Unraveling the Sugar Cube navs-2011


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  • Arateus Greek Physician
  • 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.cdc.gov/diabetes/statistics/incidence/fig1.htm
  • --http://www.cdc.gov/nccdphp/publications/factsheets/Prevention/pdf/obesity.pdf --http://www.cdc.gov/nccdphp/publications/factsheets/Prevention/obesity.htm
  • --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, "National Health Spending in 2005." Health Affairs 26:1 (2006): 142-153. --Borger, C., et al., "Health Spending Projections Through 2015: Changes on the Horizon," Health Affairs Web Exclusive W61: 22 February 2006. -- http://www.mathematica-mpr.com/health/ --http://aspe.hhs.gov/health/NDAP/NDAP04.pdf
  • http://diabetes.niddk.nih.gov/DM/PUBS/statistics/
  • 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
  • http://www.treeoflife.nu/diabetes
  • http://www.pcrm.org/index.html
  • 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

    1. 1. A presentation at the NorthAmerican Vegetarian Festival 2011 Stephan Esser MD www.esserhealth.com
    2. 2. Unraveling the Sugar Cube Stephan Esser MD www.esserhealth.com
    3. 3. Intentions• Educate• Empower• Motivate
    4. 4. Objectives• Provide background: – History, Statistics Fun – Anatomy, Patho-physiology – Risks/Complications – Treatment/Prevention Options• Provide you tools to: – Facilitate personal and societal change
    5. 5. 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.
    6. 6. • 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
    7. 7. • 1921 Insulin is discovered’• 1955 Oral drugs are introduced to help lower blood glucose levels• 1959 Two major types of diabetes described
    8. 8. • 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.”
    9. 9. 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
    10. 10. 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
    11. 11. Overweight ↑ risk of DM2 by 3 foldObesity ↑ risk by 9 fold
    12. 12. Michelangelo’s David:12 month 20 city tour of the US
    13. 13. 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.
    14. 14. Complications• Heart Disease: 2-6 ×’s higher• Stroke: 2-6 ×’s higher• Hypertension/Elevated Cholesterol• #1 Cause: – Blindness – Kidney Failure – Neuropathy – Amputation (60%)• Dental Disease• ……..and on and on………….
    15. 15. Knowledge is Power Power is responsibility
    16. 16. Digestion Cephalic Gastric Intestinal
    17. 17. Pancreas• Secretes digestive enzymes into the intestine • Amylase, lipase, trypsin, chymotrypsin, bicarbonate, water • digestion, neutralize acid• Secretes hormones into the blood • Insulin, glucagon, somatostatin • Blood sugar control, neuro-hormonal control
    18. 18. Visceral Adiposity/Belly Fat/AppleFat
    19. 19. What we know• Diabetes is an age old disease• The pathophysiology• Dramatic  in ♯’s associated with obesity, SAD,  activity• Cost is bankrupting America
    20. 20. Risk FactorsIn your control Out of your control• Weight • Genetics• Exercise Habits • Age• Diet: • Race – Total calories – Fat Consumption – Refined Carbohydrates• Elevated Lipids• Elevated Blood Pressure
    21. 21. Pima Indians
    22. 22. Treatments• Allopathic: Drugs…..drugs….drugs• Naturopathic: herbs, supplements• Homeopathic: tinctures, elixirs, extracts• Acupuncture: needles• Hypnosis: ? ? ? ? ? ? ?• Chiropractic: ? ? ? ? ?• Ayurvedic: cinnamon, bitter lemon, herbs
    23. 23. Allopathic• Oral Hypoglycemics: – Metformin – Glyburide – Glipizide – Repalinide, Nateglinide – Rosiglitazone (Avandia), Pioglitazone( Actos)• Action:  Insulin sensitivity/production• Injectables: Insulin
    24. 24. 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………
    25. 25. Increases Appetite’d Insulin Weight Gain Fat CausesSecretion Causes Insulin Resistance
    26. 26. Reversing Diabetes
    27. 27. Essentials• Remove insult• Adopt healthful behaviors• Restore normal/near-normal physiology
    28. 28. • Joel Fuhrman MD: – “ 95% of Type II Diabetics can come off medications” – “Type 1 diabetics can reduce their insulin doses by almost half.”
    29. 29. • John McDougall MD – The majority of pt’s with Type 2 Diabetes have “normalization of blood sugar in approximately 1 week’
    30. 30. • Dr. Alan Goldhamer DC: – DM2 is dramatically influenced by a brief 7-14 day stay – Most pts have normal blood sugars in days without need for medications
    31. 31. Tree of Life Rejuventation Center• Dr. Gabriel Cousens MD – 21 day Diabetes Reversal Program – Raw Cuisine
    32. 32. • Dr. Neal Barnard MD – DM2 Reversed with Vegan Diets – Extensive Studies on diabetes reversal and elimination
    33. 33. Living a Diabetes-free life
    34. 34. Getting Started• 1: Assessment • Self/Other• 2: Defining Success • Establish parameters• 3: Goal Setting – SMART (specific, measureable, achievable, realistic, timely)• 4: Establishing Priorities• 5: Take Control/ Application
    35. 35. 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
    36. 36. Defining Success• Reversing Diabetes• Reducing Insulin/Medication need• Stopping the progression/avoid complications• Improve Quality of life/energy/clarity• Preventing Diabetes
    37. 37. Goal Setting• Specific• Measurable• Achievable• Realistic• Timely
    38. 38. Establish Priorities• Balance, prioritize• Be flexible/dynamic
    39. 39. Taking Control• Network• Create support team• Catalog/Notate/Document• Re-assess intermittently
    40. 40. Essentials#0: Get informed#1: Adopt a plant based diet#2: Begin a regular exercise program (>150)#3:Achieve a more “ideal” body weight#4: Chart/Monitor/Catalog/Re-assess
    41. 41. What we know• We can prevent/reverse/eliminate some 90+ % of Type 2 Diabetes• We can dramatically reduce the need for Insulin in Type 1 Diabetes• This takes work……… but it is all worth it!!!!!!
    42. 42. The Answer……….
    43. 43. Thank you!
    44. 44. Enjoy more powerpoints and educational resources at www.esserhealth.com