Treat and even prevent diabetes with ginger: Study finds it improves several markers of the disease


Image: Treat and even prevent diabetes with ginger: Study finds it improves several markers of the disease

Are you doing everything you can to avoid diabetes or control it if you already have it? It’s a frightening illness that can severely impact a person’s quality of life and even lead to death, so it’s only natural that people who are concerned about their health take steps to reduce their risk. Perhaps you’re already avoiding sugar, watching your diet, and getting plenty of exercise, but are you eating enough ginger?

A new study has demonstrated just how powerful ginger’s effects are in fighting this all-too-common disease. Seventy patients with type 2 diabetes participated in a double-blinded, placebo-controlled trial to assess how ginger could affect their glycemic status, inflammatory markers of the condition, and their lipid profile. A control group took a 1600mg placebo, while the ginger group took 1600mg of ginger daily. Measurements were taken at the beginning and end of the study to assess their blood lipids, blood sugar levels, tumor necrosis factor alpha, prostaglandin E2, and C-reactive protein.

The researchers found that those who underwent the ginger treatment had significantly lower levels of quite a few parameters. These include the important fasting plasma glucose, insulin, triglycerides, total cholesterol, and inflammation markers C-reactive protein and Prostaglandin E2. They also had lower levels of glycated hemoglobin, or HbA1C, which measures how much sugar is damaging the body’s red blood cells, and a measurement of insulin resistance known as HOMA.

The amount of ginger the patients took equated to 1.6 grams, which is not a very big amount; it’s roughly equivalent to just ¼ of a teaspoon. They took it in capsule form in doses of 800mg twice per day.

A family of diabetes fighters

Ginger comes from the same family of plants as turmeric, which was shown in a recent study published in the journal Diabetes Care to be 100 percent effective in preventing people with prediabetes from developing full-fledged diabetes.

In the placebo-controlled, double-blinded and randomized study, researchers in Thailand divided 240 prediabetic participants into groups, one of which was given 250 mg of curcuminoid daily, while the other served as a control. A variety of parameters were measured at the beginning of the study and every three months up until nine months, and the researchers reported that while 16.4 percent of those in the placebo group went on to develop type 2 diabetes, nobody in the curcumin group developed the illness.

That’s a remarkable accomplishment, and it is excellent news for the two out of five Americans aged 40 to 74 who are estimated to have prediabetes. After all, curcumin is found in turmeric, which is not only easy to find and affordable, but also very safe.

Consuming more ginger and turmeric is easy

It’s easy to incorporate more ginger and turmeric into your diet, and doing so can give you a fighting chance against diabetes in addition to many other health benefits. The two flavors complement one another well and can be used to create stews, curries, chicken dishes and aromatic rices for a one-two punch. The easiest way to consume more ginger and turmeric is by making a simple tea out of them; you can add flavors like cinnamon, lemon or honey if desired.

You can also add them, individually or separately, to smoothies or soups. Ginger has a more noticeable presence, so it won’t work in just any soup, but it does pair nicely with carrots and other vegetables.

Turmeric has a subtler flavor, which means you can add it to eggs, vegetables, smoothies and soups without worrying about affecting the flavor too much. Many people like to consume it with milk. Just remember to consume a small amount of black pepper with the turmeric to help your body absorb it.

Turmeric and ginger capsules are also available, but it’s important to get organic varieties from trusted sources to ensure you are getting a pure product.

Why Fasting Is Such a Powerful Treatment Strategy for Diabetes


Story at-a-glance

  • An estimated 30.3 million Americans, nearly 1 in 10, have Type 2 diabetes. Another 84 million American adults — about 1 in 3 — are prediabetic, defined as an elevation in blood glucose over 100 mg/dl
  • Any fasting blood sugar regularly over 90 mg/dl really suggests insulin resistance, and work by the late Dr. Joseph Kraft suggests 80 percent — 8 out of 10 — Americans are in fact insulin resistant
  • Type 2 diabetes is curable, and the cure is less than inexpensive — it’s free. You actually save money, as the remedy is to fast and not eat anything for a number of days on a regular basis
  • Type 2 diabetes should not be treated with insulin, as insulin forces glucose into cells that are already saturated with excess glucose and cannot take in more. Instead, the glucose gets turned into fat, which is why insulin injections result in dramatic weight gain
  • The answer for Type 2 diabetes is to stop feeding your body sugar and burn off the sugar already in your cells, and the most effective way to do this is fasting

By Dr. Mercola

We have an epidemic of diabetes in the United States. An estimated 30.3 million Americans, nearly 1 in 10, have Type 2 diabetes.1 Another 84 million American adults — about 1 in 3 — are prediabetic, and most are unaware of this fact. Prediabetes2 is defined as an elevation in blood glucose over 100 milligrams per deciliter (mg/dl) but lower than 125 mg/dl, at which point it formally becomes Type 2 diabetes.

However, any fasting blood sugar regularly over 90 mg/dl really suggests insulin resistance, and seminal work by the late Dr. Joseph Kraft, author of “Diabetes Epidemic and You: Should Everyone Be Tested?” suggests that 80 percent — 8 out of 10 — Americans are in fact insulin resistant,3 which means they’re already on their way toward developing diabetes.

That’s the bad news. The good news is Type 2 diabetes is curable, and the cure is less than free. It actually saves you loads of time and money. In his book, “The Diabetes Code: Prevent and Reverse Type 2 Diabetes Naturally,” Dr. Jason Fung details how to address this exceptionally common problem.

Fung is a nephrologist (kidney specialist) with a practice in Toronto. Two years ago, I interviewed him about fasting, which is one of the most powerful interventions for Type 2 diabetes and insulin resistance. Fung was also one of the experts who peer reviewed my book, “Fat for Fuel,” which integrates some of his work.

Why Identifying Insulin Resistance Is so Important

There are two types of diabetes, Type 1, or insulin dependent diabetes, and Type 2 diabetes, which is lifestyle related. Type 2 diabetes accounts for 90 to 95 percent of all diabetes cases and is the topic of this particular discussion. Prevalence of Type 2 diabetes started to rise in the 1980s, at a time when obesity had yet to become a significant trend. However, as obesity became more prevalent, so did Type 2 diabetes.

“But the fundamental underlying problem of Type 2 diabetes, which is insulin resistance, is actually much more widespread than that,” Fung says. “And the innovative thing Kraft did was that he took a standard glucose tolerance test, and measured blood insulin levels instead of blood glucose. Because if you think about what’s happening, when you ingest 75 grams of glucose [the amount administered prior to the test], your blood glucose may stay normal.

But, your body may be producing a huge amount of insulin to really shove that glucose into the cell. Because one of the functions of insulin is to move the glucose from the blood into the cell. Insulin resistance refers to the fact that blood glucose is simply not getting in there. So, if your body needs to produce two, three, four, five times the amount of normal insulin to get that glucose in there, you have a problem, which is not detectable if you just measure blood glucose.

