Diabetes and Weight Loss January 23, 2008

A recent study published in Journal of American Medical Association (JAMA) by Dr. John Dixon and colleagues, showed that 73% of obese Type 2 Diabetes Mellitus (DM) patients that underwent weight loss surgery had complete remission.  This is compared to 13% of similar patients that used the standard therapy for Type 2 DM of diet, exercise, and diabetes medications like insulin and metformin.  Sixty patients were involved in this study and all were diagnosed with mild DM within the last 2 years.

One third of American are obese; 19 million Americans have Type 2 DM; another 54 million Americans have “pre-diabetes”, and have blood sugar levels that put them at risk for acquiring DM.  African Americans and Hispanic Americans are disproportionately more affected by DM and suffer more complications from Diabetes than Caucasians.  DM is the fifth leading cause of death in America.   The weight loss surgery conducted in this study was gastric banding, which entails placing a band around the top of the stomach to cinch it to a small pouch so people feel full and eat less.  It is used in about 25% to 30% of all weight loss surgeries and is less expensive than other gastric surgeries.  The average cost of the banning surgery is about $17,000 to $20,000, and is covered by Medicaid but a lot of private insurance companies do not cover the surgery. 

What does this say to me:  Obese people with early onset Type 2 DM that have significant weight reduction can have remission from Diabetes.  This study supports the argument for surgical intervention but also validates the fact that significant weight loss is the key to the cure of DM which can be reached with effective life style changes.   

Take a look at the abstract for yourself:

http://jama.ama-assn.org/cgi/content/abstract/299/3/316?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=dr+dixon+and+diabetis&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT 

Yours in Good Health

Cholesterol Lowering Medications January 15, 2008

The results of the ENHANCE clinical trial for the cholesterol lowering medication Zeta, was released this week and it revealed that Zeta failed to benefit patients.  ENHANCE was a two-year clinical trial that ended in April 2006 however the results have been pending for more than 18 months leading cardiologist and the US Congress to question the reason for the delay in reporting the results.  Zetia is produced by Merck and Schering-Plough.  The results of the trial may give insight into the delay, because not only did Zetia fail to slow the accumulation of fatty plaque in the arteries, it actually seemed to contribute to plaque formation.  Plaques are the major reason that heart attacks or Myocardial Infarction’s develop.  Although Zeta and Vytoria (a combination of Simvastatin or Zocor and Zeta) have been on the market and used by consumers at the tune of hundreds of thousands of prescriptions per week, clinical trials had never proven its efficacy for reducing plaque development in arteries. If you or someone you know is taking Zeta or Vytoria please consult your physician about the results of the ENHANCE trial and remember there are several ways to decrease your cholesterol level: life style changes , alcohol (moderate intake can decrease LDL levels), aerobic exercise 5 times/per (brisk walking, jogging, cycling), weight loss, and modifying your diet (15% of the bodies cholesterol is from food).  In future blogs we will discuss how life style modification can affect your cholesterol level in more detail.  I have attached links to resources that will also be helpful to you regarding this topic.

http://www.sch-plough.com/schering_plough/news/release.jsp?releaseID=1095943

http://www.acc.org/enhance.htm - American College of Cardiology

http://www.nytimes.com/2007/08/21/health/21brod.html  http://www.nhlbi.nih.gov/about/ncep/ – National Cholesterol Education Program

Yours in Good Health