Another Year, Another Damming Audit

Is there any feedback mechanism within the NHS regarding success or otherwise in controlling blood glucose levels? The National Diabetes Audit 2010-2011 Report 1: Care Processes and Treatment Targets for England and Wales are given in:

 http://www.ic.nhs.uk/webfiles/Services/NCASP/Diabetes/201011%20annual%20reports/National_Diabetes_Audit_2010_2011_Report1_Care_Processes_And_Treatment_Targets.pdf

 I have given the results for England. The results for Wales and also a breakdown by age are given in the above report.

Percentage of registered Type 1patients in England
HbA1c >= 6.5% (48 mmol/mol) = 92.6%
HbA1c >   7.5% (58 mmol/mol) = 71.3%
HbA1c > 10.0% (86 mmol/mol) = 18.1%

Percentage of registered Type 2 patients in England
HbA1c >= 6.5% (48 mmol/mol = 72.5%
HbA1c > 7.5% (58 mmol/mol) = 32.6%
HbA1c >10.0% (86 mmol/mol) = 6.8%

These results are very similar to those obtained in previous audit over the past 5 -6 years.

John

Neil Young and the best guitar solos I have ever heard !

Check this out tell me the solos are not stella. One of my favourite artists of all time. A comment posted on the utube item. “My girlfriend heard this song late one night while I was watching it. She knew this was one of my favourite songs and she also knew she was leaving soon. She? got up out of bed and hugged me. I didn't want her to leave, but she had no other choice. I wasn't what she wanted. Years passed and I never forgot her. Then one day, I tracked her down and called her. I realized something when I hung up. I didn't miss her anymore, I missed my youth. Any girl can bring you love, but time never sleeps” I guess this is what life is all about. Sex, drugs and rock and roll. OK there is love, loyalty and respect. Eddie

Saturday night is music night.

John Martyn 

In my opinion a musical genius. Vastly underrated and misunderstood by the music industry. To be fair John was hard to work with at times, and was arguably one of the most self destructive musicians of his time. Years ago when I played drums, I saw an advert in the NME stating John was looking for a drummer. The end of the add said “we are looking for the best, so think before you phone” I did not phone, and just as well, Phil Collins got the job. Check this track out, sublime guitar skills and as soulful as it gets.
Eddie

You must go blind in one eye before NHS will treat you !

Thousands of patients will be condemned to blindness because of a decision to ration the NHS treatment which could save their sight, leading charities warned last night.

They said that patients with macular degeneration, the most common cause of blindness in the elderly, would effectively have to lose the use of an eye before qualifying for therapy to save their remaining vision.

Their condemnation came as the NHS drug rationing body, the National Institute for Clinical Excellence (NICE), recommended restrictions on funding a treatment for the condition.

Steve Winyard, of the Royal National Institute of the Blind, said he was appalled, claiming the decision amounted to saying that it was acceptable for people to go blind in one eye.

Robin Hill, of the Macular Disease Society, was also disgusted.

'Despite the fact that we have an effective treatment, NICE wants to limit the number of treatments given by the NHS and is recommending that PDT should only be offered to those patients who have already lost the sight of one eye,' he said.

'Patients whose circumstances compel them to rely upon the NHS will be condemned by NICE to Russian roulette for their one good eye.

'An accident or a sudden haemorrhage, or failure to get a clinic appointment within a matter of days, may take away at a stroke life's quality as they know it.'

He added that he agreed with critics of NICE who argue that, in many cases, new treatments are being held up simply to save money.

http://www.dailymail.co.uk/health/article-122995/You-blind-eye-NHS-treat-you.html

Statins ‘linked with increased tiredness’

GPs should be alert that patients taking statins may report reduced energy and/or fatigue, say US researchers.
Both statins used in the study were found to have a significant effect on fatigue scores. Simvastatin had a mean difference in scores of 0.2, compared with placebo, meaning two in 10 patients cited worsening energy or exertional fatigue.

The effect was considerably worse for women, with a decrease of 0.4 compared to placebo. Pravastatin only saw a 0.1 decrease in all patients, and a 0.3 decrease in women.

http://www.pulsetoday.co.uk/newsarticle-content/-/article_display_list/14181455/statins-linked-with-increased-tiredness

Confused About Carbs? 5 Common Myths !

Susan B. Dopart, M.S., R.D., C.D.E

Just like the Spice Girls, carbohydrates were at the height of their popularity during the mid-1990s. When "fat-free" became the desired state, people turned to carbs instead. Consumers soon learned that a high carb diet wasn't so healthy either. Today, between marketers who promote packaged carbs as "heart healthy" and fitness "experts" who espouse that all carbs are bad, it's easy to be confused. Here are some carb myths debunked:

Myth 1: If you want to eat a low-carb diet, just cut out bread, pasta, cereal, rice and potatoes.

Although bread, pasta, cereal, rice and potatoes are among the best-known carbohydrates, the truth is that many other foods have carbohydrates, including fruits, vegetables, dairy products, nuts, seeds, beans/legumes and avocados. These foods are natural carbohydrates and have greater nutritional value than processed or low-fiber carbs. If you cut out starchy carbs, you are still consuming adequate amounts of carbohydrate depending on your lifestyle, activity level, age and medical issues.

Myth 2: Cereals are "heart-healthy."

Food manufacturers spend millions of dollars a year on cereal advertisements fooling us into thinking cereal is the best breakfast choice. However, many popular cereals, including granola, contain multiple sources of sugar and fat.

