A body in motion

Dr. Victor Sierpina

Dr. Victor Sierpina

In high school physics class, I learned from Sir Isaac Newton that a body in motion will stay in motion. The opposite is true and it is called inertia. The other day in clinic, I went in to see Dylan, a 12 year old. He didn’t look up or say hi to me as I came into the room as he was intently working his thumbs on a handheld device. His mother told him to be polite and say hello. He raised his head briefly, said, “Hi,” then back to the gaming thing. She shrugged apologetically and helplessly. I won’t dwell on how we should socialize the digital generation to learn polite human interaction, though it is quite relevant to bodies in motion.

Dylan’s complaint was a minor one and he basically came in needing a school excuse. It could have been a 5 to 10 minute visit but I noticed he was a bit chunky. In fact, his BMI at 29 was close to the obese range. At mom’s request, we ran a urine and blood test to make sure he wasn’t diabetic. He wasn’t, fortunately, at least not yet.

I asked Dylan what kinds of sports or other activities he liked to do. Mom motioned to me with both thumbs moving rapidly to mime the reality of his activity. Continue reading

Stem cells help in battling diabetes

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

Diabetes may be common, but it’s serious business. Diabetes is repeatedly in the top 10 causes of death for Americans, killing or contributing to the deaths of 300,000 Americans in 2010. An estimated one in 10 people have it, but about one-third of them are undiagnosed. Diabetes costs the country $250 billion. But scientists are working on some good news for diabetics with the help of stem cells.

Type 1 diabetes is largely associated with children and represents about 5 percent of all diabetes cases. The more common form, type 2 diabetes, mostly affects adults and manifests when cells do not use insulin effectively so higher levels are needed, this is also called insulin resistance. Insulin is a molecule of protein, made and secreted by beta cells in the pancreas, an organ that regulates glucose levels in the blood.

Diabetes is a multifaceted disease that leads to a host of medical conditions and complications, such as high blood pressure, elevated cholesterol, blindness, cardiovascular disease and kidney problems. Those with diabetes are two times more likely to die of a heart attack and one and half times more likely to die of a stroke. Diabetes is the leading cause of kidney failure, leading to transplants and dialysis. Almost 60 percent of lower extremity amputations are the result of diabetes. Continue reading

No-calorie soft drinks, weight and your gut bacteria

Dr. Victor Sierpina

Dr. Victor Sierpina

Do you know anyone who drinks a lot of diet sodas and just cannot seem to lose weight? It has been known for some time that these artificial, no-calorie sweeteners not only do not encourage weight loss but may actually promote weight gain and even diabetes by continuously stimulating our desire to taste sweetness. When they were invented by the food industry, these new-to-nature molecules promised to offer a positive option to sugar. They seemed to be a healthier alternative that promised to change our habits and health risks from drinking the high fructose, sugary soft drinks that have defined American billboard culture since the 1950s. However, there are issues.

Sweet foods, it turns out, activate a set of digestive processes, enzymes and hormones like insulin that promote weight gain and diabetes. No-calorie sweet drinks do the same. This is very different from the gut and endocrine response to more bitter or alkaline foods such as vegetables, grains, legumes and other plant-based foods. So despite no calories, these sweeteners have not been so helpful in weight loss as a substitute for the sugary soft drinks. They also are not helpful to diabetics for these same reasons. There is now another reason to suspect that there are other problems with these beverages. It turns out that no-calorie soft drinks change the profile of bacteria in our gut, part of the so-called microbiome. These bacteria, which may in aggregate weigh three to six pounds, constitute one of the largest “organs” in the body. They actually contain about 150 times as much DNA as our human genome. The key issue for our diet is that they are essential to the process of healthy digestion. Many foods, especially plant materials, cannot be adequately metabolized and absorbed without a healthy gut bacterial population. When artificial sweeteners alter this profile, our ability to utilize our food effectively is impaired. We still feel hungry. Continue reading

Research looks at sugar sensors in the digestive system

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

Your tongue isn’t the only part your body that can taste sweetness.

Three years ago, scientists discovered that our intestines and pancreas have receptors that can sense the sugars, glucose and fructose. This could revolutionize treatment for diabetics, who must closely monitor their blood sugar levels.

A drug called New-Met, made by Eleclyx Therapeutics in San Diego – that is now in phase II clinical trials – is attempting to do just that by targeting those sugar receptors in the digestive system.

It appears that these taste receptors are basically sensors for specific chemicals that can serve functions other than taste in other parts of the body, although we don’t know what all those functions are yet. We do know the function of the T1R2/T1R3 taste receptor found on some cells in the intestine. When they detect sugar molecules, these cells secrete hormones called incretins, which in turn stimulate insulin production in the pancreas. Continue reading

Agavin offers more choices to those watching caloric, sugar intake

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

Next time you have a bitter pill to swallow, think about reaching for a spoonful of agavin instead of sugar to help the medicine go down.

