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Monday 30 April 2012

Dangers of vitamin D deficiency highlighted !

6 February, 2012

Following fresh concerns about vitamin D deficiency, the UK’s 4 Chief Medical Officers have written to health professionals reminding them about this issue.

Figures show up to a quarter of the population has low levels of vitamin D in their blood and the majority of pregnant women do not take vitamin D supplements.

Health professionals are being encouraged to use their routine contact with at-risk groups to raise awareness of the advice on taking vitamin D supplements and remind them to be alert to the signs and symptoms of vitamin D deficiency.

In severe cases, deficiency can lead to bone problems such as rickets in children and weakness, aches and pains due to osteomalacia (the adult form of rickets) in adults.

People on lower incomes should also be made aware they may get free vitamin supplements through the Healthy Start scheme.

Chief Medical Officer for England Professor Dame Sally Davies said:

“A significant proportion of people in the UK probably have inadequate levels of vitamin D in their blood.
“People at risk of vitamin D deficiency, including pregnant women and children under 5, are already advised to take daily supplements.

“Our experts are clear – low levels of vitamin D can increase the risk of poor bone health, including rickets in young children.”

The following groups of people are at risk of vitamin D deficiency:
 ■all pregnant and breastfeeding women, especially teenagers and young women
 ■infants and young children under 5 years of age
 ■older people aged 65 years and over
 ■people who have low or no exposure to the sun, for example those who cover their skin for cultural reasons, who are housebound or confined indoors for long periods
 ■people who have darker skin, for example people of African, African-Caribbean and South Asian origin, because their bodies are not able to make as much vitamin D



The last straw !

Ramp up diabetes treatment after three months, GPs told !

GPs are being urged to ramp up diabetes treatment within just three months if they do not reach their glycaemic goals on metformin alone, under a radical update of guidelines issued by European and American diabetes societies.

The new approach would advise GPs to step up treatment by choosing between a range of diabetes therapies currently reserved for third or even fourth line, such as gliptins, exenatide or basal insulin.

It also urges a progression to three-drug therapy if patients are not achieving their goals within six months of initiating treatment, and a move to multiple daily doses of insulin within nine months if goals are still not achieved.

The position statement - co-authored by Department of Health diabetes tsar Professor Rowan Hillson – says guidelines should be ‘less prescriptive' as there is very little evidence to distinguish between options for diabetes, after metformin.

Current NICE guidelines for diabetes recommend sulphonylureas are used second line, with new oral therapies reserved for when there is a particular risk of hypoglycaemia or the patient does not tolerate, or has a contraindication to, sulphylureas. Insulin is strictly reserved only if HbA1c levels remain high after other measures have been tried.

The 20-page document from the American Diabetes Association and the European Society for the Study of Diabetes dispenses with fixed HbA1c targets and says therapy regimes should be designed around the patient.

 ‘With a distinct paucity of long-term comparative effectiveness trials available, uniform recommendations on the best agent to be combined with metformin cannot be made. Thus, advantages and disadvantages of specific drugs for each patient should be considered.'

The statement - published in April – says the choice should be based on factors such as lifestyle, the need to reduce cardiovascular risk and preventing weight gain. For instance, gliptins are the best option if the patient's goal is not to gain weight.

If adopted more widely, it would revolutionise the treatment patients receive, but the approach has already caused some concern among some experts that it will prove too expensive.

Professor Philip Home, professor of diabetes medicine at Newcastle University and an author of NICE guidelines on diabetes, said the approach would be ‘widely read' but he was sceptical it would be included in NICE guidelines.

‘All it does is summarise evidence, and leaves the medication choice open. There are some useful things in the detail over comparative efficacy and comparative cost, but NICE will do a proper evidence-based review and will ignore this.'

Dr Roger Gadsby, a GP in Nuneaton and primary care lead for NHS diabetes, said the approach was ‘very different' and stressed the patient as an individual.

He said: ‘They seem to say that the therapy to be used after metformin should be tailored to the individual and that a number of options are possible.

‘It will be interesting to see if NICE comes out with such a view when their updated type 2 diabetes guideline is released.'

Oh no, not again !!!

Saturday 28 April 2012

Carbohydrate Intolerance, Institutional Intransigence

It is time for me to share with you the story of Jimmy. He is a respected leader among the Kwakiutl people of Vancouver Island. He is educated and cosmopolitan while also remaining down-to-earth and connected to his home community. He is a bright, intelligent and good-hearted man. I am honoured to count him amongst my friends.

Not that long ago he was also a classic example of the devastation that metabolic syndrome and type 2 diabetes are wreaking in the Canadian Indigenous population. At 48 years of age he had been taking insulin for 17 years. Even with four shots a day of two types of insulin he was not able to get his soaring blood sugars under control. He was medicated for high blood pressure, which also remained stubbornly high. His lipids were bad and his doctor wanted him to start taking a statin. He was significantly overweight and had already suffered from a stroke. He was definitely on track for a bad outcome and likely sooner rather than later.

At that time, I was speaking out about my own diabetic experience where I had corrected everything in very short order by simply removing carbohydrates from my diet. When addressing a First Nations audience, I would draw parallels between my modern low-carb diet and their ancestral diet which was very low in carbs in this part of the world. Jimmy heard me give this talk a couple of times and then the penny dropped. He decided to try eliminating carbs from his diet.
He went to his health centre and got weighed and measured and then he started sending me email updates. I got the first note after two weeks and he reported that he had lost 17 lbs and was now getting normal fasting blood sugars and had stopped taking insulin. Completely. Consider that for a moment. Years of struggling to control blood sugar with heaps of insulin, injecting four times a day, and failing. And now, after one simple dietary intervention, he is completely free of the needle and running normal values.

A couple of weeks later, he reported a total weight loss of 31 lbs and was now normotensive and free of his antihypertensive drug. At nine weeks, he had lost 37 lbs and was continuing to record normal blood pressure and blood sugar readings. At 18 weeks, his total weight loss was 46 lbs and all his markers were normal on no medications. He had his lipids done and those were also within normal range, now, as well.

More here;


BB King & Friends : The thrill is gone/ Guitar Festival 2010

One of the all time greats. A type two diabetic for many years and still working at around eighty years of age. Started out in total poverty and rose to be an International mega star.

Saturday night is music night. Eddie

Dieticians - the lowest sub-class of nutritional grunts !

Dieticians, for the record, are the sub-class of processed food grunts who regurgitate government-approved nutritional DIS-information and design school lunch programs, prison food programs and hospital food programs. These are, for the record, the three worst places to get food, as nearly all the food served in these locations will leave you even more diseased than ever.

"Dieticians" are widely discredited in the world of real nutrition, and the dietician community has yet to even acknowledge any qualitative difference between DEAD foods and LIVING foods. Dieticians are all about counting calories, and they couldn't care less where they come from. These are the morons who actually tell cancer patients to drink Ensure! (Yeah, seriously...)

