Category Archives: Uncategorized

Can Diabetes Be Prevented?

Not Paula Deen

Paula Deen’s recent announcement of her type 2 diabetes got me to thinking about diabetes prevention again.  If you’re at high risk of developing diabetes you can reduce your risk of full-blown type 2 diabetes by 58% with intensive lifestyle modification.  Here’s how it was done in a 2002 study:

The goals for the participants assigned to the intensive lifestyle intervention were to achieve and maintain a weight reduction of at least 7 percent of initial body weight through a healthy low-calorie, low-fat diet and to engage in physical activity of moderate intensity, such as brisk walking, for at least 150 minutes per week. A 16-lesson curriculum covering diet, exercise, and behavior modification was designed to help the participants achieve these goals. The curriculum, taught by case managers on a one-to-one basis during the first 24 weeks after enrollment, was flexible, culturally sensitive, and individualized. Subsequent individual sessions (usually monthly) and group sessions with the case managers were designed to reinforce the behavioral changes.

Although the Diabetes Prevention Program encouraged a low-fat diet, another study from 2008 showed that a low-fat diet did nothing to prevent diabetes in postmenopausal women

I don’t know Paula Deen.  I’ve never watched one of her cooking shows.  She looks overweight and I’d be surprised if she’s had a good exercise routine over the last decade.  I’m sorry she’s part of the diabetes epidemic we have in the U.S.  I wish her well.  Amy Tenderich posted the transcript of her brief interview with Paula, who calculates her sweet tea habit gave her one-and-a-half cups of sugar daily.  Not quite a paleo diet.

  • Nearly 27% of American adults age 65 or older have diabetes (overwhelmingly type 2)
  • Half of Americans 65 and older have prediabetes
  • 11% of U.S. adults (nearly 26 million) have diabetes (overwhelmingly type 2)
  • 35% of adults (79 million) have prediabetes, and most of those affected don’t know it

I think excessive consumption of concentrated sugars and refined carbohydrates contribute to the diabetes epidemic.  To the extent that paleo diets (aka Old Stone Age or caveman diets) restrict concentrated sugars and refined carbohydrates, they are likely to prevent type 2 diabetes. 

Avoiding overweight, obesity, and physical inactivity may be even more important. 

The Mediterranean diet has also been linked to lower rates of diabetes (and here).  Preliminary studies suggest the Paleo diet may also be preventative (and here).

Greatly reduce your risk of type 2 diabetes by eating right, keeping your weight reasonable, and exercising.

Steve Parker, M.D.

Reference:  Diabetes Prevention Program Research Group.  Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or MetforminNew England Journal of Medicine, 346 (2002): 393-403.

How Has the U.S. Diet Changed Over the Last Century?

U.S. obesity rate over last 40 years

Beth Mazur over at Weight Maven has posted a lecture by Dr. Stephan Guyenet in which he outlines the changes in American diet over the last 100 years.  It’s only 16 minutes long.  You may  find an explanation for our excess weight problem and some other “diseases of civilization.”

Steve Parker, M.D.

Raw Vegan Diet Reverses Diabetes In 30 Days! No Kidding?

I wanted to share a link with you that’s a review of a documentary called “Simply Raw: Reversing Diabetes in 30 Days.”  It’s at Science-Based Medicine.

The guys over at Science-Based Medicine take a look at the evidence for and against such ideas as reiki, Chinese bloodletting, Chinese medicinehomeopathy, vaccines, vaccines and autism, integrative oncology, holistic medicine, naturopathy, complementary and alternative medicine, quackademic medicine, chelation therapy, and chiropractic.

Steve Parker, M.D.

How Can You Track Omega-6 and Omega-3 Fatty Acid Consumption?

It’s estimated that the Old Stone Age diet provided much more omega-3 fatty acids and much less omega-6s, compared to modern Western diets.  This may have important implications for development of certain chronic diseases like cancer and heart disease.

This'll improve your omega-6/omega-3 ratio!

I haven’t studied this issue in great detail but hope to do so at some point.  Evelyn Tribole has strong opinions on it; I may get one of her books.

I saw an online video of William E.M.Lands, Ph.D., discussing the omega-6/omega-3 ratio.  He mentioned free software available from the National Insitutes of Health that would help you monitor and adjust your ratio.

You can see the video here.  Dr. Lands’ talk starts around minute 12 and lasts about 45 minutes.  He says it’s just as important (if not more so) to reduce your omega-6 consumption as to increase your omega-3.  And don’t overeat.

Steve Parker, M.D.

LADA Awareness Week

 

“Who can tell us about LADA?”

This is the first ever LADA Awareness Week, organized by Diabetes Hands Foundation and dLife.  LADA stands for Latent Autoimmune Diabetes in Adults.  I think of it as type 1 diabetes that starts in adulthood, although there are some differences from typical juvenile-onset type 1 diabetes.

Seven-and-a-half to 10% of apparent type 2 adult diabetics have LADA.  It’s caused by the body attacking its own pancreas beta cells and thereby impairing insulin production; in other words, it’s an autoimmune thing.

Here are some generalities (with exceptions, of course) about LADA, compared to typical type 2 diabetes:

  • lower body mass index, often under 25
  • age at onset under 50
  • poorer response to dietary management
  • poorer response to oral diabetic medications
  • acute symptoms at time of diagnosis (e.g., weight loss, thirst, frequent urination, ketoacidosis, malaise, etc.)
  • higher risk of developing diabetic ketoacidosis
  • much more likely to need insulin

How Is LADA Diagnosed?

First of all, the doctor has to consider the possibility, based on the clinical factors above.  The autoimmune nature of the disease is reflected in islet-cell antiobodies (ICA) and antibodies to glutamic acid decarboxylase (anti-GAD).  These are testable in the blood.  One of the two may be enough.  If the disease is far enough along, blood levels of C-peptide will be low.  C-peptide reflects the body’s production of insulin.

For more information on LADA, talk to your doctor or see this page at dLife.

Steve Parker, M.D.