Sugar Shock

[Guest guest]

" HSI - Jenny Thompson " <HSIResearch

 

Sugar Shock

Tue, 28 Sep 2004 08:56:21 -0400

 

 

Sugar Shock

 

Health Sciences Institute e-Alert

 

September 28, 2004

 

**************************************************************

 

Dear Reader,

 

Chicken or egg – which came first? Even though it's an intriguing

question, whatever the answer may be, it doesn't really matter. I

don't expect that even chickens spend much time mulling it over.

 

But a similar sort of question – one that matters considerably – is

posed by type 2 diabetes: Is heart health compromised by the high

blood sugar levels of diabetes, or by other conditions such as

hypertension that can be triggered by diabetes? In short: Which

comes first and which matters most?

 

Two studies published this month in the Annals of Internal

Medicine indicate that hyperglycemia (high blood sugar) may be

more of a culprit in the development of heart disease than

previously expected. And more importantly, the findings send a

strong warning to those who are not considered diabetic.

 

---------------------------

Getting a little hyper

---------------------------

 

In the e-Alert " Waking Up is Hard to Do " (9/20/04), I told you

about the groundbreaking INTERHEART study that revealed a list

of health factors that put the heart at greatest risk. I'm sure that

most HSI members were not surprised to see diabetes high on that

list. For many years now, researchers have been examining the

ways diabetes is associated with heart disease.

 

One of the most recent of those studies comes from Johns Hopkins

University here in Baltimore. The Hopkins researchers reviewed

the results of 13 studies to analyze the association between heart

disease in diabetic subjects and the severity of hyperglycemia

(which is measured by the percentage of glycosylated hemoglobin

(HbA1c) in blood). Daily fluctuations of blood glucose do not

affect HbA1c, so this marker provides a more accurate overall

indicator of hyperglycemia. In a nutshell: An HbA1c level of five

percent is considered quite safe, and seven percent or less is

considered normal. A level higher than seven is a red flag,

signaling the possibility of type 2 diabetes.

 

After reviewing the 13 studies, the Hopkins team concluded that

hyperglycemia may be directly associated with an increased risk of

heart disease in people with diabetes. And more specifically, every

time HbA1c increases by one percentage point, the risk of heart

disease or stroke raises by nearly 20 percent. Likewise, when

HbA1c percentage drops, heart disease risk drops as well.

 

---------------------------

The danger zone

---------------------------

 

In the e-Alert " Sugar in the Morning, Sugar in the Evening... "

(9/4/02), I told you about the A1c test, which gives an average

measurement of HbA1c percentage in the blood over the 60 to 90

days prior to the test date. And it was this test that was used by a

UK research team to monitor hyperglycemia in more than 10,200

subjects (both diabetic and non-diabetic) over a three-year period,

with an additional three-year follow-up period.

 

The UK researchers found that for every HbA1c percentage point

that rose above five percent, risk of problems associated with heart

disease rose more than 20 percent. And this elevated risk remained

consistent, even when other factors such as smoking, high blood

pressure and a previous history of heart problems were taken into

account.

 

This study produced two striking results: 1) Moderate-to-high

blood sugar levels were apparently directly responsible for heart

disease risk, and 2) Subjects whose HbA1c percentages were well

below the conventional danger level were still at risk.

 

One of the authors of the study told the New York Times that the

commonly accepted " average " blood sugar readings may need to

be reassessed.

 

---------------------------

Way to go

---------------------------

 

The next time you have a blood test, talk to your doctor about these

two studies and ask him to make a point of including an A1c test to

determine your HbA1c level.

 

If your HbA1c reading is in the pre-diabetic or diabetic range, your

doctor may suggest taking a drug to manage blood sugar levels.

The most common drug for type 2 diabetes is Glucophage, the

brand name for metformin. But most people will probably find the

tried and true method of diet modification and daily exercise to be

more effective.