I'm not sure why anyone would even want to be labeled a "dietician." It's sort of like being called a "retard" in grade school. Because, of course, the nutritional knowledge of dieticians is rather retarded, as in "lacking in development." It's basically stuck in the dietary "science" of the 1950's, when scientists thought there were only 4 vitamins.

12-fold increased risk of severe muscle damage with simvastatin 80mg.

GPs have called for an urgent review of ‘outdated' NICE guidelines on hyperlipidaemia after an analysis showed a 12-fold increased risk of severe muscle damage with simvastatin 80mg.

Researchers showed patients taking simvastatin across its doses were 2.6 times more likely to suffer rhabdomyolysis than patients taking other statins, in the first indication of a potential raised incidence of rhabdomyolysis in the community with simvastatin.

But the 80mg dose continues to be recommended in NICE guidance for patients who are not controlled on lower doses, and latest prescribing figures from the NHS Information Centre reveal over 550,000 prescriptions of simvastatin 80mg were made in primary care in England last year.

At a dose of 80mg, it was associated with an rhabdomyolysis incidence of 64.8 per 100,000 person-years, a 12.2-fold increase in risk compared with lower doses of 20-39mg.
Study leader Dr James Floyd, a lecturer in epidemiology at the University of Washington, said: ‘Most of the risk of high-dose simvastatin is up front, within the first year.'
Dr Rubin Minhas, clinical director of the BMJ Clinical Evidence Centre and a GP in Hoo, Kent, said future NICE guidance should be changed in line with the evidence: ‘The risk of muscle damage adds to the evidence for considering atorvastatin at higher doses.'
Dr Ahmet Fuat, a cardiology GPSI in Darlington, said: ‘This study highlights the folly of the "fire and forget" approach to monitoring bloods in statin takers suggested by outdated NICE guidelines.

Friday 27 April 2012

Hi to all my disciples and anonymous fellow miscreants

Hi to all my disciples and anonymous fellow miscreants. We have had a great week on the blog. As usual, zilch in the way of educating or assisting fellow diabetics, but boy, have we slagged some people off. But first a big hand to Phoenix, Jopar and Catherinecherub for having the guts to out themselves on my magnificent blog. It takes real character and courage to do that, I know, because I haven’t got the balls to do that myself. OK, everyone knows I am the old fraud Tubolard, but he was consigned to the trash can when my forum went tits up a long time ago.

As for the Three Musketeers, as the ediot calls them, a record number of anonymous bilge quality comments. What a star Phoenix is on the big forum, every time Jopar makes a complete balls of the campaign, Phoenix always comes to the rescue with a link to six mice and bloke in a shed. I agree, her links won’t convince those lowcarb evangelists, but jeez, does she confuse the newly diagnosed or what ! Never forget, our mission is to cause confusion and help our sponsors at big pharma and the junk food companies.

On the negative side, I am very disappointed to see Phoenix has removed her permanent link on her type 1.5 blog, to my wonderful blog, and Daisy’s press button link to Kenny boys Rubber Ramada has disappeared, what the bloody hell is going on ? I hate to say it, but Bonkers, Nobhead and the Cherub appear to be slacking at the moment, a little more effort please. You have done a great job in the past for the misinformation cause, but that was yesterday, get back on the case and start kicking butt.

So my old toadies, next weeks mission is to slag off with special emphasis on those lowcarb bastards. The jungle drums are telling me the ediot and the duck are becoming immune to our comment and ravings, please can we have a special effort to tell more lies and misinformation about these scum bags, that cost me, Jopar’s, SarahQ’s and Kenny boys mod jobs at the big one. BTW I have secured a special deal by way of a bulk purchase of Oribilstat, email for the best price around.

Carbo the magnificent.

Effectiveness of a diabetes education and self management programme (DESMOND) for people with newly diagnosed type 2 diabetes mellitus:


Objective To measure whether the benefits of a single education and
self management structured programme for people with newly diagnosed
type 2 diabetes mellitus are sustained at three years.

Design Three year follow-up of a multicentre cluster randomised
controlled trial in primary care, with randomisation at practice level.

Setting 207 general practices in 13 primary care sites in the United

Participants 731 of the 824 participants included in the original trial
were eligible for follow-up. Biomedical data were collected on 604
(82.6%) and questionnaire data on 513 (70.1%) participants.

Intervention A structured group education programme for six hours
delivered in the community by two trained healthcare professional
educators compared with usual care.

Main outcome measures The primary outcome was glycated
haemoglobin (HbA1c) levels. The secondary outcomes were blood
pressure, weight, blood lipid levels, smoking status, physical activity,
quality of life, beliefs about illness, depression, emotional impact of
diabetes, and drug use at three years.

Results HbA1c levels at three years had decreased in both groups. After
adjusting for baseline and cluster the difference was not significant
(difference −0.02, 95% confidence interval −0.22 to 0.17). The groups
did not differ for the other biomedical and lifestyle outcomes and drug
use. The significant benefits in the intervention group across four out of
five health beliefs seen at 12 months were sustained at three years
(P<0.01). Depression scores and quality of life did not differ at three

Conclusion A single programme for people with newly diagnosed type
2 diabetes mellitus showed no difference in biomedical or lifestyle
outcomes at three years although there were sustained improvements
in some illness beliefs.

Thursday 26 April 2012

How to deal with a troll !


Vitamin D Levels Predict All-Cause and Cardiovascular Disease Mortality in Subjects With the Metabolic Syndrome !

The Ludwigshafen Risk and Cardiovascular Health (LURIC) study


OBJECTIVE Optimal vitamin D levels are associated with reduced cardiovascular and all-cause mortality. We investigated whether optimal 25-hydroxyvitamin D (25[OH]D) is protective in individuals with the metabolic syndrome.   

RESEARCH DESIGN AND METHODS The Ludwigshafen Risk and Cardiovascular Health (LURIC) study is a cohort study of subjects referred for coronary angiography between 1997 and 2000, from which 1,801 with the metabolic syndrome were investigated. Mortality was tracked for a median of 7.7 years. Multivariable survival analysis was used to estimate the association between 25(OH)D levels and mortality.

 RESULTS Most subjects (92%) had suboptimal levels of 25(OH)D (<75 nmol/L), with 22.2% being severely deficient (<25 nmol/L). During follow-up, 462 deaths were recorded, 267 (57.8%) of which were cardiovascular in origin. After full adjustment, including the metabolic syndrome components, those with optimal 25(OH)D levels showed a substantial reduction in all-cause (hazard ratio [HR] 0.25 [95% CI 0.13–0.46]) and cardiovascular disease mortality (0.33 [0.16–0.66]) compared with those with severe vitamin D deficiency. For specific cardiovascular disease mortality, there was a strong reduction for sudden death (0.15 [0.04–0.63]) and congestive heart failure (0.24 [0.06–1.04]), but not for myocardial infarction. The reduction in mortality was dose-dependent for each of these causes. 

CONCLUSIONS Optimal 25(OH)D levels substantially lowered all-cause and cardiovascular disease mortality in subjects with the metabolic syndrome. These observations call for interventional studies that test whether vitamin D supplementation provides a useful adjunct in reducing mortality in these subjects. 


