Posts Tagged ‘Diabetes’

Stress and the Risk of Weight Gain

July 19, 2014

Stress and weight gain? Yes they are closely associated.  Recently published data from the Biological Psychiatry has closely examined the relationship.

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Background
Depression and stress promote obesity. This study addressed the impact of daily stressors and a history of major depressive disorder (MDD) on obesity-related metabolic responses to high-fat meals.

Methods
This double-blind, randomized, crossover study included serial assessments of resting energy expenditure (REE), fat and carbohydrate oxidation, triglycerides, cortisol, insulin, and glucose before and after two high-fat meals. During two separate 9.5-hour admissions, 58 healthy women (38 breast cancer survivors and 20 demographically similar control subjects), mean age 53.1 years, received either a high saturated fat meal or a high oleic sunflower oil meal. Prior day stressors were assessed by the Daily Inventory of Stressful Events.

Results
Greater numbers of stressors were associated with lower postmeal REE (p = .008), lower fat oxidation (p = .04), and higher insulin (p = .01), with nonsignificant effects for cortisol and glucose. Women with prior MDD had higher cortisol (p = .008) and higher fat oxidation (p = .004), without significant effects for REE, insulin, and glucose. Women with a depression history who also had more stressors had a higher peak triglyceride response than other participants (p = .01). The only difference between meals was higher postprandial glucose following sunflower oil compared with saturated fat (p = .03).

Conclusions
The cumulative 6-hour difference between one prior day stressor and no stressors translates into 435 kJ, a difference that could add almost 11 pounds per year. These findings illustrate how stress and depression alter metabolic responses to high-fat meals in ways that promote obesity.

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Stress indeed can bring about eating the wrong choice of food.  Almost always we can’t avoid stress BUT we can do something about it to avoid stress induced weight gain.

It has always been my recommendation to my patients that one way to avert the temptation of eating wrong foods is to stock our pantry and refrigerator with foods that are healthy like fruits or nuts so one can prepare healthy food choices instead.

 

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Sleep and Diabetes…. The Close Link

October 14, 2013

 

Sleep debt has been considered one major risk factor for developing Diabetes. Stress hormones apparently are increased during times when one is awake instead of being asleep.  Other studies have shown that not only is quantity important but also the quality of sleep.

A study done by the Centers for Disease Control (CDC) involving more than 54,000 participants in 14 states, published in the SLEEP journal, October 2013....showed that sleep duration is critical to the development of disease.

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Study Objective:

To examine the effects of obesity and frequent mental distress (FMD) on the relationship of sleep duration with coronary heart disease (CHD), stroke, and diabetes.

Design: Cross-sectional study.

Setting:Population-based surveillance.

Participants: There were 54,269 adults age 45 y or older who completed the 2010 Behavioral Risk Factor Surveillance System survey in 14 states.

Results:

Nearly one third (31.1% or an estimated 11.1 million) of respondents age 45 y and older reported being short sleepers (≤ 6 h), 64.8% being optimal sleepers (7-9 h), and 4.1% being long sleepers (≥ 10 h) in a 24-h period. Compared with the optimal sleep duration, both short and long sleep durations were significantly associated with obesity, FMD (mental health was not good ≥ 14 days during the past 30 days), CHD, stroke, and diabetes after controlling for sex, age, race/ethnicity, and education. The U-shaped relationships of sleep duration with CHD, stroke, and diabetes were moderately attenuated by FMD. The relationship between sleep duration and diabetes was slightly attenuated by obesity.

Conclusions:

Sleep duration had U-shaped relationships with leading chronic diseases. Further prospective studies are needed to determine how mental health and maintenance of a normal weight may interact with sleep duration to prevent chronic diseases.

Citation:

Liu Y; Wheaton AG; Chapman DP; Croft JB. Sleep duration and chronic diseases among US adults age 45 years and older: evidence from the 2010 Behavioral Risk Factor Surveillance System. SLEEP2013;36(10):1421-1427.

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The study showed that the optimal number of hours of sleep should be 7-9 hours. Short sleepers averaged six hours or less, while long sleepers and averaged 10 hours or more of sleep.  There was an increased prevalence of being overweight and obese and higher rates of chronic diseases like diabetes, heart disease and stroke among the short and long sleepers. 

The study further proves that sleep indeed is a time for the body to regenerate and that rest is key to wellness.

Statins and Diabetes: What’s New?

August 22, 2012

The fear of developing Diabetes due to the use of cholesterol lowering drug Statins made headlines in the past few years.

We use Statins to lower cholesterol known to cause heart attack and stroke. Studies have shown that statins indeed can lower ones risk to suffer a heart attack or stroke. So when the issue of this drug increasing the blood sugar…which then is the lesser evil?

