Learn the basics of Diabetes Prevention, reversal and Management. The Science is clear, follow the five key behavior changes to live a diabetes-free life.
By Juliana C N Chan, MBChB, MD, FRCP Professor of Medicine & Therapeutics, Director, Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong, China
Hosted by with Sophie Tully BSc MSc, 10th October
This presentation addresses the role of cholesterol in CVD and the latest evidence into nutritional strategies to manage and treat high cholesterol and support healthy CVD function. Sophie covers the aetiology of CVD and why cholesterol has long been considered an important marker of CVD health and the emergence of newly identified CVD risk factors which may offer a more effective diagnostic tool. Finally she discusses new opinions on nutritional approaches to keep cholesterol levels healthy and prevent CVD events.
Breast cancer is the leading cause of death from cancer among women, accounting for 23% of the total cancer cases and 14% of cancer deaths in 2008. As dietary fat is thought to be one of the main risk factors, this webinar will focus on the opposing effects of the omega-6 fatty acid arachidonic acid (AA) and the omega-3 fatty acid eicosapentaenoic acid (EPA) on factors related to breast cancer risk, development and prognosis, including their influence on cyclooxygenase activity and prostaglandin production, the impact of inflammation within the tissue microenvironment, impact on aromatase and oestrogen production and impact on genetic aspects of breast cancer such as modulation of BRAC1 and BRAC2 genes.
By Juliana C N Chan, MBChB, MD, FRCP Professor of Medicine & Therapeutics, Director, Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong, China
Hosted by with Sophie Tully BSc MSc, 10th October
This presentation addresses the role of cholesterol in CVD and the latest evidence into nutritional strategies to manage and treat high cholesterol and support healthy CVD function. Sophie covers the aetiology of CVD and why cholesterol has long been considered an important marker of CVD health and the emergence of newly identified CVD risk factors which may offer a more effective diagnostic tool. Finally she discusses new opinions on nutritional approaches to keep cholesterol levels healthy and prevent CVD events.
Breast cancer is the leading cause of death from cancer among women, accounting for 23% of the total cancer cases and 14% of cancer deaths in 2008. As dietary fat is thought to be one of the main risk factors, this webinar will focus on the opposing effects of the omega-6 fatty acid arachidonic acid (AA) and the omega-3 fatty acid eicosapentaenoic acid (EPA) on factors related to breast cancer risk, development and prognosis, including their influence on cyclooxygenase activity and prostaglandin production, the impact of inflammation within the tissue microenvironment, impact on aromatase and oestrogen production and impact on genetic aspects of breast cancer such as modulation of BRAC1 and BRAC2 genes.
Plant-based Eating: Enhancing Health Benefits, Minimizing Nutritional RisksRobin Allen
Learning Objectives
At the end of the session, the participants will be able to:
1. Know there is no single definition of a plant-based diet.
2. Discuss health aspects of vegetarian and vegan diets and quality of evidence supporting health claims.
3. Assess nutritional adequacy/status of vegetarians and/or vegans throughout the life cycle and provide strategies for meeting dietary recommendations for vitamin B12, DHA calcium, and zinc.
Prevalence of obesity.Body composition & body shape (body fat distribution ) and CVD risk .Mechanisms linking obesity with cardiovascular disease.Fat-but-Fit Paradigm and CVD,The Relationship of Metabolic Risk Factors and Cardiorespiratory Fitness. Metabolically Healthy but Obese ( MHO ) Phenotype and CVD.Obesity Paradox in Patients With CVD
Lyon Diet Heart Study is still considered as the ultimate evidence for the health benefits of Mediterranean diet. Unfortunately its' results have never been re-produced since then. However, PREDIMED trial may change this situation.
Predimed study is one of the few truly long term randomized trials with disease and mortality outcomes. It is unique in many ways and will have a strong and lasting impact
Join Doc Andrew to see the research that supports plant based diet recommendations. Address common misconceptions. Ask questions @DenverWWAD or join current discussions at #PlantBased, #PlantBasedRx, or #CulinaryRx.
Also, enjoy bonus learning with these topic-related, 2-minute podcasts by Dr. Andrew:
"The Plant Based Diet and How to Get Started"
https://soundcloud.com/denverwwad/healthcast-23
"Eat Your Way to the Finish Line"
https://soundcloud.com/denverwwad/healthcast-4
Andrew Freeman, MD, FACC, FACP is a cardiologist and Assistant Professor of Medicine at National Jewish Health, Denver, Colorado. He is part of the leadership of both the local and national American College of Cardiology.
Dr. Freeman founded the Denver chapter of the Walk with a Doc program and is the leader of Walk with a Doc-Colorado.
