Research Interests: Serotonin network, GLP-1 network, feeding regulation, hepatic glucose and lipid metabolism, and medical device in the treatment of diabetes and hypertension. His major is general internal medicine, endocrinology and metabolism and hypertension and nephrology. His research interest is 1 molecular biology of nuclear hormone receptors, 2 etiology of high blood pressure, 3 pathophysiology of diabetic nephropathy, 4 gene regulation of aldosterone synthase, and 5 epigenetics of hypertension and diabetes mellitus.
University Aberta of Lisbon. Nutritionist, PhD in Nursing. Orthopaedic Surgeon H. Associate Professor of Pharmacology and Toxicology Dept. Drug Science and Technology University of Turin. Imad eddin Rahamtalla Musa. H Gao-Balch Y. Hua Gao-Balch Y. Cuero R Sanchez L. Sofra D Beer S. Djordje S. Manta A Peppa M. Berezin AE. June 12, Seko Y. Hiroshi Bando. August 02, August 03, August 07, Issa Al Salmi Suad Hannawi.
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Aljaza Saad M. That probably didn't bother those who planted it because their target audience isn't you, it's your family doctor. The group releasing the news is an organization of surgeons who perform weight loss surgery WLS What they're promoting is the idea that WLS is a cure for diabetes. They did this by holding a convention filled with surgeons who earn a great deal of money every time they perform this particular surgery and representatives of the American Diabetes Association, a group that has never failed to endorse any product or service that has the potential to earn high profits for those who prey on people with diabetes.
This convention released an impressive-sounding "Consensus Statement" designed to make busy family doctors think that world health authorities and experts have carefully analyzed bushels of research and concluded that WLS is a wonderful new cure for diabetes.
Rubino, Francesco. Annals of Surgery. If you don't sign up, your diabetes is obviously your own fault. I have already heard from people who were given just that message by their doctors. The most disturbing thing about the consensus statement is the horrifying suggestion, based on ZERO peer reviewed research--that WLS--obesity surgery--should be given to people with a BMI as low as 30, which is a much lower BMI than any used as a cutpoint in the recommendations of any experts in organizations who don't provide surgery.
But this group of bariatric surgeons is obviously rubbing its hands in glee at the thought of the millions of new customers it's self-serving recommendation will bring in and their recommendations are very high on hype and almost entirely without grounding in hard science.
The position statement recommends weight loss surgery for women who are slightly overweight. For someone 5'3" the recommendation would kick in when they weigh only lbs. I happen to be 5'3" woman who once weighed that amount.
I weigh now, thanks entirely to cutting way down on the carbs in my diet and the addition of carefully chosen safe drugs to my daily regimen. But the pitch these surgeons make is that WLS isn't just for weight loss. Oh, no. It "cures" diabetes.
In fact, the science what little there is, and there isn't much of good quality shows WLSdoesn't do anything of the kind. What WLS does is lower A1c. It does that by severely limiting how much food you can eat and, more to the point, it makes people vomit violently when they eat a lot of carbohydrate so that it imposes a low carb diet on them, like it or not. But before you get excited about the idea that WLS is a cure, it turns out, these surgeries don't even give people truly normal blood sugars.
You can read about this in an earlier blog post HERE. The study cited in that post makes it clear that the dramatic claims that diabetes has been "cured" refer only to the blood sugars taken a month or two after surgery when people can barely eat.
By five years later the average A1c is 6. Almost twelve years after diagnosis my A1c is a lot better than the 6. My highest A1c in the last 5 years was 6. My average is 5. All from cutting back on carbs and finding the right, safe, drugs to control my blood sugar. No need for risky surgery. So the cost benefit to me of WLS would take 35 years to kick in--assuming WLS worked as well as meds and the low carb diet to prevent complications, which given how high the A1c is at five years in the patients whose surgeons are among the biggest boosters of WLS as a "Cure" for diabetes, is unlikely.
The tragedy is that it does NOT take dangerous surgery to achieve dramatic drops in blood sugar. You might have learned about this on the day you were diagnosed, had the ADA not put all its energy into terrifying doctors and the public about the "dangers" of the low carb diet and pushing a blood sugar boosting diet full of pasta, oatmeal, "healthy" whole grains, and high carb fruits like the banana.
Though a decade of research has come up with not a scintilla of evidence that that low carb diet does anything but improve blood sugar and cardiovascular markers and lower the incidence of diabetic complications, the ADA is now ready to recommend expensive life-threatening surgeries about which little is known though that little shows that the safety of WLS is far worse than the most extreme low carb diet.