Because, yes, you are shoving all that glucose into the cell, but it took you a huge amount of effort to do so. And by [using the] Kraft assay, which looks at how much the insulin goes up, you can detect [insulin resistance] at a much earlier stage. This is important because there are things we can do about reversing … insulin resistance, and the sooner we get to it, the sooner we can get on the path to wellness.”

Ultimately, diabetes is just one symptom. Insulin resistance, which results in mitochondrial dysfunction, is also at the heart of cancer, heart disease, Alzheimer’s and other degenerative diseases, and it all starts because your body is unable to burn fat as a primary fuel. When your body relies primarily on sugar instead, more reactive oxygen species (ROS) are generated, which damage the mitochondria in your cells.

Why Fasting Resolves Insulin Resistance, the Cause of Diabetes

Fasting has been used for thousands of years to keep us well. Once you understand what insulin resistance actually is and what Type 2 diabetes is, then you’ll understand why something so simple as abstaining from food for a period of time can be such a powerful intervention. Contrary to infectious diseases, you cannot treat metabolic disease with a pill, because metabolic diseases such as diabetes are predicated on lifestyle, primarily diet. As explained by Fung:

“You have to use metabolic treatments, which is why using fat for fuel is so important. It really gets to the point that you cannot follow this old paradigm [of drug treatment] because you’re going to fail … Remember, the glucose goes into the cell, and insulin resistance is when the glucose doesn’t go out of the cell. So, for years we’ve used this paradigm of lock and key.

That is, the cell is sort of gated off. Outside the cell there’s blood, and when insulin comes around it turns the key, opens the gate and glucose goes in. So, if insulin is there, why is the glucose not going in? … You can measure the insulin and the insulin level is high. You can look at the insulin receptor, the gate is completely normal.

So, [conventional medicine] said something like, ‘Well, maybe there’s something gumming up the mechanism. It’s stuck in the lock so it doesn’t open properly, therefore the glucose can’t get into the cell. There’s a huge problem with this sort of paradigm, because if that is happening, the cell has no glucose and should be starving.

You should be losing lots of weight; you’d have a very thin liver. All your fat should just melt away, because if you think about untreated Type 1 diabetes, where you don’t have enough insulin, that’s exactly what happens. The cell literally starves and everything just wastes away … But that’s not what’s happening here.

In Type 2 diabetes you see that people are generally obese, they have large abdomens … What’s happening instead is that it’s actually an overflow syndrome. The cell can’t accept any more glucose because it’s jam packed full of glucose already. That’s the reason you have insulin resistance. Insulin is trying to move glucose into the cell but the cell is full … So, it’s really an overflow mechanism …

That’s also why your liver is full — it’s a big fatty liver. The liver is busy trying to get rid of all this glucose by turning it into fat … Now, if Type 2 diabetes and insulin resistance are the same sort of thing, it’s really about too much sugar. That’s the bottom line.

And if you understand that the whole problem is too much sugar, then the solution is not to use more insulin to jam more glucose into an already full cell. The key is to get rid of it all. So, what you want to do is: 1) Don’t put more sugar into your system, because you have too much sugar in already, and 2) Burn it off.”

Why Exercise Cannot Replace Fasting

To avoid adding sugar into your body it is important to adopt a cyclical low-carb, high-fat diet, which I detail in “Fat for Fuel.” Then, to burn off the sugar already in your system, intermittent fasting or time-restricted eating is a powerful tool. Exercise is not the solution for diabetes, and cannot replace fasting.

Remember, you can’t out-exercise your mouth. The reason for this is because you not only have insulin resistance in your muscles, but in all your tissues and organs, and to eliminate the excess glucose in your organs you need to temporarily “starve” the cells. Clearly, you should exercise, but that will only burn the glycogen in your muscles. It’s not going to address your fatty liver. As noted by Fung, fasting “gets rid of all the sort of excess nutrients.

That’s why, historically, people called it a cleanse or a detox, because that’s really what it is.” In his practice, Fung has used fasting for many years and can attest to the dramatic turnarounds possible. “We have people coming in with the most severe diabetes; they’re taking hundreds of units of insulin a day, and within three to four weeks we have them off everything.” Oftentimes, a severe diabetic can revert back to being nondiabetic within as little as two months.

Taking Insulin Worsens Type 2 Diabetes

This is not to say it’s easy. Fasting can be difficult when you’re used to eating multiple times a day. But it’s a natural way that will allow your body to heal itself. Meanwhile, taking insulin for Type 2 diabetes is about the worst thing you can do. As explained by Fung:

“What happens when you give insulin is that insulin lets your body use all that glucose, and when there’s too much glucose, it’s just going to [turn it into] fat. So, all these patients gain weight. And they always come back and say, ‘Whoa doc, you’ve told me I need to lose weight, then you give me insulin and I’ve gained 20 pounds. How is that good?’

And the answer is that it’s not. As you gain more weight your diabetes gets worse, which means you need to take more insulin, which means you’re going to gain more weight. They can see themselves spiraling down the drain, and the doctors do nothing but give them more insulin. It doesn’t even make any sense because the underlying issue is the hyperinsulinemia and insulin resistance. That is, if you look at Type 2 diabetes, insulin levels are very high.

So [why give] more insulin in a situation where you have too much insulin already? If you have hyperthyroidism, if you have too much thyroid hormone, you don’t give more thyroid hormone. If you have an alcoholic, you don’t give more alcohol. It’s the exact wrong thing to do. In fact, if your levels of insulin are too high and that’s your disease, you need to lower insulin. By giving insulin, you’re actually making the fundamental problem much worse.”

How Fasting Benefits Your Mitochondria

Fasting is the most profoundly effective metabolic intervention I’m aware of. It’s like getting a free stem cell transplant, and it massively upregulates autophagy and mitophagy. It also stimulates mitochondrial biosynthesis during the refeeding phase, which allows your body to naturally regenerate. For these reasons, fasting is not only beneficial for Type 2 diabetes and obesity but also for health in general, and likely even longevity.

There’s even evidence to suggest fasting can help prevent or even reverse dementia, as it helps your body clean out toxic debris. As noted by Fung, “It’s fundamentally one of the keys of wellness.” By lowering insulin, you also increase other important hormones, including growth hormone (aka the fitness hormone), which is important for muscle development and general vitality.

Other ailments that can benefit from fasting include polycystic ovaries, polycystic kidneys and fast growing cancer cells. The reason for this is because when autophagy increases, your body starts breaking down old protein, including fast growing cells. Then, during the refeeding phase, growth hormone increases, boosting the rebuilding of new proteins and cells. In other words, it reactivates and speeds up your body’s natural renewal cycle.

Getting Started

Most people fear being hungry and avoid it like the plague. Here, intermittent fasting can make the process a lot easier. Before I tried my first five-day water fast, I increased my intermittent daily fasting to the point that I was fasting for 20 hours a day for a few months, but one month is likely sufficient.

