Peripheral nerves are responsible for detecting sensations of touch, pain, and warmth. When these nerves are harmed by high blood sugar levels, the body is no longer able to perceive these stimuli. This can cause discomfort and, even worse, put a diabetic at danger of failing to notice minor damage to their extremities. These minor wounds carry the risk of skin and bone infection and, ultimately, amputation.

Bariatric surgery is recommended?

Obesity is a condition that some type 2 diabetics may also have. Some surgical treatments may be suggested by doctors as a result of these contributing variables.

There are several different bariatric surgery choices, and they can help in maintaining weight loss. For those who have had trouble reducing weight through other methods including diet and exercise, these solutions might be helpful.

Without participating in the study, Dr. Mir Ali, a bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Centre at Orange Coast Medical Centre in Fountain Valley, California, told that “the indications for bariatric surgery currently accepted by most insurance carriers is a BMI greater than 40 or 35 with additional comorbid conditions, such as diabetes, hypertension, or sleep apnea.”

“The goal with surgery, which has been demonstrated in many studies, is to resolve or improve comorbid conditions, increase life expectancy, and improve the quality of life,” he continued.

Bariatric surgery benefits for diabetes

This prospective cohort study examined the effects of bariatric surgery on metabolic risk variables and the reduction of diabetic complications. The components of the analysed metabolic risk factors included weight, cholesterol, and blood sugar levels.

79 patients who underwent bariatric surgery and finished the 2-year follow-up were included in the study. All subjects had obesity of class 2 or 3.

The data revealed a decrease in peripheral neuropathy after two years. Cardiovascular autonomic neuropathy and retinopathy remained constant. Additionally, participants’ quality of life and pain levels improved, according to researchers.

The majority of the metabolic risk indicators, including weight loss, showed improvement. They also discovered a link between improvement in retinopathy and improvement in fasting glucose levels.

Benefits of weight-loss surgery

In the 18 to 24 months following surgery, the majority of patients lose 50 to 80% of the extra weight. But following surgery, the impacts on blood sugar start happening right away (within days). Patients who have this procedure can decrease or stop taking their diabetes medications.

Particularly helpful at managing diabetes is Roux-en-Y surgery. After surgery, about 33% of these patients do not require diabetes medication. 85% of patients are medication-free within two years of surgery. Their diabetes is no longer an issue.

People with a kind of diabetes that does not require medication and those with diabetes for less than five years have a higher likelihood of experiencing complete remission from the disease.

The dangers of weight loss surgery

The following are possible risks linked to these procedures:

  • Anaesthesia doesn’t work well.
  • surgery-related harm to neighbouring organs.
  • Bleeding.
  • production of blood clots.
  • Infection.
  • The tissue that surrounds and supports the internal organs in the abdomen experiences peritoneal inflammation, or peritonitis.

Additional dangers comprise:

  • the intestines are blocked.
  • development of kidney and gallstones.
  • Anastomotic stenosis is the medical term for narrowing of the stomach-to-intestine opening.
  • Early and late dumping syndromes include nausea, abdominal pain, and vomiting after eating.
  • Malnutrition.

limitations of the study and further research

There were certain restrictions on the study. First of all, there were not enough volunteers and there was no control group. Additionally, some of the patients who underwent bariatric surgery made it challenging for the researchers to follow up with them.

The fact that they were then constrained by the follow-up period shows the need for research that focus more on the immediate impacts and have even longer follow-up periods. There is a need for future studies with a wider range of participants because more than 98% of the participants were non-Hispanic and more than 73% were women.

The results of the study do not prove a causal connection between the variables they looked at. Further research into this topic may shed more light on the subject because researchers only employed particular assessments of peripheral neuropathy.

When reviewing the study’s findings, D.R. Pate issued the following warnings: The type of bariatric surgery was also not thoroughly analysed in that of the 79 patients, 71 received sleeve gastrectomy and 8 got gastric bypass surgery. We may conclude that weight loss in general, and not necessarily the method through which the weight loss occurred, was crucial to the outcomes as the type of technique was not further evaluated for the outcome.

Dr. Callaghan stated that he and his associates “We are currently conducting a study to see which treatment for peripheral neuropathy, exercise, bariatric surgery, or both, helps the most.”

He explained, “This is a randomised trial that will offer even more reliable information on the effects of exercise and bariatric surgery on peripheral neuropathy.”

