Tag Archives: insulin

Low Vitamin D Linked to Obesity and High Triglycerides


Understanding of the various ways vitamin D effects the body is growing rapidly. Originally this vitamin was thought to only effect calcium in the blood and bone but recent research shows it possesses important influences on the immune system and cancer development. A study just published in Journal of Endocrinology and Metabolism June 2012 now shows that this same vitamin can possibly influence metabolism. A common disorder of metabolism known as Syndrome X or the Metabolic Syndrome is characterized by high triglycerides and low good cholesterol (HDL), abdominal obesity, along with elevated blood pressure and blood sugar. The researchers discovered those with vitamin D levels between 16 and 20 were 75% more likely to develop the Metabolic Syndrome within 5 years than those with vitamin D levels above 34 (levels below 30 are considered low).

Whether low vitamin D is the cause of the Metabolic Syndrome is unclear. Vitamin D prevents fat cells from reproducing, helps the natural process of triglyceride breakdown and helps regulate blood sugar by making insulin work more efficiently. Without enough vitamin D the fat cells could multiply faster, triglyceride levels accumulate and blood sugar rise as is seen in Metabolic Syndrome.

As I have explained in previous posts at metabolism.com, vitamin D is also related to development of hardening of the arteries (atherosclerosis) and obesity in Type 2 Diabetes which could be considered a more advanced form of Metabolic Syndrome.

Doctors’ efforts to monitor vitamin D levels are being hindered by new regulations by Medicare and private insurance carriers to deny payment for vitamin D screening. Lately, a number of my patients’ vitamin D tests were denied by insurance carriers with patients being charged over $200 per test because it was not “indicated”.

Recommendations for vitamin D supplementation are debated. When skin is exposed to sunlight it manufactures vitamin D so there is thought that people who get sun exposure should not need vitamin D supplement but that is not borne out in reality. Previously the recommended daily allowance (RDA) was 400 units per day an amount which has been increased slightly for the elderly. Some experts recommend 1000 unit daily or more. In my practice I generally recommend starting at 1000 units and then rechecking 25 hydroxy vitamin D levels a few months later. Some individuals require 4000 unit or more daily to achieve vitamin D levels over 30. When purchasing vitamin D the D3 form appears to be converted in the body more rapidly than the D2 variety. High priced brands of vitamin D, in my opinion, are a waste of money.

Gary Pepper, M.D.
Editor-in-Chief, Metabolism.com

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Large Neck Size Equals Big Metabolic Problems


Large Neck Size Equals Big Metabolic Problems:

A bulging stomach is widely accepted as a sign of poor metabolic health. A recent study published in the August Clinical Endocrinology and Metabolism (95:3701, 2010), finds a chubby neck is likely to hold even a worse prognosis for metabolic health.

The research team evaluated the relationship between waist circumference and neck circumference with levels of blood sugar, good cholesterol (HDL), bad cholesterol (LDL), triglycerides, and insulin resistance, as well as blood pressure. What was found was that neck circumference was a better predictor than waist circumference of elevated blood pressure, LDL, triglycerides and insulin resistance, with lower levels of HDL. All this amounts to a greater risk of cardiovascular disease as neck size increases. As an example, an increase in neck circumference of about one inch is expected to result in a 2.5 point rise in blood pressure.

The authors point out that the neck circumference was a more accurate predictor of cardiovascular risk in women than men. The average neck size for men in this study was about 16 inches (40.5 cm) and about 13.7 inches for women (34 cm).

Alfred Hitchcock, the famous director of suspense movies, made a trademark of his corpulent silhouette with bulging chin and abdomen. Thanks to this research we know his silhouette can signify more than a movie that will thrill you but also a metabolism that will kill you.

Gary Pepper, M.D.
Editor-in-Chief, Metabolism.com

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Spirulina and other Green Superfoods Can Jumpstart Good Health by Tom Hines


Metabolism.com is pleased to share the following article provided by our guest contributor, Tom Hines.
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In some ways, your body is like a machine — it works best when it’s properly maintained and tuned up. Food is your fuel and when you fill your tank with lousy fuel, your engine sputters and stalls. If your body’s engine is sluggish and needs a jumpstart, spirulina and other green superfoods can help deliver the energy necessary to keep the machine running smoothly, avoiding a breakdown.