At that point, going several days without food was easy, since my body had had gained metabolic flexibility and was able to burn fat as my primary fuel, Most people get really hungry by Day Three on a water fast, yet I had no hunger at all. Fung agrees, saying:

“That’s a great point. If you are fueling yourself primarily with carbohydrates, then you can’t use fat very well … So, when you transition from a predominantly carbohydrate diet to a predominantly fat-based diet, your body can’t store glycogen, because those are chains of glucose, it needs to burn body fat (or dietary fat). To your body it’s sort of the same thing, they’re just triglycerides.

When you biopsy muscle over a period of several weeks, you can actually see the that the machinery necessary to burn triglycerides for fuel increase. You see expression of genes increasing that are able to use the fat. So, if you go from a standard 50 or 60 percent carbohydrate diet to fasting … your muscles are going to be weaker, because they’re used to glucose. They’re like, ‘Where’s my glucose?’

You have triglycerides [but] you can’t use it at first. Some people call it keto flu. But, over a period of about two weeks or so, your body gets used to it. So, an easy transition is to switch over to a very low-carbohydrate, high-fat diet, so that your body is used to using fat.

You’re not fasting per se, but your body gets used to burning fat for fuel. The other thing is you can start lengthening your period of fast. You should be fasting every day … Whether it’s 12 hours or 14 hours. There should be a period in there that you’re fasting. Then you extend it, so that you gradually go to 16 hours, 18 hours, 20 hours and then 24 hours, and then kind of go into it from there. Those are two ways to ease the transition and make the fasting easier …

Even shorter periods of fasting of 24 to 36 hours have a lot of benefits. You start to get into that period where you’re depleting your glycogen and you’re getting into fat burning. You start to see autophagy start around 24 to 30 hours as well. One of the other benefits people talk about nowadays is this sort of bio-hacking.

People, especially in Silicon Valley, are fasting because it gives them more mental capacity. Their brain works better; they find they’re clearer and they can think better. So, this is a free way to boost your brain power. So yeah, there’s all different regimens, and there’s all different ways to ease into it. But the key is to just get started.”

How to Minimize Side Effects

Gradually easing into longer fasts will naturally minimize most side effects associated with fasting, as will transitioning over to a high-fat, low-carb diet, to help your body to adjust to using fat as a primary fuel. The so-called “keto flu” is often related to sodium deficiency, so it’s recommended to take a high-quality unprocessed salt each day. I typically pour salt in my hand and lick it throughout the day when fasting, as I obviously can’t put it on food. This will also help reduce the likelihood of intractable muscle cramps at night.

Headaches are also common when you first start water fasting. These too can often be minimized by taking salt. An alternative to eating salt straight, or putting it in water, is to add it to a bit of bone broth. Another important mineral is magnesium. It’s particularly important if you are diabetic, as magnesium deficiency is very common among Type 2 diabetics. This is another possible culprit if you’re getting muscle cramps.

There are several types of magnesium, some of which are more poorly absorbed than others. During water fasting, your best bet is to use Epsom salt baths, as this allows your body to absorb the magnesium through your skin rather than your digestive tract. Magnesium has a laxative effect in high doses, and when you’re not eating anything, oral magnesium can easily result in “disaster pants.” Multivitamins can also be useful during extended fasts, especially if you’re doing them regularly.

It is also important to understand that if you are on a multiday water fast you will liberate many toxins from your fat stores, so using an infrared sauna and taking effective binders, like chlorella, modified citrus pectin, cilantro or even activated charcoal can help eliminate these liberated toxins from your body and prevent their reabsorption.

Work With a Knowledgeable Physician if You’re on Any Medications

While fasting is a profoundly effective intervention for Type 2 diabetes, you do need to use caution if you’re diabetic. If you are taking medication, especially for your blood sugar, you have to make sure you talk to your doctor, because there’s a risk your blood sugar may end up dipping too low. If you’re taking insulin, and keep taking insulin while fasting, you could get into trouble.

“Some people say that for that reason, Type 2 diabetics should never fast. But that’s not true,” Fung says. “What’s true is that you need to adjust the medication in anticipation of [your blood] sugar going down … So, if you’re on these medications for diabetes, you need to make sure you monitor very closely and make sure that your blood sugar doesn’t go too low.

Remember, the fasting is going to drive your blood sugars down, and your insulin or your medications will drive your blood sugars down, so you’ve got kind of two things driving your blood sugars down. All of a sudden you go low, you can have seizures, you can wind up in the emergency room and you could absolutely die.

And that’s one of the things you have to be very careful of. So yes, you can do it, but you have to make sure you do it in a supervised setting with somebody who knows what they’re doing.”

Why You Need Not Fear Starvation

Last but not least, one of the greatest fears people have about fasting is the concept of starvation and the loss of lean muscle mass. In his book, Fung explains why such fears are overblown. Your metabolic rate is the energy your body uses to generate body heat and keep your organs working. Your body basically needs a certain number of calories a day. People have a tendency to think that skipping a meal means your metabolic rate will decrease.

In reality, the exact opposite occurs. In studies looking at basal metabolic rate, people’s metabolic rate is actually 10 percent higher at the end of a four-day fast than at the beginning. So, your body is not shutting down, it’s actually ramping itself up. The reason for this has to do with counterregulatory hormones. As insulin drops, counterregulatory hormones go up.

Some of these activate your sympathetic nervous system (the so-called fight or flight response). “So, as you fast, all these hormones are going up, your sympathetic nervous system is going up, your adrenaline is going up, your growth hormone’s going up,” Fung says.

“Obviously, if you’re pumping your body full of adrenaline, your basal metabolic rate is not going down. In fact, it maintains itself, which is in distinction to calorie restriction diets where, if you just try and cut a few calories a day, your metabolic rate will go down. The growth hormone is also important because of [its] protein sparing effect …

When you study people fasting, you don’t see an increase in burning of protein. There is a normal turnover. But at the end of it, because your growth hormone is so high, when you eat again, you will make up these new proteins. So, it’s actually much healthier for you because you’re getting rid of all protein and you’re bringing new protein.”

More Information

If you’re among the 80 percent of people who are insulin resistant, get yourself a copy of Fung’s brand-new book that comes out April 3, “The Diabetes Code: Prevent and Reverse Type 2 Diabetes Naturally.” Fung’s book, “The Complete Guide to Fasting,” is another excellent resource. As Fung says, we’ve known that fasting is beneficial for thousands of years. We just strayed away from it, and we need to re-embrace this foundational aspect of health.

“[A few years ago] somebody was telling me about fasting and I thought, ‘Well that’s the dumbest thing I’ve ever heard of.’ And then I thought, why? Why was this so silly? I dug into the research and then I just started doing it.

I probably have more clinical experience, truthfully, than anybody in the world, and that’s not hard because nobody was doing it a few years ago. And now it seems so obvious that [fasting is] the solution … You don’t eat, then your blood sugar comes down, you lose weight and your diabetes gets better. There’s the solution right there.”