Walk with a Doc-Denver is a free health improvement and community empowerment initiative. Local doctors and a team of healthcare professionals--all volunteers--host Saturday walks that include expert talks, health screenings, refreshments, and motivational giveaways. For more info visit: Denver.WalkWithADoc.org
The root cause of chronic diseases, cancer and aging was recently understood. It includes 1- A state of chronic low grade inflammation secondary to hyperglycemia and obesity leading to insulin - leptin resistance. 2- Mitochondrial dysfunction. Diet, Intermittent fasting or its alternative the Metabolic Bariatric Surgery and Exercise play a significant rule in the salvage of these problems. Exercise is any bodily activity that enhances or maintain physical fitness and overall health, Exercise with its Countless Benefits is the logical salvage for a group of diseases related to inactivity . In view of the prevalence, global reach and health effect of these physical inactivity related diseases, the issue should be appropriately described as pandemic, with far-reaching health, economic, social and Environmental consequences.These diseases include, Obesity, Coronary artery disease, Diabetes, Hypertension, Cancer, Depression and anxiety, Arthritis, Osteoporosis, Etc, etc, etc… I think we have no option except doing regular exercises if we seriously search for a salvage to escape the bad and serious consequences of these new life style diseases.
Fat intake US has remained rather stable during the past decades despite many claims. I present here the case based on USDA and NHANES data.
Claiming that fat intake has decreased in US is as silly as advising a dieter: “If you want to follow a low-fat diet just keep your fat intake at the current level and simply increase the consumption of carbs. Then you are on low-fat diet and you will reap all the benefits of the diet”
Join Doc Andrew to see what's new in health research that supports plant based diet recommendations. Share your questions via @DenverWWAD or email FreemanA@njhealth.org
Andrew Freeman, MD, FACC, FACP is a cardiologist and Director of Clinical Cardiology and Operations at National Jewish Health in Denver, Colorado. He holds leadership roles in the American College of Cardiology at the local and national levels. Dr. Freeman founded Denver's chapter of the Walk with a Doc program and heads Walk with a Doc-Colorado.
Walk with a Doc-Denver is a cost-free empowerment initiative powered by people improving their health, local doctors, and other health professionals who prescribe exercise-as-medicine. The mission? To elevate community health--one walk at a time! The program's Saturday walks include expert talks, health screenings, refreshments, and motivational giveaways. For more info visit: http://walkwithadoc.org/our-locations/denver/
Fishing Clues for the Efficacy of Chemotherapy Role of Fastingijtsrd
This Article is on how Fasting is effective in chemotherapy and how it prevents cancer. Fasting in disease intercept and treatment has recently become a popular topic and fasting is the part of most spiritual tradition in the world. Cell is the basic unit to the human body. Actually these cell division takes normally but due to some disturbance or mutation in cell it lead to cancer or tumor. chemotherapy is used to treat the cancer but it having the side effect. In this article we are describing about how cancer is prevented by fasting by different mechanism like Cellular fasting mechanism, Systemic changes by fasting, Mechanism of killing cancer cells in solid tumors by fasting and Autophagy Mechanism. Dr. C. Nithish | Dr. G. Ajith Kumar | Dr. P. Sravani ""Fishing Clues for the Efficacy of Chemotherapy: Role of Fasting"" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-3 | Issue-4 , June 2019, URL: https://www.ijtsrd.com/papers/ijtsrd23581.pdf
Paper URL: https://www.ijtsrd.com/medicine/other/23581/fishing-clues-for-the-efficacy-of-chemotherapy-role-of-fasting/dr-c-nithish
Guest Lecture at University of Delhi - The Entangled Relationship between Dia...Vinod Nikhra
The talk at Ramjas College, University of Delhi on 18th Feb 2015. It highlights the latest issues in biological and molecular research which link overweight/obesity with diabetes, metabolic syndrome and aging.
What constitutes "Women's Health" issues? All too often this category is hijacked with conversations related exclusively to sex and breast care. In this revealing conversation we review other topics related to women's health and the relationship to "plant based nutrition" and general preventive strategies
All too often we hear nutrition myths. They confuse many people and result in personal choices that compromise health and increase the risk of disease. In this powerpoint, Dr Esser reviews some foundational and a few specific myths and presents compelling science to set the record straight. Enjoy and remember to keep on asking questions and learning how you can achieve your best health in 2018.
Plant-based Eating: Enhancing Health Benefits, Minimizing Nutritional RisksRobin Allen
Learning Objectives
At the end of the session, the participants will be able to:
1. Know there is no single definition of a plant-based diet.
2. Discuss health aspects of vegetarian and vegan diets and quality of evidence supporting health claims.
3. Assess nutritional adequacy/status of vegetarians and/or vegans throughout the life cycle and provide strategies for meeting dietary recommendations for vitamin B12, DHA calcium, and zinc.