Spirulina is a ‘green superfood,’ a term used to describe various nutrient-rich natural supplements, which include Chlorella, Wheat Grass, Barley Grass, Alfalfa and Kelp. Unlike most store-bought supplements, the concentrated vitamins and minerals they provide are not synthetic. Green superfoods are whole foods harvested directly from nature and are exactly what your body needs to offset stress and to clear away toxins.

SAD is very sad indeed

S.A.D. stands for Standard American Diet – there was never a more apt acronym. The majority of U.S. citizens today subsist on processed fast food laden with refined carbohydrates and saturated fats. Meats are frequently tainted with growth hormones, antibiotics and pathogens. For people who manage to work the recommended five to nine daily servings of fruit and vegetables into their diet, modern agricultural techniques have stripped crops of many vitamins and minerals.

Processed and cooked foods, which are the cornerstones of the S.A.D, and beverages such as coffee, tea, soft drinks and alcohol create an acidic blood pH, encouraging the growth of bacteria, fungus and mold. In an overly acidic environment, the body literally begins to compost. Illnesses such as heart disease and diabetes are often the result of the composting process. Green superfoods have an alkalizing effect, counteracting the acidity caused by poor diet, stress and toxic overload and setting the stage for a return to good health.

Spirulina and Chlorella, the most super of the green superfoods

Spirulina is a blue-green algae whose name comes from its spiral coil shape. High quality spirulina thrives in both salt and fresh water in tropical climates and it is known to have nourished the Aztecs, who harvested the algae from Lake Texcoco. Some of the benefits of Spirulina are:

  • Contains all of the essential amino acids vital to human health
  • An excellent protein source for all vegetarians, including vegans
  • Balances blood sugar by boosting glycogen, which offsets insulin
  • Rich in GLA (gamma linolenic acid) and other essential fatty acids Delivers an array of vitamins, including the all-important folic acid
  • High in potassium and a dozen other minerals
  • Improves focus and mental clarity

Chlorella is a single-celled green algae whose name is derived from Greek and Latin words that translate to “little green.” In the 1940’s and 1950’s, intensive research was done on little green algae’s potential role in solving world hunger, due to its high protein content and its bounty of beneficial vitamins and minerals. The natural health community, meanwhile, has always touted Chlorella’s health-imparting properties, particularly in the area of detoxification. In addition to being the very best source of chlorophyll, here are some more of Chlorella supplement benefits:

  • Rids the body of toxins and stored waste
  • Tones and cleanses the blood
  • Reduces body odor, acting as an internal deodorant
  • Improves bowel health and reduces flatulence
  • Naturally freshens the breath
  • Clears the skin

Cereal grasses and seaweed

Wheat grass is a popular juicing ingredient due to its superior nutrition, which it delivers without raising blood sugar. It also helps to lower blood pressure.

Barley grass alkalizes the blood and strengthens the digestive system.

Alfalfa helps reduce LDL (low-density lipoprotein) or bad cholesterol, without affecting levels of HDL (high-density lipoprotein) or good cholesterol and studies are underway to determine its effectiveness at lowering blood sugar levels and its ability to invigorate the immune system.

Kelp is a brown-algae seaweed, which grows in abundant kelp forests in shallow oceans all around the world. Kelp is rich in iodine and therefore beneficial to overall thyroid health. Its high vitamin and mineral content promotes pituitary and adrenal gland health as well. It’s renowned for its contribution to lustrous hair and skin. Taken shortly after exposure, it can also mitigate the negative ramifications of heavy metals and irradiation.

Making the most of green superfoods

Incorporating Spirulina, Chlorella and other green superfoods into the diet is easy, since they are all available in powdered form. Simply mix the desired amount into salad dressing, or add it to soup, juice or water. The taste is fresh and green and the active enzymes of living food add a healthy dimension even to a less than healthy meal. Of course, pregnant or breastfeeding women and people taking medications should consult with their doctors before incorporating any new food into their diets.