8 Health Conditions That Disproportionately Affect Black Women


And what you can do to prevent some of them
black-women-diseases-health-conditions

Although being black in this world certainly comes with its struggles, I wouldn’t trade that integral part of my identity for anything. Black-girl magic is real. But it’s a sad fact that black women are often plagued with disproportionately high incidences or mortality rates for various health conditions, like heart diseasebreast cancer, and more.

It sounds scary—and it can be—but knowledge is power, especially when it comes to your physical and mental health. Here are eight health conditions black women should be especially aware of, plus how to best prevent them.

1. Heart disease, stroke, and diabetes

These conditions often occur together or exacerbate each other, and they’re striking black women hard.

Around 7.6 percent of black women have heart disease, compared to 5.8 percent of white women and 5.6 percent of Mexican-American women, according to Centers for Disease Control and Prevention data from 2011-2013. In 2016, around 46 of every 100,000 black women died from strokes, while 35 of every 100,000 white women did. And while white women’s diabetes diagnosis rate is 5.4 per 100, that number is 9.9 per 100 for black women, according to CDC data from 1980-2014—almost double.

Infographic of the heart disease/stroke/diabetes racial disparities

A group of risk factors known as metabolic syndrome increases a person’s chance of getting these diseases. These risk factors include having a waist circumference above 35 inches in women and 40 inches in men, high levels of triglycerides (fat in the blood), a low HDL (“good”) cholesterol level, high blood pressure, and high fasting blood sugar.

Someone must have at least three of these factors to be diagnosed with metabolic syndrome, but having even one can signal higher chances of getting heart disease, stroke, and diabetes. Those first two are particularly lethal, killing one woman about every 80 seconds.

The black community’s obesity crisis is a symbol of just how at-risk this segment of the population is. “The vast majority of African-American adult women are either overweight or obese,” Hilda Hutcherson, M.D., professor of obstetrics and gynecology at Columbia University Medical Center, tells SELF. While 37.6 percent of black men ages 20 or over are obese according to the latest data, that number jumps to 56.9 percent for black women. It stands at 36.2 percent for white women.

Various genetic components are likely at play with metabolic syndrome—for instance, some research points to a gene that might make black people more sensitive to salt, thus influencing blood pressure—but much of this issue is societal.

“It’s the foods we eat—many communities don’t have easy access to healthier options,” Dr. Hutcherson says. A 2013 study in Preventive Medicine found that “poor, predominantly black neighborhoods face…the most limited access to quality food.” Dr. Hutcherson also cites stress and adds that a lack of exercise can be a problem, too, if it’s hard to get access to a gym or the neighborhood isn’t safe.

Lifestyle changes like eating better, exercising, and stopping smoking can prevent 80 percent of heart disease events and stroke and lower people’s chances of developing diabetes, according to the CDC. But clearly, that’s sometimes easier said than done.

2. Breast cancer

Black women have a 1 in 9 chance of developing breast cancer; for white women the odds are 1 in 8, according to the American Cancer Society. But black women are more likely to die from the disease: White women’s probability of dying from breast cancer is 1 in 37, while black women’s is 1 in 31.

“The reasons why black women are more likely to die [from breast cancer than other groups] are very complex,” Adrienne Phillips, M.D., oncologist at Weill Cornell Medicine and NewYork-Presbyterian, tells SELF, citing “an interplay between genetics, biology, and environment.”

Along with BRCA mutations (which may be higher in black women than experts previously thought), black women are more likely to get triple-negative breast cancer—a particularly aggressive form of the disease—than women of other races. Then there are the environmental factors Dr. Phillips mentions, like socioeconomic issues that lead to trouble accessing early diagnosis and treatment.

Much like metabolic syndrome, lowering your risk of getting breast cancer mainly comes down to exercising, maintaining a healthy weight, not going overboard on alcohol, and quitting smoking. And even though major organizations haven’t found a notable benefit from breast self-exams, many doctors strongly recommend you check your breasts monthly so you’re aware of any changes.

3. Cervical cancer

Research published in January in the journal Cancer found that not only are black women more likely to die of cervical cancer than women of other races, they’re also 77 percent more likely to die from it than experts previously thought. Prior estimates said 5.7 black women per 100,000 would die of the disease, but this new research puts the number at 10.1 per 100,000.

“Unlike breast cancer, cervical cancer is absolutely preventable in this day and age,” Dr. Phillips says. “In 2017, no woman should be diagnosed with cervical cancer.”

That’s partly because the HPV vaccine is excellent at preventing infection of certain strains of human papillomavirus that can go on to cause cancer. But as of August 2016, only 6 out of 10 girls ages 13 to 17 and 5 of 10 boys in the same age range had started the vaccine series, which doctors recommend getting before age 26 for optimal results. Racial disparities are relevant here—a 2014 report from the CDC showed that around 71 percent of white girls 13 to 17 had completed the three-shot series, compared with about 62 percent of black girls in that age group. (The CDC changed these recommendations in 2016: It now says only two doses are necessary for optimal protection if the patient is between 11 and 12, but three are still ideal if the patient is between 15 and 26.)

Timely Pap smears are also wonderfully effective at preventing full-blown cervical cancer. “A Pap smear will detect preinvasive cervical cancer, but…studies have shown women who are having Pap smears may not get appropriate follow-up,” Dr. Phillips says. “A number of barriers exist for proper follow-up, and African-American women may be more vulnerable.”

Another potential factor, though, may be racial disparities in cervical cancertreatment. A 2014 study published in Plos One found that black women in Maryland were significantly less likely than white women to get surgery for cervical cancer instead of radiation or chemotherapy.

“Equivalent treatments are not being administered to white and black patients with cervical cancer in Maryland,” the study authors concluded. “Differences in care may contribute to racial disparities in outcomes for women with cervical cancer.”

A 2016 study in the Journal of Obstetrics and Gynecology reached a similar conclusion. The study looked at more than 16,000 patients who had received care for advanced cervical cancer, finding that white women received National Cancer Institute guideline–based care 58 percent of the time, black women 53 percent of the time, and Hispanic women 51.5 percent of the time.

4. Fibroids

Black women are three times more likely than women of other races to get uterine fibroids, noncancerous tumors in the walls of the uterus, according to the Department of Health and Human Services Office on Women’s Health. Fibroids are largely genetic, and there’s no known way to prevent them.

“Most of the time, women don’t know they have fibroids because they don’t have symptoms,” Dr. Hutcherson says. “But when [the fibroids] start to grow or increase in number, they can cause a large number of problems, from pain to bleeding to miscarriages, to problems with urination and problems with bowel movements.”

When fibroids do make themselves known, the first sign is often heavy bleedingor pelvic pain, Dr. Hutcherson says.

These symptoms can have a lot of other causes, but if you do have fibroids, you and your doctors can work on a treatment plan. To tackle heavy bleeding and pelvic pain, your doctor may recommend hormonal birth control. But doctors can also perform a myomectomy to remove the fibroids or use techniques like uterine artery embolization and radiofrequency ablation to either block the fibroid from getting nutrients or shrink it.