There are healthy cereals, but even eating an average bowl of cereal is like eating 4-6 slices of bread for breakfast in terms of carbohydrate. Many people will skip breakfast, saying that eating increases their hunger. This happens because cereal causes a large increase in blood sugar, followed by a big drop, thereby increasing one's appetite for the whole day.

Myth 3: Your body needs bread, pasta and cereal to get enough nutrients.

Our ancestors survived for hundreds of years without eating bread, pasta or cereal. All of your needs for vitamins and minerals can easily be met without these foods. A heart-healthy diet can be realized with foods without a label and multiple ingredients. If you are eating a food with a label, try to stick with something with less than five ingredients.

Myth 4: If you don't eat whole grains you won't get enough fiber in your diet.

There are many excellent sources of fiber in the diet besides whole grains. Most health organizations recommend eating 25 grams of fiber per day. Just eating a few of these good-for-you foods can easily add up to that:

• Two tablespoons of ground flax seeds equals 4.5 grams.
• One cup of broccoli has a little over 5 grams.
• A one-ounce snack of almonds (about 20) has 3 grams.
• One-third of an avocado has 4 grams.
• A medium apple has 5 grams.
• One half-cup of beans contains 6 grams.

Myth 5: If you want to avoid eating too many carbs look for foods with "net carbs" on the label.

Net carbs is a term the food industry made up as a way to fool consumers into thinking their products contain fewer carbohydrates. To arrive at a net carb number, they take the carbohydrates coming from fiber or sugars known as "alcohol sugars" and subtract them from the total amount of carbohydrates.

The premise is that those carbohydrates from fiber or alcohol sugar are not processed by the body, or have minimal effects on blood sugars. Maltitol is one of the primary alcohol sugars found in foods, and it does increase blood sugars. Fiber adds bulk to food, but to think it does not add any calories or impact blood sugars is a fallacy and has not been proven by research. Net carbs on labels are just another way food manufacturers use to market their products.

The Simple Truth: A healthy way of eating is to consume natural, non-man-made carbohydrates from vegetables, fruits, nuts/seeds, beans and legumes. They have a low glycemic index (meaning they do not raise your blood sugar) since they contain fiber, and are full of vitamins, minerals and nutrients to enhance your health... and there's nothing mythical about that!

http://www.huffingtonpost.com/susan-b-dopart-ms-rd/carbs-myths_b_1583461.html?ncid=edlinkusaolp00000003&ir=HuffPostBlog

Graham

The Men Who Made Us Fat Part 3 BBC2

Episode 3 of 3

DURATION: 1 HOUR

Jacques Peretti examines assumptions about what is and is not healthy. He also looks at how product marketing can seduce consumers into buying supposed 'healthy foods' such as muesli and juices, both of which can be high in sugar.

He speaks with Simon Wright, an 'organic consultant' for Sainsbury's in the 1990s, who explains how the food industry cashed in on the public's concerns around salmonella, BSE and GM crops. By 1999 the organic industry was worth over £605M, a rise of 232% within two years.

How did the mainstream food producers compete? Peretti speaks with Kath Dalmeny, former policy director at the Food Commission, who explains some of the marketing strategies used by mainstream food producers to keep our custom.

The programme also explores the impact of successive government initiatives and health campaigns, such as the proposal of 'traffic light labelling', the introduction of which the food industry lobbied hard against.

But in 2012, when we have an Olympic Games sponsored by McDonalds and Coca Cola, has anything changed? 

http://www.bbc.co.uk/programmes/b01kd06l

Edit this episode has been cancelled due to Wimbledon overrun and will be shown at a later date.

Ok it’s not Saturday night, but check this out, Miles Davis ! One of the best musicians that ever drew breath !

Ok it’s not Saturday night, but check this out, Miles Davis. One of the best musicians that ever drew breath  !




Eddie

Can a lowcarb diet also be low fat ?

This question comes up time and again on forums and blogs. In the short term, I believe a lowcarb-lowfat diet can be adhered to, arguably, almost any diet can be used in the short term, including starvation. The problem is, diabetes is for life, and hopefully that will not be a short term situation. Before going further, I would like to state what I consider to be a lowcarb diet, for me that is 50 or less grams of carb per day. I have seen many people and trials referring to lowcarb diets and often using well over a hundred carbs per day, often 150 carbs plus has been mentioned. These sorts of carb intakes are a complete and utter nonsense when described as lowcarb, and would have most non insulin using type two diabetics in double BG numbers most of the time. The next point to consider is energy expenditure, we turn food into fuel and burn it, or we store excess food as fat for fuel at a later date. So, how does this food/fuel get used ? 


About 70% of a human's total energy expenditure is due to the basal life processes within the organs of the body. I.E. 70% of  energy expenditure would be used if we were  sleeping or resting. It powers the brain, heart and other organs. For instance, 27% is used by the liver alone, the brain also scoffs up 19%, can you see where this is going ? Very low calorie diets do not work ! That is why they fail almost all of the time, starvation does not work, full stop ! Not only is it highly dangerous, it takes iron will. Let’s move on.


Back to the lowcarb diet. There are three main food groups, carbohydrates, proteins and fats. Logic must tell you if you have reduced carbs drastically, you must make full use of the foods that are left, proteins and fats. There are limits to proteins regarding the quantity of proteins that are safe and we can afford. I would love to give a diet based on fillet steak, foie gras, venison, , lobsters, crab and scallops a go, but I can’t afford it. I have to rely on fats. Good quality fats. The sort of fats man has used for millions of years, the fats used long before heart disease, type two diabetes and obesity become the epidemics we now see. Fats from meat, eggs, coconut, other nuts, seeds, butter, cream, olive oil and cheese. 


