Brain may play key role in blood sugar metabolism and diabetes development.


A growing body of evidence suggests that the brain plays a key role in glucose regulation and the development of type 2 diabetes, researchers write in the Nov. 7 ssue of the journal Nature. If the hypothesis is correct, it may open the door to entirely new ways to prevent and treat this disease, which is projected to affect one in three adults in the United States by 2050.

In the paper, lead author Dr. Michael W. Schwartz, UW professor of medicine and director of the Diabetes and Obesity Center of Excellence, and his colleagues from the universities of Cincinnati, Michigan, and Munich,  note that the brain was originally thought to play an important role in maintaining normal glucose metabolism  With the discovery of insulin in the 1920s, the focus of research and diabetes care shifted to almost exclusively to insulin. Today, almost all treatments for diabetes seek to either increase insulin levels or increase the body’s sensitivity to insulin.

“These drugs,” the researchers write, “enjoy wide use and are effective in controlling hyperglycemia [high blood sugar levels], the hallmark of type 2 diabetes, but they address the consequence of diabetes more than the underlying causes, and thus control rather than cure the disease.”

New research, they write, suggests that normal glucose regulation depends on a partnership between the insulin-producing cells of the pancreas, the pancreatic islet cells, and neuronal circuits in the hypothalamus and other brain areas that are intimately involved in maintaining normal glucose levels. The development of diabetes type 2, the authors argue, requires a failure of both the islet-cell system and this brain-centered system for regulating blood sugar levels .

In their paper, the researchers review both animal and human studies that indicate the powerful effect this brain-centered regulatory system has on blood glucose levels independent of the action of insulin. One such mechanism by which the system promotes glucose uptake by tissues is by stimulating what is called “glucose effectiveness.” As this process accounts for almost 50 percent of normal glucose uptake, it rivals the impact of insulin-dependent mechanisms driven by the islet cells in the pancreas.

The findings lead the researchers to propose a two-system model of regulating blood sugar levels composed of the islet-cell system, which responds to a rise in glucose levels by primarily by releasing insulin, and the brain-centered system that enhances insulin-mediated glucose metabolism while also stimulating glucose effectiveness.

The development of type 2 diabetes appears to involve the failure of both systems, the researchers say. Impairment of the brain-centered system is common, and it places an increased burden on the islet-centered system. For a time, the islet-centered system can compensate, but if it begins to fail, the brain-centered system may decompensate further, causing a vicious cycle that ends in diabetes.

Boosting insulin levels alone will lower glucose levels, but only addresses half the problem. To restore normal glucose regulation requires addressing the failures of the brain-centered system as well. Approaches that target both systems may not only achieve better blood glucose control, but could actually cause diabetes to go into remission, they write.

Measuring Blood Sugar With Light.


Technology designed in Germany may help people with Type 1 and Type 2 diabetes; described in Review of Scientific Instruments

WASHINGTON D.C. October 25, 2013 — One of the keys to healthful living with Type 1 and Type 2 diabetes is monitoring blood glucose (sugar) levels to ensure they remain at stable levels. People can easily and reliably do this at home using electronic devices that read sugar levels in a tiny drop of blood.

Now a team of German researchers has devised a novel, non-invasive way to make monitoring easier. Using infrared laser light applied on top of the skin, they measure sugar levels in the fluid in and under skin cells to read blood sugar levels. They describe their method in the current edition of Review of Scientific Instruments, which is produced by AIP Publishing.

“This opens the fantastic possibility that diabetes patients might be able to measure their glucose level without pricking and without test strips,” said lead researcher, Werner Mäntele, Ph.D. of Frankfurt’s Institut für Biophysik, Johann Wolfgang Goethe-Universität.

“Our goal is to devise an easier, more reliable and in the long-run, cheaper way to monitor blood glucose,” he added.

The “Sweet Melody” of Glucose

Their new optical approach uses photoacoustic spectroscopy (PAS) to measure glucose by its mid-infrared absorption of light. A painless pulse of laser light applied externally to the skin is absorbed by glucose molecules and creates a measurable sound signature that Dr. Mäntele’s team refers to as “the sweet melody of glucose.” This signal enables researchers to detect glucose in skin fluids in seconds.

The data showing the skin cell glucose levels at one-hundredth of a millimeter beneath the skin is related to blood glucose levels, Mäntele said, but previous attempts to use PAS in this manner have been hampered by distortion related to changes of air pressure, temperature and humidity caused by the contact with living skin.