Prevalence of obesity.Body composition & body shape (body fat distribution ) and CVD risk .Mechanisms linking obesity with cardiovascular disease.Fat-but-Fit Paradigm and CVD,The Relationship of Metabolic Risk Factors and Cardiorespiratory Fitness. Metabolically Healthy but Obese ( MHO ) Phenotype and CVD.Obesity Paradox in Patients With CVD
Lyon Diet Heart Study is still considered as the ultimate evidence for the health benefits of Mediterranean diet. Unfortunately its' results have never been re-produced since then. However, PREDIMED trial may change this situation.
Predimed study is one of the few truly long term randomized trials with disease and mortality outcomes. It is unique in many ways and will have a strong and lasting impact
Join Doc Andrew to see the research that supports plant based diet recommendations. Address common misconceptions. Ask questions @DenverWWAD or join current discussions at #PlantBased, #PlantBasedRx, or #CulinaryRx.
Also, enjoy bonus learning with these topic-related, 2-minute podcasts by Dr. Andrew:
"The Plant Based Diet and How to Get Started"
https://soundcloud.com/denverwwad/healthcast-23
"Eat Your Way to the Finish Line"
https://soundcloud.com/denverwwad/healthcast-4
Andrew Freeman, MD, FACC, FACP is a cardiologist and Assistant Professor of Medicine at National Jewish Health, Denver, Colorado. He is part of the leadership of both the local and national American College of Cardiology.
Dr. Freeman founded the Denver chapter of the Walk with a Doc program and is the leader of Walk with a Doc-Colorado.
Walk with a Doc-Denver is a free health improvement and community empowerment initiative. Local doctors and a team of healthcare professionals--all volunteers--host Saturday walks that include expert talks, health screenings, refreshments, and motivational giveaways. For more info visit: Denver.WalkWithADoc.org
The root cause of chronic diseases, cancer and aging was recently understood. It includes 1- A state of chronic low grade inflammation secondary to hyperglycemia and obesity leading to insulin - leptin resistance. 2- Mitochondrial dysfunction. Diet, Intermittent fasting or its alternative the Metabolic Bariatric Surgery and Exercise play a significant rule in the salvage of these problems. Exercise is any bodily activity that enhances or maintain physical fitness and overall health, Exercise with its Countless Benefits is the logical salvage for a group of diseases related to inactivity . In view of the prevalence, global reach and health effect of these physical inactivity related diseases, the issue should be appropriately described as pandemic, with far-reaching health, economic, social and Environmental consequences.These diseases include, Obesity, Coronary artery disease, Diabetes, Hypertension, Cancer, Depression and anxiety, Arthritis, Osteoporosis, Etc, etc, etc… I think we have no option except doing regular exercises if we seriously search for a salvage to escape the bad and serious consequences of these new life style diseases.
Fat intake US has remained rather stable during the past decades despite many claims. I present here the case based on USDA and NHANES data.
Claiming that fat intake has decreased in US is as silly as advising a dieter: “If you want to follow a low-fat diet just keep your fat intake at the current level and simply increase the consumption of carbs. Then you are on low-fat diet and you will reap all the benefits of the diet”
Join Doc Andrew to see what's new in health research that supports plant based diet recommendations. Share your questions via @DenverWWAD or email FreemanA@njhealth.org
Andrew Freeman, MD, FACC, FACP is a cardiologist and Director of Clinical Cardiology and Operations at National Jewish Health in Denver, Colorado. He holds leadership roles in the American College of Cardiology at the local and national levels. Dr. Freeman founded Denver's chapter of the Walk with a Doc program and heads Walk with a Doc-Colorado.
Walk with a Doc-Denver is a cost-free empowerment initiative powered by people improving their health, local doctors, and other health professionals who prescribe exercise-as-medicine. The mission? To elevate community health--one walk at a time! The program's Saturday walks include expert talks, health screenings, refreshments, and motivational giveaways. For more info visit: http://walkwithadoc.org/our-locations/denver/
Fishing Clues for the Efficacy of Chemotherapy Role of Fastingijtsrd
This Article is on how Fasting is effective in chemotherapy and how it prevents cancer. Fasting in disease intercept and treatment has recently become a popular topic and fasting is the part of most spiritual tradition in the world. Cell is the basic unit to the human body. Actually these cell division takes normally but due to some disturbance or mutation in cell it lead to cancer or tumor. chemotherapy is used to treat the cancer but it having the side effect. In this article we are describing about how cancer is prevented by fasting by different mechanism like Cellular fasting mechanism, Systemic changes by fasting, Mechanism of killing cancer cells in solid tumors by fasting and Autophagy Mechanism. Dr. C. Nithish | Dr. G. Ajith Kumar | Dr. P. Sravani ""Fishing Clues for the Efficacy of Chemotherapy: Role of Fasting"" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-3 | Issue-4 , June 2019, URL: https://www.ijtsrd.com/papers/ijtsrd23581.pdf
Paper URL: https://www.ijtsrd.com/medicine/other/23581/fishing-clues-for-the-efficacy-of-chemotherapy-role-of-fasting/dr-c-nithish
Guest Lecture at University of Delhi - The Entangled Relationship between Dia...Vinod Nikhra
The talk at Ramjas College, University of Delhi on 18th Feb 2015. It highlights the latest issues in biological and molecular research which link overweight/obesity with diabetes, metabolic syndrome and aging.