You might not know what agavin is yet, but you’ve probably noticed that a number of alternative natural sweeteners like Stevia have been added to grocery store shelves next to traditional sugar.

These products sweeten foods but often do not add calories or raise blood sugar levels. Recent research suggests that a sweetener made from agave, the same plant used to make tequila, may lower blood sugar levels and help people maintain a healthy weight.

Agavin is a natural form of sugar, fructose, called fructan. With fructan, individual sugar molecules are linked together in long chains.

The human body cannot use this form of fructose so it is a non-digestible dietary fiber that does not contribute to blood sugar levels. But it can still add sweetness to foods and drinks. Continue reading

Bearly Understanding Diabetes

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

While they are some of the largest bears on earth, Grizzly bears aren’t usually accused of being fat. Regardless, these animals are helping scientists discover new and better treatments for human obesity and diabetes.

Grizzlies spend the late summers consuming more than 50,000 calories per day. As a comparison, a moderately active 50-year-old human female is recommended 2,300. Grizzlies then hibernate for up to seven months, relying on the pounds of stored fat they accumulated before winter. While hibernating, bears do not eat, urinate, or defecate.

Scientists wondered if all the weight and fat bears gain results in diabetes like it does in humans. Overweight people face an increased risk of type 2 diabetes, in which the body does not make enough of the hormone insulin or cells do not respond to it. Insulin helps move a type of sugar called glucose from the blood into cells, where it is used for energy and as a precursor for other molecules the body needs. If sugar levels in the blood remain elevated and the body doesn’t have enough insulin, cells are starved for energy, leading to damaged eyes, kidneys, nerves, and hearts. Continue reading

How much sugar is safe?

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

Former Mayor Michael Bloomberg of New York City caused a controversy when he tried to ban the sale of sugary drinks more than 16 ounces.

Thus the “Big Gulp” rebellion was born, and the ban was later overturned by the courts. Yet the rates of diabetes, heart disease and obesity remain out of control in the United States.

More than 24 million Americans older than 20 years old have diabetes. Another 78 million have pre-diabetes with blood glucose levels higher than they should be — the start of glucose intolerance.

And down the road, this may lead to life-threatening heart disease — the No. 1 killer of adults — which also is linked to obesity affecting more than 80 million Americans.

Much of the obesity epidemic has been blamed on unhealthy eating and poor nutrition. Refined sugar has been identified as a source of excess calories.

According to the U.S. departments of Agriculture and Health and Human Services, almost 50 percent of sugar in the diets of Americans comes from sugary drinks and sweetened fruit drinks. Continue reading

The skinny on sugar substitutes

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

Here is a sweet story. Sort of. Do you know the difference between artificial sweeteners and sugar substitutes?

One tastes good and the other doesn’t?

Not quite. Artificial sweeteners have improved over the years from the early days of cyclamate. Overall, sugar substitutes are anything used as a sweetener other than table sugar (what is chemically called sucrose).

Artificial sweeteners include sugar alcohols like xylitol, which you find in sugarless gum, and natural products like maple syrup and molasses. They also include the pink, blue and yellow packets found on restaurant tables across the country. Aspartame is found in Equal, saccharin in Sweet N’ Low and sucralose in Splenda. Artificial sweeteners can also be “natural” like the recently launched Stevia products, which include Truvia. Most artificial types are known to be more intense sweeteners than natural sugar. One down side of some of these products is the aftertaste that follows. Continue reading

Researchers develop new insulin delivery system

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

Diabetes is a life-changing diagnosis that can mean several injections of insulin and several tests of blood glucose levels every day.

Some people with diabetes say they feel like a pin cushion, and children with Type 1 diabetes often find it particularly challenging.

However, there may be some relief in sight thanks to nanoparticles.

Nanoparticles range in size from one to 2,500 nanometers. For an idea, the width of a strand of human hair is 100,000 nanometers.

Researchers have developed a new insulin delivery system that involves a network of nanoparticles. Once injected, the nanoparticles release insulin in response to increases in blood sugar levels for up to a week.

They have been tested in mice and if they perform similarly in people, this may be a better solution to managing diabetes than multiple daily injections. Continue reading

A top 10 list to die for

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

How are you going to die?

The Centers for Disease Control would answer that life expectancy depends greatly on where someone lives. Life expectancy in the United States ranks 40th in the world with 77.97 years. That addresses when someone might die but what about how? Most likely, it will be from one of these top 10 causes, based on how many Americans they kill each year.

10) Suicide – 38,285. Many factors are now known to influence suicide: mental illnesses, genetics, certain pharmaceuticals, traumatic brain injuries, drug and alcohol abuse and chemical or hormonal imbalances. To decrease these rates, education about the signs preceding suicide and accessible treatment is necessary.

9) Kidney Disorders – 45,731. Although dialysis can help people survive a little longer without a kidney, it is no cure. Kidney damage can occur from infection, high blood pressure, or toxic reactions to drugs, leading to chronic kidney disease that affects more than 26 million Americans. Continue reading