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Diabetes, Diet and Insulin Sensitivity; Changing the State of Things

Diabetes, Diet and Insulin Sensitivity; Changing the State of Things. Michael Fox. 25.8 million in U.S. 1 347 million globally 2. Diabetes. Type 1 -5% of diabetics -Do not produce insulin -Require insulin injections. Type 2 -95% of diabetics ….

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Diabetes, Diet and Insulin Sensitivity; Changing the State of Things

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  1. Diabetes, Diet and Insulin Sensitivity; Changing the State of Things Michael Fox

  2. 25.8 million in U.S.1 347 million globally2 Diabetes Type 1 -5% of diabetics -Do not produce insulin -Require insulin injections Type 2 -95% of diabetics …. 24.5 million U.S. and 330 million globally -Produce insulin but either quantity produced or ability to function is impaired -May be able to manage through diet and lifestyle changes -May require additional treatment: oral medication or insulin injections

  3. Insulin is a hormone that is produced by the pancreas. It is secreted after you eat meals. Through digestion, most food gets broken down into smaller components called glucose. Insulin helps turn the food – now glucose – into energy you can use. It also tells the body to store some of the energy – in the form of glycogen and fat Insulin – what it is and how it works Insulin’s activity related to blood glucose regulation is largely focused on the liver and the skeletal / adipose tissue. Retrieved from https://nutritionalfrontiers.com/sites/default/files/nldigestion.jpg

  4. Glucose How to get glucose inside the cell Insulin Graphic provided by M.Miles Nutr421

  5. When insulin does not work: Insulin resistance Retrieved from: http://www.empowernetwork.com/gerardoalmaraz/files/2012/10/Blood-Sugar.jpg

  6. Heart Disease – ‘50% of people with diabetes die of cardiovascular disease (primarily heart disease and stroke)’3 Diabetics 2 to 4 times more likely to die from heart disease than those without diabetes.1 ‘Cardiovascular disease is the leading cause of death among people with diabetes — about 68 percent die of heart disease or stroke.’6 Hypertension – 67% of diabetics had high blood pressure : > 140/90 mm/Hg1 Kidney Disease – ‘Diabetes is the leading cause of kidney failure, accounting for 44% of all new cases of kidney failure in 2008.’1 Blindness – ‘Diabetes is the leading cause of new cases of blindness among adults aged 20–74 years [representing 28.5%]’1 Amputation – ‘More than 60% of nontraumatic lower-limb amputations occur in people with diabetes ‘1 Obesity – 57% of diabetics are obese14 85% of diabetics are overweight or obese13 Health Consequences of Sustained High Blood Sugars

  7. A1C – Average blood glucose: <7% (Cholesterol) – LDL: <100 mg/dl Blood pressure: <130/80mm/Hg Cornerstones of Treatment of Diabetes BP --- ace inhibitors LDL --- statins Diet and Exercise Carb Counting, an insulin to carbohydrate ratio. Take home message: Eat what you want, just inject appropriately. Any exercise is good. Intensity and duration dependent on health status.

  8. Retrieved from: http://www.cdc.gov/diabetes/statistics/risk_factors_national.htm

  9. Current Vegetable and Fiber Intake Myplate recommends 2.5-3 cups of vegetables per day 9 The average American consumes 1.7 cups – including legumes – per day8 Males 2 yo and over consumed 18.7 grams of fiber RDA – 38g/day10 Females 2 yo and over consumed 15.5 grams of fiber RDA – 25g/day10

  10. The Forecast “[World Health Organization] projects that diabetes deaths will increase by two thirds between 2008 and 2030.”2 “A 2010 CDC study projected that as many as one of three U.S. adults could have diabetes by 2050 if current trends continue.”4 26.9% of all diabetics age 65 and older have diabetes, representing 43% of all diabetics, 10.9 million Americans.7,6 With the baby boomers getting older, this number is expected to grow.

  11. Annual Number (in Thousands) of New Cases of Diagnosed Diabetes Among Adults Aged 18–79 Years, United States, 1980–2010 Retrieved from: http://www.cdc.gov/diabetes/statistics/incidence/fig1.htm

  12. We have gotten better at diagnosing diabetes, treating its complications, and keeping diabetics alive for longer… But not at preventing the onset of diabetes or slowing its progression.

  13. Diabetes $174 billion annually1,6 The Monetary Cost Heart disease $273 billion annually14 Obesity $147 billion annually11 ….to list a few….