If you’re done having children or are not interested in having them in the first place, as a last resort, doctors can perform a hysterectomy to put a definitive end to fibroids. Since this makes it impossible to get pregnant, it’s an incredibly delicate decision that varies from woman to woman.

5. Premature delivery

Giving birth prematurely, or going into labor before 37 weeks of pregnancy, can predispose a child to breathing issues, digestive problems, brain bleeding, and long-term developmental delays. It can also lead to death—the earlier a baby is born, the higher this danger becomes.

Unfortunately, black women are particularly susceptible to going into labor too early. According to the CDC, the 2015 preterm birth rate in black women was 13 percent; for white women it was 9 percent.

Infographic of the preterm birth rate racial disparity

“This is multifactorial—it can be affected by obesity, by stress, by diet, by increased vaginal infections, and the decreased access to care in some of our populations,” Dr. Hutcherson says. Women having access to prenatal care is incredibly important for slashing the risk of preterm birth, but when socioeconomics come into the picture, it becomes a complex situation with too few solutions. However, the CDC’s Division of Reproductive Health is working on a variety of state- and national-level initiatives to reduce preterm birth in all women.

6. Sickle cell disease

This is an umbrella term for a collection of inherited, lifelong blood disorders that around 1 of every 365 black babies is born with, according to the CDC. Sickle cell disease is caused by a sickle hemoglobin, which happens when the structure of a person’s hemoglobin, the protein that carries oxygen to the red blood cells, is abnormal. Instead of being circular, their red blood cells can look like sickles, a C-shaped farming tool, Dr. Phillips explains.

Sickle-shaped red blood cells can get destroyed in the blood stream, so patients may become anemic. These cells can also clog blood vessels, which can lead to infection, chest pain, and even stroke. And if a pregnant woman has sickle cell disease, it increases the probability of miscarriage, premature birth, and having a baby with a low birth weight, according to the March of Dimes.

Black women who are considering children should get screened for sickle cell no matter what, Dr. Phillips says. It’s possible to not have the disease but have the sickle cell trait, meaning you inherited one sickle cell gene and one normal gene from your parents. If your partner also has sickle cell trait, there is a 25 percent chance your child will inherit sickle cell disease. According to a CDC estimate from 2014, 73 out of every 1,000 black newborns was born with sickle cell trait, compared with 3 out of every 1,000 white newborns.

With proper care and caution to avoid complications, kids with sickle cell disease can live healthy, happy lives, Phillips says—it’s essential for their parents to get the proper education about how to keep them safe.

7. Sexually transmitted diseases

Here’s a bit of good news: Rates of reported chlamydia cases in black people decreased 11.2 percent from 2011 to 2015, according to the CDC. There was a similar downward trend with gonorrhea, which declined 4 percent in that time frame. But black women still outpace other groups when it comes to new diagnoses of these diseases, along with new diagnoses of syphilis.

This problem also extends to HIV/AIDS. Besides black men, black women comprise a majority of new HIV/AIDS diagnoses per year (although the number is thankfully falling). For example, according to the CDC, in 2015, 4,524 black women were diagnosed with HIV in the United States, while 1,431 white women and 1,131 Hispanic/Latina women received the same diagnosis.

“It’s not like black women are having more sex than anyone else,” Dr. Hutcherson says. “Access to good preventive care is the crux of it—if [women] could see health care providers on a regular basis and be educated about what they should be doing to take care of themselves, we probably wouldn’t have as much of a problem.”

Economic insecurity is also an element—condoms and dental dams cost money, after all—as is a general reticence to discuss safe sex.

“There’s a stigma around talking about sex, so people engage in risky sexual activity without protection,” Dr. Hutcherson says.

8. Mental health issues

In addition to the usual biological culprits that can contribute to mental illnessissues, economic insecurity and racism can negatively impact mental health status in the black community.

Overall, black people are 10 percent more likely to report experiencing serious psychological distress than white people, according to the Department of Health and Human Services Office of Minority Health.

“In 2017, we still face a lot of economic insecurity and racism in general. It’s a problem that causes stress and anxiety, which then can lead into depression, and that’s something we never discuss,” Dr. Hutcherson says. “I wish we could make it more acceptable to talk about this and seek care.” Just like in many other cultures, the black community is wrestling with the stigma of seeking help for mental distress. There’s also the reduced access to this kind of counseling in the first place, and the fact that mental health care can be prohibitively expensive. Many counselors, psychologists, and psychiatrists don’t take health insurance, which may deter people from getting the help they need. Combined, these factors resulted in 9.4 percent of black adults getting mental health treatment or some form of counseling in 2014 versus 18.8 percent of white people age 18 and older, per the Office of Minority Health.

Black women are especially vulnerable to wrestling with their mental health, consistently reporting higher feelings of sadness, hopelessness, worthlessness, and the sense that everything is an effort than white women do. “Black women are frequently the pillars of our community, taking care of everyone’s health but our own,” Dr. Phillips says. “But it’s very important for women to practice self-care and not forget about themselves when trying to be so strong.”

If you or a loved one is struggling with mental health, help is out there. The National Alliance on Mental Illness has a comprehensive page about mental health concerns in the black community and a help line that operates Monday through Friday, 10 A.M. to 6 P.M. NAMI also provides a list of 25 different help lines people can turn to when they need support.

How to decrease your risk for a heart attack


Heart disease

Heart disease kills more than 600,000 Americans each year – making it the most deadly killer in the United States. But the good news is that there are many things you can do to decrease your risk of succumbing to this all too common killer. Written by Matthew Budoff, the book Enhancing Heart Health: Preventing a Heart Attack breaks down important need-to-know statistics regarding heart disease, while providing relatively easy ways to improve their heart health. Budoff writes:

CVD (Cardiovascular Disease) has claimed the lives of more females than males. And the gap between male and female deaths has increased dramatically … In addition, black females are more at risk than white females. According to the statistics, a woman dies of heart disease every minute, more than half a million each year. Annually, heart disease kills 10 times more women than breast cancer.

Men and women experience and react to heart disease differently. According to the Center for the Advancement of Health, women take significantly longer to seek care for their heart symptoms than men do.

Studies indicate that women usually wait more than six hours before seeking medical attention, while men wait five hours on average.

A marked difference is also apparent in the symptoms of women and men. Women typically describe their chest pain as sharp, rather than the “classic” male complaints of pressure, heaviness or tightness in the center or left side of the chest.

In addition, women are more likely to describe other symptoms that are not necessarily related to the chest pain. These symptoms include back pain, nausea, and indigestion. Thus, doctors are less likely to recognize a heart attack in women.

Improving Your Odds

High blood pressure, high cholesterol levels, and elevated homocysteine can increase your chances of developing heart disease or dying of a heart attack. But other controllable factors can also increase your risk of these three conditions.