So, in the long term can we lowcarb and lowfat ? In my opinion, not a chance. What about heart disease and high fat ? I am a heart disease case. Atherosclerosis and two heart stents fitted three years ago. Do I take statins no,  am I worried about a high fat diet no ! For around twenty years before diabetic diagnosis, I was low fat high carb. I believe this contributed to my type two diabetes. I firmly believe the hypothesis put forward by Ancel Keys was deeply flawed. I believe John Yudkin, was right and that a diet based on sugar/refined carbs is the reason for the type two diabetes epidemics, I also believe heredity components are involved.


I have asked Doctors and diabetic nurses, and dietitions this question for four years. How do I keep a safe weight, non diabetic BG numbers and good lipid counts on two Metformin tablets a day other than lowcarb ? I have yet to receive an answer.


Eddie




http://en.wikipedia.org/wiki/Basal_metabolic_rate

FDA official: Amylin held back safety data on Byetta !

Agency's critique surfaces as Big Pharma bids in Amylin auction.

June 26, 2012 | By Tracy Staton

The FDA says Amylin Pharmaceuticals hasn't been completely honest about its diabetes drugs. Actually, a top agency official said so back in January, but the documents were only just posted to the FDA website. And Amylin ($AMLN) might well be wishing the FDA had waited a little longer to post them. Until it found a buyer, for instance.

Mary Parks, who runs the FDA's division responsible for diabetes treatments, contended in those documents that Amylin held back data about the cardiovascular side effects of Byetta at a time when the agency was determining whether to approve a longer-acting version, Bydureon. FDA officials only discovered those "concerning findings" about Byetta after Canadian regulators contacted them, Parks stated.

And even when FDA asked for the data, to add it to the Bydureon submission, Amylin submitted older documentation instead, Parks said. When the agency asked for a new study to check out the "concerning findings," Amylin stalled, according to the document. So, Bydureon's agency review was "long and complicated ... in part due to Amylin's withholding of information on Byetta that FDA deemed important to its evaluation of the safety and effectiveness of Bydureon."

As Amylin points out, FDA did eventually approve Bydureon. But that was only after an initial rejection. AsTheStreet reports, Amylin's deception didn't stop with FDA. Executives didn't disclose to investors that its held-back heart-safety data influenced the agency's earlier decision to reject the drug.

What will the Big Pharma bidders eyeing Amylin think about these allegations? Takeda, Merck, Sanofi, Pfizer, Bristol-Myers Squibb, AstraZeneca--all have been identified as Amylin shoppers. They might be a bit more diligent about their due diligence now.

- check out the FDA document
- get the news from TheStreet
- read the Financial Times story

http://www.fiercepharma.com/story/fda-official-amylin-held-back-safety-data-byetta/2012-06-26

Diabetes.co.uk, and the moron of the year prize goes to ?

Over at our favourite forum, the good news re. lowcarbing comes in by the hour. Non or minimal med type two’s are reporting HbA1c numbers in the fours. In the last week the well known Doctor and low carb promoter for diabetics John Briffa has joined the  forum. All positive stuff eh, not quite. Long term anti lowcarbers, Jopar aka the Jokar, who recently had the audacity to comment on another members spelling,  and Sid (the enforcer) Bonkers aka the pharmacist, are up to their usual tricks. When not calling lowcarbers out and out liars, they are implying they are not being honest. I could go on, and on, but regular watchers on the forum, and this blog know the score. So we need your vote ! Who is the biggest moron on the forum ? The Jokar or the Bonkers one ? Who is the most anti lowcarber, the most idiotic, the most rude and obnoxious, in short, who deserves the moron of the year award ? I know a tough call but please let us know.


Eddie


PS.


I see Kenny boy is going for the sympathy vote on the ghost forum.

The Men Who Made Us Fat Episode 2 P1

Paleo Theme Tune ?

Graham

Diabetes, Glucose Control, and 9-Year Cognitive Decline Among Older Adults Without Dementia !

Objectives  To determine if prevalent and incident diabetes mellitus (DM) increase risk of cognitive decline and if, among elderly adults with DM, poor glucose control is related to worse cognitive performance.

Design  Prospective cohort study.

Setting  Health, Aging, and Body Composition Study at 2 community clinics.

Participants  A total of 3069 elderly adults (mean age, 74.2 years; 42% black; 52% female).

Main Outcome Measures  Participants completed the Modified Mini-Mental State Examination (3MS) and Digit Symbol Substitution Test (DSST) at baseline and selected intervals over 10 years. Diabetes mellitus status was determined at baseline and during follow-up visits. Glycosylated hemoglobin A_1c level was measured at years 1 (baseline), 4, 6, and 10 from fasting whole blood.

Results  At baseline, 717 participants (23.4%) had prevalent DM and 2352 (76.6%) were without DM, 159 of whom developed incident DM during follow-up. Participants with prevalent DM had lower baseline test scores than participants without DM (3MS: 88.8 vs 90.9; DSST: 32.5 vs 36.3, respectively; t = 6.09; P = .001 for both tests). Results from mixed-effects models showed a similar pattern for 9-year decline (3MS: −6.0- vs −4.5-point decline; t = 2.66; P = .008; DSST: −7.9- vs −5.7-point decline; t = 3.69; P = .001, respectively). Participants with incident DM tended to have baseline and 9-year decline scores between the other 2 groups but were not statistically different from the group without DM. Multivariate adjustment for demographics and medical comorbidities produced similar results. Among participants with prevalent DM, glycosylated hemoglobin A_1c level was associated with lower average mean cognitive scores (3MS: F = 8.2; P for overall = .003; DSST:F = 3.4; P for overall = .04), even after multivariate adjustment.