What constitutes "Women's Health" issues? All too often this category is hijacked with conversations related exclusively to sex and breast care. In this revealing conversation we review other topics related to women's health and the relationship to "plant based nutrition" and general preventive strategies
All too often we hear nutrition myths. They confuse many people and result in personal choices that compromise health and increase the risk of disease. In this powerpoint, Dr Esser reviews some foundational and a few specific myths and presents compelling science to set the record straight. Enjoy and remember to keep on asking questions and learning how you can achieve your best health in 2018.
An introduction to the paleo diet and its health benefits. A short summary of research is presented as well as a description of blood sugar managment.
Best Nutritionist in Sarastoa, Cynthia Clark, http://www.cranehealth.net
How to prevent heart disease and diabetesEsserHealth
Heart disease is the leading cause of death in men and women in America today. Learn how the food you eat can radically alter your risk of both heart disease and type two diabetes. You can achieve better health starting today.
A recent presentation on health and healthy living. Learn how you personal choices just may be the most powerful predictors of your personal health. Be empowered and inspired to achieve your best health in 2018.
Intermittent fasting and metabolic syndromefathi neana
Metabolic syndrome reached an epidemic
No Cure by Insulin, Drugs, Low fat diet
Can be cured by Bariatric surgery, Intermittent fasting, Very low carb diet
Do fructose-containing sugars lead to adverse health consequences? Results of...Corn Refiners Association
At Experimental Biology 2014, the Sponsored Satellite Program “Sugars and Health Controversies: What Does the Science Say?” held in conjunction with the American Society for Nutrition’s Scientific Sessions took place on Saturday, April 26, 2014.
Panelist John L Sievenpiper, MD, PhD, presented science about sugars and their associated health outcomes.
The Intersection of Orthopedics and Lifestyle MedicineEsserHealth
What you eat, drink and how you move can radically influence the health and happiness of your joints! Learn how to make powerful science based decisions about your personal health and keep your joints healthy and pain free.
Autoimmune Disease: Understanding the Inflammation WithinEsserHealth
AutoImmune Disease can seem scary, overwhelming and complicated. In this powerpoint we break down the science into applicable nuggets for your life. Enjoy it live on facebooklive as well at esserhealth
The Intersection of Sports and Spine Medicine and Plant Based Nutrition EsserHealth
Whether it is pain, performance or recovery, plant based nutrition has a great deal to offer orthopedic patients. Enjoy reviewing this presentation and learning.
The mind is powerful. Emotions are perhaps the most powerful influence of our personal choices every day. As you transition to a more healthy tomorrow, be sure you evaluate your personal thoughts, emotions and feelings on a daily basis. These thoughts and feelings might just be the key to your long term success.
Back to the Swing of Things: Golf InjuryEsserHealth
Golf Injury is a real risk of participation, Dr Esser teaches other medical providers about some common golf injuries and both management and prevention in this presentation.
Learn why heart disease is a major issue and what you can do to prevent and reverse the number one killer of American's today. Review extensive science and studies demonstrating the effect of nutrient dense foods, exercise and mental health on heart health. Establish your own personal heart health program today.
Many of us know we should eat more of those healthy foods but find it hard to stick with our "healthy" goals. Why is that and what can you do to make maintaining healthy habits easier.
The Ties that Bind: Depression and DisabilityEsserHealth
The Disability status of an individual and their risk of concomitant mental health needs is linked. If you or a loved one are considering going out on " disability" be sure you have the tools to deal with depression and the like. Reach out, find support and be proactive.
Tennis Injuries can keep athletes off the court and unable to achieve their personal on court goals. Learn how to reduce the risk of these injuries and to enhance function.
Conservative Management of Knee osteoarthritisEsserHealth
Osteoarthritis is a major burden on personal health and international health care expenditures. Learn the basics of osteoarthritis and conservative management options for the physician.
What you eat is powerful "medicine." The foods, you choose to eat or to skip can radically influence your risk of disease. Learn what you can do and why it matters to your breast cancer risk in this presentation.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
3. • ADA: “Diabetes is a disease in which the body
does not produce or properly use insulin.”
• NIH: “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.”
4. 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
5. Statistics
• 2017
– 9.4% of the population
– 30.3 million US citizens
– 22 mill. diagn. 8.1 mil. undia.
• 7th
Leading Cause of Death
6.