• Overweight or obesity
• Lack of physical activity
• Cigarette smoking
• Diabetes
• Increased and uncontrolled stress and anxiety
• Poor diet

Fortunately, because these factors are controllable, you can increase your odds of avoiding heart disease by making better lifestyle choices. Even more promising, if you’ve been diagnosed with heart disease or have had heart problems in the past, you can reverse that negative process by making positive changes. A comprehensive plan of attack is the most effective strategy.

Cigarette and tobacco smoke

  • Smokers’ risk of heart attack is more than twice that of nonsmokers.
  • Cigarette smoking is the biggest risk factor for sudden cardiac death: smokers have two to four times the risk of nonsmokers.
  • Smokers who have a heart attack are more likely to die and die suddenly (within an hour) than are nonsmokers.

High blood cholesterol levels

  • The risk of coronary heart disease rises as blood cholesterol levels increase.
  • High blood pressure
  • High blood pressure increases the heart’s workload, causing the heart to enlarge and weaken over time.

Physical inactivity

  • Regular, moderate-to-vigorous exercise plays a significant role in preventing heart and blood vessel disease.
  • Exercise can help control blood cholesterol, diabetes and obesity as well as help to lower blood pressure in some people.
  • Exercise is one of the best ways of raising HDL, or “good” cholesterol.

Obesity and overweight

  • People who have excess body fat are more likely to develop heart disease and stroke even if they have no other risk factors.
  • Being overweight is directly linked to coronary heart disease because it influences blood pressure, blood cholesterol and triglyceride levels, and increases the risk of diabetes.

Diabetes mellitus

  • Diabetes seriously increases the risk of developing cardiovascular disease.
  • More than 80 percent of diabetics die of some form of heart or blood vessel disease.

 

Heart Failure, Saxagliptin, and Diabetes Mellitus: Observations from the SAVOR-TIMI 53 Randomized Trial.


Diabetes mellitus and heart failure frequently coexist. However, few diabetes mellitus trials have prospectively evaluated and adjudicated heart failure as an end point.
METHODS AND RESULTS: A total of 16 492 patients with type 2 diabetes mellitus and a history of, or at risk of, cardiovascular events were randomized to saxagliptin or placebo (mean follow-up, 2.1 years). The primary end point was the composite of cardiovascular death, myocardial infarction, or ischemic stroke. Hospitalization for heart failure was a predefined component of the secondary end point. Baseline N-terminal pro B-type natriuretic peptide was measured in 12 301 patients. More patients treated with saxagliptin (289, 3.5%) were hospitalized for heart failure compared with placebo (228, 2.8%; hazard ratio, 1.27; 95% confidence intercal, 1.07-1.51; P=0.007). Corresponding rates at 12 months were 1.9% versus 1.3% (hazard ratio, 1.46; 95% confidence interval, 1.15-1.88; P=0.002), with no significant difference thereafter (time-varying interaction, P=0.017). Subjects at greatest risk of hospitalization for heart failure had previous heart failure, an estimated glomerular filtration rate </=60 mL/min, or elevated baseline levels of N-terminal pro B-type natriuretic peptide. There was no evidence of heterogeneity between N-terminal pro B-type natriuretic peptide and saxagliptin (P for interaction=0.46), although the absolute risk excess for heart failure with saxagliptin was greatest in the highest N-terminal pro B-type natriuretic peptide quartile (2.1%). Even in patients at high risk of hospitalization for heart failure, the risk of the primary and secondary end points were similar between treatment groups.
CONCLUSIONS: In the context of balanced primary and secondary end points, saxagliptin treatment was associated with an increased risk or hospitalization for heart failure. This increase in risk was highest among patients with elevated levels of natriuretic peptides, previous heart failure, or chronic kidney disease.

Antidiabetic Drugs May Threat Your Bladder.


Latest research published in Canadian Medical Association Journal has indicated that one class of Antidiabetic drug may increase the risk of bladder cancer.

 According to the WHO diabetes can be defined as,

“The term “diabetes mellitus” describes a metabolic disorder of multiple aetiology characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action, or both”.

There are almost 346 million people who are suffering from diabetes mellitus and in 2004 3.4 million people died due to increased blood sugar.  (WHO)

Diabetes

Now this recent research may increase the rate of death among diabetic patients due to drug induced bladder cancer. The researchers have conducted a systematic review and meta-analysis to determine the chances of bladder cancer in adults suffering from type 2 diabetes mellitus using thiazolidinediones. They suggested that type 2 diabetic patients have 40% more chances of development of cancer.

This study was conducted on more than 2.6 million diabetic patients. Among them, 3,643 were those diabetic patients who were recently diagnosed bladder cancer.

Yeffrey Johnson of the School of Public Health at the University of Alberta gives the statement that,

“We observed an increased risk of bladder cancer associated with the use of thiazolidinediones,”

He further added,

“In particular, use of pioglitazone was associated with an increased risk of bladder cancer based on a pooled estimate from three cohort studies involving more than 1.7 million individuals.”

This study was also done on another drug named as rosiglitazone (another type of thiazolidinedione), but researchers have not determined any effect fortunately.

Researchers give a very useful statement that,

“Although the absolute risk of bladder cancer associated with pioglitazone was small, other evidence-based treatments for Type 2 diabetes may be equally effective and do not carry a risk of cancer,”

Ending remarks:

This study is very helpful for physicians who are specialist in diabetes management and treatment. It would be very healthy for patients if they are not prescribed pioglitazone rather there are various other Antidiabetic drugs that could be prescribed and they do not have any carcinogenic effect.

Are Alzheimer’s and diabetes the same disease?


HAVING type 2 diabetes may mean you are already on the path to Alzheimer’s. This startling claim comes from a study linking the two diseases more intimately than ever before. There is some good news: the same research also offers a way to reverse memory problems associated with diabetes – albeit in rats – which may hint at a new treatment for Alzheimer’s.

“Perhaps you should use Alzheimer’s drugs at the diabetes stage to prevent cognitive impairment in the first place,” says Ewan McNay from the University at Albany in New York.

Alzheimer’s cost the US $130 billion in 2011 alone. One of the biggest risk factors is having type 2 diabetes. This kind of diabetes occurs when liver, muscle and fat cells stop responding efficiently to insulin, the hormone that tells them to absorb glucose from the blood. The illness is usually triggered by eating too many sugary and high-fat foods that cause insulin to spike, desensitising cells to its presence. As well as causing obesity, insulin resistance can also lead to cognitive problems such as memory loss and confusion.

Are brain changes associated with Alzheimer's (green) reversible? <i>(Image: Medical Body Scans/Jessica Wilson/Photo Researchers/SPL)</i>

In 2005, a study by Susanne de la Monte’s group at Brown University in Providence, Rhode Island, identified a reason why people with type 2 diabetes had a higher risk of developing Alzheimer’s. In this kind of dementia, the hippocampus, a part of the brain involved in learning and memory, seemed to be insensitive to insulin. Not only could your liver, muscle and fat cells be “diabetic” but so it seemed, could your brain.