Conclusion  Among well-functioning older adults, DM and poor glucose control among those with DM are associated with worse cognitive function and greater decline. This suggests that severity of DM may contribute to accelerated cognitive aging.

Full Text http://archneur.jamanetwork.com/article.aspx?articleid=1183076

Graham

Zimbabwe MPs get circumcised in Aids fight !

"Forty-four members of Zimbabwe's parliament were circumcised on Friday as part of a national HIV/Aids awareness campaign"

Oh dear.


Since when did having a foreskin have anything to do with aids ? Go the whole hog and have a leg off for all the good it will do ! Keeping it in your trousers, use a condom,  or keep to one partner is  a far safer bet.


Eddie

http://www.telegraph.co.uk/health/healthnews/9349371/Zimbabwe-MPs-get-circumcised-in-Aids-fight.html

You can’t win em all !

We have six kids and despite our best efforts they are not all lowcarbers. But here’s a strange thing, all of their kids are. No sugar or factory produced foods for their kids. A diet based on low starch vegetables, protein and fruit. High quality artisan bread and natural fats. Sweets and crisps, are a once a week treat at most. One of our granddaughters, only three years old at a recent ballet prize giving day.

Eddie

Dr. John Briffa joins diabetes.co.uk. The lowcarb good news grows by the week !

I like John Briffa, despite him committing the worst sin a Doctor can make, he writes books. If you are a lowcarb anti, and there a plenty about, writing books is a cardinal sin. I have lost count of the times I have read “He’s only in it for the money”. This has applied to Doctors Richard Bernstein, Malcolm Kendrick, Jay Wortman and others. How dare these people publish what they believe to be the truth. Let’s make no mistake, these are very daring people ! They have dared to go against the monumental power of big  pharma, junk food companies, and many of their peers.  They dare to question poor science and dogma that has failed miserably.


What should we do ? Go back to Nazi Germany days and burn books written by Jews, or others, no matter how brilliant. Do we castigate men and women who have the courage to rock the boat, to put their head above the parapet ? In my opinion these people are great educators. In my opinion great educators makes us think. They make us ask why ? Now, when you ask yourself why ? You may ask yourself the question, why am I told to eat the foods that raise my BG numbers. You may come to realise high BG numbers are dangerous, and can only be controlled with drugs and medication, or a complete change in lifestyle and diet. You may come to realise, drugs are not a get out of jail free card, and side effects are many. After four years of research, I have yet to find a downside of a standard meat and non starchy three veg meal.


Check out the John Briffa blog here.


http://www.drbriffa.com/blog/






Eddie

BBC2 9pm The Men Who Made Us Fat Episode 2

Episode 2 of 3

DURATION: 1 HOUR

Jacques Peretti investigates how the concept of 'supersizing' changed our eating habits forever. How did we - once a nation of moderate eaters - start to want more?

Speaking to Mike Donahue, former McDonalds Vice President, Peretti explores the history behind the idea of supersizing. 40 years ago, McDonalds hired David Wallerstein, a former cinema manager who had introduced the idea of selling larger popcorn servings in his Chicago cinema. Wallerstein realised that people would eat more but they didn't like the idea of appearing gluttonous by going back for seconds. By increasing the portion sizes and the cost, he could sell more food. In 1972, he introduced the idea to McDonalds and their first large fries went on sale.

By the 1980s, we were eating more - and eating more often. Perretti speaks with industry professionals to examine the story behind the introduction of value meals, king-size snacks and multi-buy promotions. How did the advertising industry encourage us to eat more often?

The programme also explores the developments in dietary advice - by 2003, the Chief Medical Officer was warning of an 'obesity time bomb.' Peretti speaks to obesity expert Professor Philip James, who made recommendations in his 1996 report that the food industry should cease targeting children in their advertisements. He also speaks with Professor Terry Wilkin, who led a pioneering study into childhood weight gain; and former Labour MP David Hinchliffe, who chaired the 2003 Parliamentary Select Committee on Health.

http://www.bbc.co.uk/programmes/b01k6l6l

Now available on BBC iplayer:

http://www.bbc.co.uk/iplayer/episode/b01k6l6l/The_Men_Who_Made_Us_Fat_Episode_2/

Dr. Jay’s Blog

Check out Jays blog. Jay is a type two diabetic, a Doctor, a lowcarb expert and great guy. Intensely proud of his family and a man to be respected. 


http://www.drjaywortman.com/blog/wordpress/


Eddie

Best place on earth ?

Back from a few days of tramping and driving around the Lake District. If you have never been to this heaven on earth I highly recommend it. When my Wife was young she travelled all over the world, I have never been outside Europe, but I have worked in Italy, Austria and Germany and visited many European countries. I remember her joy when I took her to the lakes for the first time. Around four hours from London on a good run and the most relaxing place we know. Go out of season or when the Schools are still open and have the place to yourself.

Eddie

The Ken and Sue show turns to farce !

