Sunday, July 6, 2008 

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Diabetes Mellitus Type II has been a failure to treat.

Type II diabetes (Adult Onset Diabetes) counts for over 90% of all cases. The epidemic keeps growing as the number of obese Americans reaches an all time high. We should all be deeply concerned about the onslaught of disease prevalence associated with Type II Diabetes and obesity. They are likely to bankrupt our healthcare system. Drug companies and bariatric surgeons see great PROFITS in diabetes and obesity respectively.

The diagnosis of Diabetes can be established if the fasting plasma glucose is 126 mg/dl or greater on two different occasions. The diagnosis is likely if a patient has specific symptoms, extreme thirst (polydipsia), excessive urination (polyuria), weight loss, overwhelming vaginal yeast infection or yeast balanitis and a random glucose that is over 200 mg/dl. A simple screening can be done by checking the urine glucose via a Diastix which is available over-the-counter. There are infrequently some false positives with Diastix, and patients must have public access so that they can check their plasma glucose with the aid of a readily available professional (Pharmacist) or nurse. If the urine shows glucose, it means that the blood level exceeded the renal threshold of 180 mg/dl and the body dumped excess glucose, a protective mechanism, into the urine. Our immune system does not function well when the glucose is over 180 mg/dl.

For Type I Diabetics (Insulin Dependent) diabetics are thin, young and have excessive eating (polyphagia) and dramatic weight loss and many of the same symptoms described above for Type II Diabetes.

What are the best approaches to reign in Diabetes and Obesity and thus reduce morbidity, and mortality? We must address the various factors that contribute to excess in caloric intake. It may be very difficult for patients with anxiety, stress or depression to follow specific caloric restrictions or guidelines. The provider must meet with the family and encourage certain nutritional changes at home. Instead of investing more on of the same or "Me Too Drugs," we must focus on new horizons.

We must consider expanding the dietitian's role and make them readily available for home visits. Psychologists must be recruited in other to help "bad habits" become "healthy habits." The psychological aspects cannot be underestimated. I do recommend that we begin to prescribe a specific diet for our diabetics, be it through Jenny Craig or new private companies rather than "new" and toxic drugs. We as physicians must be able to prescribe a specific diet or intake per day that is managed by allied healthcare professionals who report to the primary care provider.

For instance, if an adult's daily requirement is 2,000 Calories/24 hours, and we reduce his intake to 1,800 Calories/24 hours, then this patient would lose, on average, 3.8 pounds per month or more if an exercise regimen is added. There is a euphoria associated with weight loss and a dysphoria associated with obesity.

The time has come for us to re-invent our approach to Obesity and Diabetes. The drug companies are poised to develop profitable new drugs. We must view this with fear since many of these drugs are toxic as was Rezulin (troglitazone), which was taken off the market because of liver toxicity. Two similar drugs, Avandia (rosiglitazone) and Actos (pioglitazone), should be studied by the clinician before prescribing them. For instance, Avandia may be less hepatotoxic, but it has potentially serious side effects that include "cardiac events," edema, fluid retention (which may exacerbate hypertension).

Clinicians must encourage their patients to become fiscally responsible, comply with treatment and find ways to modify the environment that has made the consumption of food socially acceptable. The best treatment for Type II Diabetes is through diet and exercise. If drugs are to be used, we already have many generics available, the Sulfonylureas like Glipizide, Glyburide and the Biguanides, Metformin (Glucophage).

It has become evident that our private (and public) companies can no longer afford retiree health care, i.e., General Motors. At present, only 33% of companies with more than 200 employees offer retiree health benefits compared to 66% in 1988. The business community, especially small employers, cannot afford to provide health care coverage as envisioned by Senator Clinton.

"The evolving public morality seems to be turning away from the concept of health care as a right, toward treatment of health as a private matter," NEJM, September 20, 2007. Before we let health care become a private matter, we must educate consumers on how to get the most value out of health care. We must all get involved.




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The power of fasting is not in losing weight during the fast, but in gaining control of your appetite, which is the REAL problem.

A long term study by the federal Centers for Disease Control and Prevention shocked scientists. The study showed that 1/4 (25%) of Americans were seriously overweight in the 1960s and 70s.

The number of seriously overweight Americans jumped to 33% (an increase of over 30%), during the 1980s and 90s. The figures show an even more dangerous trend in the younger generation. 15 percent of teenagers were seriously overweight in the 1970s. In 1991, the figure was 21 percent, a 40 percent increase in fat teenagers. Usually, most people don't get fat until they become adults.

If you or someone you know is struggling with an eating disorder, we are here to help. Call our toll free, confidential Helpline Monday-Friday, 8:30 am to 4:30 pm, pacific time: 1-800-931-2237. Our helpline volunteers will be there to offer support and guidance with compassion and understanding.

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How To Get Rid of a Beer Belly

If you want to know how to get rid of your beer belly, you've stumbled upon the right article. Here I shall write the necessary steps to start losing your excess belly fat and having a flat stomach. But just so you'll know, it may take some time for you to complete this process, but if you take the steps I write of here, you will see constant and improving results.

Step #1 - Remove the cause

Before starting to reverse the process which brought about your beer belly, you need to erase the thing which caused it. By this I mean that you have to stop feeding it so that the only place it will have to go is down. If you think I mean that you need to go on a fad diet, or anything, then you've got me all wrong. What I do want you to do is make some simple adjustments to your diet:

  1. Cut down on alcohol - They don't call it a beer belly for nothing. Alcohol is filled with sugar and empty calories. Cut down on alcohol and you will have a much easier time to get rid of your beer belly.
  2. Cut down fried, fast food, and processed food - If you eat fresh food, a lot of vegetables, fruit, lean meat, and complex carbs like brown rice and whole flour pasta, your body will have much easier time to use the calories you're feeding it instead of turning them into ugly abdominal fat.
  3. Eat more meals but make them smaller - Most people eat large meals making it impossible for their body to cope with all the food they eat. The only thing left is to turn much of their food to fat. If you break your meals into 4-6 smaller portions throughout the day, your body will have a much easier time of it.

Step #2 - Reverse the Process

The second step in your process to lose your beer belly is to get a little more active. Even a small amount of exercise can do wonders. You wouldn't believe the results you may have. Start walking in the evenings, play a sport (even golf or bowling is better than sitting at home), or join a gym. Whatever suits you. You need to do some exercise in order to accelerate the fat burning process. Don't think that sit-ups will do anything to your stomach fat, because they won't. The key to getting rid of it is to lower overall body fat. The best way to do this is through complete strength and cardiovascular workouts. But again, start slow and gradually build up your activity levels.

The best thing to do in order to get rid of your beer belly is to become better educated at fitness and diet issues. Once you know the right things to do, it'll be much easier for you to succeed.

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