To overcome these constraints, the team devised a design innovation of an open, windowless cell architecture. While it is still experimental and would have to be tested and approved by regulatory agencies before becoming commercially available, the team continues to refine it.

High Glucose Linked to Poorer Memory, Even in People Without Diabetes.


Higher levels of both short-term and long-term blood glucose markers are significantly associated with poorer memory and with decreased volume and microstructure of the hippocampus in persons without diabetes or impaired glucose tolerance (IGT), according to a new study.

The results imply that lowering blood glucose levels, possibly even to relatively low levels, might help preserve cognition, study author Agnes Flöel, MD, Department of Neurology and Center for Stroke Research Berlin, Charite-University Medicine, Berlin, Germany, toldMedscape Medical News.

Strategies that help lower blood glucose levels include a healthy Mediterranean-type diet and regular physical activity, she added.

The study is published online October 23 in Neurology.

Direct Relationship

The cross-sectional study included 141 healthy persons (mean age, 63.1 years) who were recruited through advertising. Persons with diabetes, IGT, or neurologic disorders and those taking antidepressants were excluded.

Researchers obtained blood measurements, including glycosylated hemoglobin (HbA1c), which reflects peripheral glucose levels of the preceding 8 to 12 weeks; fasting glucose; and insulin. They also carried out apolipoprotein E (APOE) genotyping.

Participants underwent cognitive testing using the German version of the Rey Auditory Verbal Learning Test. Researchers calculated hippocampal volume from MRI scans and assessed hippocampal microstructure by mean diffusivity (MD) estimated by using diffusion tensor imaging.

According to Dr. Flöel, this was the first time that this MD method provided data on the association between hippocampal microstructure and glucose metabolism.

The investigators found that lower performance on 3 memory tasks (delayed recall, learning ability, and consolidation) was associated with higher levels of both the long-term marker of glucose control (HbA1c) and the short-term glucose marker (all P ≤ .01).

For insulin, there was a “general trend going in the same direction” but correlations were less clear, and without the same direct relationship, said Dr. Flöel.

Potential Mechanisms

Memory performance was correlated with hippocampal volume (P = .001) and lower MD (P = .01), lower age, and, in part, lower blood pressure and female sex. Researchers did not find a statistically significant association between memory performance and APOE genotype, body mass index, Beck Depression Inventory score, physical activity, or smoking.

Lower levels of HbA1c were associated with larger hippocampal volume (nonsignificant trend; P = .06). The associations between lower fasting glucose levels and higher hippocampal volume did reach significance (P = .01). There was no significant relationship between hippocampal volume and insulin.

As for hippocampal microstructure, the researchers noted that lower levels of all 3 markers of glucose metabolism significantly correlated with lower MD within the hippocampus.

There was no significant association between glucose markers and volume or MD in brain areas other than the hippocampus (eg, gray matter and thalamus).

The hippocampus is particularly vulnerable to disturbances in metabolic supply, including glucose, said Dr. Flöel.

“Elevated blood sugar levels may damage the outer membrane of the cells, or decrease neurotransmitter levels, which would disturb signaling within and between hippocampal cells. Information transfer between cells, which is indispensable for memory encoding, storage and retrieval, would then be compromised.”

Elevated blood sugar levels may also damage small and large vessels in the brain, leading to decreased blood and nutrient flow to brain cells or even brain infarcts, and this may further damage memory-relevant brain structures, added Dr. Flöel.

The current findings are in line with studies of patients with type 2 diabetes mellitus and IGT, but earlier research was unable to confirm the deleterious effects of nondiabetic glucose levels on cognition. This, said the authors, may be because of different methods for classifying glucose levels and varying cognitive tests used.

Prevention Research

The authors also pointed out that the current study used MRI with higher magnetic field strength, which offers a higher sensitivity of hippocampal volumetry and greater statistical power to observe significant associations.

Following a diet high in lean protein and complex carbohydrates (such as whole grains, vegetables, fruits, and fiber) and low in heavily refined foods will help lower blood glucose, said Dr. Flöel. Another important lifestyle strategy is regular physical activity.

How low is it safe to go in terms of blood glucose levels? According to Dr. Flöel, that depends in part on lifestyle. “If you’re used to low blood sugar levels, you can go quite low,” she said.

She likened this to the situation with blood pressure. “At one time, it was assumed that you needed a certain level to function, but that actually is not true. You can go very low and still maintain normal function, and it might actually be better in the long run.”

Although the study uncovers the protective potential of lower blood glucose levels, the relationship between high blood glucose and poor memory “seems to be more linear” and changing recommended cutoffs may not make much of a difference, said Dr. Flöel.