7. Overweight ↑ risk of DM2 by 3 fold
Obesity ↑ risk by 9 fold
Overweight ↑ risk of DM2 by 3 fold
Obesity ↑ risk by 9 fold
9. Age-adjusted Prevalence of Obesity and Diagnosed Diabetes
Among US Adults
Obesity (BMI ≥30 kg/m2
)
Diabetes
1994
1994
2000
2000
No Data <14.0% 14.0%–17.9% 18.0%–21.9% 22.0%–25.9% > 26.0%
No Data <4.5% 4.5%–5.9% 6.0%–7.4% 7.5%–8.9% >9.0%
CDC’s Division of Diabetes Translation. National Diabetes Surveillance System available at
http://www.cdc.gov/diabetes/statistics
2013
2013
10.
11. Cost to the Nation
• Healthcare is 2-3 times that of those without DM(WHO)
• 2007: Total costs exceeded $174 billion dollars
• In 2007 projected costs by 2020 of $192 billion
• 2012:Cost =$ 245 billion dollars
• “Without preventive action, 1 in 3 children born in 2000
will develop diabetes in their lifetime.” (HHS)
• Perspective
• Diabetes care is 12 percent of the total health care
spending nationwide—roughly one of every eight dollars.
21. Risk Factors
In your control
• Weight
• Exercise Habits
• Diet:
– Total calories
– Fat Consumption
– Refined Carbohydrates
• Elevated Lipids
• Elevated Blood Pressure
Out of your control
• Genetics
• Age
• Race
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………
29. Insulin Effects
• Carbohydrate metabolism
– Increases the rate of glucose transport across the cell membrane in muscle and
adipose tissue by activating Glut4
– Stimulates glycogen synthesis in muscle, fat and liver tissue
– Inhibits glycogenolysis and gluconeogenesis in the liver
• Lipid metabolism
– Inhibits lipolysis
– Stimulates fatty acid and triacylglycerol synthesis
– Increases the rate of Low-density lipid (LDL) formation in the liver
– Increases the rate of triglyceride uptake from the bloodstream to muscle and
adipose tissue
– Decreases the rate of fatty acid oxidation in muscle and liver tissue
– Increases the rate of cholesterol synthesis in the liver
• Protein metabolism
– Increases the rate of amino acid transport into tissues from the bloodstream
– Increases the rate of protein synthesis in muscle, adipose and liver tissue
– Decreases the rate of protein degradation in muscle and other tissue
30. Insulin
• Increases Glut4 receptors in cell membrane
• Adipogenic: anabolic effects of insulin, appetite increases, and reduction of glycosuria
• Heller, S Weight gain during insulin therapy in patients with type 2 diabetes mellitus Diabetes Research and Clinical Practice, 2004
• Atherogenic: Uusitupa, M, 5-year incidence of atherosclerotic vascular disease in relation to general risk factors, insulin
level, and abnormalities in lipoprotein composition in non-insulin-dependent diabetic and nondiabetic subjects. Circulation, 1990
35. Exercise
• Resistance Training
– Ishii et al Resistance training improves insulin sensitivity in NIDDM subjects without altering maximal
oxygen uptake. Diabetes Care 1998 Aug; 21(8): 1353-1355.
– Ibanez, J. Twice-Weekly Progressive Resistance Training Decreases Abdominal Fat and Improves
Insulin Sensitivity in Older Men With Type 2 Diabetes Diabetes Care 2005 Mar; 28(3): 662-667.
• Cardiovascular Exercise
– Eriksson, J. et al Aerobic endurance exercise or circuit-type resistance training for individuals with
impaired glucose tolerance? Hormone and Metabolic Research 1998
– Albright, A American College of Sports Medicine position stand. Exercise and type 2 diabetes.
Medicine and Science in Sports 2000
36.
37. Fat
• Increased Fat = Impaired Insulin Sensitivity
– Lee JS, Pinnamaneni SK, Eo SJ, Cho IH, Pyo JH, Kim CK, Sinclair AJ, Febbraio MA, Watt MJ. Saturated, but not n–6 polyunsaturated, fatty acids
induce insulin resistance: role of intramuscular accumulation of lipid metabolites. J Appl Physiol 100: 1467–1474, 2006.
– Leyton J, Drury PJ, Crawford MA. Differential oxidation of saturated and unsaturated fatty acids in vivo in the rat. Br J Nutr 57: 383–393,
1987.
– Lonnqvist F, Arner P, Nordfors L, Schalling M. Overexpression of the obese (ob) gene in adipose tissue of human obese subjects. Nat Med 1:
950 -953, 1995.
• Increased Fat Consumption = Impaired Insulin
Sensitivity
– Maron DJ, Fair JM, Haskell WL. Saturated fat intake and insulin resistance in men with coronary artery disease. The Stanford Coronary Risk
Intervention Project Investigators and Staff. Circulation 84: 2020–2027, 1991.
– Montell E, Turini M, Marotta M, Roberts M, Noe V, Ciudad CJ, Mace K, Gomez-Foix AM. DAG accumulation from saturated fatty acids
desensitizes insulin stimulation of glucose uptake in muscle cells. Am J Physiol Endocrinol Metab 280: E229–E237, 2001.