In fact, there is very little high quality research about the long term effects of weight loss surgery. Most studies only involve a very few individuals followed for a short time, or, often in the case of diabetes "cures" of rodents. But what human research there is comes up with disturbing findings. Weight loss surgery, it turns out, is dangerous. To know just how dangerous it is you have to remember that it is standard practice when evaluating the outcome of a surgery to report on the patient's status six weeks after the surgery.
After that, most patients are "lost to follow up. You do not hear about the complications--or deaths--that take place two, five and ten years after the surgery.
December , Volume , Issue 6, pp Even then, in this group of patients,. That's 25 for each 10, people who had the surgery. Drugs that can be shown to have killed that many people are taken off the market--viz Rezulin, Bextra, etc. But if you accept that it was worth killing 25 people so that thousands can lose weight and have their diabetes "cured", you might want to look at another very similar study that expanded the time horizon.
You can read about it in my previous blog post HERE This study analyzed registry statistics collected in Pennsylvania and it too found modest death rate. But there were a lot more families left to mourn because the death toll rose dramatically as the group was followed longer. One year after surgery, 2. Twenty-one out of every thousand. By two years, 2. Then things got worse.
Three years after they had had the surgery, 3. By four years, 4. That's slightly more than one out of every seventeen dead. And yet the ADA's leaders, who have railed about the "dangers" of the low carb diet, stand by when these surgeons suggest that people whose weight is only slightly above normal should be subjecting themselves to a surgery this dangerous to attain an A1c if they live of 6.
The reason that the death rate increases as time goes by is that people who have had these surgeries are prone to develop problems as the years go by that often require more surgery. The stomach stretches and incisions burst. Bands get embedded in tissue or infected. Some people develop so much scarring in their intestinal tract they can no longer absorb nutrients and starve to death. Some develop profound anorexia, due to the destruction of part of the gut that secretes the hormones that regulate brain hormone centers and they literally starve themselves to death--often blaming themselves for what they think are psychologicla problems because no one explains to them that the brain hunger regulatory system depends on gut hormones.
Would a drug that killed 6. Of course not. But surgeries don't have to be approved. The FDA does not examine surgeries. No one does. Surgeons are free to do any surgery they can get paid for and the only limit on them is how likely they are to get sued by unhappy survivors of their victims. This simple, moderate approach works extremely well. Try it for two months before you let someone amputate portions of your stomach. This techniques will give most people much better results, over time, than the surgery.
If you can't control your eating, Byetta may help a lot. One out of three people respond well to it, and when they do, they find that they can easily cut way back on their food and that their blood sugar improves greatly.
I know two people who have lost over lbs each on Byetta and several who have lost lbs. All have seen better blood sugars. Best of all, if you don't do well on Byetta, all you have to do is stop taking it and any problems it has caused will reverse. If your blood sugars can't be controlled by cutting carbs, surgery probably won't fix it, because if your beta cells are dead, messing with your digestive tract won't do much.
According to Dr. And of course, that number excludes those who die of the surgery whose diabetes became tragically irrelevant. Insulin, prescribed by a doctor whose staff is willing to work with you to set the dose correctly, will normalize your blood sugar, especially if you cut way down on your carb intake so that the insulin doesn't have as much work to do.
None of thse is a "cure" but neither, according to the blood sugar statistics released by the most enthusiastic proponents of WLS, is the surgery. Vitamin C supplementation, it turns out, is also associated with a higher rate of cataracts. This finding emerged in a long study of 24, women 49—83 years old from the Swedish Mammography Cohort who were followed from September to October Data about their supplement use was collected by questionnaire, and cataract extraction cases were identified by linkage to the cataract extraction registers in the geographical study area where there is a public health system.
Am J Clin Nutr November 18, Bad News About Niacin Niacin is heavily promoted as a heart disease fighter but it turns out people with diabetes appear to have less ability to rid the body of niacin and that high levels may promotes insulin resistance. The study discussed in the Science Daily article is: Nicotinamide overload may play a role in the development of type 2 diabetes. Shi-Sheng Zhou, et al.
World J Gastroenterol December 7; 15 45 : The authors speculate that the commercial addition of B vitamins to foods like cereal and bread may be harmful. In addition, they note that niacin is eliminated from they body by sweating, which casts an interesting light on why exercise might be helpful to people with diabetes. The answer to the question posted in the title of the Science Daily article, turns out to be a resounding "No! As is so distressingly common, you will read several paragraphs which make it sound as if low dose aspirin had a protective effect on AMD, only to run up to this phrase, " Though not statistically significant, the WHS risk reduction is similar to the result of the only other large randomized trial on this question Not statistically significant means, "Even after we played all the games we could with these statistics we had to admit our results could easily be attributed to chance.
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