REFERENCES:

For Diabetes medications that have been suggested by doctors worldwide are available here https://mygenericpharmacy.com/index.php?therapy=13

Is moderate exercise safe for the muscles of statin users?

Is moderate exercise safe for the muscles of statin users?

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According to a recent study, statin users are concerned about exercising. Because they think it can cause muscle damage and shouldn’t be. Both the statin-taking participants and the control participants in the research reported similar muscle soreness after moderate activity.

Nonetheless, statin users are not advised to engage in vigorous activity. Those on statins who are reluctant to exercise out of concern that it could harm their muscles should take heart from a recent study.

Some persons using the cholesterol-lowering medication claim to have muscle pain, and they may stop engaging in cardiovascular-healthy physical exercise.

The study reveals that statin users, regardless of whether they have muscle issues or not, have the same muscle-related consequences from moderate-intensity exercise.

Everybody who engages in such exercise is likely to experience brief muscle soreness and weariness. For those using statins, this is also accurate. Statin users, however, recovered slightly more slowly than trial participants who did not take any medication.

The effects of exercising at a moderate intensity were examined in this study. According to other studies, patients using statins are more likely to have skeletal muscle injuries when engaging in eccentric, or high-intensity, activity.

The most recent research results have been published in the Journal of the American College of Cardiology. The study’s results are crucial for the cardiovascular health of statin users, as is highlighted in an editorial that is included with the paper.

An analysis of the effects of walking

100 people took part in the study as a participant. This comprised 31 individuals not taking statins as a control group. 34 individuals on statins who did not display any muscle difficulties. And 35 individuals taking statins who had statin-associated muscular symptoms.

Before the research, those taking statins had been doing so for at least three months. The following health conditions were omitted from the study: diabetes, hypo or hyperthyroidism, and genetic skeletal muscle disease. Supplement users of CoQ10 were also not included.

Body mass index (BMI), waist circumference, levels of physical activity, and vitamin D3 levels were identical at the beginning of the trial. Those who had symptoms at the start of the trial scored higher on muscle soreness and fatigue.

The researchers looked at those who participated in the 4Days Marches, a four-day event in Nijmegen, the Netherlands. Participants walk anything between 18 and 30 miles each day.

“During four days, participants walk 30, 40, or 50 kilometers (18, 24, or 31 miles) each day. Accordingly, participants walk anywhere from 120 (74 miles) to 200 (124 miles) km over four days, according to the study’s lead author, Dr. Neeltje A.E. Allard of the Radboud Institute for Health Sciences and the Department of physiology at Radboud University Medical Center in the Netherlands.

The participants prepare beforehand because there is a lot of walking. In actuality, it was first held as a military exercise in 1909 and has since developed into the biggest walking competition in the world, in which both active duty personnel and casual walkers compete.

The effects of walking on muscular damage in people who experienced symptoms and those who did not were compared by the researchers.

What are statins?

Low-density lipoprotein (LDL) cholesterol, also known as “bad cholesterol,” can be reduced by using the statin drug class. The best treatment for hyperlipidemia is statins.

According to cardiologist Dr. David Lee from Oregon Health & Study University (OHSU), who was not engaged in the study, “high cholesterol” and a significant treatment after a heart attack.

He emphasised that they are crucial preventative measures against repeat heart attacks and strokes.

Further stating that statins “have been a primary reason that heart disease and strokes have declined dramatically since their debut in the early 1990s,” Emilee Taylor, a doctor of pharmacy who works at OHSU but is not involved in the present study, was quoted.

They have significant enough effects to lower all-cause mortality in persons with even modest cardiac disease, according to the researcher.

Workout volume matters.

The study included 31 non-statin users, 34 asymptomatic statin users, and 35 symptomatic statin users—those who experienced muscle issues as a result of taking statins.

Eighty percent of the participants with symptoms were men, and their average age was 64. The participants in the control group were all of the same age, and 62% of them were men. The asymptomatic participants were 82% male and slightly older, at 68 years old.

Each person took part in a moderate exercise regimen that involved walking 30, 40, or 50 kilometers (km) per day for 4 straight days at a pace of their choosing.

One or two days before the start of the walking experiment, researchers took the participants’ baseline measurements of height, weight, and waist circumference. Every 5 kilometers on the first walking day, their heart rates were recorded.

Participants’ weights were measured after the first, second, and third days to gauge their level of hydration. The researchers were able to gauge their walking pace and workout duration based on their start and finish times. An estimate of exercise intensity was provided using a heart rate-based calculation.

