http://www.diabetes.org/about-diabetes.jsp http://www.uptodate.com/patients/content/topic.do?topicKey=~X0jjLnBn4._ko http://diabetes.niddk.nih.gov/DM/PUBS/statistics/ http://www.cdc.gov/diabetes/pubs/estimates07.htm Diabetes is a group of diseases marked by high levels of blood glucose, also called blood sugar, resulting from defects in insulin production, insulin action, or both
--http://www.ncbi.nlm.nih.gov/pubmed/12679416-- --http://www.chrp.org/pdf/HSR10_08_04.pdf --http://www.nchc.org/facts/cost.shtml --Catlin, A, C. Cowan, S. Heffler, et al, &quot;National Health Spending in 2005.&quot; Health Affairs 26:1 (2006): 142-153. --Borger, C., et al., &quot;Health Spending Projections Through 2015: Changes on the Horizon,&quot; Health Affairs Web Exclusive W61: 22 February 2006. -- http://www.mathematica-mpr.com/health/ --http://aspe.hhs.gov/health/NDAP/NDAP04.pdf
Weight loss 5-10% of weight….improve insulin sensitivity Exercise 150 min/wk Diet…reverse vs manage…….30% is national recc….useless……real benefits…10% or less
Gila Reservation Arizona Maycoba, Mexico
http://content.karger.com/ProdukteDB/produkte.asp?doi=10.1159/000099065 40-50% require insulin UGDP study Incr. risk of sudden cardiac death with sulfonylureas
A few problems…………..most DM2 have not too little insulin……..but too much fat in their bodies and in their food……in fact their insulin levels are dramatically elevated……..insulin is pro-inflammatory, pro-atherogenic, inc. aging, inc. heart dz risk dramatically…….
Lantus Insulin…and increased risk of cancer nearly 2 fold
Before we get started by a show of hands how many of you want to be healthy, functional, mobile for years to come? 5 steps of Wellness Motivational Process for Healthy Living 2 Success: must be facilitating not inhibiting………
Unraveling the Sugar Cube navs-2011
A presentation at the NorthAmerican Vegetarian Festival 2011 Stephan Esser MD www.esserhealth.com
Unraveling the Sugar Cube Stephan Esser MD www.esserhealth.com
Objectives• Provide background: – History, Statistics Fun – Anatomy, Patho-physiology – Risks/Complications – Treatment/Prevention Options• Provide you tools to: – Facilitate personal and societal change
History• 1552 B.C. 3rd Dynasty Egyptian Hesy-Ra describes the condition• 1st Century A.D. Arateus the melting down of flesh and limbs into urine’ Diabetes “siphon”• 164 A.D. Galen describes diabetes as an ailment of the kidneys.• 11th Century: – Diabetes “Mellitus” and water tasters• 19th Century first chemical tests to indicate and measure the presence of sugar in the urine.
• Late 1850s French physician, Priorry says eat extra large quantities of sugar as a treatment.• 1870s French physician, Bouchardat, notes disappearance of glycosuria during the rationing of food in Paris while under siege by Germany• Late 19th Century Italian diabetes specialist, Catoni, isolates his patients under lock and key in order to get them to follow their diets.• 1869 Paul Langerhans, a German medical student, describes islets of Langerhans’ in the pancreas
• 1921 Insulin is discovered’• 1955 Oral drugs are introduced to help lower blood glucose levels• 1959 Two major types of diabetes described
• ADA 2009: “Diabetes is a disease in which the body does not produce or properly use insulin.”• NIH 2009: “Diabetes is a group of diseases marked by high levels of blood glucose, also called blood sugar, resulting from defects in insulin production, insulin action, or both.”
Types of Diabetes• Type 1: Insufficient or non-existent Insulin production • Pancreatic destruction (autoimmune, cancer etc..) • 5-10% of all cases• Type 2: Insulin is unable to work • Insulin insensitivity/resistance • 90-95% of all cases
Statistics• 2007 – 7.8% of the population – 23.6 million US citizens – 17.9 mill. diagn. 5.7 mil. undia. – 23.1% age > 60 have DM2• 7th Leading Cause of Death
Overweight ↑ risk of DM2 by 3 foldObesity ↑ risk by 9 fold
Michelangelo’s David:12 month 20 city tour of the US
Cost to the Nation• Healthcare is 2-3 times that of those without DM(WHO)• 2007: Total costs exceeded $174 billion dollars• Projected costs by 2020 of $192 billion• “Without preventive action, 1 in 3 children born in 2000 will develop diabetes in their lifetime.” (HHS)• Perspective• Cost of DM2 care in 2005 > budget of the D. of Ed.• Diabetes care is 12 percent of the total health care spending nationwide—roughly one of every eight dollars.
Allopathic• T• To do list: – Check Blood Sugar 4-8 ×’s/day (1460/yr) – Inject yourself with Insulin 3-5 times/day – Go to your doctor for blood work every 3 months – Get HBA1C, foot and retinal exam yearly – And more………
Assesment• Do/did I have DM2?• Has my blood sugar been tested?• If with DM2 what is my A1C?• How many close family members have DM2?• Am I my ideal weight?• Is my diet SAD, moderate or plant based?• How often do I exercise
Defining Success• Reversing Diabetes• Reducing Insulin/Medication need• Stopping the progression/avoid complications• Improve Quality of life/energy/clarity• Preventing Diabetes