  14. My Story Date: Nov. 4, 1989 Patient: 12 yo male Bg level: 354 mg/dl Diagnosis: Insulin Dependent Diabetes Mellitus – Type 1 A Few Observations: I was vegetarian for seven years. After being vegetarian, I ate a well balanced diet with lots of salads. I found that treating diabetes primarily with salads and meat worked well. I have always weighed about the same. I have always been relatively active.

  15. Mostly: Real, whole foods; the fresher, the better Lots of green, leafy plants that have been grown in the earth. Most vegetables are not cooked above 118 degrees Fermented vegetables Nuts and seeds Drink mainly water and coffee Diet Change 2010 A Minimal Amount Of: Animal protein When I do, it is mostly: Sardines, anchovies, fish and wild game Never: Processed, Refined ANYTHING

  16. Relevant Changes After 2010, my exercise decreased and stress increased due to moving, birth of child and time spent studying. This would normally stimulate increased insulin resistance.

  17. If I don’t produce any insulin, what’s going on? Can something else act like insulin and use the same door to let glucose into my cells? Is there a ‘back door’ that glucose can fit through? Am I producing insulin?!? Am I an anomaly? The research would say NO

  18. Current Research pH- To maintain alkaline mineral reserves – sodium, potassium, calcium, magnesium – in the body that are critical to maintaining health, an alkaline diet should be consumed. If it is not, a state of metabolic acidosis will develop. Short Chain Fatty Acids- Produced by fermentation of fiber, SCFA have been shown to alter gene expression, increase insulin cell signaling and alter energy metabolism, resulting in an increase of insulin sensitivity. Bioavailability- Though mechanisms are unclear, it has been proposed that bioactive foods – foods that are still alive- can alter gene expression. Microbiomes- The state of microbiomes has more to do with health than was originally thought. Disruption to the environment in which these microbiomes flourish may explain a variety of conditions and/or diseases. Gene Expression- Gene expression can be altered by different things, including dietary intake.

  19. Real, whole foods primarily plant based Fiber Bioavailability pH - Alkaline SCFA Microbiomes Gene Expression Insulin Sensitivity

  20. Glucose Insulin

  21. A diet composed of real, whole foods, primarily plant based, be promoted. Recommendations: Medical professionals utilize diet as a form of treatment and management of diabetes as aggressively as insulin, oral antidiabetic meds, statins, and ace inhibitors. That a remarkable change to the food system occurs so that local, healthy foods are made more accessible to all people. This kind of change will require national, state and local participation.

  22. Implications of Change Health: 50%-75% reversal rate of Type 2 diabetes and related health consequences CVD, hypertension, ESRD, obesity Economy: Savings from diabetes $91.6 - $124 billion annually Savings from coronary heart disease $136.5 billion annually Savings from obesity related medical costs $87 billion annually …to name a few … Total approximate savings: $347.5 billion annually

  23. The question is not whether this change should happen…. As evidenced by the benefits to: Individual health National health National economy The question is: How is this change going to happen?

  24. 1. Retrieved from http://www.cdc.gov/diabetes/pubs/estimates11.htm#11 2. Retrieved from http://www.who.int/mediacentre/factsheets/fs312/en/index.html 3. Retrieved from http://www.who.int/mediacentre/factsheets/fs312/en/index.html 4. Retrieved from http://www.cdc.gov/diabetes/pubs/reportcard/diabetes-prevalence.htm 5. Retrieved from http://www.heart.org/HEARTORG/Conditions/Diabetes/WhyDiabetesMatters/Cardiovascular-Disease-Diabetes_UCM_313865_Article.jsp 6. Retrieved from http://ndep.nih.gov/diabetes-facts/index.aspx#type 7. Retrieved from http://ndep.nih.gov/media/fs_olderadult.pdf 8. Retrieved from http://www.ers.usda.gov/media/922639/vgs351.pdf 9. Retrieved from http://www.choosemyplate.gov/food-groups/vegetables_amount_table.html 10. What We Eat In America, NHANES, 2009-2010. Nutrient Intakes of Food: Mean Amounts Consumed per Individual by Gender and Age in the United States. 11. Retrieved from http://www.cdc.gov/media/pressrel/2009/r090727.htm?s_cid=mediarel_r090727 12. Retrieved from http://www.cdc.gov/diabetes/statistics/cvd/fig1.htm 13. Retrieved from http://www.cdc.gov/diabetes/statistics/comp/fig7_overweight.htm 14. Retrieved from http://www.cdc.gov/diabetes/statistics/comp/fig7_obesity.htm 15. Retrieved from http://circ.ahajournals.org/content/123/8/933 References

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