Finally, participants discussed how their muscles felt both before and after exercise. The effects of exercise were similar in both groups, the researchers discovered, except the fact that statin users required more time to recover from post-exercise muscle weakness than the control group.

Participants’ levels of CoQ10 were also monitored in the trial. CoQ10 has been suggested as a potential contributor to statin-related muscular issues.

The levels of CoQ10 were not different between the three groups, and they were also unrelated to muscular function, reported muscle problems, or injury signs.

Statin-associated muscle symptoms

SAMS, which stands for “statin-associated muscular symptoms,” is the aggregate term used to describe muscle issues that have been documented while taking statins. Myalgia, cramps, and a feeling of weak muscles are a few of these.

Due to worries about SAMS, some individuals who could benefit from statins choose not to take them or do not take the recommended amounts.

Regarding how common SAMS are, there is some disagreement. According to the American Academy of Cardiology, clinical observation studies show a substantially higher frequency of SAMS than randomized controlled trials do.

According to one survey of former statin users, 62% of them stopped using the medication due to negative effects.

The National Lipid Association (NLA) reports that research indicates the true incidence of SAMS is approximately 10%, with several studies indicating its prevalence among statin users to range from 5% to 25%. While the symptoms that patients experience are real, 80% of them, according to the NLA, are not brought on by statins.

For patients to be more aware of what to watch out for, Dr. Lee believes it is crucial that doctors adequately inform them of how SAMS often manifest.

Exercising on statins

The current advice for those taking statins was summarised by board-certified interventional cardiologist Dr. Michael S. Broukhim of Providence Saint John’s Health Center in Santa Monica, California. He was not involved in the study.

“Patients should establish a regular exercise regimen, with a preference for a moderate-intensity exercise programme,” he advised. “Patients should continue to take their statins at their maximally tolerated dose following discussion with their healthcare professionals.”

Dr. Broukhim noted that he advises 150 minutes of moderate activity each week, the same amount of exercise as is advised for those who do not take statins.

He advised against high-intensity exercise since it can increase the levels of muscle enzymes that can cause muscle damage in statin-using individuals.

Exercises with a moderate level of intensity include:

  • rapid walking
  • Cycling
  • Aquatic exercise
  • general exercises
  • Tennis pairs
  • tango dancing

According to Masi, doctors advise a mix of resistance training and cardiovascular exercise for people who wish to start working out. Everyone should begin at their own pace and abilities and progressively increase both duration and resistance, according to Masi.

REFERENCES:

For Muscle disease medications that have been suggested by doctors worldwide are available here https://mygenericpharmacy.com/index.php?cPath=28

The natural peptide could help tackle obesity and diabetes.

The natural peptide could help tackle obesity and diabetes.

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Smaller versions of proteins known as peptides can serve a variety of functions. This includes the potential to lessen the effects of ageing, reduce inflammation, or stimulate the creation of new muscle.

In 2015, scientists made the discovery of a kind of peptide known as PEPITEM and recognized its role in the adiponectin-PEPITEM pathway. It controls the onset and severity of autoimmune or chronic inflammatory disorders.

The potential for this peptide to provide a game-changing treatment for numerous diseases has just been discovered by new study in animal models.

The study suggests that the peptide may reduce the risk of type 2 diabetes and. Other illnesses are connected to obesity, like fatty liver disease.

Obesity alters the metabolism of adipose (fat) tissue significantly, damages the pancreas, reduces insulin sensitivity, and finally results in hyperglycemia (high blood sugar), which is the primary cause of type 2 diabetes.

It also causes a low-grade inflammatory response throughout the body. This encourages the infiltration of white blood cells into a variety of tissues, including visceral adipose tissue. It is a deep-lying fat deposit that surrounds organs like the liver and gut, as well as the peritoneal cavity, a thin membrane that encloses the gut.

According to a recent study, the adiponectin-PEPITEM pathway connects obesity, the related low-grade inflammatory response, and changes in the pancreas that take place before the onset of diabetes. The study was published in Clinical and Experimental Immunology.

To see if the effects of a high-fat diet on the pancreas could be avoided or even reversed, the researchers used a mouse model of obesity and a slow-release pump to inject the peptide PEPITEM.

When PEPITEM was given to mice on a high-fat diet, the researchers discovered that this significantly decreased the size of the insulin-producing cells in the pancreas. Also, the quantity of white blood cells in the visceral adipose tissue and peritoneal cavity as compared to the control group.