Feeding animals a diet designed to give them type 2 diabetes leaves their brains riddled with insoluble plaques of a protein called beta-amyloid – one of the calling cards of Alzheimer’s. We also know that insulin plays a key role in memory. Taken together, the findings suggest that Alzheimer’s might be caused by a type of brain diabetes.

If that is the case, the memory problems that often accompany type 2 diabetes may in fact be early-stage Alzheimer’s rather than mere cognitive decline.

Although there is no definitive consensus on the exact causes of Alzheimer’s, we do know that brains get clogged with beta-amyloid plaques. One idea gaining ground is that it is not the plaques themselves that cause the symptoms, but their precursors – small, soluble clumps of beta-amyloid called oligomersMovie Camera. The insoluble plaques could actually be the brain’s way of trying to isolate the toxic oligomers.

To investigate whether beta-amyloid might also be a cause of cognitive decline in type 2 diabetes, McNay, Danielle Osborne and their colleagues fed 20 rats a high-fat diet to give them type 2 diabetes. These rats, and another 20 on a healthy diet, were then trained to associate a dark cage with an electric shock. Whenever the rats were returned to this dark cage, they froze in fear – measuring how long they stayed still is a standard way of inferring how good their memory is.

Memory boost

As expected, the diabetic rats had weaker memories than the healthy ones – they froze in the dark for less than half the time of their healthy counterparts. To figure out whether this was due to the beta-amyloid plaques or the soluble precursors, Pete Tessier at the Rensselaer Polytechnic Institute in Troy, New York, engineered fragments of antibodies that disrupt the action of one or the other.

When the plaque-disrupting antibodies were injected into diabetic rats, no change was seen. However, after receiving antibodies specific for oligomers, they froze for just as long as the healthy rats. “The cognitive deficit brought on by their diabetes is entirely reversed,” says McNay.

Until now, the standard explanation for the cognitive decline associated with type 2 diabetes is that it is a result of insulin signalling gone awry. One effect is to reduce the hippocampus’s ability to transport energy, or glucose, to neurons during a cognitive task. The fact that amyloid builds up in the brains of diabetic animals – and also in people, was seen as an unhappy consequence of insulin imbalance.

These experiments suggest oligomers are actually to blame. Previous work from other groups has shown that the same enzymes break down both insulin and beta-amyloid oligomers – and that the oligomers prevent insulin binding to its receptors in the hippocampus. So when there is too much insulin around – as there is in someone with type 2 diabetes – those enzymes are working flat out to break it down. This preferential treatment of insulin leaves the oligomers to form clumps, which then keep insulin from its receptors, causing a vicious spiral of impaired brain insulin signalling coupled with cognitive decline.

“We think that our treatment soaked up the amyloid oligomers, so that they could no longer block insulin from binding to its receptors,” says McNay, who presented the preliminary data at the Society for Neuroscience meeting in San Diego earlier this month. “Everyone thinks of amyloid build-up as a consequence of the events that cause cognitive impairment in diabetes, but we’re saying it’s actually a cause.” It means, he says, that the cognitive decline seen in type 2 diabetes may be thought of as early-stage Alzheimer’s.

It’s a bold claim, and if correct, one with big implications. Given that the number of people with type 2 diabetes is expected to jump from 382 million now to 592 million by 2035, we might expect to see a similar trajectory for associated Alzheimer’s (New Scientist, 1 September 2012). If beta-amyloid build-up can be stopped in people with type 2 diabetes and their cognitive impairment reversed – perhaps many of them will never progress to Alzheimer’s.

For the last few years, organisations like the UK’s Alzheimer’s Society have been backing clinical trials to look for diabetes drugs that may have an effect on Alzheimer’s patients. “We’re saying that this may be not the only way to think about it,” says McNay.

The next step is to repeat the work, and if the results are corroborated, start looking for a drug that would do the same thing as the group’s modified antibodies, without having to inject the drug directly into the hippocampus. It will also be necessary to work out just how much amyloid the brain can safely do without, since low levels are important for memory formation.

“The work opens the door to inoculating the most at risk group, people with type 2 diabetes,” says Tres Thompson of the University of Texas at Dallas. There have been plenty of failed attempts to use antibodies to relieve Alzheimer’s in the past. “But these were all in people with advanced stages of the disease. Vaccinating people much earlier could give better results.”

Some researchers are still wary of focusing on beta-amyloid when 20 years of working on a treatment for that particular aspect of the disease has come to nothing. “I think it’s brilliant work – he’s using new techniques that seem to be working, but it’s still very beta-centric,” says Olivier Thibault at the University of Kentucky in Lexington. He cautiously agrees that McNay’s data do seem to suggest a causative link between beta-amyloid and impaired insulin signalling but says the group needs to factor in the effect of ageing – both diabetes and Alzheimer’s become more likely as we grow older.

Jessica Smith, spokeswoman for the UK Alzheimer’s Society in London welcomes the work. “We need to tease out the difference between those with type 2 diabetes who develop Alzheimer’s and those who don’t. If people were developing the signs earlier than we thought, then perhaps we can intervene earlier, rather than waiting until they have full clinical Alzheimer’s.”

Of course, there is another solution to staving off type 2 diabetes and any consequential Alzheimer’s that requires no drugs at all. “Go to the gym and eat fewer twinkies,” says McNay.

Today is World Diabetes Day


530349_642254725796138_1854913460_n

Let today be the beginning of the end of your diabetes. Today being the World Diabetes Day, there is no better a day to take a new step for the awareness of the lifestyle disease, Diabetes. Every year, World Diabetes Day is co-ordinated by the International Diabetes Federation (IDF) with a particular theme; between 2009 and 2013 the theme has been ‘education and prevention’.

The Discovery of Insulin.


Before the discovery of insulin, diabetes was a feared disease that most certainly led to death. Doctors knew that sugar worsened the condition of diabetic patients and that the most effective treatment was to put the patients on very strict diets where sugar intake was kept to a minimum. At best, this treatment could buy patients a few extra years, but it never saved them. In some cases, the harsh diets even caused patients to die of starvation.

pancreasDuring the nineteenth century, observations of patients who died of diabetes often showed that the pancreas was damaged. In 1869, a German medical student, Paul Langerhans, found that within the pancreatic tissue that produces digestive juices there were clusters of cells whose function was unknown. Some of these cells were eventually shown to be the insulin-producing beta cells. Later, in honor of the person who discovered them, the cell clusters were named the islets of Langerhans.

In 1889 in Germany, physiologist Oskar Minkowski and physician Joseph von Mering, showed that if the pancreas was removed from a dog, the animal got diabetes. But if the duct through which the pancreatic juices flow to the intestine was ligated – surgically tied off so the juices couldn’t reach the intestine – the dog developed minor digestive problems but no diabetes. So it seemed that the pancreas must have at least two functions:

  • To produce digestive juices
  • To produce a substance that regulates the sugar glucose

This hypothetical internal secretion was the key. If a substance could actually be isolated, the mystery of diabetes would be solved. Progress, however, was slow.