 

In the e-Alert " Common Sense Approach To Treating Type II

Diabetes " (2/13/02), I told you about a New England Journal of

Medicine study that enlisted more than 3,200 adults (the average

age was 51) who were diagnosed with pre-diabetic elevated

glucose levels. Subjects were divided into three groups: one group

received a daily dose of Glucophage; one group received a daily

placebo; and one group participated in an intensive program with a

goal of at least 7 percent weight loss through diet adjustment, two

and a half hours of moderate exercise each week, and educational

sessions to reinforce behavior modification.

 

After following these subjects for an average of almost 3 years, the

researchers found that Glucophage reduced the incidence of

diabetes by about 30 percent versus placebo, but lifestyle changes

slashed the incidence rate by more than HALF - a full 58 percent.

Plus, patients in the Glucophage group had six times more

gastrointestinal side effects than those in the exercise and diet

group.

 

Changing key lifestyle factors such as diet and physical activity is

easier said than done. But in the case of controlling blood sugar, a

little effort goes a long way.

 

**************************************************************

 

....and another thing

 

Sometimes I wonder how experts in any given field attain that

exalted level of " Expert " . I've come to believe that the number one

requirement is to simply sound like an expert. Never mind the

actual content of what's being said, as long as you give it the ring

of expertise.

 

Here's a good example...

 

A couple of weeks ago, members of the Royal College of General

Practitioners gathered for a conference in London. One of the

items on their agenda: How to address the growing obesity

epidemic. The solution: Make exercise more accessible and

affordable.

 

Of course, this bright idea overlooks the glaringly obvious fact that

exercise is already free and accessible to all. It's called Get Off

Your Duff And Walk, Jog, Do Pushups, Situps, Whatever, Just Get

Moving!

 

But the Royal College's idea is to make workout and sports

equipment more accessible. And how do you do that? According to

an Associated Press report, one of the College's experts has the

answer: Tax breaks for exercisers! Under this plan, if you purchase

sports or exercise equipment, you'll be allowed a deduction at tax

time.

 

Okay... is this REALLY the motivation that obese people have

been waiting for? Imagine someone who's overweight, sitting

down to watch a couple hours of television after finishing off a

large meal. I'm pretty sure they're NOT thinking, " I'd be

exercising right now if I could just get a tax break. "

 

It's logic only a bureaucrat could love: Motivate good health with

tax breaks.

 

The best part is a quote from one of the College's experts. (I won't

mention his name. No reason to rub it in.) This expert – a doctor –

told the AP, " After all, obese people are likely to use more

National Health Service resources than fit and healthy people. "

 

Uh... how's that again?

 

I wonder if this expert ever saw the inside of a health club?

Because if he had, he would have seen lots of fit and healthy

people working out. That's how they GET fit and healthy: They

use the resources. If obese people were in the least bit inclined to

do any type of exercise (which doesn't really require any NHS

resources), then they would be fit and healthy instead of obese.

 

Maybe it's time to give experts a tax break every time they keep a

crackpot idea where it belongs: back on the drawing board.

 

To Your Good Health,

 

Jenny Thompson

Health Sciences Institute

 

**************************************************************

 

Sources:

" Meta-Analysis: Glycosylated Hemoglobin and Cardiovascular

Disease in Diabetes Mellitus " Annals of Internal Medicine, Vol.

141, No. 6, 9/21/04, annals.org

" Association of Hemoglobin A1c with Cardiovascular Disease and

Mortality in Adults: The European Prospective Investigation into

Cancer in Norfolk " Annals of Internal Medicine, Vol. 141, No. 6,

9/21/04, annals.org

" High Blood Sugar Also Poses Risk to Heart " Denise Grady, The

New York Times, 9/21/04, nytimes.com

" Reduction in the Incidence of Type 2 Diabetes with Lifestyle

Intervention or Metformin " The New England Journal of

Medicine, Vol. 346, No. 6, 2/7/02, content.nejm.org

" U.K. Docs Suggest Tax Breaks for Exercise " The Associated

Press, 9/16/04, usatoday.com

 

Copyright ©1997-2004 by www.hsibaltimore.com, L.L.C.

The e-Alert may not be posted on commercial sites without

written permission.