Wednesday 25 April 2012

My food Bible !

I have lost count of the times I have referred to the Worlds Healthiest Foods website, a fantastic resource of very in depth information on food. From nutrient values to the best way to cook, it is a masterpiece.

After using the free website for a couple of years, I thought it was pay back time and purchased the book from Amazon, price including postage £28. The book should be renamed ‘the worlds heaviest food book’ ! At 880 pages and close to A4 size and two inches thick in paper back, it’s one hell of a beast. 

I cannot recommend it highly enough, the book is not aimed at diabetics, or low carbers, but I believe the book will be priceless, for anyone wanting to understand what good food is all about, and the correct way to prepare and cook food, without wasting vital nutrients and flavours. In my opinion, this book is fantastic value for money, and an absolute must have for all foodies, check it out on the website below.


Lowcarb boring ? people can't keep to it, another myth !

A days grub.

Check out our lowcarb food and recipe blog here.


British strawberries back in the shops.


Mix all dry ingredients in a bowl.
Melt the butter I used a Pyrex jug, add the eggs and cream, then add the dry ingredients and mix thoroughly. Add some lowcarb fruits, blueberries, raspberries and strawberries to the mix and spoon into a baking container. I used a silicone bread mould. Microwave in a 700watt for 6 minutes. Take out of the mould, if still damp place upside down on four layers of kitchen paper and microwave for a further one minute. Allow to cool then spread on a layer of extra thick cream, then add fruits to the top. A little tip, allow to cool on four or five layers of kitchen paper to remove any excess moisture. Serve in a bowl with some double cream. Serves eight.


200g ground almonds
2 heaped teaspoons baking powder
3 medium eggs
2 tablespoons of butter
2 tablespoons double cream
Summer fruits

Diabetes: Most NHS costs wasteful, says Diabetic Medicine.

The majority of NHS spending on diabetes is avoidable, says a report in the journal Diabetic Medicine.
Experts say much of this is preventable with health checks and better education - something the Department of Health says it is tackling.
The report also predicts that by 2035, diabetes will cost the NHS £16.8bn, 17% of its entire budget.

"That's hugely wasteful - in human life, in the quality of human life, and in NHS budgets. We need to stop this now and make sure people get the right sort of care early on in their condition."
At a separate conference in Copenhagen, the cost of diabetes has also been under discussion.
General Yves Leterme, from the Organisation for Economic and Co-operation and Development said: "Preventing and treating diabetes and its complications costs about 90bn euros (£73bn) annually in Europe alone.
"With health budgets already under great pressure and national budgets severely strained, for the sake of our health and the health of our economies we must find ways to prevent and manage diabetes in a cost-effective manner."

Why are the experts always years behind the average informed and well controlled diabetic. Almost all healthcare professionals have seen a remarkable reversal of type two diabetes in some of their patients, and what do we hear ? If it works for you stick with it at best. How DUK have the cheek to comment is a sick joke. It’s the NHS and DUK dietary information that is causing much of the misery and complications. More drugs is not the answer !

Tuesday 24 April 2012

Is it me or does my bum look big in this penguin suit ?

High blood sugar lowers chances of surviving a heart attack.

The impaired substrate metabolism of diabetes patients is often expressed in an increase in fatty deposits in the cells of the heart muscle. Until now, the exact cause of this was unknown. Now, Austrian researchers at the MedUni Vienna in the Division of Endocrinology and Metabolism of MedUni Vienna in cooperation with the MR Centre of Excellence Vienna have shown that high blood sugar in combination with high levels of insulin – not an influx of fats – results in such deposits within a few hours. This could form the basis for even more heart-friendly treatments of diabetes patients, especially in the early stages of the disease.

In the study, published in the respected American journal Diabetes, 18 healthy women and men were given a large amount of grape sugar intravenously. “Within as few as six hours, the glucose already caused clearly visible fatty deposits in the heart. The injection of grape sugar, in combination with the release of insulin caused by the sugar, resulted in an overexertion of the heart’s metabolism“, said the study’s director, Michael Krebs of the University Department of Internal Medicine III.

In Austria alone, around 500,000 people are affected by diabetes. “The first diagnosis usually occurs by accident and on average five years too late“, said Krebs. Most patients with diabetes die of heart diseases. “Our data show that the foundation for damage can be laid early on, especially in patients with high blood sugar and hyperinsulinemia – an elevated insulin level – during prediabetes and early diabetes.“ Building on these new findings in relation to elevated blood sugar (hyperglycemia) and hyperinsulinemia, MedUni Vienna is conducting studies that should help to make the treatment of diabetes patients  even more heart-friendly.

My red text emphasis. Check out my post below re. early testing for those at risk.


Rising HbA1c levels ‘predict diabetes’

HbA1c levels rise rapidly in the year before a diagnosis of type 2 diabetes, say Japanese researchers.

Their study looked at 1,722 individuals aged 26–80 years without diabetes and measured fasting plasma glucose and HbA1c were measured annually for a mean of 9.5 years. A diagnosis of diabetes was given to 193 people, who had a mean HbA1c level of over 38mmol/mol (5.6%) each year before diagnosis. Average blood glucose and HbA1c values throughout the observational period were significantly higher in incident cases compared with non-cases, with differences of 1.02 mmol/L and 18 mmol/mol (0.471%) higher, respectively.

In the entire group, marked increases in HbA1c of 20 mmol/mol (0.3%) per year and fasting plasma glucose of 0.63 mmol/L/year predicted a diagnosis of diabetes.

Professor Hirohito Sone, diabetologist at the University of Tsukuba Institute of Clinical Medicine, Tsukuba, Japan, said their findings showed the value of screening regularly in those at risk of diabetes.

I suggested three years ago on a certain forum, that testing plasma glucose and plasma insulin levels for at risk people, i.e. over weight or people with generations of diabetics in their family. Result a major argument and I was accused of being a scare monger by an ex mod. What possible use would it be he asked. I thought knowing possibly years in advance of all the health problems that can go with type two diabetes would be very useful. Many would not take head of the warning, but many would dump the carbs and get on there bikes. They would have a very early warning and change their lifestyles.

The mod “a simple carb loving person with diabetes, struggling with managing the condition and living a normal life” Got fired, I got banned. Funny old life eh.


Victoza Public Citizen wants withdrawal of diabetes drug !

A consumer advocacy group is calling on government regulators to withdraw a diabetes drug from Novo Nordisk, saying the injectable medication raises the risk of thyroid cancer, pancreatitis and kidney failure.

"The need for new therapies for Type 2 diabetes is not so urgent that one must tolerate a significant degree of uncertainty regarding serious risk concerns," wrote reviewer Dr. Karen Mahoney, in an agency memo obtained by Public Citizen.