Small protein impacts some effects of obesity

The adiponectin-PEPITEM pathway, which is important in regulating the onset and severity of auto-immune and chronic inflammatory illnesses, is where the peptide employed in this study plays a part.

Obesity can have a variety of negative impacts on the body. This includes altering the metabolism of adipose tissue (fat), harming the pancreas, decreasing insulin sensitivity, etc. Ultimately causing the high glucose levels associated with type 2 diabetes.

But, it also triggers a low-grade inflammatory response, causing white blood cells to flow into visceral adipose tissue, which surrounds organs like the liver and gut, as well as into the area of the abdomen that houses the intestines, stomach, and liver (peritoneal cavity).

In the latest research, which was released on March 9 in the journal Clinical and Experimental Immunology, mice were administered PEPITEM in addition to a high-fat diet.

The size of the pancreatic beta cells that produce insulin was reduced in mice who received the peptide as compared to those who did not. Also, they noticed a reduction in the quantity of white blood cells in the peritoneal cavity and visceral adipose tissue.

“Our results show us that PEPITEM can both prevent and reverse the impact that obesity has on metabolism,” study author Asif Iqbal, PhD, an associate professor at the University of Birmingham’s Centre of Cardiovascular Sciences, said in the release.

The next step, he continued, is to transform these promising findings into human-useable treatments.

Reversing obesity

Dr. Christoph Buettner, an endocrinologist and professor of medicine at the Rutgers Robert Wood Johnson Medical School in New Brunswick, New Jersey, told Healthline that experts have known for many years that obesity and diabetes are connected with elevated inflammation.

In contrast, “although in mice various medications that particularly lower inflammation have demonstrated to also reduce obesity and diabetes, in humans—where obesity is also typically related with inflammation—the facts are much less clear,” he noted.

The current study’s findings imply that PEPITEM may be effective in lowering some of the negative consequences of obesity, including the growth of insulin-producing beta cells and the accumulation of white blood cells in particular regions.

Yet, mice given PEPITEM still put on weight when given a high-fat diet. The researchers added that there was “no effect” on fasting glucose tolerance or insulin resistance, both of which are impacted in type 2 diabetics.

“To me, that suggests that this is an anti-inflammatory treatment that is unlikely to have a meaningful effect on either obesity or high blood sugar,” said Buettner.

Aiding in type 2 diabetes prevention

This could “potentially be a useful additional tool for patients regarding the prevention or treatment of type 2 diabetes, especially as related to the decrease in enlargement of the beta cells,” according to Nicole Anziani, a registered dietitian, certified diabetes care and education specialist, and senior clinical manager for Cecelia Health who was not involved in the study.

For the purpose of examining PEPITEM’s effects on obesity, Anziani noted that the mice used in the study were fed a high-fat diet either before or during the administration of PEPITEM.

Anziani emphasised that it’s crucial to recognise that obesity has a complex aetiology, which means it can be brought on by a variety of variables and isn’t always related to a high-fat diet. Moreover, Anziani emphasised that obesity was “more than just a biological phenomenon.”

Discovering the root of obesity

While it’s great that there are more options for patients to help with the biochemical aspects of obesity and preventing systemic inflammation, especially when there may already be pancreatic damage present, Anziani told us that it’s also crucial to acknowledge the behavioural and social aspects related to the development of obesity and other related ailments.

To properly understand these pathways, she continued, “additional research into the relationship between inflammation and obesity is still needed.” “Although this therapeutic strategy is being examined to get to the underlying cause of obesity-related disorders,” she noted.

While stating that “additional studies would be required,” Dr. Bosa-Osario concurred and said that “the findings appear encouraging.”

PEPITEM might be a useful treatment target for additional causes, he added. “While the body can make a bioprotein comparable to PEPITEM, it can be made in a lab and administered to patients. He remarked, “That’s exciting.

Currently authorised effective weight loss medications

Several medications have previously been approved to treat obesity, but more research is required to determine whether PEPITEM will be useful in the management of illnesses linked to obesity, such as type 2 diabetes.

This contains semaglutide, a type of medication known as a GLP-1 agonist (brand names Ozempic, Wegovy, and Rybelsus). Those who took semaglutide in clinical trials saw weight loss and a decrease in inflammation. In one trial, participants lost up to 14.9% of their starting weight.