On the other hand, what could be key is prevention, she said.

“There have been some initiatives to put prevention more on the agenda of dementia research,” she said. “There has been so much money spent on treatment of Alzheimer’s disease and it has already been established that this is not very successful. “

Dementia prevention strategies could include taking measures at an earlier stage to encourage physical fitness and control hypertension, blood lipids (including cholesterol and triglycerides), and now, possibly, blood glucose levels, she said.

Patients should have their fasting glucose and HbA1c levels measured as part of a regular medical check-up starting at age 55 years, unless there’s a personal or family history of diabetes or the patient is obese, in which case the family doctor may opt for earlier and more intense monitoring, said Dr. Flöel. She pointed out that such tests are easy to do and are already carried out regularly in pregnant women.

Fresh Eyes

Commenting on the findings for Medscape Medical News, Marwan N. Sabbagh, director, Banner Sun Health Research Institute, Sun City, Arizona, said that the study looks at the link between glucose metabolism and cognition with fresh eyes.

“This is saying that immediate learning and A1c levels, and potentially even blood sugars, interact even in people who are nondemented, and I don’t think anyone has looked at it that way before,” said Dr. Sabbagh.

“The idea is that the lower the A1c the better your brain function. This is a very exciting development and clearly helps put a frame around the Alzheimer’s discussion, but more importantly, it talks about how blood sugar metabolism and cognitive function directly interact.”

The study opens “a whole new territory” because until now, HbA1c and blood glucose have been looked at only in the context of diabetes and the risk for diabetes, added Dr. Sabbagh. “Maybe we need to rethink our normalization of glucose with an eye toward cognition and not simply a diabetes risk.”

Blood sugar levels could be linked to memory loss in people without diabetes – Mirror.co.uk


Journal study finds with with lower blood sugar levels achieved highest scores in memory tests – those with high levels could suffer memory loss

People who have even slightly raised blood sugar levels may suffer memory loss, a study shows.

Researchers performed tests on 141 healthy people with an average age of 63.

None had diabetes or pre-diabetic symptoms.

But the study published in journal Neurology found those with with lower blood sugar levels achieved better scores in memory tests.

In a test to recall 15 words 30 minutes after hearing them, higher blood sugar levels were linked with poorer memory.

Lead researcher Dr Agnes Floel, of the Charite University Medicine in Berlin, Germany, said: “These results suggest that even for people within the normal range of blood sugar, lowering their blood sugar levels could be a promising strategy for preventing memory problems and cognitive decline as they age.

“Strategies such as lowering calorie intake and increasing physical activity should be tested.”

Dr Clare Walton, of the Alzheimer’s Society, said: “We already know that Type 2 diabetes is a risk factor for developing Alzheimer’s disease but this new study suggests that higher blood sugar levels may also be linked to poor memory in people without diabetes.

“The research suggests that regulating blood sugar levels might be a way to improve people’s memory, even if they don’t have diabetes.”

Dr Simon Ridley, of Alzheimer’s Research UK, added: “While we do not know whether the people in this study would have gone on to develop dementia, the findings serve as a warning that we should be conscious of the impact that subtle changes in our health could have on our brain.

“Current evidence suggests the best way to keep the brain healthy is to eat a balanced diet, take regular exercise, maintain a healthy weight, not smoke and keep blood pressure and cholesterol levels in check.”

New Trigger of Alzheimer’s Identified: Stress


Story at-a-glance

  • According to recent research, stress appears to be related to the onset of Alzheimer’s disease, by triggering a degenerative process in your brain and precipitating disruption of your neuroendocrine and immune system
  • The researchers found that nearly three out of four Alzheimer’s patients had experienced severe emotional stress during the two years preceding their diagnosis, compared to just over one in four in the control group
  • Alzheimer’s disease currently afflicts about 5.4 million Americans, including one in eight people aged 65 and over
  • Research suggests the best hope is in prevention focusing on diet, exercise and staying mentally active
  • Avoiding gluten and casein appears to be of critical importance, as is making sure you’re getting plenty of healthful fats (including demonized saturated fats). Fasting also has a remarkably beneficial influence on your brain health.
  • Alzheimer's Disease

The connections between stress and physical and mental health are undeniable. Studies have found links between acute and/or chronic stress and a wide variety of health issues.

This includes reduced immune function, increased inflammation, high blood pressure, and alterations in your brain chemistry, blood sugar levels and hormonal balance, just to name a few.