– Vessby, V et al. Substituting dietary saturated for monounsaturated fat impairs insulin sensitivity in healthy men and women: The KANWU
study, Diabetolopgia, 2001: 44: 3 (312-219))
– Mayer-Davis, EJ et al. Dietary fat and insulin sensitivity in a triethnic population: the role of obesity. The Insulin Resistance Atherosclerosis
Study (IRAS), AJCN, 1997 65: 1: 79-87.
38.
39. Meat
• Meat consumption impairs Insulin Sensitivity
– Jung Hung et al Taiwanese vegetarians have higher insulin sensitivity than omnivores British Journal of Nutrition
2006
– Kuo et al. Insulin sensitivity in Chinese ovo-lactovegetarians compared with omnivores European Journal of Clinical
Nutrition 2004
• Meat Consumption increases risk of Type
Two Diabetes
– Fung et al Dietary Patterns, Meat Intake, and the Risk of Type 2 Diabetes in Women Arch Intern Med 2004
– Micha et al Red and Processed Meat Consumption and Risk of Incident Coronary Heart Disease, Stroke, and Diabetes
Mellitus A Systematic Review and Meta-Analysis Circulation, 2010
– Pan et al Red meat consumption and risk of type 2 diabetes: 3 cohorts of US adults and an updated meta-analysis
ACJN 2011
– Van Der Mann Dietary Fat and Meat Intake in Relation to Risk of Type 2 Diabetes in Men Diabetes Care 2002 Mar;
25(3): 417-424.
– Aune, D. et al. Meat consumption and the risk of type 2 diabetes: a systematic review and meta-analysis of cohort
studies Diabetologie November 2009, Volume 52, Issue 11, pp 2277-2287
40. Meat
• Dietary Protein Intake and Risk of Type 2
Diabetes in US Men and Women Am. J. Epidemiol,
March 2016
• Investigated the associations between total, animal, and vegetable protein and
incident T2D in 72,992 women from the Nurses' Health Study (1984–2008), 92,088
women from Nurses' Health Study II (1991–2009) and 40,722 men from the Health
Professionals Follow-up Study (1986–2008).
• “Substituting 5% of energy intake from vegetable protein for animal
protein was associated with a 23% (95% CI: 16, 30) reduced risk of
T2D. In conclusion, higher intake of animal protein was associated with an
increased risk of T2D, while higher intake of vegetable protein was associated with
a modestly reduced risk.”
41. Meat
• Low Carbohydrate–Diet Scores and Long-
term Risk of Type 2 Diabetes Among Women
With a History of Gestational Diabetes
Mellitus: A Prospective Cohort Study Diabetes Care
January 2016 vol. 39 no. 1 43-49
– Among women with a history of GDM, a low-carbohydrate dietary pattern,
particularly with high protein and fat intake mainly from animal-source foods, is
associated with higher T2DM risk, whereas a low-carbohydrate dietary pattern with
high protein an fat intake from plant-source foods is not significantly associated
with risk of T2DM.
42. Meat
• The Less meat consumed the lower the risk
of Type 2 Diabetes
– Type of Vegetarian Diet, Body Weight, and Prevalence of Type 2 Diabetes
Tonsted, S et al Adventist Health Study Diabetes Care May 2009 vol. 32 no. 5
791-796
• vegans (OR 0.51 [95% CI 0.40–0.66])
• lacto-ovo vegetarians (0.54 [0.49–0.60])
• pesco-vegetarians (0.70 [0.61–0.80])
• semi-vegetarians (0.76 [0.65–0.90])
• As compared to nonvegetarians.
43.
44. Inflammation and Insulin resistance
• Elevated Levels of Pro-inflammatory Cytokines
Impair Insulin Sensitivity
– Olson NC et al. Circulating levels of TNF-α are associated with impaired glucose tolerance, increased
insulin resistance, and ethnicity: The insulin resistance atherosclerosis study. J Clin Endocrin Metab.
2012.
– Bradley JR. TNF-mediated inflammatory disease. J Pathol. 2008; 214:149-160.39.
– Cawthorn WP, Sethi JK. TNF-α and adipocyte biology. FEBS Lett. 2008; 582:117-131.40. Moller DE.
Potential role of TNF-α in the pathogenesis of insulin resistance and type 2 diabetes. Trends
Endocrinol Metab. 2000; 11:212-217.