Yet according to Buettner, “it does not imply that [these drugs] function by reducing inflammation” because they aren’t often thought of as anti-inflammatory medications. As an alternative, “they function in the brain to decrease appetite and balance the autonomic nerve system,” he said.

Some medications also have side effects, including nausea, diarrhoea, vomiting, and stomach pain. Buettner is therefore concerned about whether people will be able to handle these medications over the long term, which may be necessary to assist people in maintaining a healthy weight throughout their lives.

That’s why other medications to treat obesity are still needed, he added, including ones that function through different mechanisms than GLP-1 agonists and don’t have the adverse effects of those treatments.

According to Buettner, “for now, the tolerance for the adverse effects is still high, but with time, patients may become dissatisfied with the [lower enjoyment of eating food].”

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Are the eyes the window to our health condition?

Are the eyes the window to our health condition?

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Diabetes, multiple sclerosis, and even Alzheimer’s disease can all be identified simply looking into someone’s eyes. Most people have their eyes checked periodically. However,few may be aware that an eye exam is used for more than simply vision correction and vision testing.

The eye is the only organ in the body that allows for a non-invasive examination of the inside by medical professionals due to its frontal “window.” The retina, which is located at the back of the eye, is where blood vessels and the optic nerve are visible in detail.

An optometrist may refer a patient to a medical ophthalmologist if a normal eye exam causes them to have concerns. The medical ophthalmologist will further investigate by doing additional eye exams. If the results of their examinations point to a systemic disease, doctors can then refer the patient to the appropriate expert.

What can be diagnosed?

A routine eye exam can discover vision issues including nearsightedness, farsightedness, and astigmatism. Also, other eye conditions like glaucoma and age-related macular degeneration. The optometrist can learn a lot about a person’s general health by checking the blood vessels in the retina and the optic nerve.

This non-invasive method can identify a wide range of medical illnesses. This includes hypertension, diabetes, thyroid issues, neurodegenerative diseases like Alzheimer’s and multiple sclerosis, and hypertension that may not be immediately apparent to the eyes (MS).

“Ocular inflammation can damage a variety of eye structures and is frequently the initial symptom of a systemic illness. According to Dr. Ibrahim, concentrated history-taking and a guided evaluation of the pertinent physiological systems, including blood testing, are the keys to determining the cause.

Eye Exams and Your Health

Doctors can identify general health concerns early enough to intervene with the use of eye examinations. With the use of advanced tests, ophthalmologists can more accurately forecast cardiovascular events. This includes stroke and perhaps spot early indications of mental deterioration like Alzheimer’s. Learn how eye exams can reveal much more than simply eye health by reading the information below.

Brain tumours and stroke

Because the blood vessels in the brain and eyes are similar, an eye doctor may occasionally be able to identify a problem with the brain by looking at the blood vessels in the eyes. If swelling or shadows are noticed in the eye, this could be a sign of a dangerous brain problem. This includes a tumour or blood clots that could cause a stroke.

Diabetes

Diabetic Retinopathy (DR) and diabetic macular edoema are conditions where diabetes has damaged the blood vessels in the retina at the back of the eye (DME). In order to help control their blood sugar, the patient would be encouraged to consult a doctor if an optometrist discovered leaky blood vessels in their eyes. The slow changes begin before any visible symptoms are seen. The likelihood of maintaining vision improves with earlier management of diabetic eye illness.

Hypertension

An eye exam can identify high blood pressure, which is characterised by excessive blood vessel pressure. Sometimes even before your regular doctor makes the diagnosis. You can see swelling, haemorrhages, and leakage in the eyes as a result of the blood vessels that are injured. The CDC claims that approximately one in three adults have hypertension, known as “the silent killer,” and that up to 20% of those people are unaware of their condition. Thus, early diagnosis during an eye doctor’s evaluation can actually save lives.

High Cholesterol

Exams of the eyes might also spot cholesterol accumulation. One of the simplest illnesses to diagnose during a thorough eye exam is high cholesterol. Since the deposits of the disease show up on the front of the eye as a thin, grey rim surrounding the cornea. By analysing artery and vein patterns, it can also be found in the retina.

Retinal Blood Vessel Occlusion is a condition in which blockages limit blood flow to the back of the eye. This leads to temporary or permanent vision loss. These deposits may be an indication of the current or future development of this condition.

Heart Problems

Certain heart disorders that cause the carotid artery in the heart to accumulate plaque can also result in deposits that obstruct the ocular arteries in the eyes. An optometrist would often advise consulting a specialist if they notice these modifications to the vascular system at the back of the eye.