According to recent research, stress also appears to be related to onset of Alzheimer’s disease, which currently afflicts about 5.4 million Americans, including one in eight people aged 65 and over.1

It is projected that Alzheimer’s will affect one in four Americans in the next 20 years, rivaling the current prevalence of obesity and diabetes. There is still no known cure for this devastating disease, and very few treatments. Alzheimer’s drugs are often of little to no benefit, which underscores the importance of prevention throughout your lifetime.

Fortunately, there’s compelling research showing that your brain has great plasticity and capacity for regeneration, which you control through your diet and lifestyle choices.

Avoiding gluten and casein, or wheat and dairy primarily, appears to be of critical importance, as is making sure you’re getting plenty of healthful fats (including demonized saturated fats). Casein is the primary protein found in dairy, and can be problematic for dairy intolerant individuals. However, it’s also found in human breast milk. Additionally, raw dairy is generally well tolerated by casein sensitive individuals, but contraindicated for those with a severe allergy.

Fasting also has a remarkably beneficial influence on your brain health. At the end of this article, I share my best tips for maintaining healthy brain function well into old age.

Stress May Be Related to Clinical Onset of Alzheimer’s Disease

Researchers in Argentina recently presented evidence suggesting that stress may be a trigger for the onset of Alzheimer’s disease. The research was presented at the annual World Congress of Neurology in Vienna. According to lead author, Dr. Edgardo Reich:2

“Stress, according to our findings, is probably a trigger for initial symptoms of dementia.

Though I rule out stress as monocausal in dementia, research is solidifying the evidence that stress can trigger a degenerative process in the brain and precipitate dysfunction in the neuroendocrine and immune system. It is an observational finding and does not imply direct causality. Further studies are needed to examine these mechanisms in detail.”

The study found that 72 percent—nearly three out of four—Alzheimer’s patients had experienced severe emotional stress during the two years preceding their diagnosis. In the control group, only 26 percent, or one in four, had undergone major stress or grief. Most of the stresses encountered by the Alzheimer’s group involved:

  • Bereavement; death of a spouse, partner, or child
  • Violent experiences, such as assault or robbery
  • Car accidents
  • Financial problems, including “pension shock”
  • Diagnosis of a family member’s severe illness

When you consider all the adverse biological effects that stress and anxiety causes, it might not be such a stretch that severe stress could trigger Alzheimer’s. For example, researchers have found links between emotional distress and physical pain,3 chronic inflammation4 and even stillbirths.5 

It can also wreak havoc on your gut health, which is critical to maintaining mental and physical health. Most recently, Forbes6 reported the findings of a study7 exploring the role of stress in rewiring your brain—in this case, altering your sense of smell:

“Two brain circuits that don’t typically “talk” to each other—one linked to our sense of smell and another linked to emotional processing—can become cross-wired when we experience stress-induced anxiety. The result is that stressful experiences transform normally neutral odors into bad ones…

‘After anxiety induction, neutral smells become clearly negative,’ explains Wen Li, a professor of psychology at the University of Wisconsin-Madison Waisman Center, who led the study. ‘People experiencing an increase in anxiety show a decrease in the perceived pleasantness of odors. It becomes more negative as anxiety increases.’”

How Stress Causes Disease

When you’re experiencing acute stress, your body releases stress hormones like cortisol, which prepare your body to fight or flee the stressful event. Your heart rate increases, your lungs take in more oxygen, your blood flow increases and parts of your immune system become temporarily suppressed, which reduces your inflammatory response to pathogens and other foreign invaders.

When stress becomes chronic, however, your immune system becomes less sensitive to cortisol, and since inflammation is partly regulated by this hormone, this decreased sensitivity heightens the inflammatory response and allows inflammation to get out of control. 

This is in large part how stress “predisposes” you to getting sick in the first place. And, in the event you do get sick, emotional stressors can make your symptoms worse, especially if the stress is severe or longstanding.

For example, research presented at this year’s annual meeting of the American Psychosomatic Society in Miami, Florida, found that ruminating on a stressful incident can increase your levels of C-reactive protein, a marker of inflammation in your body.8 It was the first study to directly measure this effect. Inflammation, in turn, is a hallmark of most diseases, from diabetes to heart disease, cancer, and Alzheimer’s.