I take a week out, and on my return Ken is taking stupidity to a new level, on what is now known as the ghost forum. The forum started well, and in time could have been a useful resource, but Ken couldn’t let the old forum go. Constantly bitching about Benedict and the members, and the way diabetes.co.uk has changed since his unedifying demise as a moderator. We have complimented Sue many times on this blog, she used to be a great mod, until Ken turned her head, now she has become as deluded as him. Borofergie gets a lot of stick from Ken and his Moll Mole, so let's compare the two’s progress in controlling type two diabetes. Ken has been a type two diabetic for around 15 years, the first ten years following the NHS diet recommendations. He saw the light after ten years when a bunch of lowcarbers put him straight. He thanked them and admitted NHS personnel very near killed him. These days he says he has good control with various medications but still has some weight to lose.


Let’s take a look at Borofergie. Within days of diagnosis he was researching hard, it did not take him long to realise the foods that lead to his obesity and type two diabetes. Carbs had to go big time, he realised he had to carry on eating and quickly realised food containing natural fats, food that man had been eating since the beginning of time was not going to lead to a swift demise. Within months a huge weight loss, lipids of a teenager and most importantly, HbA1c in the fours. Check around and you will find very few diabetics ever get into the fours, in the fives is a great result, unfortunately most diabetics never get to a safe number. Borofergie does not know all the answers, nor does any healthcare professional, diabetes is an ultra complicated disease. It will probably be many years before the most brilliant Doctor or Scientist knows all the answers, but for a gifted amateur Fergie is doing a great job. Ken once called Dr. Richard Bernstein an amateur, Bernstein is arguably the world leading expert on blood glucose control. He was the first diabetic to test BG at home and realise the exact effect food had on his BG control, he also pioneered basal/bolus insulin techniques. I think it’s fair to say, millions of diabetics around the world, have had their quality and length of life improved thanks to Bernstein.


So, who are you going to follow Ken or Borofergie ? If you need to think about that question, I would go for psychiatric counselling before tackling the control of your diabetes.


Ken, for what my opinion is worth, dump the ranting against better men than you and me, and try to turn that horses arse you call a forum into something that makes a positive contribution to other diabetics. 


Eddie

The Men Who Made Us Fat

Graham

ADA: Glycemic Control Reduces CV Risk !

By Chris Kaiser, Cardiology Editor, MedPage Today

Published: June 13, 2012

Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston and Dorothy Caputo, MA, BSN, RN, Nurse Planner

PHILADELPHIA -- Diabetes patients who responded to glucose-lowering treatment also improved their risk of adverse cardiovascular outcomes, a Swedish observational study found.

Those who reduced their hemoglobin A1c levels by nearly one percentage point -- from a mean of 7.8% to 7% -- had a significant 45% decreased risk of cardiovascular death (HR 0.55, 95% CI 0.49 to 0.63, P<0.001), according to Katarina Eeg-Olofsson, MD, from the University of Gothenburg in Sweden, and colleagues.

The absolute risk of a death from a cardiovascular cause was 9.9 events per 1,000 person-years in patients with decreasing HbA1c and and 17.8 per 1,000 in those with stable or increasing HbA1c, the team reported here at the annual meeting of the American Diabetes Association.

The above results were after the researchers adjusted for covariates such as age, diabetes duration, sex, blood pressure and blood pressure treatment, lipid status and lipid-lowering treatment, HbA1c, albuminuria, and BMI, as well as changes in those risk factors and treatments over time.

The research team said that they undertook the study because of the ongoing debate about the relationship between glycemic control and adverse cardiovascular outcomes.

They analyzed data from the Swedish National Diabetes Register and identified 18,035 patients with baseline HbA1c between 7% and 8.9%. They ranged in age from 30 to 75, had a body mass index over 18 kg/m2, and serum creatinine ≤1.7 mg/dL.

Patients with a history of cardiovascular disease, congestive heart failure, or atrial fibrillation were excluded from the study. The mean duration of diabetes was between 8 and 10 years and the median follow-up was more than 5 years.

Patients were nearly equally divided into those whose HbA1c decreased by 0.1% or more (mean baseline HbA1c 7.8% and final 7.0%) and those whose baseline remained stable or increased (mean baseline HbA1c 7.7% and final 8.3%).

Besides the decrease in total mortality, the researchers found that better glycemic control was significantly associated with risk reductions in fatal and nonfatal coronary heart events of 39% (HR 0.61, 95% CI 0.54 to 0.69) and in fatal/nonfatal cardiovascular disease events of 37% (HR 0.63, 85% CI 0.57 to 0.70). The decreases were both significant at P<0.001.

According to the researchers, the absolute risk of a first fatal or nonfatal event caused by coronary disease was 10.3 per 1,000 person-years for those who had better glycemic control versus 17.9 per 1,000 for those without better control.

Those numbers for a first cardiovascular event were 15.1 and 26.1 events per 1,000 person-years, respectively.

Eeg-Olofsson noted that these patients were receiving routine care for type 2 diabetes, which shows that targeting HbA1c to 7% (the treatment target) can help mitigate the higher risk of cardiovascular events generally seen in diabetics.

http://www.medpagetoday.com/MeetingCoverage/ADA/33262

What caused the obesity crisis in the West?

British people are on average nearly three stone (24kg) heavier than 50 years ago, but who or what is to blame? Jacques Peretti (pictured above) investigates.

Contrary to popular belief, we as a race have not become greedier or less active in recent years. But one thing that has changed is the food we eat, and, more specifically, the sheer amount of sugar we ingest.

"Genetically, human beings haven't changed, but our environment, our access to cheap food has," says Professor Jimmy Bell, obesity specialist at Imperial College, London.

"We're being bombarded every day by the food industry to consume more and more food.

