Dental Prism

This AP article via the Washington Post is typical of many articles that have been reporting on a recent study of 9,000 observations of middle-aged men and women which was published Monday online in the journal Circulation.

The study has reported that “People who drank one or more diet sodas each day developed the same risks for heart disease as those who downed sugary regular soda.”

Needless to say this is somewhat of a surprising result since it’s definitely counter intuitive that the diet colas would have the same impact as fully sweetened sodas given the massive calories contained in the latter. Not surprisingly, a representative from the American Beverage Association opined:  "How can something with zero calories that's 99 percent water with a little flavoring in it ... cause weight gain?"

Still, the study found those who “drank one or more sodas a day diet or regular had an increased risk of metabolic syndrome, compared to those who drank sodas infrequently. Metabolic syndrome is a cluster of symptoms that increase the risk for heart disease including large waistlines and higher levels of blood pressure, blood sugar, cholesterol and blood fats called triglycerides.”

Some of the theories being put forth are as follows:

1.      Adverse selection problems.  One contingent of diet soda drinkers are already overweight and drink diet sodas in an attempt to keep from gaining more.  Their link to heart disease is due to their overweight status, not the fact that they drink diet sodas.

2.      Diet sodas condition the palette to sweetness and users over consume non diet sweetened products elsewhere in their dietary intake, increasing weight gain and heart disease.

3.      There is something about diet drinks that we don’t understand.

Still, according to the article, the American Heart Association still condones the use of diet sodas as part of a program to control weight.

In our opinion, the most useful function of diet drinks is to help wean yourself off of regular fully sweetened soft drinks.  If you are still drinking fully sweetened soft drinks you are definitely not serious about losing weight.  However, once you have successfully accomplished this goal, the next step should be to replace diet drinks with, yes you guessed it, water.  Over time, you can adjust your palette so that ice water or carbonated ice water is just as refreshing as diet sodas.  And when you drink water you don’t have to be concerned with the caffeine content, availability, or the risk that this recent study  may in fact be correct.  Dribbling a little orange juice into soda water over ice can also be a refreshing low calorie and healthful drink.

No vials of blood. No visit to a doctor's office. Check out your risk for diabetes and heart disease from the comfort of your own home. Sorry phlebotomists!

Home Access Health Corporation already markets at-home testing for HIV, Hepatitis C and Instant Cholesterol. They now offer at-home kits that can screen for diabetes and heart disease. Home Access devised a laboratory algorithm (patent pending) that can accurately test a tiny sample of dried blood. A solution within the collection device separates red blood cells from blood serum, allowing the lab techs to apply the algorithm to provide results which correlate to traditional testing performed by commercial labs. Cool.

Just order the kit, provide a few drops of blood and pop the sample in snail mail. For the Cardiometabolic Risk Panel, results are provided on a full lipid panel and hemoglobin A1c. The Diabetes Risk Test offers results on hemoglobin A1c. Home Access also has a toll-free call center with counselors available to educate people about their test results. Considering the lack of one-on-one time spent with doctors these days, this is an important piece of the process.

These products sound like the real deal. Home Access has partnered with the American Diabetes Association to co-brand the test kits to reach a wider audience at risk for type 2 diabetes and heart disease. The kits will be sold in stores in 2008 and available for direct internet purchase later this year. Right now, the products are offered through employer-sponsored programs, health fairs or with a physician's order by calling 800-448-8378 or visiting Home Access Health Corporation's website. Photo by Psycho Crow at Flickr.

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Help Wanted.

Needed: Researchers with several years of experience in a laboratory setting who are able to produce conclusive results from studies on patient-oriented outcomes. The perfect candidate will be familiar with the insufficient evidence that has been collected thus far to determine if the so-called antidiabetic drug rosiglitazone is effective enough to warrant its use in spite of potential side-effects. This candidate will also be aware that rosiglitzone has been shown to raise the risk of edema, increase body weight, and possibly increasing cardiovascular risk.

Research is currently being done on this drug, and a meta-analysis of data from 18 trials that involved close to 8,500 patients are being examined by the Chochrane Systematic Review. Those involved in this study are calling for additional studies to be held to support their analysis and assist them in making a determination of efficacy on this drug.

And just in case you thought I was serious with this, please know that I'm not. Although, the information involving the drug rosiglitazone and its potential side-effects is true. As for the whole job opening thing -- who knows, maybe it's worth looking into.

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There is still no evidence to declare superiority of rapid-acting insulin analogues in the treatment of type 1 diabetes. These studies compared either insulin aspart (NovoLog) or insulin lispro (Humalog) with human insulin; no such study was available for glulisine (Apidra).

Based on average HbA1c values, patients treated with NovoLog had lower levels. However, statistical comparisons were so small that an effect on patients' health is not to be expected. It was also hypothesized that Humalog may prevent night time lows better than Apidra.

Even though patients have been treated with insulin analogues for 10 years, it is still unclear as to how these types of insulin affect long-term complications of type 1 diabetes. The long-term effects of insulin decisively increase the risk of heart disease and cancer, according to recent studies at Howard Hughs Medical Institute. Would you be surprised to learn that one of the insulin analogue manufacturers chose to withhold some of the results of their studies?

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Type 1 is considered an autoimmune disease, and in the last few years, the immune system has been implicated in type 2 diabetes. Imbalances of the immune system's cytokines cause inflammation linked to both forms of diabetes.

The gene 12/15-LO (12/15-lipoxygenase) produces two proteins which convert fatty acids into cytokines. Mice research by Dr. Jerry Nadler and team has determined obesity in and of itself is not the cause of type 2 diabetes. (Many obese people are not type 2s). Studies done on knockout mice -- mice with inoperative genes -- have shown activation of the 12/15-LO gene is the problem. Knockout mice fed an extremely high-fat diet do not develop diabetes.

12/15-LO lies within insulin-producing cells of the pancreas, and its activation causes the cells to malfunction. The gene is also activated by white blood cells called macrophages. Now here is the link to obesity -- macrophages appear in high concentrations in fatty tissues, and imbalances in cytokines become especially pronounced as people become obese. Dr. Nadler's work has identified how large numbers of fat cells stimulate macrophages to activate 12/15-LO, and documented the inflammatory fallout.

Dr. Nadler stated 12/15-LO under normal conditions is likely involved in cell development. But it is only in pathologic conditions that the gene is activated in adults. Dr. Nadler believes blocking 12/15-LO activation could be a new therapy to protect inflammation in the pancreatic beta cells. 12/15-LO is also involved in heart and blood vessel disease and nerve cell death seen in Alzheimer's.

In terms of type 1, Dr. Nadler has found eliminating 12/15-LO in a mouse model results in over 90 percent protection from developing the disease. He is working on identifying the role of the gene in type 1. Read more in Science Daily.

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