Several Sclerosis (MS)

Multiple Sclerosis may be to blame for sudden visual loss (MS). While the colour and appearance of the optic nerve are indicators of MS that the optometrist can detect, such instances will be sent for additional testing to confirm the diagnosis.

Thyroid

There are various ways that thyroid disease can manifest in the eyes. Certain thyroid abnormalities can lead to dry eye illness because the thyroid gland regulates the hormones that influence tear production. Furthermore, hyperthyroidism, an overactive thyroid condition, can cause the extraocular muscles to expand and stiffen, resulting in bulging eyes, a sign of Graves’ disease.

Inflammation

The eyes may become inflamed as a result of systemic illnesses that are linked to inflammation in the body. For instance, uveitis, which can result in eye inflammation, redness, and blurred vision, is more common in patients with autoimmune illnesses including lupus, rheumatoid arthritis, and others.

Cancer

An eye exam can occasionally reveal metastatic malignancies like breast cancer, leukaemia, and other types of cancer. Eye specialists can also diagnose lymphoma and other eye cancers in addition to the previously stated brain cancer, basal cell carcinoma and melanoma (skin cancer), which can also be diagnosed. A good eye check saves lives.

REFERENCES:

  • https://www.medicalnewstoday.com/articles/biking-vs-running-2
  • https://www.brightfocus.org/glaucoma/article/eye-window-your-health
  • https://health.clevelandclinic.org/your-eyes-a-window-to-your-health/
  • https://www.eyecaredoctors.com/2019/12/22/eyes-are-windows-to-your-health-2019/

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Type 2 diabetes drug may help lower rose dementia risk.

Type 2 diabetes drug may help lower rose dementia risk.

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According to new research, older persons with newly diagnosed type 2 diabetes mellitus (T2DM) who have a history of stroke or ischemic heart disease may benefit most from treatment with the thiazolidinedione pioglitazone.

In general, over the course of an average of 10 years, patients who took pioglitazone had a 16% lower risk of dementia. This compares to the people who take medication, according to a large cohort study from Korea.

However, the risk of dementia was decreased by 54% and 43%, respectively, among people with ischemic heart disease and stroke histories.

Reports

There will be 139 million cases of dementia worldwide by 2050, with the number continuing to rise. Dementia is more likely to affect some people, particularly those with type 2 diabetes.

Researchers have shown that persons with type 2 diabetes who used the diabetic medication pioglitazone had a lower risk of dementia in old age.

Dementia affects an estimated 55 million individuals worldwide, and by 2050, that figure is anticipated to rise to 139 million.

Type 2 diabetes and dementia

Why would someone with type 2 diabetes have a higher chance of getting dementia?

At Pinehurst, North Carolina, Dr. Karen D. Sullivan, a board-certified neuropsychologist and proprietor of I CARE FOR YOUR BRAIN, claims that diabetes has a detrimental effect on nearly every system of the body, including the brain.

“Compared to people without diabetes, people with type 2 diabetes have a 50–60% increased risk of developing dementia. She stated in an interview with Medical News Today that this is one of the most potent modifiable risk factors for dementia.

She said: “The insulin resistance we detect in diabetes increases atherosclerosis and alters energy metabolism. This results in microvascular alterations in the brain and ultimately a decrease of blood supply to networks of neurons.”

16% lower risk with pioglitazone

Researchers used information on newly diagnosed type 2 diabetics without dementia from the National Korean Health Database for their investigation. The average follow-up period for the more than 91,000 participants was 10 years. 3,467 of the individuals received the medication pioglitazone.

Following examination, researchers discovered that 8.3% of those taking pioglitazone experienced dementia. This is opposed to 10% of those with type 2 diabetes who did not take the medication.

Scientists discovered that persons with type 2 diabetes who took pioglitazone were 16% less likely to acquire dementia later in life after controlling for a number of lifestyle factors. This study was limited by the fact that it was based on data from insurance claims. Therefore it is possible that some participants did not even take pioglitazone.

The study contains no data on the severity of the illness, the participants’ glycemic control, or their genetic susceptibility to dementia.

How blood vessels may play a role

Dr. Eosu Kim is a professor in the Department of Psychiatry in the College of Medicine at Yonsei University in Seoul, Republic of Korea, and the lead author of this study responded when asked how pioglitazone helps reduce the risk of a person with type 2 diabetes developing dementia by pointing out that this study was to investigate the association between pioglitazone use and incidence of dementia, not how — with what mechanisms — this drug can suppress dementia pathology.