Public Citizen also cites Victoza's association with pancreatitis, reports of which were 3.7-fold higher among patients tested with the drug than those taking other diabetes drugs. In its first 17 months on the market, the FDA received 200 reports of patients diagnosed with pancreatitis, according to a search of FDA databases. Public Citizen estimates only 10 percent of cases are reported to the agency, suggesting there may be as many as 2,000 cases of among patients taking Victoza.

Fatty acids in cardiovascular health and disease: A comprehensive update !


Research dating back to the 1950s reported an association between the consumption of saturated fatty acids and risk of coronary heart disease. Recent epidemiological evidence, however, challenges these findings. It is well accepted that the consumption of SFA increases low-density lipoprotein cholesterol (LDL-C), whereas carbohydrates, monounsaturated fatty acids (MUFAs), and polyunsaturated fatty acids (PUFAs) do not. High-density lipoprotein (HDL)-C is known to increase with SFA intake. Among individuals who are insulin resistant, a low-fat, high-carbohydrate diet typically has an adverse effect on lipid profiles (in addition to decreasing HDL-C, it also increases triglyceride and LDL particle concentrations). Consequently, a moderate fat diet in which unsaturated fatty acids replace saturated fatty acids and carbohydrates are not augmented is advised to lower LDL-C; compared with a low-fat diet, a moderate-fat diet will lower triglycerides and increase HDL-C. Now, there is some new evidence that is questioning the health benefits of even monounsaturated fatty acids and polyunsaturated fatty acids. In addition, in a few recent studies investigators have also failed to demonstrate expected cardiovascular benefits of marine-derived omega-3 fatty acids. To clarify the clinical pros and cons of dietary fats, the National Lipid Association held a fatty acid symposium at the 2011 National Lipid Association Scientific Sessions. During these sessions, the science regarding the effects of different fatty acid classes on coronary heart disease risk was reviewed.


Monday 23 April 2012

The Three Musketeers starring Borofergie, Grazer and xyzzy.

At an informal press conference today, Legendary film maker Thelonius P Wilderbeast announced the resurrection of his film company Lowcarb Film Productions Inc., and gave details of the soon to be released remake of the The Three Musketeers. Regular members from the old days will remember the company provided some much needed mirth in the some-times bleak world of diabetes. Wilderbeast a protégée of the Hollywood film moguls Sam Wongamaker and Dino De Dememtis was their most successful Director.

Wilderbeast who first found world acclaim as one of the most forward thinking musicians of his age and was regarded by many as the finest bass player that ever drew breath. Taking early retirement Theo brought an Island in the Caribbean, spending his days fishing and seriously chillin out. At an awards ceremony in LA he was introduced to Wongamaker and thus began his meteoric rise in motion picture film business.

One of Wongamaker’s companies Lowcarb Film Productions Inc. was failing fast. In its day it was a big earner, but sales of adult movie videos were plummeting. Theo was tasked with turning the ailing company around. On arrival at the studio he was appalled, it was a shambles, but had one redeeming factor. The star of hundreds of porn films, the one and only Monty Beantipper, was on a five year retainer. Immediately Theo realised he had a future mega star on his hands, but a complete change in direction was required. Short of funding and time of the essence Theo had a stroke of genius. He would re-make old classics but with twist.

His first film Lowcarb Picnic at Hanging Rock brought critical acclaim, but failed to make money at the box office. Swiftly followed up by The Cod Father 1 2 and 3 the money started rolling in. It was with the remake of Jonathan Demme’s masterpeice The Silence of the Spam’s Theo’s and his star Beantipper careers went into the stratosphere. Could this be followed up ? yes it could. Within twelve months they had made and released their Magnum Opus, a remake of the gangster classic, Sam Peckinpah’s 1974 masterpiece ‘Bring Me The Lunch Of Alfredo Garcia’.

This time Wilderbeast is using three relative newcomers, Borofergie, Grazer and xyzzy. When asked why he is not using his regular stars, Eddie, Graham and John, Theo thought they were too old and ugly for the starring roles. Also they were at the pre-production stage and appearing in his remake of the Alan Clarke film SCUM !

Further details will be announced soon.

The clique, the antis, the liars and the deranged.

Around four years ago I became a type two diabetic. It completely changed my life. Call it skill, luck or fate, but I have almost always turned a bad situation around. So often when a situation looked bleak and unsolvable the remedy was so close to hand. Almost any problem can be resolved with the correct information, I went looking for good information. I found it at The man with the information was Fergus Craig. A type one diabetic for around thirty years. So many diabetics thirty years in are suffering serious complications, many have died. Fergus had no complications, in fact he was stronger and fitter than most non diabetics of the same age. He was regularly running marathons and competing in 100 mile plus bike races and competing against non diabetics half his age. Most importantly, he had reached the holy grail of all diabetics, HbA1c in the fours. He still holds those numbers four years on. He still runs and still rides his bike, and is a drummer in a band. In short, he is a shinning example for what can be achieved with some good information, dedication and self discipline. These fact are even more remarkable when you consider he had spent many years in the diabetes wilderness.

Overweight with very poor control of BG numbers, and the start of diabetic complications. Fergus had discovered the way back to good health, discovered the way back to a long and active life. He could have got on with his life and kept the information he had learned to himself. Thankfully for me and so many others including our little team he taught us how to get to non diabetic blood numbers, how to return to a healthy weight, how to get far better lipid numbers without the use of statins. He taught us how to substitute foods that raised BG numbers to highly dangerous numbers, with foods that were not only far better from a nutritional point of view, but kept our BG numbers in the safe zone. It all sounds so simple, almost far too easy, too good to be true. Most things that sound too good to be true, usually are, but not in this case. With a change of diet and some modest physical activity, type two diabetes could be reversed. Reversed but not cured. A return to the old diet with only a modest increase in carbs for many would almost certainly result in dangerous BG numbers. This lowcarb diet was not a quick fix, it was for life.

The forum in those days was fairly new with only a few thousand members. Many were newly diagnosed. Like me they new nothing about controlling diabetes, but it was a place to hang out. It was the first forum I had ever joined, and I thought it may help to talk to others in the same boat as me. I certainly did not expect to find a way to total diabetic salvation, from a man I had never heard of. It was a total bomb shell. It was totally beyond my comprehension that the diet recommended to me by my healthcare team was so far wrong it bordered on the comical. Not that I was laughing. Two weeks after I was diagnosed, I buried my Father. He had died riddled with diabetic complications. The last ten years of his life had been blighted. By following the NHS diabetics diet, he had swiftly progressed to injected insulin and ten different types of drugs. Pill taking had become a part time job. All this could have been avoided, if he had heard from someone like Fergus, around the time he was diagnosed. He was of the old school that believed Doctors always knew best, I now know that is certainly not the case.