Or are we treating on one disease and in return give rise to another disease?

The recent analysis of the big statin study called JUPITER  published in Lancet August 11, 2012 raised some very important issues that can clear the controversy:

  1. The risk of developing diabetes mellitus with statin therapy is limited to patients already at a high risk for developing diabetes. These individuals include those with impaired fasting glucose, metabolic syndrome, severe obesity, or increased hemoglobin A1c (HbA1c) levels.
     
  2. In these high-risk patients however, the benefits of statin therapy outweighed the risk of diabetes

This is therefore a very welcome development in this area of Medicine.

The Link Between Sleep Apnea and Memory Loss

June 13, 2008
Obstructive Sleep Apnea from the word itself means there is an obstruction to sleep.  As a result majority of our obese diabetics who have OSA almost always have this obstruction corrected, diagnosed and managed because of the complications that can arise for this condition including stroke, heart disease and worsening diabetes.

Partners of patients with sleep apnea will complain that their partners snore a lot, usually stops breathing and awaken repeatedly during the night.  Due to the lack of deep sleep, these patients manifest chronic daytime fatigue with memory lapses and importantly has difficulty  concentrating or focusing.

A new review published in the Neuroscience Letters this June shows that there is a relationship between this condition and the dreaded memory loss. And that this memory loss is not only because of fatigue but structural abnormalities in the brain:
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Obstructive sleep apnea (OSA) patients show compromised emotional and cognitive functions, including anterograde memory deficits. While some memory inadequacies in OSA may result from earlier-described structural deficits in the hippocampus, mammillary body injury also could contribute,
We evaluated mammillary body volumes in 43 OSA and 66 control subjects. Two high-resolution T1-weighted image volumes were collected on a 3.0 T magnetic resonance scanner, averaged to improve signal-to-noise, and reoriented (without warping) into a common space. Brain sections containing both mammillary bodies were oversampled, and the bodies were manually traced and volumes calculated.
  • OSA patients showed significantly reduced left, right, and combined mammillary body volumes compared with control subjects, after partitioning for age, gender, and head size (multivariate linear model, p < 0.05).
  • Left-side mammillary bodies showed greater volume reduction than the right side.
  • Diminished mammillary body volume in OSA patients may be associated with memory and spatial orientation deficits found in the syndrome.
  •  The mechanisms contributing to the volume loss are unclear, but may relate to hypoxic/ischemic processes, possibly assisted by nutritional deficiencies in the syndrome.

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There you go guys…. if you have the symptoms of OSA, have it checked right away.  It can be treated and managed so as to avoid brain injury.  It has been shown that repeated bouts of apnea or lack of oxygen flow to the brain can lead to brian cell death which eventually can lead to memory loss or forgetfullness!!!!

How to address OSA?  If you are obese then try to lose weight.  This is one of the major complications of being overweight and being obese.  We have sleep centers that can manage this disease medically or surgically.

Sleep Debt Equals Health Debt!

Tips For The Insomniacs….

June 11, 2008

One of the common complaints I get from my patients is the inability to sleep.  It may seem so simple but if you are an insomniac, trying to sleep can be a torture.  We all know sleep debt makes us feel weak and sluggish.  But what is not known is that sleep debt can lead to chronic illnesses like an increased risk to develop diabetes and heart disease.

So what should an insomniac do?

Here are some simple tips from the Harvard Health Letter…

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 Changing your behavior, rather than medication, may be the first step to a better night’s sleep. And surprisingly, for chronic insomnia, the best treatment may be to cut back on the time you spend trying to sleep.

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People with insomnia often find that spending less time in bed promotes more restful sleep and helps make the bedroom a welcome sight instead of a torture chamber. As you learn to fall asleep quickly and sleep soundly, the time in bed is slowly extended until you obtain a full night’s sleep.

Some sleep experts suggest starting with five or six hours at first, or whatever amount of time you typically sleep at night. Setting a rigid early morning waking time often works best. If the alarm is set for 7 a.m., a five-hour restriction means that no matter how sleepy you are, you must stay awake until 2 a.m. Once you are sleeping well during the allotted five hours, you can add another 15 or 30 minutes, then repeat the process until you’re getting a healthy amount of sleep.

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Hope this simple formula can work well for you.  If we can do this without any dependence to medications, the better. 

Lastly…Dont go to bed if you’re not sleepy! Dont watch TV! Read a book instead on a dim lighted area favorably with a yellow light! Asscociate your bed with sleep.  Enjoy every minute of your time with your bed.  Dont think of it as a torture chamber!  Just hug your pillow and think about how nice it is to sleep.  Dont think otherwise or you will really find yourself wondering… why you’re still awake and the more you think about it…. the more you will feel frustrated about not going to sleep.

Good Sleep Keeps You Fit!