Nonetheless, he told Medical News Today, “Several could be recommended based on [the] basic pharmacological activities of this medicine and findings from past studies.”

“First of all, maintaining healthy blood sugar levels is advantageous for brain activities. Also, this medication enhances cells’ capacity for metabolism and encourages them to use bioenergy more effectively. This helps the brain’s insulin resistance.

“Second, certain studies have demonstrated that pioglitazone removes harmful beta-amyloid proteins from the brain. One of the main causes of Alzheimer’s disease is the buildup of beta-amyloid in the brain, he continued.

“Lastly,” he continued, “we hypothesise that pioglitazone’s anti-dementia action may be related to increasing blood vessel health as we found that this medication is more beneficial in diabetic patients who have blood circulation difficulties in the heart or brain than in those without such problems.

Strongest defence in people with heart illness

Speaking about the heart, Dr. Kim and his team discovered that individuals with type 2 diabetes who had previously experienced an ischemic stroke or ischemic heart disease benefited from pioglitazone the most in terms of dementia protection.

Researchers discovered that dementia risk was lowered by 54% in people with ischemic heart disease. Also, by 43% in people with ischemic stroke. Dr. Kim claimed that these outcomes astounded him and his team. It was a surprising discovery, he added.

“Ischemic heart or brain disorders are key risk factors for dementia, thus it would have made sense if pioglitazone’s effects were found to be less effective in those with these conditions. The outcome, though, was the exact reverse of what was anticipated, he said.

Anti-diabetic drugs against dementia

Dr. Kim stated that the next stage of this research is looking at how current anti-diabetic medications or potential medications. These meds enhance cell energy metabolism can inhibit dementia pathogenesis in animal models.

To confirm this medication’s anti-dementia properties and the risk-benefit ratio of using it, prospective trials are required in clinical research. That is, [a] balance between adverse symptoms and advantageous long-term consequences of this medication in terms of dementia prevention,” he said.

Dr. Sullivan replied that the next stage for pioglitazone would be to evaluate long-term safety in people and determine the ideal dose that minimises side effects while maintaining the desired results.

Due to safety concerns, pioglitazone is presently only used as a second-line medication for type 2 diabetes. It is well recognised to raise the risk of fractures, weight gain, and heart failure hospitalisation.

Until then, Dr. Sullivan advised persons with type 2 diabetes to focus on stabilising their blood glucose levels because both high blood sugar (hyperglycemia) and low blood sugar (hypoglycemia) might harm brain blood vessels.

According to her, brain damage occurs when people experience extreme highs and lows.

REFERENCES:

  • https://www.medscape.com/viewarticle/988388
  • https://www.bmj.com/company/newsroom/older-class-of-type-2-diabetes-drugs-linked-to-22-reduced-dementia-risk/
  • https://www.medicalnewstoday.com/articles/type-2-diabetes-drug-may-help-lower-increased-dementia-risk

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Heart related diseases linked to specific kinds of sugars.

Heart related diseases linked to specific kinds of sugars.

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According to a recent study, the type of sugar you consume may have a greater impact on your risk of developing heart disease than the quantity of sugar you consume.

Researchers from the University of Oxford in the UK found that eating foods high in “free sugars” dramatically increased the risk of heart disease and stroke. They discovered that the risk rose in proportion to how much more free sugar a person consumed.

Free sugars are all sugars that have been intentionally added to food by a producer, cook, or consumer. Also, sugars that are naturally found in honey, syrups, and unsweetened fruit juice. Those naturally found in entire fruits and vegetables are not considered to be free sugar.

How much sugar is permitted?

What quantity of additional sugar is appropriate if 24 tablespoons daily is too much? Since sugar is not a necessary nutrient in your diet, it is difficult to say. There is no official sugar RDA set by the Institute of Medicine, which establishes RDAs for other nutrients.

The American Heart Association advises against exceeding the daily added sugar calorie limits for men and women, respectively. A respectively 100 calories (about 6 teaspoons or 24 grammes) and 150 calories (roughly 9 teaspoons or 36 grammes). That equates to roughly one 12-ounce soda can’s worth of liquid.

Taking sugar alternatives into account

Consuming excessive amounts of sugar can increase the risk of stroke and heart disease. This results in high blood pressure, inflammation, weight gain, diabetes, and fatty liver disease.