Tips for Reducing Work Stress

Polls have shown that work is the number one source of stress in people’s lives. In a recent survey9 of more than 2,000 people, 34 percent of respondents reported that their work life was either “very” or “quite” stressful. One in five people also reported developing anxiety due to work-related stresses. In a related article, Forbes magazine10 lists nine tips to reduce work-related stress, such as:

  • Adding personal touches to your work space, such as photographs or art work, and live plants
  • Keeping your work space clean and organized
  • Learning to handle or ignore interruptions
  • Incorporating relaxation exercises into your work day
  • Improving your communication skills

Conquer Your Stress and Anxiety with Energy Psychology

While it’s not possible or even recommended to eliminate all stress from your life, you can provide your body with tools to compensate for the bioelectrical short-circuiting that takes place when you’re stressed. Using energy psychology techniques such as the Emotional Freedom Techniques (EFT) can help reprogram your body’s reactions to the unavoidable stressors of everyday life, thereby reducing your chances of experiencing adverse health effects. Exercising regularly, getting enough sleep, and meditation are also important “release valves” that can help you manage your stress.

EFT was developed in the 1990s by Gary Craig, a Stanford engineering graduate specializing in healing and self-improvement. It’s akin to acupuncture, which is based on the concept that a vital energy flows through your body along invisible pathways known as meridians. EFT stimulates different energy meridian points in your body by tapping them with your fingertips, while simultaneously using custom-made verbal affirmations. This can be done alone or under the supervision of a qualified therapist.11

By doing so, you help your body eliminate emotional “scarring” and reprogram the way your body responds to emotional stressors. Since these stressors are usually connected to physical problems, many people’s diseases and other symptoms can improve or disappear as well. For a demonstration, please see the following video featuring EFT practitioner Julie Schiffman, in which she discusses EFT for stress relief. However, for serious problems it is far preferable to see an experienced EFT therapist as there is a significant art to the process that requires a high level of sophistication if serious problems are to be successfully treated.

Tips for Maintaining Healthy Brain Function and Avoiding Alzheimer’s Disease

The beauty of following my optimized nutrition plan is that it helps prevent and treat virtually ALL chronic degenerative diseases, including Alzheimer’s disease. Remember, while memory loss is indeed common among Westerners, it is NOT a “normal” part of aging, and cognitive changes are by no means inevitable.

As explained by neurologist Dr. David Perlmutter in a recent interview, Alzheimer’s is a disease predicated primarily on lifestyle choices; the two main culprits being excessive sugar and gluten consumption. Another major factor is the development and increased consumption of genetically engineered (GE) grains, which are now pervasive in most processed foods sold in the US. His book, Grain Brain, provides a powerful argument for eliminating grains from your diet.

Knowing that it is a preventable disease puts the power into your hands. People who experience very little decline in their cognitive function up until their deaths have been found (post-mortem) to be free of brain lesions, showing that it’s entirely possible to prevent the damage from occurring in the first place… and one of the best ways to do this is by leading a healthy lifestyle.

    • Avoid Sugar and fructose. Ideally, you’ll want to keep your sugar levels to a minimum and your total fructose below 25 grams per day, or as low as 15 grams per day if you have insulin resistance or any related disorders.
    • Avoid gluten and casein (primarily wheat and pasteurized dairy, but not dairy fat, such as butter). Research shows that your blood-brain barrier, the barrier that keeps things out of your brain where they don’t belong, is negatively affected by gluten. Gluten also makes your gut more permeable, which allows proteins to get into your bloodstream, where they don’t belong. That then sensitizes your immune system and promotes inflammation and autoimmunity, both of which play a role in the development of Alzheimer’s.
    • Optimize your gut flora by regularly eating fermented foods or taking a high quality probiotic supplement.
    • Increase consumption of healthful fats, including animal-based omega-3. Beneficial health-promoting fats that your brain needs for optimal function include organic butter from raw milk, clarified butter called organic grass fed raw butter, olives, organic virgin olive oil and coconut oil, nuts like pecans and macadamia, free-range eggs, wild Alaskan salmon, and avocado.

Also make sure you’re getting enough animal-based omega-3 fats, such as krill oil. (I recommend avoiding most fish because, although fish is naturally high in omega-3, most fish are now severely contaminated with mercury.) High intake of the omega-3 fats EPA and DHA help by preventing cell damage caused by Alzheimer’s disease, thereby slowing down its progression, and lowering your risk of developing the disorder.

    • Reduce your overall calorie consumption, and/or intermittently fast. Contrary to popular belief, the ideal fuel for your brain is not glucose but ketones, which is the fat that your body mobilizes when you stop feeding it carbs and introduce coconut oil and other sources of healthy fats into your diet. A one-day fast can help your body to “reset” itself, and start to burn fat instead of sugar.

As part of a healthy lifestyle, I prefer an intermittent fasting schedule that simply calls for limiting your eating to a narrower window of time each day. By restricting your eating to a 6-8 hour window, you effectively fast 16-18 hours each day. To learn more, please see this previous article.