• Fruit and Vegetable Intake reduce levels of Pro-
Inflammatory Cytokines
– Root, M et al. Combined Fruit and Vegetable Intake Is Correlated with Improved Inflammatory and
Oxidant Status from a Cross-Sectional Study in a Community Setting Nutrients 2012, 4(1), 29-41
47. Diabetes
• Does a vegetarian diet reduce the occurrence of
diabetes? American Journal of Public Health, Vol. 75, Issue 5 507-512
– 25,698 adult White Seventh-dayAdventists identified in 1960 followed for 21 years
– vegetarians had a substantiallylower risk than non-vegetarians of diabetes as an
underlyingor contributing cause of death
• Fruit and Vegetable Consumption and Diabetes
Mellitus Incidence among U.S. Adults Preventive Medicine Vol 32 Iss
1 January 2001. Pages 33-39
– Appr. 10, 000 participants, highest fruit and vegetable consumption = lowest risk of
T2D
• Dietary Patterns and the Incidence of Type 2
Diabetes Am. J. Epidemiol. (2005) 161 (3): 219-227.
– 4,000 Finnish men and women, followed 23 years
– Highest consumption of fruits/vegetables in prudent diet resulted in decreased risk
48. Diet and Exercise in the Treatment of NIDDM:
The need for early emphasis
Diabetes Care December 1994 vol. 17 no. 12 1469-1472
• 652 with NIDDM
• 3-week intensive dietary modification
program
• 71% of 197 on oral hypoglycemic agents and
39% of 212 on insulin were able to
discontinue their medication with normalized
BS’s
49. Pritikin Program
• Pritikin et al Long-Term Use of a High-Complex-Carbohydrate,
High-Fiber, Low-Fat Diet and Exercise in the Treatment of NIDDM
Patients Diabetes Care 1983
– 26 day inpatient stay, 77% off Oral Hypoglycemics, 25% in TC
• Effect of Short-Term Pritikin Diet Therapy on the Metabolic
Syndrome Journal of Cardio-Metabolic Disease 2006
– 12-15 day stays, BMI 3%, SBP, SG, LDL 10-15%
– 37% no longer met criteria for Metabolic Syndrome
50. Toward Improved Management of NIDDM: A
Randomized, Controlled, Pilot Intervention
Using a Low-fat, Vegetarian Diet
Preventive Medicine, Volume 29, Number 2, August 1999 , pp. 87-91(5)
Over 12 weeks, 28% mean reduction in fasting serum
glucose of the experimental group, from 10.7 to 7.75
mmol/L (195 to 141 mg/dl), was significantly greater
than the 12% decrease, from 9.86 to 8.64 mmol/L
(179 to 157 mg/dl), for the control group (P < 0.05).
The mean weight loss was 7.2 kg in the experimental
group, compared to 3.8 kg for the control group (P <
0.005).
51. Regression of Diabetic Neuropathy with Total
Vegetarian (Vegan) Diet
• 21 pts with T2D and SDPN average age of 64
• Low fat (10–15% of cal), high fiber, total vegetarian diet (TVD) of
unrefined foods and conditioning exercise
• 17/21 (81%) had complete relief of the SDPN pain in 4 to 16 days.
• Weight loss averaged 4-9 ± 2-6 kg during the 25 days.
• By the 14th day, the fasting blood glucose level averaged 35% lower
• 5 got off hypoglycemic agents
• Serum triglyceride and total cholesterol had decreased by 25-0 ±
23% and 13 ± 15% respectively (p <0-01) in 2 weeks.
• Follow-up studies of 17 of the 21 patients for 1-4 years indicated that
71% had remained on the diet and exercise program as advised in
nearly every item.
Journal of Environmental and Nutritional Medicine 1994, Vol. 4, No. 4 , Pages 431-439
52. Multi-System Benefit
A Low-Fat Vegan Diet Improves Glycemic Control and
Cardiovascular Risk Factors in a Randomized Clinical
Trial in Individuals With Type 2 Diabetes
Diabetes Care August 2006 vol. 29 no. 8 1777-1783
– 100 people randomized vegan vs ADA diet
22 weeks
– 43% VG 26% ADA reduced diabetes
medications.
– HbA1c (A1C) 0.96 points VG 0.56 points
in the ADA group
– Excluding those who changed medications,
A1C fell 1.23 points in the vegan group
compared with 0.38 points in the ADA
group
– Body weight 6.5 kg VG and 3.1 kg ADA
– LDL cholesterol 21.2% in the vegan
group and 10.7% in the ADA group (P =
0.02).
– urinary albumin reductions 15.9 mg/24h
VG than in the ADA group 10.9 mg/24 h
• A low-fat vegan diet and a conventional diabetes diet in the
treatment of type 2 diabetes: a randomized, controlled, 74-
wk clinical trial
Clin Nutr May 2009 vol. 89 no. 5 1588S-1596S
• Weight loss was significant within each diet group but not
significantly different between groups (−4.4 kg in the vegan
group and −3.0 kg in the conventional diet group, P = 0.25)
and related significantly to Hb A1c changes (r = 0.50, P =
0.001). Hb A1c changes from baseline to 74 wk or last
available values were −0.34 and −0.14 for vegan and
conventional diets, respectively (P = 0.43). Hb A1c changes
from baseline to last available value or last value before any
medication adjustment were −0.40 and 0.01 for vegan and
conventional diets, respectively (P = 0.03). In analyses before
alterations in lipid-lowering medications, total cholesterol
decreased by 20.4 and 6.8 mg/dL in the vegan and
conventional diet groups, respectively (P = 0.01); LDL
cholesterol decreased by 13.5 and 3.4 mg/dL in the vegan
and conventional groups, respectively (P = 0.03).Conclusions:
Both diets were associated with sustained reductions in
weight and plasma lipid concentrations. In an analysis
controlling for medication changes, a low-fat vegan diet
appeared to improve glycemia and plasma lipids more than
did conventional diabetes diet recommendations. Whether
the observed differences provide clinical benefit for the
macro- or microvascular complications of diabetes remains
to be established.