According to Dr. Elizabeth H. Dineen, an integrative cardiologist with the UCI Health Susan Samueli Integrative Health Institute, “it looks wise to limit the use of artificial sweeteners” in light of the cardiovascular events observed among research participants.

Dr. Ailin Barseghian El-Farra, an integrative cardiologist with the institute, adds that these findings “can help open a dialogue with patients about their dietary consumption of sugars, as well as artificial sweeteners, and their associated risk for coronary heart disease and cerebrovascular events.” Neither doctor took part in the investigation.

Over 100,000 French people were monitored for approximately nine years as part of the NutriNet-Santé project. When they first began, the participants’ average age was 42, and over 80% of them were women. Everyone was prompted to share information on their diet, health, physical activity, level of education, smoking status, and line of work.

They recorded all food and drinks consumed within a 24-hour period every six months. This provides thorough breakdown of their overall consumption of artificial sweeteners. Also, the consumption of other foods and nutrients, such as fruit, vegetables, dairy, and meat.

Impact on your heart

In a study that was published in 2014 in JAMA Internal Medicine, Dr. Hu and his coworkers discovered a link between a high-sugar diet and an increased risk of dying from heart disease. Over the course of the 15-year trial, those who consumed between 17% and 21% of their calories as added sugar had a 38% higher chance of dying from cardiovascular disease than those who only consumed 8% of their calories in this way.

According to Dr. Hu, the risk of heart disease is essentially inversely proportional to the amount of added sugar consumed.

Monitoring the intake of sweeteners

According to the study, 37% of individuals drank diet Coke or another type of artificial sweetener on average, which works out to 42 milligrammes per day or around one packet of sweetener. The average daily intake of artificial sweeteners among people who consumed more of them was nearly double at 78 milligrammes, or about 7 ounces of diet soda.

Overall, those who used the most artificial sweeteners were younger, had higher body mass indices (BMI). They were more likely to smoke, were less active, and didn’t follow a diet to control their weight. Curiously, they ate fewer calories, drank less alcohol, and consumed less fibre, fruit, and vegetables, as well as saturated and polyunsaturated fats. However, they consumed more sodium, red and processed meats, and dairy foods.

Researchers also kept tabs on the health of the participants, including physical examinations, medical procedures, and cardiovascular occurrences. This includes heart disease, heart attacks, and strokes.

Researchers found that those who consumed the most artificial sweeteners, particularly aspartame, acesulfame potassium, and sucralose, had a 9% higher risk for cardiovascular disease and an 18% greater risk for stroke or other cerebrovascular disease when compared to participants who ate none. This was true even after taking into account differences in age, sex, physical activity, education, smoking, and family history of heart disease.

The same authors’ previous spring PLoS ONE study revealed increased artificial sweetener intake. Additionally risk for cancer was linked to  aspartame and acesulfame-K.

Sugar and Other Health Problems

Studies have shown a connection between sugar consumption and animal models of hypertension. According to a human study, people with diabetes who use diuretics have a higher risk of coronary heart disease (CHD) if they consume a lot of sugar in their diet.

Consuming sugar can improve one’s body’s ability to store and use carbohydrate energy. This improvement, however, only happens at levels of physical activity and exercise intensity that are connected to endurance performances lasting at least 30 minutes. The main sources of energy for muscular contraction are blood glucose, liver glycogen, and muscle glycogen. The consumption of sugar can quickly restore blood glucose levels to normal when these substances reach dangerously low levels, which can lead to weariness. Consuming sugar has no effect on performance for the majority of low- to moderate-intensity tasks, such as walking or household chores.

The link between dietary sugar and cognition and behaviour has garnered a lot of attention. Two theories served as the foundation for the notion that sugar and hyperactivity are related. The first was a potential allergic reaction, and the second was the possibility of functional reactive hypoglycemia in hyperactive children. Both of these concepts remain unproven, and a meta-analysis of 16 randomised studies in hyperactive children revealed that cutting back on sugar in the diet had no positive impact on hyperactivity levels.

REFERENCES:

  • https://www.healthline.com/health/diabetes/diabetes-and-stroke
  • https://www.webmd.com/stroke/news/20230214/heart-disease-stroke-linked-specific-kinds-of-sugar-study
  • ucihealth.org/blog/2022/09/sugar-substitutes-may-boost-heart-disease-stroke-risk
  • https://www.ahajournals.org/doi/full/10.1161/01.CIR.0000019552.77778.04

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