"It's a war between our bodies and the demands our body makes, and the accessibility that modern society gives us with food. And as a scientist I feel really depressed, because we are losing the war against obesity."

One of the biggest changes in our modern diet stems back to the 1970s when US agriculture embarked on the mass-production of corn and of high-fructose corn syrup, commonly used as a sweetener in processed foods.

This led to a massive surge in the quantities of cheaper food being supplied to American supermarkets, everything from cheap cereal to cheap biscuits. As a result, burgers got bigger and fries (fried in corn oil) got fattier.

According to nutritionist Marion Nestle, this paved the way for obesity.

"The number of calories produced in America, and available to American consumers, went from 3,200 in the 1970s and early 80s to 3,900 per person, almost twice as much as anybody needed. And that enormous increase, I think it's the cause of a great deal of difficulty," she says.

High Fructose Corn Syrup (HFCS), a highly sweet by-product of waste corn, was also incredibly cheap. It began being used in every conceivable food - pizzas, coleslaw, meat. It provided a "just baked" sheen on bread and cakes.

By the mid 1980s, corn syrup had replaced sugar in fizzy soft drinks. The move made financial sense from the soft drink companies' point of view, as corn syrup was a third cheaper than sugar.

But it was also sweeter and, argue some scientists, more addictive. In the next two decades, the average American's consumption of fizzy drinks almost doubled - from 350 cans a year to 600.

But Susan Neely from the American Beverage Association says the increased consumption of fizzy drinks is not to blame for increased obesity in the West.

"The evidence says that obesity is caused when people consume too many calories without the exercise to balance it out," she says.

"Certainly our regular soft drinks are a source of calories, so if you're consuming too many calories and watching too much television or not getting enough exercise, you're going to have a problem."

Full article here http://www.bbc.co.uk/news/health-18393391

Graham

The Men Who Made Us Fat !

 BBC2 tonight 9pm

Episode 1 of 3

DURATION: 1 HOUR

Around the world, obesity levels are rising. More people are now overweight than undernourished. Two thirds of British adults are overweight and one in four of us is classified as obese. In the first of this three-part series, Jacques Peretti traces those responsible for revolutionising our eating habits, to find out how decisions made in America 40 years ago influence the way we eat now.

Peretti travels to America to investigate the story of high-fructose corn syrup. The sweetener was championed in the US in the 1970s by Richard Nixon's agriculture secretary Earl Butz to make use of the excess corn grown by farmers. Cheaper and sweeter than sugar, it soon found its way into almost all processed foods and soft drinks. HFCS is not only sweeter than sugar, it also interferes with leptin, the hormone that controls appetite, so once you start eating or drinking it, you don't know when to stop.

Endocrinologist Robert Lustig was one of the first to recognise the dangers of HFCS but his findings were discredited at the time. Meanwhile a US Congress report blamed fat, not sugar, for the disturbing rise in cardio-vascular disease and the food industry responded with ranges of 'low fat', 'heart healthy' products in which the fat was removed - but the substitute was yet more sugar.

Meanwhile, in 1970s Britain, food manufacturers used advertising campaigns to promote the idea of snacking between meals. Outside the home, fast food chains offered clean, bright premises with tempting burgers cooked and served with a very un-British zeal and efficiency. Twenty years after the arrival of McDonalds, the number of fast food outlets in Britain had quadrupled.

http://www.bbc.co.uk/programmes/b01jxzv8

Doc´s Opinion! The Case Against Saturated Fat

From the blog of Dr. Sigurdsson a  cardiologist.


Common knowledge is something we all regard as plain truth and does not need to be debated or discussed. Go for a walk on a rainy day and you´ll get wet. Staying for to long in the sun will make your skin burn.  Drinking coffee before you go to sleep may keep you awake. Smoking may damage your lungs and so on.


But, is there a common knowledge regarding diet and heart disease? I asked a friend of mine recently what food he would associate with the risk of getting heart disease. He said: “Butter, cream, bacon, fat cheese, french  fries, red meat and steaks”. I said: “How do you know that?” He replied: “Well doctor, it´s common knowledge. Everybody knows this. Animal fats and cholesterol! This is the stuff that´s blocking our arteries. That´s what you doctor´s have been telling us.” 


For years I have been recommending my patients to stay away from saturated fats. This is what I learned in medical school and during my training as a cardiologist. The concept sounds quite simple indeed. I´ll explain it to you:Cholesterol is a risk factor for heart disease. The higher your blood cholesterol, the higher your risk for heart attack. Lowering cholesterol therefore should be beneficial. Furthermore, we have been told that saturated fats raise blood cholesterol. Therefore, obviously; Eat less saturated fats if you want to avoid heart attacks.


However, considering the complexity of the human body, this sequence of events is probably too simple to be true. Moreover, total cholesterol and LDL – cholesterol (the “bad” cholesterol) are absolutely not the only factors that matter when it comes to diet and heart disease. Why should they be? Nature seldom provides us with such simplicity. What about refined carbohydrates? What about obesity? What about insulin resistance and the metabolic syndrome? What about blood levels of triglycerides and HDL – cholesterol (the “good” cholesterol)? What about LDL particle size which may be negatively affected by sugars. What about inflammation which many specialists nowadays believe plays a role in heart disease? So, what is the case against saturated fat?


Let´s look at the theories on cholesterol a little closer. Basically they are twofold. One is the so-called lipid hypothesis which simply implies that an elevated level of cholesterol causes heart disease and therefore lowering cholesterol will be helpful. The other is the diet – heart hypothesis which implies that eating saturated fats and cholesterol will increase the risk of heart disease, supposedly by raising blood levels of cholesterol. I am not going to discuss the lipid hypothesis this time, but rather focus on the latter, the diet – heart hypothesis.


The main reason saturated fats have been linked to an increased risk of heart disease is their tendency to elevate LDL – cholesterol. We´ve learned that LDL is the bad cholesterol. The lower the blood levels of this substance, the less risk of heart disease. This has been the main focus of dietary recommendations in cardiovascular prevention and treatment for decades. Why such a huge effort has been put in promoting the risk of saturated fat,s and their possible effects on blood cholesterol is hard to understand, not least because the scientific basis behind it is indeed fairly weak.

It is important not to confuse saturated fat with trans fat. Saturated fat is a natural fat found in animal products such as meat, milk and cheese. Saturated fat is also typically found in tropical oils such as coconut, palm and palm kernel oils. On the other hand, the vast majority of trans fats in our food are manufactured by adding hydrogen bonds to unsaturated fats. This makes the fat more stable, so it doesn’t spoil as quickly. These fats are usually referred to as “hydrogenated fats” or “partially hydrogenated fats”. There is evidence linking consumption of trans fats with increased risk of heart disease.


Although saturated fats are often thought of as a group, it is important to keep in mind that they are not all the same. There are many different types of saturated fats and they may have different health effects. Grouping them all together is based on their chemical nature which implies that all the hydrogen bonds in the fat molecule are used. Saturated fats with carbon chain lengths of 14 (myristic) and 16 (palmitic), which are chiefly found in full fat dairy products and red meat, appear most likely to increase blood levels of cholesterol. Stearic acid (18 carbon) which is also found in beef, and is the main fatty acid of cocoa butter, appears to increase cholesterol less.


Now, let´s say we are going to cut down the consumption of saturated fats. What do we replace them with? Are we going to increase carbohydrate consumption instead? Or, are we going to eat more monounsaturateded or polyunsaturated fatty acids instead? Data from some clinical trials have shown that substitution of polyunsaturated fat for saturated fat may result in a reduced incidence of coronary artery disease. However, this is not true for all studies.


Many studies have linked the so-called Mediterranean diet with a reduced incidence of coronary artery disease. This diet generally involves an increased intake of the omega-3 fatty acid alpha-linolenic acid. Alpha-linolenic acid is a kind of omega-3 fatty acid found in plants. It is similar to the omega-3 fatty acids that are in fish oil, called eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

The Lyon Diet Heart Study compared the Mediterranean diet to a one involving higher consumption of saturated fats in patients with a prior history of heart attack (myocardial infarction).  In the Mediterranean diet group there was a slightly more consumption of carbohydrates and fiber. In this study there was a 72% reduction in recurrent coronary events in the group receiving the Mediterranean diet. Secondary analysis has indicated that this positive effect correlates with the increased consumption of alfa-linolenic acid. However, the fact that omega – 3 fatty acids may be beneficial does not in itself imply that saturated fats are dangerous. Why should it?

Let´s look at the largest controlled intervention trial on diet and heart disease to date, the Women´s Health Initiative. This trial randomly assigned more than 48 thousand women, 50 – 79 years old, to a low-fat intervention or a comparison group. Saturated fat intake was lower in the intervention group as was dietary polyunsaturated fat. However, dietary carbohydrates were higher in the intervention group. After six years of follow-up there were no differences between the groups in the incidence of coronary heart disease and stroke. So, replacing fat with carbohydrates does not appear to be beneficial.

A metaanalysis, published 2010 in The American Journal of Clinical Nutrition, including 16 prospective observational cohort studies has indicated that there is no association between the intake of saturated fats and coronary artery disease. There is another study addressing the intake of saturated fats in childhood that found no association with adult coronary heart disease mortality.

There is evidence that for a large proportion of the population, high carbohydrate diets may create a metabolic state which is characterized by elevated triglycerides, reduced HDL – cholesterol and increased concentrations of small, dense LDL particles. This is especially true for those who are overweight, have insulin resistance or diabetes. Recent studies indicate that reducing carbohydrate intake in this population, but not saturated fat, ma be beneficial.

Therefore, the common knowledge that saturated fats are associated with cardiovascular disease lacks scientific evidence. Furthermore, the  common wisdom that reducing the intake of saturated fats will reduce the risk for heart disease has a very weak scientific support. In light of the available scientific evidence it is hard to understand how we have managed to create those misconceptions. The case against saturated fat could not be won in any court.

Furthermore, the message to reduce the intake of dietary fat may have stimulated consumers and manufacturers to choose foods that may be potentially harmful and could have contributed to the so-called obesity epidemic and increased incidence of type 2 diabetes. Over consumption of sugar and refined carbohydrates probably plays the biggest role, the case against those indeed appears very strong.

 http://www.docsopinion.com/2012/06/04/the-case-against-saturated-fat/

Graham

Carbo the gutless and despicable !

The day before yesterday we copied and posted a thread from Carbophiles blog. We gave him full attribution. We stated very clearly this was his work and gave a clickable link to his blog and the post in question. He asked us to remove the post and stated we were in breach of his copyright. Copyright to what ? A cess pit and totally useless piece of work the anonymous and gutless Carbo hides behind. A man that has insulted people from Hana to Dr Jay Wortman. A blog of hate and misinformation. As reported, he fears his employer would find out who he is because he would be fired, because of the nature of his blog. He appears to have complained to Google, as he said he would do. See link below.