    • Improve your magnesium levels. There is some exciting preliminary research strongly suggesting a decrease in Alzheimer symptoms with increased levels of magnesium in the brain. Unfortunately, most magnesium supplements do not pass the blood brain levels, but a new one, magnesium threonate, appears to and holds some promise for the future for treating this condition and may be superior to other forms.
    • Optimize your vitamin D levels with safe sun exposure. Strong links between low levels of vitamin D in Alzheimer’s patients and poor outcomes on cognitive tests have been revealed. Researchers believe that optimal vitamin D levels may enhance the amount of important chemicals in your brain and protect brain cells by increasing the effectiveness of the glial cells in nursing damaged neurons back to health.

Vitamin D may also exert some of its beneficial effects on Alzheimer’s through its anti-inflammatory and immune-boosting properties. Sufficient vitamin D is imperative for proper functioning of your immune system to combat inflammation that is also associated with Alzheimer’s.

    • Keep your fasting insulin levels below 3. This is indirectly related to fructose, as it will clearly lead to insulin resistance. However other sugars (sucrose is 50 percent fructose by weight), grains and lack of exercise are also important factors. Lowering insulin will also help lower leptin levels which is another factor for Alzheimer’s.
    • Vitamin B12: In addition to the research presented above, a small Finnish study published in the journal Neurology12also found that people who consume foods rich in B12 may reduce their risk of Alzheimer’s in their later years. For each unit increase in the marker of vitamin B12, the risk of developing Alzheimer’s was reduced by two percent. Remember, sublingual methylcobalamin may be your best bet here.
    • Eat a nutritious diet, rich in folate, such as the one described in my nutrition plan. Vegetables, without question, are your best form of folate, and we should all eat plenty of fresh raw veggies every day. Avoid supplements with folic acid, which is the inferior synthetic version of folate.
    • Avoid and eliminate mercury from your body. Dental amalgam fillings, which are 50 percent mercury by weight, are one of the major sources of heavy metal toxicity. However, you should be healthy prior to having them removed. Once you have adjusted to following the diet described in my optimized nutrition plan, you can follow the mercury detox protocol and then find a biological dentist to have your amalgams removed.
    • Avoid aluminum, such as antiperspirants, non-stick cookware, vaccine adjuvants, etc.
    • Exercise regularly. It’s been suggested that exercise can trigger a change in the way the amyloid precursor protein is metabolized,13 thus, slowing down the onset and progression of Alzheimer’s. Exercise also increases levels of the protein PGC-1alpha. Research has also shown that people with Alzheimer’s have less PGC-1alpha in their brains and cells that contain more of the protein produce less of the toxic amyloid protein associated with Alzheimer’s. I would strongly recommend reviewing the Peak Fitness Technique for my specific recommendations.
    • Avoid flu vaccinations as most contain both mercury and aluminum, well-known neurotoxic and immunotoxic agents.
    • Eat blueberries. Wild blueberries, which have high anthocyanin and antioxidant content, are known to guard against Alzheimer’s and other neurological diseases. Like any fruit though, avoid excesses here.
    • Challenge your mind daily. Mental stimulation, especially learning something new, such as learning to play an instrument or a new language, is associated with a decreased risk of Alzheimer’s. Researchers suspect that mental challenge helps to build up your brain, making it less susceptible to the lesions associated with Alzheimer’s disease.
    • Avoid anticholinergic and statin drugs. Drugs that block acetylcholine, a nervous system neurotransmitter, have been shown to increase your risk of dementia. These drugs include certain nighttime pain relievers, antihistamines, sleep aids, certain antidepressants, medications to control incontinence, and certain narcotic pain relievers.

Statin drugs are particularly problematic because they suppress the synthesis of cholesterol, deplete your brain of coenzyme Q10 and neurotransmitter precursors, and prevent adequate delivery of essential fatty acids and fat-soluble antioxidants to your brain by inhibiting the production of the indispensable carrier biomolecule known as low-density lipoprotein.

The FDA Has Approved The First Artificial Pancreas.


An easier way for diabetics to control their insulin intake

The U.S. Food and Drug Administration has approved its first “artificial pancreas” to automatically control the insulin levels of diabetics.

medtronic

The hormone insulin controls blood sugar levels and is normally produced in the body by the pancreas. But in Type 1 diabetics (and sometimes Type 2), the pancreas just doesn’t make insulin, meaning diabetics’ bodies can’t regulate blood sugar levels. This system, designed by Minneapolis-based medical tech company Medtronic, is a wearable little gadget that stops insulin delivery automatically when glucose levels get too low, hopefully keeping the wearer from going into a diabetic coma. 