I have great respect for the medical profession and the people that work in the NHS, but have come to learn most are generalists not specialists. They deal with thousands of different diseases and medical conditions. They cannot be expected to be diabetes experts. The huge problem for diabetics here and in other countries, few of us ever get to see a diabetes expert. As is common knowledge, many type two diabetics can’t even get a test strip on prescription. Many people of modest income cannot afford to by their own testing kits and are so often discouraged from testing. A recipe for guaranteed diabetic complications and a foreshortened life. For so many a lowcarb diet is the answer. What other chronic disease can be reversed in days with a change in diet, non that I know of. Surely a lowcarb diet would be embraced by all, minimal or no medication, many pain free years added to our lives, and little financial cost. It never entered my head,  not everyone would  feel a sense of wonder and elation, that this chronic disease could become a life sentence and not a death sentence so easily.  How naive and stupid was I, never in my life had I got something so wrong. Carb wars at had begun.

To be continued...................


Sunday 22 April 2012

Quote of the month !

"Harsh perhaps but calling someone a troll because they hold a different view to you is not on in my book"

From Bonkers on today. When Dr. Jay Wortman was labelled a troll by Ken, Bonkers put the boot into Jay.

Tinker Taylor Liar Troll ! Part two.

Karla awoke with a shudder from the usual nightmare. Laying in her chair and in a cold sweat. Was it the never ending nightmare, or the surfeit of junk she had been eating since dawn. The thought quickly left her mind as she put on the kettle, put the cat out, the loyal cat that would always be her friend, and went in search for her chocolate digestives. The tea and bikkies cheered her up and she felt more positive. How dare the team cast me adrift she thought, after all I had done for that mad man Eddie and his ungrateful team, and all of them refusing to return my barrage of emails, instant messages and pms. How could the great Karla be dumped like yesterdays empty hobnob packets.

What ever the cost, no matter how long it took, she would destroy the team. Another plan was required, a plan to re-establish the lost communication with Eddie, a fool proof plan that he would fall for hook, line a sinker. The old diabetic in trouble ploy. It had worked beautifully before, why not again. From her vast network of email accounts and invented characters she brought out Lindka Palmer.
Palmer would contact Eddie via the address on the lowcarb website and pretend to be a diabetic in trouble requiring help. Eddie was always a sucker for a trying to help people. She could lead him along and waste his time, when he trusted her, the trap could be sprung. She would thank him profusely and offer the services of a Revenge Man website.
Sent on Friday 24th. June 2011

Dear Mitch
Please look here and then tell the Revemgeman what needs to be done, I think these horrible people need to be taught a lesson.
I am very angry,k you have helped me, you and Karen did, I will back you up till the day i die and continue from my grave.
I know you and the Revengeman can come up with something perfect. Wipe the smile of their starchy faces.
All the best

How Karla had cursed her own stupidity at the time. Eddie who had smelt a rat, but gave the diabetic in distress, the benefit of the doubt, realised he had been fitted up like a box of kippers. Not only had Eddie realised Karla was back to her old tricks, he had refused to have anything to do with the troll, and her scheme to anonymously rubbish Carbo. She realised, she had failed to take into account, Carbo was the anonymous coward, and Eddie used his real name, and would never stoop to the level of Carbo and the clique. Cover blown, but revenge man could be used at a future date, she thought, as she lunged at a box of celebration chocolates. As she shook with rage, she vowed to get even with Eddie. Whatever lies she had to tell, no matter how long it took, revenge would be hers. Revenge man would be used again in the future, and this time he would not be thwarted, because she would post the filth herself.

To be continued…….

Saturday 21 April 2012

Kens a great bloke. Honest !

Posted on the Rubber Ramada Fri Apr 20, 2012 11:47 pm

“Just for the information of our members, over the past few days there has been a concerted effort by certain people not only to blacken Ken's name but also this forum. Let me assure you that the recent trolling behavour on DCUK had nothing to do with either Ken or myself.

The Admin at DCUK was informed about this and removed the offending posts and comments made by members and a Moderator there who wrongly assumed that Ken was in some way involved.

If we wish to comment on subjects at DCUK we do so openly not sculking about in disguise. There are many people out there that know Ken's style and pet subjects well enough to imitate him in print and have their own reasons to malign him. Look to them for the culprits not this forum.

We apologise to any members here if you got caught up in this, these people have no feelings for anyone they hurt only for the twisted game they play”

We are delighted to announce, we have been awarded the contract, to restore the tarnished image of Ken aka Sideshow Bob. Having successfully handled the public relations campaigns for Genghis Kahn, Attila the Hun and Vlad the Impaler, we feel we are well placed to restore the credibility of our much maligned client. Never let it be said we shy away from the toughest of challenges.

At a London press conference yesterday, a spokesman for BKW stated, unlimited funds were available for the positive promotion of their client. He denied all knowledge of heavy tactics used in the past, and denied having ever heard of Sid (the enforcer) Bonkers.

Eddie (the madman) Mitchell Director of Public Relations and Damage Limitation. Bullshite, Koverupp and Whitewash of New York

Friday 20 April 2012

Fat ex cop that used to be a mod surfaces as the Riddler !

Tinker Tailor Liar Troll !

Tinker Tailor Liar Troll part 1
Karla sat in her safe house and watched the sun rising over Bloomsbury Park. How had it gone so wrong she thought. Four years of planning, treachery and betrayal all for nothing. The plan was brilliant, she had planned every move down to the smallest detail. She had infiltrated the lowcarb team, destroyed Kenny boy with a cunning plan. She had praised the lowcarb team, indeed she had even left forums in support of Eddie. After a making a cup of tea and given her hobnob a good dunking, she pondered further. She realised her vicious and cowardly attack on a friend of the team had been a massive error of judgement, and was the start of her unravelling. The team had held suspicions for a long time, but now she had completely blown it. Exiled by the team, a new plan was required. Banned at the big forum, and her sock puppet trollery had take the lowcarb forum out, there was only one place left. The last bastion of the failed and disgraced, Carbo’s cess pit.

Knowing it was the hang out of the low carb anti’s she would have to work hard to win them over. She quickly realised they would accept anyone that rubbished Eddie and the team, much to her amazement they even stated they had forgiven her. Karla smiled to herself when she thought how easy Carbos crew had been taken in. Phase two of her new plan was a master stroke, get some of the anonymous ones to start posting on Carbo’s blog using their forum names. Even she had admitted to herself the plan was daring, and not foolproof, could she pull off one last big coup d’état. Within hours Phoenix, Jopar and the cherub had outed themselves. As she put the kettle on and opened her jar of kefir, she laughed out and almost screamed with pleasure, how could they have been so dumb she thought. The cherub and Jopar yes, but the member code name the intellectual, this was more than she dared hope for. The intellectual long regarded as the most slippery anti in the known world, had actually posted on Carbo’s blog. How desperate the antis must be she thought. What credibility did they have left.

While the glove puppets, Bonkers and Knobhead had been bleating on about gruesome blogs and forums on the big one, had these dullards forgotten they were the first joiners of the Kenny boys home of misinformation and self adulation. She fell into hysterical laughter when it dawned on her, she had started the destruction of Kenny boy, and there he was trolling again at the big one, the very forum Kenny boy had banned her from, during what became known as ' The Reign of Terror’ She had sowed the seeds of Kenny’s demise, but it was beyond her wildest dreams, to see he had blown out what remained of his brains yet again.