53. Retrospective Cohort Study
Outcomes: Incidence of CVD events
379,0003 Diabetics to 9 Million non-DM2
Diabetics four times more likely to have CVD
“Diabetes confers an
equivalent risk to
ageing 15 years!”
55. Finnish Diabetes Prevention Trial
Total 522: 172M 350W
Av. age 55
Av. BMI 31
Randomized to standard of care or
individualized lifestyle counseling
Av. f/u 3.2 yrs
Risk of
Diabetes ↓ 58 %
(P<0.001)
N Engl J Med 2001;344:1343-50
“The reduction in the incidence of diabetes was
directly associated with changes in lifestyle”
59. Fat Intake
• Ornish < 10% from fat
• Esselstyne < 10% from fat
• Mcdougall < 10% from fat
• Pritikin < 10% from fat
• Rice Diet 2% from fat
• China Study <15% from fat
60. Fat Intake
• Goals?
– “Pretty Good” Health
– Prevention
– Reversal
– “Excellent” Health
64. 8% from Fruits
and Vegetables
8% from Fruits
and Vegetables
≈ 50% from Added
fat/oil and
processed flour
≈ 50% from Added
fat/oil and
processed flour
71. Exercise
• Leisure time Exercise: organized sports,
running, gym activities, rehabilitation etc.
• Lifestyle Exercise: activity incorporated into our
daily pattern of life
– eg: parking in the distant portion of the parking lot rather then the first
bumper, taking the stairs instead of the elevator etc.
72. Types of Physical Activity
• Cardiovascular
• Strength/Resistance Training
• Core Stability/Balance
• Flexibility/Coordination
74. Present Recommendations
• Resistance Training:
– 2-3 days per week
– All major muscle groups
– 2-4 sets of each exercise
– 48 hours in between sessions
http://www.acsm.org/about-acsm/media-room/news-releases/2011/08/01/acsm-issues-new-recommendations-on-
quantity-and-quality-of-exercise
79. Examples
• Seek Opportunity
– Fear of Death/Amputation
– Cost of Care
– Loss of Function
– Side effects of Drugs
– Image/Sexual function
– Performance
81. Conclusion
• Scientific Evidence is clear/incontrovertible
• Plant Based nutrition can prevent and reverse
Type 2 Diabetes
• The greater the changes, the more rapid and
significant the health changes
• Readiness for change and “marketing” of the
product influence clinical success
84. • Joel Fuhrman MD:
– “ 95% of Type II Diabetics can come off
medications”
– “Type 1 diabetics can reduce their insulin doses by
almost half.”
85. • John McDougall MD
– The majority of pt’s with Type 2 Diabetes have
“normalization
of blood sugar in
approximately 1 week’
86. • 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
87. Tree of Life Rejuventation Center
• Dr. Gabriel Cousens MD
– 21 day Diabetes Reversal Program
– Raw Cuisine
88. • Dr. Neal Barnard MD
– DM2 Reversed with Vegan Diets
– Extensive Studies on diabetes reversal
and elimination
91. Defining Success
• Reversing Diabetes/Heart Disease
• Reducing Insulin/Medication needs
• Stopping the progression/avoid complications
• Improve Quality of life/energy/clarity
• Preventing Diabetes or Heart Disease
92. What we know
• We can prevent/reverse/eliminate most Type
2 Diabetes
• This takes work………
but it is all worth it!!!!!!
Editor's Notes
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
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
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
Produced by beta cells in the pancreas in humans
Some studies suggest in “at risk” populations, all fats may impair insulin insensitivity
Metformin phosphorylates Glut4 thus increasing it’s sensitivity to Insulin
Diabetes confers an equivalent risk to aging 15 years. Due to earlier transition to a high risk category of CVD and other health concerns
--Diabetics are 4 times more likely to have CVD
--Diabetics have a similar risk of Coronary Heart Disease to those without diabetes who have had an MI
--FDDP (N Engl J Med 2001;344:1343-50.)
-Weight reduction &gt; 5%
-Fat Intake &lt; 30% of total calories
-Saturated fat &lt; 10% of total calories
-Fiber intake &gt; 15g per 1000 Kcal
-Physical activity &gt; 30 min per day