Unlike traditional insulin pumps, which require the wearer to still monitor blood sugar levels and manually program the pump to deliver insulin, this one monitors blood sugar for you, and delivers the appropriate amount accordingly. With a traditional pump, the device can keep delivering insulin even when the your blood sugar is too low, lowering levels even further and sometimes causing loss of consciousness. This is especially dangerous during sleep, when you can’t exactly gauge your own blood sugar. Medtronic’s MiniMed 530G system can detect up to 93 percent of hypoglycemia (low blood sugar) episodes, and will sound an alarm to wake you up if your blood sugar gets too low. If you don’t respond, the system will shut off insulin delivery for two hours, hopefully staving off dangerously low blood sugar levels.

One caveat: Medtronic got a warning letter from the FDA only a few weeks ago related to manufacturing processes of their Paradigm Insulin Infusion Pumps (which are used in this system) at their facility in Northridge, Calif. The pumps had been recalled in June because they were malfunctioning and delivering either too much or not enough insulin, and the FDA found the company was not doing enough to verify that the failure wouldn’t happen again. The company said in the press release accompanying the product approval that it had “already addressed many of the observations noted in the warning letter and is committed to resolving the remaining observations as quickly as possible.”

‘Sugar gel’ helps premature babies


A dose of sugar given as a gel rubbed into the inside of the cheek is a cheap and effective way to protect premature babies against brain damage, say experts.

Dangerously low blood sugar affects about one in 10 babies born too early. Untreated, it can cause permanent harm.

Researchers from New Zealand tested the gel therapy in 242 babies under their care and, based on the results, say it should now be a first-line treatment.

Their work is published in The Lancet.

Sugar dose

Dextrose gel treatment costs just over £1 per baby and is simpler to administer than glucose via a drip, say Prof Jane Harding and her team at the University of Auckland.

 “Start Quote

This is a cost effective treatment and could reduce admissions to intensive care services which are already working at high capacity levels”

Andy ColeBliss

Current treatment typically involves extra feeding and repeated blood tests to measure blood sugar levels.

But many babies are admitted to intensive care and given intravenous glucose because their blood sugar remains low – a condition doctors call hypoglycaemia.

The study assessed whether treatment with dextrose gel was more effective than feeding alone at reversing hypoglycaemia.

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Neil Marlow, from the Institute for Women’s Health at University College London, said that although dextrose gel had fallen into disuse, these findings suggested it should be resurrected as a treatment.

We now had high-quality evidence that it was of value, he said.

Andy Cole, chief executive of premature baby charity Bliss, said: “This is a very interesting piece of new research and we always welcome anything that has the potential to improve outcomes for babies born premature or sick.

“This is a cost-effective treatment and could reduce admissions to intensive care services, which are already working at high capacity levels.

“While the early results of this research show benefits to babies born with low blood sugars, it is clear there is more research to be done to implement this treatment.”

Source: BBC

Certain Antibiotics Tied to Blood Sugar Swings in Diabetics.


Diabetes patients who take a certain class of antibiotics are more likely to have severe blood sugar fluctuations than those who take other types of the drugs, a new study finds.

The increased risk was low but doctors should consider it when prescribing the class of antibiotics, known as fluoroquinolones, to people with diabetes, the researchers said. This class of antibiotics, which includes drugs such as Cipro(ciprofloxacin), Levaquin (levofloxacin) and Avelox(moxifloxacin), is commonly used to treat conditions such as urinary tract infections and community-acquired pneumonia.

One expert said the study should serve as a wake-up call for doctors.

“Given a number of alternatives, physicians may consider prescribing alternate antibiotics … in the place of fluoroquinolones (particularly moxifloxacin) to patients with diabetes,” said Dr. Christopher Ochner, assistant professor of pediatrics and adolescent medicine at the Icahn School of Medicine at Mount Sinai, in New York City. “In general, this study demonstrates that closer attention needs to be paid to particular drug-condition interactions.”

The study included about 78,000 people with diabetes in Taiwan. The researchers looked at the patients’ use of three classes of antibiotics: fluoroquinolones; second-generation cephalosporins (cefuroxime, cefaclor, or cefprozil); or macrolides (clarithromycin or azithromycin).

The investigators also looked for any emergency-room visits or hospitalizations for severe blood sugar swings among the patients in the 30 days after they started taking the antibiotics.

The results showed that patients who took fluoroquinolones were more likely to have severe blood sugar swings than those who took antibiotics in the other classes. The level of risk varied according to the specific fluoroquinolone, according to the study, which was published in the journal Clinical Infectious Diseases.

The incidence of hyperglycemia (high blood sugar) per 1,000 people was 6.9 for people taking moxifloxacin, 3.9 for levofloxacin and 4.0 for ciprofloxacin. The incidence of hypoglycemia (low blood sugar) was 10 per 1,000 for moxifloxacin, 9.3 for levofloxacin and 7.9 for ciprofloxacin.

The incidence of hyperglycemia per 1,000 people was 1.6 for those taking the macrolide class of antibiotics and 2.1 for those on cephalosporins. The incidence of hypoglycemia per 1,000 people was 3.7 for macrolides and 3.2 for cephalosporins.

“Our results identified moxifloxacin as the drug associated with the highest risk of hypoglycemia, followed by levofloxacin and ciprofloxacin,” wrote Dr. Mei-Shu Lai, at National Taiwan University, and colleagues.

They said doctors should consider other antibiotics if they have concerns that patients might experience severe blood sugar swings.

“The study … does not prove a causal connection between particular fluoroquinolones and blood sugar dysregulation,” Ochner said. But he believes that it provides evidence that people with diabetes may be at special risk from moxifloxacin in particular.

“If moxifloxacin is to be prescribed to diabetic patients, there should be some additional expected benefit that justifies the increase in incurred risk,” Ochner said.

But another expert said there could be other explanations for why people on fluoroquinolones had more blood sugar fluctuations.

“It is hard to draw conclusions that fluoroquinolones themselves are the culprit, as all of these patients had infections, and infection can lead to hypo- or hyperglycemia in persons with diabetes,” said Dr. Alyson Myers, an endocrinologist at North Shore University Hospital in Manhasset, N.Y.

“In addition, those in the fluoroquinolone group were more likely to have chronic kidney disease or steroid use – the former can increase rates of hypoglycemia and the latter can increase rates of hyperglycemia,” Myers said. “Another confounding factor would be the type of diabetes treatments that patients were receiving, as sulfonylureas and insulin are both associated with greater risks of hypoglycemia than other diabetes medications.”

Source: Drugs.com

Glucose Levels Predict Risk for Dementia.


Higher glucose levels within the nondiabetic range predicted higher risk for dementia.
Observational studies have established an association between diabetes and dementia. In this prospective study from Seattle’s Group Health Cooperative, researchers sought to determine whether average glucose levels in people without diabetes predict development of dementia. The study involved 2067 older adults (mean age 74; 11% with diabetes) who had no evidence of dementia at baseline and who were screened every 2 years using the Cognitive Abilities Screening Instrument. Average glucose levels were estimated using models that incorporated both serial glycosylated hemoglobin and blood glucose values.

During a median follow-up of 7 years, 25% of participants were diagnosed with dementia. Among participants who did not have diabetes, risk for developing dementia increased with increasing average glucose levels, after adjustment for potentially confounding variables. For example, in those whose average glucose level was 115 mg/dL, relative risk for dementia was 18% higher than in those whose average glucose level was 100 mg/dL. Among participants who had diabetes, relative risk for dementia was 40% higher in those whose average glucose level was 190 mg/dL compared with 160 mg/dL.

COMMENT

The prospective nature of this study, in which patients screened negative for dementia at baseline, is a strength. However, unmeasured confounders might have influenced the association between glycemia and dementia, and reverse causality is remotely possible (e.g., lifestyle changes in patients with early subclinical dementia might promote higher glucose levels). If higher blood glucose levels within the nondiabetic range do contribute to development of dementia, the mechanism is unclear.

Source: NEJM

Elevated Glucose Levels Associated with Dementia.


Higher glucose levels are associated with increased dementia risk, according to a prospective cohort study in the New England Journal of Medicine.

Researchers followed roughly 2100 people aged 65 and older who were free of dementia at baseline. Over a median follow-up of 6.8 years, patients had at least five measurements of glucose or glycated hemoglobin taken. About a quarter of patients developed dementia.

For all participants, the risk for dementia increased with increasing glucose readings. For patients without diabetes, an average glucose level of 115 mg/dL was associated with an 18% higher risk for dementia, compared with a level of 100 mg/dL. For those with diabetes, 190 mg/dL was associated with a 40% increased risk, relative to 160 mg/dL.

The authors speculate that microvascular disease of the central nervous system could contribute to the association.

Source: NEJM