She was beside herself with joy, as she opened her favourite brand of Austrian chocolates. The big one she had infiltrated was in uproar, thread locking and post deletion was on the way back to the ‘fat ex copper that used to be a mods days’ The dullards had fell for her ‘They think they know who I am but it’s my employee’ ruse and life was looking sweet. Carbo and his miscreants were rubbishing Eddie and the team, posting lie after lie anonymously, but making mistakes she would never have made. While tucking into her second packet of hobnobs, she weighed up her options. Should she sit back and watch the mayhem, or should she bring in her special operator and arch troll and asset, Lindka Palmer, and bring about Eddie’s and the teams total destruction.

To be continued………

Thursday 19 April 2012

Diabetes Groups Issue New Guidelines on Blood Sugar !

Type 2 illness can't be treated with one-size-fits-all approach, new recommendations advise

THURSDAY, April 19 (HealthDay News) -- Type 2 diabetes is a complex metabolic disorder, and treating the disease often requires a personalized, multi-pronged approach, say new expert guidelines on treating high blood sugar levels, issued Thursday.

The recommendations are a joint effort by the American Diabetes Association and the European Association for the Study of Diabetes.

"We're making a lot of progress in managing type 2 diabetes," said Dr. Vivian Fonseca, president of medicine and science for the American Diabetes Association. "The new guidelines are more patient-centered. The message is to choose an appropriate [blood sugar] goal based on the patient's current health status, motivation level, resources and complications."

"It is very possible to manage type 2 diabetes well and keep blood sugar under good control," he noted. "It's important that patients have a discussion with their doctor about what their [blood sugar] goals should be, and what is the best treatment or treatments to get them to that goal."

The new guidelines are scheduled to be published in the June issue of Diabetes Care, but were released online ahead of publication on April 19.

Full Article


Wednesday 18 April 2012

Dietary saturated fat and fibre and risk of cardiovascular disease and all-cause mortality among type 1 diabetic patients: the EURODIAB Prospective Complications Study

Low adherence to recommendations for dietary saturated fatty acid (SFA) and fibre intake in patients with type 1 diabetes mellitus may heighten their increased risk of cardiovascular disease (CVD) and mortality. We examined the relationship of SFA and total, soluble and insoluble fibre with incident CVD and all-cause mortality in type 1 diabetic patients.
A prospective cohort analysis was performed in 2,108 European type 1 diabetic patients aged 15–60 years who were free of CVD at baseline and enrolled in the EURODIAB Prospective Complications Study (51% male). Diet was assessed from a standardised 3 day dietary record. HR were calculated using Cox proportional hazards models.
During a mean follow-up of 7.3 years, 148 incident cases of fatal and non-fatal CVD and 46 all-cause deaths were documented. No statistically significant association was found between SFA and CVD and all-cause mortality. Total dietary fibre, per 5 g/day, was associated with lower all-cause mortality risk (HR 0.72; 95% CI 0.55, 0.95). This association was stronger for soluble fibre (per 5 g/day, HR 0.34; 95% CI 0.14, 0.80) compared with insoluble fibre (per 5 g/day; HR 0.66; 95% CI 0.45, 0.97). Similar results were found for the association with CVD.
This study suggests that reported dietary SFA is not significantly associated with CVD and all-cause mortality in type 1 diabetic patients. On the contrary, higher dietary fibre consumption, especially soluble fibre, within the range commonly consumed by type 1 diabetic patients, may contribute to the prevention of CVD and all-cause mortality in type 1 diabetic patients.

Gone Fishing !

Back Soon Don't Worry!

Tuesday 17 April 2012

“You Will Know Them by Their Fruits”

With apologies to Matthew 7:15-16 (New King James Version) but you know the blog by its followers.

Karen/Chocfish/WhitbyJet has posted “I never felt hounded by jopar, she never even tried to do that. I have often met with jopar, Sarah Q in the chat room “ on Carbo’s blog.

A piece of friendly advice for Jopar and SarahQ. Have a quiet word with Ken regarding personal communication with Karen/Chocfish/WhitbyJet. Now Ken’s a big boy, and after some time was able to deal with Karen/Chocfish/WhitbyJet. However, a more vulnerable member of suffered much emotional distress after personal ‘communication with Karen/Chocfish/WhitbyJet.

Some time ago, some very worrying, and disturbing information came our way. Karen was not the hugs, kisses and cuddly person she appears to be on various forums and blogs and our advice would be to refrain from PMs and other forms of personal communication.


Long is the way, And hard, that out of hell leads up to light. Milton

A question for Edie
Posted on Carbos blog last night by Carbs United.
"Can you explain in simple terms what exactly you have been doing to the non low carbers for the last four years?"

The term non low carbers is too wide. Many of my family and good diabetic and non diabetic friends are not low carbers. I have nothing against non low carbers. I feel what have I been doing to a small group of non low carbers is more accurate. The non low carbers that have done their best to stifle almost every good debate at The type of non low carbers, that start a thread on the forum, knowing it will lead to an argument, and then have brass necked nerve, to ask a mod to lock the thread when losing the argument. See the links posted here yesterday. That have been the main cause of misinformation and spreaders of fear. The small band of antis, that have worked in a pack, very often with the aid of a moderator, to get good people banned, to bully and ridicule quite members, who do not want confrontation, to rail road so many off the forum. The small band of antis that formed a clique behind a moderator that deleted, thousands of posts by low carbers, because they stood up and exposed him for what he is. And hasn’t he proved us right, with his efforts to rubbish the forum, and members that dare to speak the truth and not be intimidated. I could go on a bore people rigid, but in short, I believe this small band have been destructive and a total menace to the confused and newly diagnosed.

Doctor Katharine Morrison summed the situation up so succinctly four years ago, in her post to Ally, anther spreader of fear and misinformation and a devout member of the clique, but how well it also applies to the other clique members.

November 13th, 2008, 7:45 am

I think there would be a lot less hostility towards you Ally if you actually gave constructive advice to people. Many diabetics have not had a positive relationship with NHS dieticians, myself included. A few have had their problems listened to and appropriately addressed and I hope the situation will continue to improve.

I have yet to see a post from you which is written with the aim of helping someone get better control of their diabetes or improve their nutritional state. So far I have simply seen one post after another of the "Do not try this at home variety." None of your negative comments regarding low carbing have been substantiated by scientific evidence. I am patiently waiting for your scientifically based expose of the errors of Dr Bernstein's method and Gary Taubes collection of evidence. All we have got so far is personal opinion.

Doctor Katharine, like so many great people, got the third degree from the clique and left the forum. A diabetes expert with a type one son, a highly valuable asset to any diabetes forum, gone and sadly missed. We know how Doctor Jay was treated, abysmally. And what did Ken do as soon as Jay was gone ? Launch a poll asking, Do we want healthcare professionals posting on forum ? You can understand why, the last thing the clique wanted was an expert exposing the dross from the same bunch of antis.
So, “what exactly have I been doing for the last four years” Well on the positive side, I have been paying for a website that helps the newly diagnosed and poorly controlled. This site has brought us into contact with many people our team has helped. Our team has been helping people on and off forums, spreading the low carb good news, we have helped so many to lose weight, so many to non diabetic BG numbers, so many to improved lipids and many to nil or reduced medication. We have posted lots of great food ideas and links to diabetes information. The positive side is long, what about the negative.

Some will say that list is also long. It is true I have ridiculed the ridiculers, bullied the bullies, taken on the wreckers and spreaders of fear and misinformation. I have fought and exposed people like Ken, Carbo, the registered dietition and director of the BDA, who had so much to say, but so little by way of showing compassion, or assistance to the growing band of newly diagnosed diabetics. I have used every way possible to expose the low carb antis, that the links posted yesterday clearly demonstrate how they operate. I have regrets, I and our team had few tools at our disposal. All banned from the forum, we would have liked to have stayed on the forum, and help others. To continue the great work started by Fergus, Dennis, Timo, Doctor Katharine and so many others that the small band of naysayers and low carb antis wore down, alas, it was not to be. Back to the positive.

Under Benedict’s leadership his moderator team are doing a great job. Gone are the days when ex mods like Ken, Tubolard, SarahQ and Jopar could thread lock, ban and delete members posts on a whim. A comparatively new bunch of good honest people are helping the poorly controlled, the newly diagnosed and people in trouble. I believe the forum is back to being a great place. If you are not a member or are a member that decided to leave, please get back over there, help others less fortunate than yourselves. Tell them your good news and how you achieved it. The last word to Doctor Malcolm Kendrick.

“The reality is that over the years, and around the world we have killed literally millions of diabetics by advising them to eat a high-carb diet and avoid fats. Only now is it being recognised that previous advice was and remains useless, dangerous and scientifically illiterate"

Monday 16 April 2012

Carbophile and the anti-lowcarbers, how low can they go ?

Carbos latest post states the following.

“A word, if I may, about anonymity. I can explain my desire for anonymity in a simple phrase...I don't want my employers involved. I like being able to say what I want...when I want...without my employers becoming involved - or feeling that they are being exposed unnecessarily to unpopular views. It shouldn't be that way, but that's the world we live in. I'm sure others have their own, equally valid, reasons for wanting to remain anonymous.

There is a certain element of cowardice to anonymity - I don't want to lose my job for instance - I'm not self-employed or nearing retirement. That isn't to say that anonymity is necessarily indicative of cowardly behaviour, there are plenty of examples out there of the absolute need for anonymity to protect lives, but I'm sorry the world of diabetes isn't one of those examples. I will say, however, with hand on heart that I will always post as Carb O'Phile. it's my way of accepting responsibility for the words that I write and the impact those words may (or may not) have”

I can understand this, what decent and respectable employer would employ the likes of Carbo. It should be remembered every post that appears on Carbo blog he has to approve. So let’s have a look at some of the posts on his blog and latest thread. Please bear in mind I have offered to meet Carbo aka Tubolard on numerous occasions to discuss and progress the argument. Not only that I offered to help him on the forum three or fours years ago. Just before he was banned as a member, he stated on his profile in the hates section. I hate Richard Bernstein and Eddie Mitchell.

So. Some comments from Carbos readers and posters.

"Rest assured Eddie isn’t going into school’s taking pictures of little children; his company was dissolved last year, after 10 years of what the company accounts suggest after a very poor trading record!"
“Errrr excuse me? Karen....dangerous? Hmmm who is the plonker with not one, but 5 (!!)low carb blogs, one more vile and abusive than the other? Its not Karen thats for sure.

Nope its the Eddiot, a grandfather no less, a bloke that goes out taking pics of innocent little children in schools. Would you let him anywhere near your kids?”

"Eddie is guilty though, of having a filthy vial mind, he’s been known to post some perverted sexual activities he wished to carry out, and sharing crude Jokes concerning Gym slip girls, whether this is a indicator of other depravities is unknown, and it’s wrong and unfair to make these allocations without proof, but saying that I sure wouldn’t want him anywhere near my children purely based on his other vile characteristics…

See Eddie there’s wisdom about keeping Anonymous"

The lowcarb antis do love their petty torments.

Let me tell you how Schools work these days. Anyone working with children needs a full disclosure Criminal Records Bureau check. Anyone with the slightest blemish is considered unsafe. There is no grey area when working with children, you are safe, or you are not. I have worked in over three hundred Schools, some for the past seventeen years. I have photographed hundreds of thousands of children and young adults. I work with my wife and I am trusted by hundreds of teachers and School management teams, and Carbo allows these smears to appear on his blog. I have offered to meet him on numerous occasions, and other lowcarb detractors. It seems no one has the courage. How brave they are hiding in the shadows. Safe in their cowardly anonymity. It’s the liars, anonymous ones and spreaders of fear that keep me going. The sort of people that want to add to the gruesome NHS stats. we see. The carb and medication addicted that refuse to see a healthy lifestyle and quality food diet is the way forward for most diabetics. As I said earlier, Carbo has to approve these comments, and by implication, agrees with them.

My Father taught me many things. He was a simple man of rudimentary education. He was in his younger days a Royal Marine. He believed a man that was not a protector and provider to woman and children was not a man. Diabetes complications killed him, I try to live up to his beliefs. I will fight the liars and spreaders of fear, the cowardly gutless people, that hang out in the likes of the despotic Carbo’s blog, till the day I die.

The big question ? what does Carbo's blog say about Carbo ? A blog that has rubbished Dr.Jay Wortman, Fergus, Dillinger, Hana, AliB, Graham and so many others. Make up your own minds what this says about Carb/Tubolard. For me, a highly damage individual, with zero courage and a complete failure, as a mod, as forum owner, and a blog owner. To be fair he was not born this way. Years of systematic abuse, has brought him to the terrible place he now resides. I do not hate or dislike you Carbo, I think I understand, and am always prepared to to turn the other cheek, and help. Contact me via our contact page at


Modus Operandi of the Clique

Sunday 15 April 2012

Why The Health Care Professionals Are Failing Diabetics

You may believe that one of the functions of the HCPs would be to inform their diabetic patients of the dangers of diabetes. Think again.

From:  ABPI/Diabetes UK/Ask About Medicines. Diabetes Medicines Information Survey. June 2006.
9% of diabetics do not know that blindness can be a complication of not managing their condition.
18% of diabetics do not know that amputations can be a complication of not managing their condition.
30% of diabetics do not know that kidney failure can be a complication of not managing their condition.
32% of diabetics do not know that heart disease can be a complication of not managing their condition.
33% of diabetics do not know what questions to ask those who provide their care.
33% of diabetics don’t know what questions to ask in order to find out more about their treatment options.
33% of diabetics don’t understand what their insulin or tablets are for or how to take them.
35% of diabetics take their medicines as prescribed.
40% of diabetics do not know that stroke can be a complication of not managing their condition.
58% of diabetics do not know what the diagnosis means.
60% of diabetics do not fully understand the meaning of their diagnosis or what different medicines are available.

From: 10. Dr Foster/Diabetes UK. Wales, England and Northern Ireland. 2005.
33% of diabetics are unaware that they will have the condition for life.

From: Morgan CLI et al. The prevalence of multiple diabetes-related complications, Diabetic Medicine 2000;17:146-151.
50% of diabetics do not understand that diabetes can reduce life expectancy.

Perhaps they spent the consultations extolling the virtues of the NHS 50% starchy carbohydrate diet  


Kenny boy on the warpath again !

"I have been following xyz's thread with interest and I do agree with some of what he is 'BANGING ON ABOUT'. Yes the NHS/DUK dietary advice is pretty abysmal for Diabetic's.....of whatever kind. That is MY opinion, always stated in many threads on DCUK previously. I was a 'victim' of such bad advice for years before I discovered a low carb method which suited me."

He discovered diddly squat, Fergus and others including me put this guy straight and he knows it, as reported here. He says I am obsessed with him ! Not with him, just the bilge he spouts.


Coming soon, the Jopar memorandum.

Stand by for the big one.


Saturday 14 April 2012

New youngest lowcarber four hours old!

A three day break and fishing trip with one of my sons, and we got more than we planned for. His wife went into labour at 6.30 this morning and our son delivered this little bundle of joy 45 minutes later, a girl. What with lowcarbing and our lad delivering his own daughter, we are saving the NHS a fortune !

One-Hour Glucose Levels a Marker for Heart Disease !

Elevated 1-hour plasma glucose (1hPG) levels in persons without overt diabetes (DM) may be a marker for cardiovascular risk, according to the results of a study.

Pre-Diabetes identifies individuals with elevated fasting glucose or impaired glucose tolerance who may be at risk for DM, and it is also associated with increased risk for CVD and insulin resistance. 1hPG Levels during an OGTT may also be a risk indicator for CVD and Type 2 DM.

This is a cross-sectional study of patients with NGT and with pre-DM to examine the association between impaired 1-hour glucose tolerance and inflammatory markers and metabolic syndrome

Gianluca Bardini, MD, PhD, from the University of Florence in Italy, writes, "Pre-Diabetes identifies subjects with impaired fasting glucose ... and/or impaired glucose tolerance (IGT) at high risk for Type 2 diabetes (DM2); moreover, it is associated to insulin resistance ..., subclinical inflammation and cardiovascular diseases (CVD)." "Recently, 1-hour hyperglycemia (1hPG) during glucose tolerance test (OGTT) with a cut point of 155 mg/dl has been indicated as a further risk factor for DM2 and showed early carotid atherosclerosis."

The study goal was to evaluate metabolic characteristics and markers of inflammation in 1062 participants with normal glucose tolerance (NGT) and pre-DM. Fibrinogen and leukocytes count (WBC) for subclinical inflammation, lipid ratios, and insulin sensitivity measured with the Matsuda Index were compared in participants with or without 1hPG levels higher than 155 mg/dL after oral glucose loading.

Compared with participants with 1hPG levels of 155 mg/dL or lower, those with 1hPG levels higher than 155 mg/dL had significantly increased inflammatory markers and lipid ratios (P < .05 for all comparisons). An analysis adjusted for age, sex, and body mass index showed that 1hPG was associated with significantly increased WBC count and fibrinogen (P < .05). Compared with patients with 1hPG levels of 155 mg/dL or lower, those with 1hPG levels higher than 155 mg/dL had significantly lower insulin sensitivity (P < .01).

"Elevated 1hPG in NGT and pre-DM subjects is associated to subclinical inflammation, high lipid ratios and insulin resistance," the study authors write. "Therefore, 1hPG >155 mg/dl could be considered a new 'marker' for cardiovascular risk."

Thursday 12 April 2012

Hard Arteries More Likely with Diabetes!

Patients with metabolic syndrome and diabetes are more likely to develop detectable levels of coronary artery calcium and to have greater progression of calcification compared with patients without those conditions, researchers found.

Compared with individuals with neither condition, those with either or both of the conditions had a significantly greater risk of developing calcification in between cardiac CT scans (RRs 1.6 to 2.0), according to Nathan Wong, PhD, MPH, of the University of California Irvine, and colleagues.

In addition, among those with detectable levels of calcium at baseline, progression was significantly greater in patients with either or both of the conditions (P<0.01 for all comparisons), the researchers reported in the April issue of JACC: Cardiovascular Imaging

Progression of calcification significantly predicted coronary heart disease events in patients with metabolic syndrome alone (HR 4.1, 95% CI 2.0 to 8.5) and in those with diabetes alone (HR 4.9, 95% CI 1.3 to 18.4). Both of those patient groups have previously been shown to have a greater risk of cardiovascular events.

This begs the question of whether clinicians should be performing serial CT scans to identify patients with metabolic syndrome or diabetes and significant coronary artery calcium progression who may benefit from particularly aggressive medical therapy," wrote Jason Kovacic, MD, PhD, and Valentin Fuster, MD, PhD, of Mount Sinai School of Medicine in New York City.

"Although interesting in theory," they added in an accompanying editorial, "in the current climate of cost containment and clinical use appropriateness criteria, we believe that this use of resources would be unlikely to gain widespread acceptance."

Wong and colleagues examined data from the Multiethnic Study of Atherosclerosis (MESA). The current analysis included 5,662 adults (mean age 61) who were free of cardiovascular disease at baseline and who received both a baseline and follow-up cardiac CT scan. The average time between the two scans was 2.4 years.

Overall, 25.2% of the participants had metabolic syndrome only, 3.5% had diabetes only, 9% had both, and 62.3% had neither.

The prevalence of detectable coronary artery calcium at baseline ranged from 44% for those with neither condition to 62% for those with both conditions.

Compared with patients with neither metabolic syndrome nor diabetes, the relative risks of developing coronary artery calcium in between the two scans were higher for patients with the conditions:

 Diabetes only (RR 1.6, 95% CI 1.0 to 2.6)
 Metabolic syndrome only (RR 1.8, 95% CI 1.5 to 2.2)
 Both conditions (RR 2.0, 95% CI 1.5 to 2.8)

Similarly, the absolute increase in coronary artery calcium volume score was significantly greater for patients with metabolic syndrome only (7.4), diabetes only (16.7), and both conditions (22.4) compared with those with neither condition (0.0; P<0.01 for all.

The progression of coronary calcium was most strongly related to increases in glucose and blood pressure.

The researchers acknowledged some limitations of the analysis, including the assumption that the progression of coronary calcium was linear in between the two scans, the exclusion of patients who had a coronary heart disease event between the two scans, and the possibility that a different definition of metabolic syndrome could have influenced the results.

Kovacic and Fuster noted that the study also was limited by the lack of information on renal function and statin use.

"Nevertheless," they wrote, "we believe that these caveats would appear unlikely to have made an appreciable impact on the overall results or conclusions."