Many people who regularly incorporate green superfoods into their daily regimen have reported increased energy, mental clarity and an overall healthy glow. When stress, toxic thoughts and an imperfect diet have left your body’s engine sluggish, green superfoods are a quick and easy way to put yourself back on the road to health. Long may you run!

About the Author
Tom Hines, co-owner of NutritionGeeks.com (MN #1 Now Foods herbal provider), has been working in the nutrition industry since 1997, is a competitive powerlifter, lives with his wife Netti and three boys TJ, Grady and Brock on the prairie in west central Minnesota, spends his leisure time coaching youth wrestling, working with his horses and being play toy #1 for his boys.

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Will Insomnia Lead to Diabetes?


During the past decade researchers have discovered that lack of adequate sleep can cause metabolic defects similar to those of diabetes. Blood sugar tends to be higher and insulin resistance more pronounced in people who don’t get adequate sleep. To create these abnormalities in blood sugar metabolism for studies, researchers typically deprived subjects of sleep to an extreme degree for several days. Recent research however, showed that less drastic sleep deprivation can create the same diabetes-like problems in metabolism.

In a study just published in the June edition of the Journal of Clinical Endocrinology and Metabolism (95:2963-2968, 2010), researchers in the Netherlands allowed normal subjects to sleep for only 4 hours for a single night. They found that after one night of sleep deprivation the body was not able to respond nearly as well to insulin as after a normal night of sleep.

Can this type of sleep deprivation eventually lead to permanent blood sugar problems? A group of researchers from Columbia University found that people who habitually sleep less than 5 hours per night are twice as likely to develop diabetic levels of blood sugar compared to those who sleep more.

What is the connection between sleep deprivation and diabetes? The thought is that lack of sleep fosters an inflammatory environment in the body. Whether this is because during sleep the body removes inflammatory cells and toxins or whether sleeplessness increases the production of inflammatory agents is not known. Inflammation, in turn, creates the basic metabolic defect in type 2 diabetes known as insulin resistance. Since insulin is the hormone that regulates blood sugar, if the body is resistant to insulin than high blood sugar (diabetes) can develop.

Conclusion? Work and worry less, sleep better and longer, and reduce your risk of getting diabetes. (Did I hear you say he must be dreaming?)

This article is for educational purposes only and is not meant as medical advice or treatment.

Gary Pepper, M.D.
Editor-in-Chief, Metabolism.com

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Elderly, Broke, Blind, and Left Behind by New Diabetes Treatment Guidelines and Big Pharma.


Here is a clear example of how the new Diabetes Treatment Guidelines and big Pharma have failed to protect the needs of diabetics who are disadvantaged by economic circumstances and disease. This is the story of one of my patients, an elderly, blind and impoverished woman with blindness due to diabetes. She managed to maintain some degree of independence and did not complain about what a lousy hand life had dealt her. One of the ways she remained independent was by using a device known as an insulin pen. The pen is an all-in-one device equipped with a needle , contains an insulin reservoir and is adjusted to a specific insulin dose by a twist of its dial. With this device she was able to inject her insulin dose daily by herself with sufficient accuracy to control her diabetes. The older method of using a separate syringe and insulin vial required too much dexterity and vision for her to use safely and would have require someone to help her on a regular basis. The type of insulin she uses, NPH, dissolves slowly so her risk of low blood sugar (hypoglycemia) was less than if she used the newer insulins which contain rapid acting insulin. What’s more, NPH insulin is still relatively inexpensive, costing about one half the price of the newer insulins.

I became aware of her problem at her visit with me last week. I learned the NPH insulin pen was being discontinued and there is nothing on the market to replace it. The only insulin pens now available contain insulin with rapid action or are at least twice as expensive as her present pen. What could have caused this sudden shift in the medical supply chain? I recently reviewed the American Association of Clinical Endocrinologists (AACE) new Diabetic Treatment Guidelines (see http://www.metabolism.com/2010/01/18/diabetes-treatment-guidelines-flawed/ ) which dismisses NPH insulin as out moded and recommends the newer (more expensive) insulins be used in its place. The company’s decision to stop making NPH insulin pens coincides almost simultaneously with this new AACE policy statement. In my mind the close timing of the corporate and the professional actions implies cross communications between them. Could the AACE decision to downgrade the use of NPH in some way support corporate economics? I wouldn’t be suprised at all.

Diabetes is the most common cause of blindness in the U.S. . My guess is that there are more blind, and poor diabetics who could make good use of the inexpensive NPH insulin pen. In the case of my patient, we are scrambling to put together a support plan for her so she can maintain her independence, her pocket book and still control her diabetes to a reasonable degree. I hope others in her position can find a similar support network.

Gary Pepper, M.D. Editor-in-Chief, Metabolism.com

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Can Eating Carbs Reduce Food Cravings?


In a new book, The Serotonin Power Diet: Eat Carbs — Nature’s Own Appetite Suppressant — to Stop Emotional Overeating and Halt Antidepressant-Associated Weight Gain, the authors Judith J. Wurtman, PhD and Nina T. Frusztajer, MD, propose that eating carbs before a meal can actually help weight loss efforts. The connection between carb consumption and appetite suppression is due to a change in brain chemistry that occurs when carbs are eaten before a meal. Their theory is supported by independent research conducted by the authors.

I am intrigued by this new concept because until now I have always considered carbs an appetite stimulant because of their action to raise insulin levels which can then cause blood sugar levels to drop a few hours later, resulting in relative hypoglycemia (low blood sugar) which is a powerful trigger to more eating.

Thanks to the authors and their publisher we are able to provide an excerpt from the book The Serotonin Power Diet, and you can decide for yourself if this is an idea you would like to pursue.

Serotonin: What It is and Why It’s Important for Weight Loss
By Judith J. Wurtman, PhD and Nina T. Frusztajer, MD,
Authors of The Serotonin Power Diet: Eat Carbs — Nature’s Own Appetite Suppressant — to Stop Emotional Overeating and Halt Antidepressant-Associated Weight Gain

Serotonin is nature’s own appetite suppressant. This powerful brain chemical curbs cravings and shuts off appetite. It makes you feel satisfied even if your stomach is not full. The result is eating less and losing weight.

A natural mood regulator, serotonin makes you feel emotionally stable, less anxious, more tranquil and even more focused and energetic.

Serotonin can be made only after sweet or starchy carbohydrates are eaten.

More than 30 years ago, extensive studies at MIT carried out by Richard Wurtman, M.D., showed that tryptophan, the building block of serotonin, could get into the brain only after sweet or starchy carbohydrates were eaten. Although tryptophan is an amino acid and found in all protein, eating protein prevents tryptophan from passing through a barrier from the blood into the brain. The reason is simply numbers: Tryptophan competes for an entry point into the brain with some other amino acids. There are more of those other amino acids in the blood than tryptophan after protein is eaten. So in the competition to get into the brain, tryptophan is at a total disadvantage and very little gets in after a protein meal like turkey or snack like yogurt.

But carbohydrates tip the odds in tryptophan’s favor. All carbohydrates (except fruit) are digested to glucose in the intestinal tract. When glucose enters the bloodstream, insulin is released and pushes nutrients such as amino acids into the cells of the heart, liver and other organs. As it does this, tryptophan stays behind in the bloodstream. Now there is more tryptophan in the blood than the competing amino acids. As the blood passes by the barrier into the brain, tryptophan can get in. The tryptophan is immediately converted to serotonin, and the soothing and appetite controlling effects of this brain chemical are soon felt.

Our studies with volunteers found that when people consumed a pre-meal carbohydrate drink that made more serotonin, they became less hungry and were able to control their calorie intake. Volunteers whose drinks contained protein — so that serotonin was not made — did not experience any decrease in their appetite.

Most of us have experienced the carbohydrate-serotonin effect on our appetite even though we were not aware of the connection. Have you ever munched on rolls or bread while waiting for the main course to be served in a restaurant? By the time dinner is served, twenty minutes or so after you ate the roll, your appetite has been downsized. “I don’t even feel that hungry” is a common response when the plate is put down on the table.

This blunting of appetite is not because you may have eaten 120 calories of roll. It is caused by new serotonin putting a brake on your appetite.

Successful weight loss depends on the power of serotonin to control food intake.

The carbohydrate-serotonin connection has a direct impact on our emotional state, too. Drugs that increase serotonin activity have been used for several decades as a therapy for mood disorders. However, our studies showed that natural changes in serotonin could have a profound impact on daily fluctuations in mood, energy levels and attention. In one of our early studies, we found that our volunteers became slightly depressed, anxious, tired, and irritable around 3 to 5 pm every day. At the same time, they experienced, in the words of one volunteer “a jaw-aching need to eat something sweet or starchy.” Several studies later, we were able to state that late afternoon seems to be a universal carbohydrate-craving time, and people who experience this craving use carbohydrates to “self-medicate” themselves. Carbohydrate cravers who consume a sweet or starchy snack are increasing serotonin naturally.

We carried out careful clinical studies to measure the effect of carbohydrates on mood and to make sure that the effect was not just due to taste or the effect of taking a break from work. Volunteers, all carbohydrate cravers, were given a carbohydrate or protein- containing food or drink that had identical tastes. Their moods, concentration and energy were measured before and after they consumed the test beverages. The carbohydrate serotonin-producing beverage improved their moods but the protein-containing beverage had no effect on either their mood or their appetite.

Eating carbohydrates allows serotonin to restore your good mood and increase your emotional energy.

Eating low or fat-free, protein-free carbohydrates in the correct amounts and at specific times potentiates serotonin’s ability to increase satiety. You will eat less, feel more satisfied and lose weight.

Here are five tips to get serotonin working for you:

Eat the carbohydrate on an empty stomach to avoid interference from protein from a previous meal or snack. Wait about 3 hours after a meal containing protein.

The carbohydrate food such as graham crackers or pretzels should contain between 25-35 grams of carbohydrate. The carbohydrate can be sweet or starchy. High-fiber carbohydrates take a long time to digest and are not recommended for a rapid improvement in mood or decrease in pre-meal appetite. Eat them as part of the daily food plan instead for their nutritional value.

The protein content of the snack should not exceed 4 grams.

To avoid eating too many calories and slowing down digestion, avoid snacks containing more than 3 grams of fat.

Do not continue to eat after you have consumed the correct amount of food. It will take about 20-40 minutes for you to feel the effect. Eating more carbohydrates during the interval is unnecessary and may cause weight gain.

Stress may increase your need for serotonin and make it harder to control food intake. Prevent this by shifting protein intake to the early part of the day; i.e. protein for breakfast and lunch and switching to carbohydrates by late afternoon. Eating a carbohydrate dinner with very little protein increases serotonin sufficiently to prevent after dinner nibbling. And the soothing effect of the serotonin prevents stress from interfering with sleep.

Boost Serotonin to switch off your appetite and turn on a good mood.

©2009 Judith J. Wurtman, PhD and Nina T. Frusztajer, MD, authors of The Serotonin Power Diet: Eat Carbs — Nature’s Own Appetite Suppressant — to Stop Emotional Overeating and Halt Antidepressant-Associated Weight Gain

Author Bios
Judith J. Wurtman, PhD, co-author of The Serotonin Power Diet: Eat Carbs — Nature’s Own Appetite Suppressant — to Stop Emotional Overeating and Halt Antidepressant-Associated Weight Gain, has discovered the connection between carbohydrate craving, serotonin, and emotional well-being in her MIT clinical studies. She received her PhD from George Washington University, is the founder of a Harvard University hospital weight-loss facility and counsels private weight management clients. She has written five books, including The Serotonin Solution, and more than 40 peer-reviewed articles for professional publications. She lives in Miami Beach, Florida.

Nina T. Frusztajer, MD, co-author of The Serotonin Power Diet: Eat Carbs — Nature’s Own Appetite Suppressant — to Stop Emotional Overeating and Halt Antidepressant-Associated Weight Gain, counsels private weight management clients and is a practicing physician and certified professional life coach. She received her master’s degree in Nutrition from Columbia University and her medical degree from George Washington University. She lives in Boston, MA.

For more information, please visit www.SerotoninPowerDiet.com and Amazon.com.

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Inhaled Insulin – An alternative To Needles


There are an estimated 16 million diabetics in the United States today. This number can be further subdivided into Type 1 (juvenile-onset) or Type 2 (adult-onset) diabetics. At the root of both types of diabetes is the inability to control levels of blood glucose, the main energy source for the human body. This is due to either a deficiency or developed insensitivity to insulin which mediates the uptake of glucose from the bloodstream into the cells.

There are many long term complications including stroke, heart disease, kidney disease, blindness, and loss of sensation in the limbs all due to an excess of glucose in the blood.

Fortunately, insulin therapy can delay the onset and slow the progress of complications of diabetes by as much as 35-60%. Insulin therapy currently involves either oral medications or subcutaneous self-injections. Injections are required for Type 1 diabetics and if oral medications fail in Type 2 diabetics.

Nevertheless, these injections can obviously be undesirable due to local discomfort and disruption of normal lifestyle. As a result, there has been constant research into alternative forms of insulin delivery. Recently, inhaled insulin has been gaining ground as a potential therapy. The pulmonary system with its extensive blood supply and easy access to the outside world would seem like an excellent candidate for drug administration. However, there have been many problems surrounding this form of delivery. Blood glucose must ideally be maintained throughout the day in the range of 64-112 mg/dL. This requires that a measured amount of insulin be administered on a time schedule centered around meals to provide adequate control. There must be consistency in the amount of insulin delivered and received by the body with each dosing.

The pulmonary system of people does not always exhibit this consistency due to the anatomical differences between individuals as well as differences in breathing patterns. One study in 1993 utilizing an aerosolized insulin preparation demonstrated this variability with a 43-71% decrease in glucose levels among 6 patients. Furthermore, the effect of inhaled insulin is rapid, but is not maintained.

In the same study of 1993, insulin absorption quickly peaked near 40 minutes while subcutaneous injections have a slow peak at 144 minutes. This slow peak and fall helps to maintain glucose levels appropriately whereas the fast peak and fall can initially send the patient into dangerously low levels of blood sugar and subsequently high levels before the next dose.

But that was in 1993 and aside from the Y2K bug, we have much to look forward to. Inhale Therapeutics System in partnership with Pfizer has created a novel form of pulmonary insulin and delivery system which has been demonstrated to have dose to dose consistency similar to injectable insulin with respect to the amount of insulin absorbed. The new portable aerosol delivery system is about the size of a flashlight and it converts a packet of fine insulin powder into an aerosol. The packaged powder is stable under a great range of environments including room temperature. One or two inhalations provides a therapeutic dose and it is mechanically operated without requiring an external power source.

Two studies were conducted comparing subcutaneous insulin versus inhaled insulin with measurements of HbA1c which is a measure of glucose control over the prior 2-3 months. The first study of 70 type 1 diabetics showed a decrease in Hb1Ac from 8.5% to 7.7% over 3 months in the injection group whereas the inhaled group averaged a decrease from 8.5% to 7.8%. In the second study of 50 patients with type 2 diabetes, the drop in Hb1AC over 3 months was virtually identical. The incidence of undesirably low blood glucose was similar in both the injection and inhalant groups, no changes were noted in the pulmonary function of subjects, and it was well tolerated.

Moreover, 80% of the type 1 participants and 92% of the type 2 participants who received inhaled insulin, opted to continue on the inhaled preparation. Nevertheless, patients were still required to take an injection at night before bedtime in order to maintain blood glucose levels throughout the night. Currently, inhaled insulin is in its last phase of testing before FDA submission and potential approval. If approved, it may provide a less painful means of controlling diabetes and preventing the dangerous outcomes for all diabetic patients.

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