I am away from a computer for a week and have left this matter in the hands of our team. How this guttersnipe has the audacity to complain beggars belief. He has spent years spreading fear and alarm amongst diabetics. He has told lies and authorised lies that rubbish good people, and knows if his identity was known, he would have been sued in the courts. He is a malicious troll, no more, no less. He is a failed mod at diabetes.co.uk and a failed owner of the forum diabetes for life. He is in short a coward and a hypocrite that hides under the guise of anonymous. In all my years, I have yet to meet a more gutless and despicable excuse for a human being.


Should this blog disappear in the next few days, please check on and place in your favourites http://www.lowcarbdiabetic.co.uk/ We will start a new blog on our website, we are here for the long term and none will silence or intimidate us into submission, least of all the likes of Carbo/Tubolard.


Eddie Mitchell


The link


http://www.blogger.com/blogger.g?blogID=2600659484694637338#editor/target=post;postID=4635498698659329961


From Google


"We have received a DMCA complaint for your blog, The Low Carb Diabetic. An email with the details of the complaint was sent to you on 13-Jun-2012 and we have reset the post status to "Draft"; you can edit it here. You may republish the post with the offending content and/or link(s) removed. If you believe you have the rights to post this content, you can file a counter-claim with us. For more on our DMCA policy, please clickhere. Thank you for your prompt attention." 


We will be issuing a counter claim.

Having a break, off tomorrow for some R and R !

The Lake District, our favourite place on earth.

Eddie

Libby and Steven two lowcarb superstars ! AKA Wiflib. and Borofergie

Check out the forum diabetes.co.uk, and you will see a great deal of success in the fight against diabetes. This week, two people I admire greatly, have posted their latest blood test results, and they are stunning, check out the link below. Both follow a close to Dr Richard Bernstein’s dietary recommendations, and both have Bernstein’s HbA1c in the fours. 


Both have reduced and maintained a big weight loss, and both have the lipids of teenage healthy kids. Look no further in the way to control your type two diabetes, type ones can also learn a lot in reducing weight, if necessary, and a reduction of insulin and more predictable BG control.


Type two diabetes can be a life sentence, these two prove it. They are dedicated and have worked hard, but they are the same as me and you. 


Go for it yourself, turn over a new leaf tomorrow, and follow their example. Don’t become a victim of dietary misinformation ! You can do what they have done, the younger you are, the more important fighting high BG numbers are. Join diabetes.co.uk today, it could be the best move you ever made.


Good luck and health to all.


Eddie

http://www.diabetes.co.uk/diabetes-forum/viewtopic.php?f=18&t=30297

Heart Disease Risk Increases With Even Slightly Elevated Blood Glucose Levels

New research from the University of Copenhagen shows that even slightly higher levels of glucose in the blood noticeably increase the risk of ischemic heart disease. The study involves more than 80,000 people and has just been published in the well-reputed Journal of the American College of Cardiology. 

It is not only diabetics who risk heart-related problems resulting from lifelong above-average blood glucose levels. New research from the University of Copenhagen shows that even a slightly elevated level of blood glucose in non-diabetic people results in a conspicuously greater risk of ischemic heart disease. 

These results surprised the research team behind the study, because until now cholesterol had quite legitimately been declared the paramount threat to global heart health. 

"We know that diabetics and people with high cholesterol levels are prone to ischemic heart disease, but our study also made it possible to look at blood glucose level in isolation. It is surprising that even a slightly higher blood glucose value appears to be dangerous over a longer period - and that sugar alone makes a negative difference," says Marianne Benn, chief physician at Copenhagen University Hospital and associate professor at the University of Copenhagen. 

Healthy people without diabetes have a normal, fasting blood glucose value of less than 6 mmol (=108 mg) glucose per litre blood. However, the study published in the Journal of the American College of Cardiology shows that over many years, a blood glucose value of only 1 mmol (=18 mg) per liter above normal increases the risk of heart attack by a surprising 69 per cent. 


Sugar in the spotlight

Using observational studies combined with genetic analyses, researchers were able to show in a group of 80,522 Danes drawn from the general population that a slightly elevated level of blood glucose is enough on its own to damage the heart.

Observational studies are not enough to document a correlation between elevated blood glucose and heart disease. Participants in such studies who have elevated blood glucose levels may share characteristics or physical problems that influence heart and weight - in contrast, the genetic analyses used in the present studies strip distracting elements from the analyses from the three large population studies. Sugar gets the full focus.

The three population-based studies that provided the basis for the scientific article are: The Copenhagen General Population Study, The Copenhagen City Heart Study, and The Copenhagen Ischemic Heart Disease Study. 


Research can be used for prevention

The scientists believe that glucose impacts the risk of ischemic heart disease directly, but are still unsure why. However, they recommend that the general intake of sugar should be limited for the benefit of health worldwide:

"The World Health Organization estimates that 6 per cent of all deaths are due to elevated blood glucose. Therefore, our results may potentially have great importance for the design of programmes to prevent heart disease and early death worldwide," explains Borge Nordestgaard, chief physician at Copenhagen University Hospital and clinical professor at the Faculty of Health and Medical Sciences, University of Copenhagen.

Heart attacks, atherosclerosis and angina - also known as ischemic heart disease - are the most common cause of death among adults worldwide. According to the World Health Organization, 17 million people die each year from heart-related diseases - a number that is expected to rise in the years ahead.


http://www.medicalnewstoday.com/releases/246425.php