Banting’s Idea

In October 1920 in Toronto, Canada, Dr. Frederick Banting, an unknown surgeon with a bachelor’s degree in medicine, had the idea that the pancreatic digestive juices could be harmful to the secretion of the pancreas produced by the islets of Langerhans.

He therefore wanted to ligate the pancreatic ducts in order to stop the flow of nourishment to the pancreas. This would cause the pancreas to degenerate, making it shrink and lose its ability to secrete the digestive juices. The cells thought to produce an antidiabetic secretion could then be extracted from the pancreas without being harmed.

Early in 1921, Banting took his idea to Professor John Macleod at the University of Toronto, who was a leading figure in the study of diabetes in Canada. Macleod didn’t think much of Banting’s theories. Despite this, Banting managed to convince him that his idea was worth trying. Macleod gave Banting a laboratory with a minimum of equipment and ten dogs. Banting also got an assistant, a medical student by the name of Charles Best. The experiment was set to start in the summer of 1921.

Banting and Best with a diabetic dog
Banting, right, and Best, left, with one of the diabetic dogs used in experiments with insulin.
Credits: University of Toronto Archives

The Experiment Begins

Banting and Best began their experiments by removing the pancreas from a dog. This resulted in the following:

  • It’s blood sugar rose.
  • It became thirsty, drank lots of water, and urinated more often.
  • It became weaker and weaker.

The dog had developed diabetes.

Experimenting on another dog, Banting and Best surgically ligated the pancreas, stopping the flow of nourishment, so that the pancreas degenerated.

After a while, they removed the pancreas, sliced it up, and froze the pieces in a mixture of water and salts. When the pieces were half frozen, they were ground up and filtered. The isolated substance was named “isletin.”

The extract was injected into the diabetic dog. Its blood glucose level dropped, and it seemed healthier and stronger. By giving the diabetic dog a few injections a day, Banting and Best could keep it healthy and free of symptoms.

Banting and Best showed their result to Macleod, who was impressed, but he wanted more tests to prove that their pancreatic extract really worked.

Banting and Best's laboratory Banting’s and Best’s laboratory, where insulin was discovered. 
Credits: University of Toronto Archives

Extended Tests

For the increased testing, Banting and Best realized that they required a larger supply of organs than their dogs could provide, and they started using pancreases from cattle. With this new source, they managed to produce enough extract to keep several diabetic dogs alive.

A dog and a cowThe new results convinced Macleod that they were onto something big. He gave them more funds and moved them to a better laboratory with proper working conditions. He also suggested they should call their extract “insulin.” Now, the work proceeded rapidly.

In late 1921, a third person, biochemist Bertram Collip, joined the team. Collip was given the task of trying to purify the insulin so that it would be clean enough for testing on humans.

During the intensified testing, the team also realized that the process of shrinking the pancreases had been unnecessary. Using whole fresh pancreases from adult animals worked just as well.

Testing on Humans

The team was eager to start testing on humans. But on whom should they test? Banting and Best began by injecting themselves with the extract. They felt weak and dizzy, but they were not harmed.

Collip continued his work to purify the insulin. He also experimented with trying to find the correct dosage. He learned how to diminish the effect of an insulin overdose with glucose in different forms. He discovered that the glucose should be as pure as possible. Orange juice and honey are good examples of foods rich in glucose.

A human and honeyIn January 1922 in Toronto, Canada, a 14-year-old boy, Leonard Thompson, was chosen as the first person with diabetes to receive insulin. The test was a success. Leonard, who before the insulin shots was near death, rapidly regained his strength and appetite. The team now expanded their testing to other volunteer diabetics, who reacted just as positively as Leonard to the insulin extract.

The Nobel Prize

The news of the successful treatment of diabetes with insulin rapidly spread outside of Toronto, and in 1923 the Nobel Committee decided to award Banting and Macleod the Nobel Prize in Physiology or Medicine.

The decision of the Nobel Committee made Banting furious. He felt that the prize should have been shared between him and Best, and not between him and Macleod. To give credit to Best, Banting decided to share his cash award with him. Macleod, in turn, shared his cash award with Collip.

The Nobel Prize in Physiology or Medicine for insulin has been much debated. It has been questioned why Macleod received the prize instead of Best and Collip. However, Macleod played a central role in the discovery of insulin. It was he who supported the project from the beginning. He supervised the work and it is also most likely that Macleod’s contacts in the scientific world helped the team in getting a speedy recognition of their discovery.


Frederick G. Banting and John Macleod were awarded the Nobel Prize in Physiology or Medicine in 1923 “for the discovery of insulin.”

The Legacy of Insulin

Banting, Macleod, and the rest of the team patented their insulin extract but gave away all their rights to the University of Toronto, which would later use the income from insulin to fund new research.

Very soon after the discovery of insulin, the medical firm Eli Lilly started large-scale production of the extract. As soon as 1923, the firm was producing enough insulin to supply the entire North American continent.

Although insulin doesn’t cure diabetes, it’s one of the biggest discoveries in medicine. When it came, it was like a miracle. People with severe diabetes and only days left to live were saved. And as long as they kept getting their insulin, they could live an almost normal life.

Phentermine-topiramate reduced incident type 2 diabetes by nearly 80%.


Patients with prediabetes and/or metabolic syndrome demonstrated significant weight loss and a markedly reduced progression to type 2 diabetes after 2 years of treatment with phentermine-topiramate extended-release plus lifestyle modifications, according to data published in Diabetes Care.

The medically assisted weight-loss intervention was highly effective in preventing diabetes among high-risk patients by 78.7%, W. Timothy Garvey, MD, chairman of the department of nutrition sciences at the University of Alabama at Birmingham, told Endocrine Today.

“If we can prevent 80% of diabetes in America, we’d go a long way toward reducing health care costs and the burden of diabetes on patients and the suffering that it causes,” Garvey said.

The researchers conducted SEQUEL, a subanalysis of the phase 3, randomized, placebo-controlled, double blind CONQUER trial, consisting of overweight or obese patients (BMI ≥27 to ≤45) with more than two comorbidities, according to data.

Patients with prediabetes (n=292) and metabolic syndrome (n=451) were included in the subanalysis.

After 108 weeks of random assignment to either placebo or phentermine-topiramate (Qsymia, Vivus), the cohort lost 10.9% of their body weight in the phentermine-topiramate 7.5-mg/46-mg treatment arm and 12.1% of their body weight in the 15-mg/92-mg treatment arm (P<.0001), compared with 2.5% in the placebo group.

There also was a 70.5% decreased annual incidence rate of type 2 diabetes for those assigned to 7.5 mg/46 mg and 78.7% for those assigned to 15 mg/92 mg (P<.05), compared with placebo.

“Here, we have two diagnostic codes for prediabetes and metabolic syndrome; you identity those patients, you know they have high risk for diabetes and cardiovascular disease and risk factors,” Garvey said. “These can be improved with weight loss. In this case, medicine-assisted weight loss particularly yielded up to 10% or more loss of body weight.” – by Samantha Costa

%d bloggers like this: