Science Fact: Diabetes is a disease that everyone should understand and at least be wary of, if not fear.
Excellent information abounds from the ADA (American Diabetes Association) and the National Institutes of Health. Nevertheless, it’s a complex disease and its data is overwhelming.
Travis Johnson’s Stock Gumshoe website mainly consists of selling his newsletter that researches and comments on the mountains of “hot stock tips” that stuff our mailboxes. However, Johnson also hosts articles by medical journalist Michael Jorrin, whom Johnson dubs “Doc Gumshoe.” And those medical articles – thank you, Mr Johnson! – do not require a subscription to the Gumshoe newsletter.
Charles South called my attention to a pair of excellent articles on diabetes by Doc Gumshoe that I found to be very informative as well as a great resource. This is one of those cases where the articles themselves are so great that I have nothing to add to them. I want to say just enough to tell you what’s there, and encourage you to go to the sources for the full story.
These are the two articles by Michael Jorrin:
– Part 1: The Why and the What of Diabetes Management
– Part 2: Where is the Management of Type 2 Diabetes Heading?
What I learned from Part 1:
What Jorrin calls “basic points”:
– Diabetes is growing, most especially with younger and poorer people.
– The largest risk in treating the disease is the patient’s non-cooperation, because many patients just do not follow directions.
– With early diagnosis, diabetes patients can lead an almost-completely-normal life. Unfortunately, this does not occur with many people.
– Once the disease takes hold in a person, especially a young person, a single type of medical treatment will not be enough: it will have to be ramped up over time to keep up with the disease.
The elevated blood sugar caused by diabetes is toxic to many organs: the eyes, nerves, kidneys and the blood vessels.
The best prevention is an annual physical checkup with basic blood work, to catch diabetes early on. However, measuring blood sugar (glucose) is an unreliable way to diagnose the disease because glucose fluctuates so much. It’s much better to measure “glycated hemoglobin” (HbA1C) in the blood, which averages blood glucose over a one-month period.
The most dangerous causes of diabetes are refined carbohydrates such as white bread, white rice and sugar.
Sugary soft drinks are especially harmful for two reasons:
– The sugar enters the bloodstream immediately, before the body can respond with insulin from the pancreas, which takes about two minutes.
– It takes solid food to trigger an insulin response; if sugary drinks are taken alone, the pancreas doesn’t react at all and the impact on the body is even worse.
Part 2 focuses on treatments, and which drug companies might be good investment bets. Since I am neither a diabetes patient nor a potential investor in pharma stocks, Part 2 was less useful for me.
Is a diabetes test (blood sugar or preferably, HbA1C) part of your annual physical? In fact, when was your last physical exam?
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The following comment was submitted by reader Jim Thompson. I’m posting it for him since comments were already closed on this post.
Thanks Art for you researching and comments on this issue.
Just to add, there are some who believe that the increase in Diabetes has a direct link to the increase in GMO’s.
Also, the VA has linked T2DM to the use of agent orange in Korea and South East Asia in the 50’s, 60’s and 70’s. However, it only took the VA ~50 years to admit this to us vets.
Thanks, Jim. Type 2 Diabetes is such a serious ailment, affecting so many people, that it merits increased research and understanding. Thank you for pointing out the demonstrated linkage to Agent Orange and the potential association with GMOs.
Since so many diseases can be treated or cured when caught early, it’s kind of ridiculous that in an age where everyone carries a computer in their pocket all day, we don’t have constant and real-time health monitoring devices. Where are the nanobots we were promised?
Along those lines I’d like to shamelessly plug my employer:
Michael Jorrin, the “Doc Gumshoe” journalist whose articles are featured in this post, offers the following comment: Art, many thanks for the favorable mention on your blog. Your summary of my main points is right on. The only thing I would have added is that way too many of the T2DM patients don’t get diagnosed until their disease is pretty far along & irreversible complications have begun, especially retinopathy.
Well, I do have diabetes. Part 1 just repeated what I consider the usual misinformation parroted by the newspapers all the time. Part 2 was more interesting to me both as a patient and an investor.
First, let me say my (very subjective) take on what I consider the main flaws in part 1.
I don’t think that eating sugar and refined carbs by itself leads to diabetes. There is certainly a correlation with increasing wealth in developing countries such as China, but that correlates with increasing use of autos as well as with more refined food.
Definitely a lack of walking has a huge effect on insulin resistance. I have experimented on myself as to what does and does not affect my insulin resistance — an hour workout in the gym does not help, nor does 6 hours of playing violin, or modest swimming. But a 10 minute walk can bring my glucose levels down by 40mg/dL. And the effect lasts about a day. So for decades all my efforts to stay in shape by exercising on weekends were useless as far as diabetes… a 10 minute walk every day would have been much better.
As far as diet, I think a lot of damage was done by the low fat movement of the last 40 years. Carbs are fine if digested slowly. Yes, it’s true that soft drinks hit the bloodstream too quickly, but so do juices and carbs that are eaten without fat or fiber.
Measuring my own fasting glucose levels every morning, there is little correlation with what I ate the previous day, but a huge correlation with even minute amounts of stress and lack of sleep. And my 32 years working as a scientist were tremendous on stress and lack of sleep! So, do I blame my career for my diabetes? Yup… although in concert with the effort to eat low fat and saving my exercise for the weekends.
Now to part 2. I am on metformin and Victoza, both discussed in the article. My HbA1C ranges from 5.1 to 5.5; it was over 10 when I was first diagnosed. I eat dessert and bread and fruit and all. Victoza was the first diabetes drug with absolutely no side effects. But it’s too expensive for most health plans to pay for.
The new approaches touted by the drug companies are solutions to nonexistent problems… inhalable insulin (it takes about 2 days to realize that shots are no big deal), shots that last a week (and what happens if you get a side effect like nausea, do you have to live with that for a week?), and “electronic pancreas” — insulin/glucose feedback for type 2’s (it’s useful for type 1s, but that’s a much smaller market). The author assumes that all type 2s eventually progress to needing insulin, but nobody right now has the slightest idea if that’s going to happen with the new drugs since they are already completely effective.
So IMO the author of the articles, looking for the next blockbuster, is far off the mark. The new drugs work. The effect of competition will be, hopefully, to bring the price way down. That will shift the balance to different companies, but not create a blockbuster in profits to any of them.
What is my personal prescription to the reader to avoid diabetes? Walk, just 10 minutes, EVERY day. (I’ve heard that bicycling works too. But not other exercise.) Sleep. Eat very dark chocolate and drink wine (both seem to bring down glucose levels.) Avoid juice and soft drinks. — enjoy your carbs with fat and fiber.
Hi Monica, many thanks for your thoughtful comment and real-life experience. Since walking seems to be so effective but many other forms of exercise are not, that’s a real mystery. It calls for understanding, or at least proposals on what’s the mechanism, what’s going on there. As far as walking, dark chocolate and wine, I for one am happy to get with that program!
Art, Complementary articles on Type 1 diabetes would be welcome!
Thanks for posting this, Art. My 3 siblings and I are all type 2.