Pre-diabetes and heart disease risk

An article on even pre-diabetes affecting heart disease
risk:

http://www.healthday.com/Article.asp?AID=605667

x-no-archive: yes

Robert Miles wrote:
> An article on even pre-diabetes affecting heart disease
> risk:
>
> http://www.healthday.com/Article.asp?AID=605667
>
>

When you consider how many people with "pre diabetes" get retinopathy,
nephropathy, peripheral neuropathy and CVD, it seems kind of stupid to
keep calling it "pre" anything, doesn't it?


Susan

Susan <nevermind@nomail.com> wrote in part:

>x-no-archive: yes
>
>Robert Miles wrote:
>> An article on even pre-diabetes affecting heart disease
>> risk:
>>
>> http://www.healthday.com/Article.asp?AID=605667
>>
>>
>
>When you consider how many people with "pre diabetes" get retinopathy,
>nephropathy, peripheral neuropathy and CVD, it seems kind of stupid to
>keep calling it "pre" anything, doesn't it?

Though people with normal blood sugars get peripheral neuropathies and CVD.
It seems that DM diagnosis is based on impairment of the ability to tightly
regulate blood glucose. It looks like glucose regulation does tend to
diminish with age (even among the apparently healthy) and to vary from
person to person. So the definition of DM is a statistical issue.
--
Jim Chinnis Warrenton, Virginia, USA

Robert Miles wrote:
> An article on even pre-diabetes affecting heart disease
> risk:
>
> http://www.healthday.com/Article.asp?AID=605667

"After five years, people who had diabetes had a 2.6 times higher risk
of dying from cardiac problems than healthy people. Those with
impaired fasting glucose (considered "pre-diabetes") had a 2.5 times
higher risk.

Diabetes and pre-diabetes together accounted for almost two-thirds of
all deaths from heart disease, the researchers noted."

Pre-diabetes is metabolic syndrome (MetS).

The only known cure for MetS is losing the visceral adipose tissue
(VAT).

The only known way to safely lose the VAT is by eating less down to
the optimal amount.

May GOD bless you in HIS mighty way making you healthier (hungrier)
than ever.

Prayerfully in Jesus' awesome love,

Andrew <><
--
Andrew B. Chung, MD/PhD
Cardiologist

x-no-archive: yes

Jim Chinnis wrote:

> Though people with normal blood sugars get peripheral neuropathies and CVD.
> It seems that DM diagnosis is based on impairment of the ability to tightly
> regulate blood glucose.

That may depend upon what you're calling "normal."

>It looks like glucose regulation does tend to
> diminish with age (even among the apparently healthy) and to vary from
> person to person. So the definition of DM is a statistical issue.

That's the problem. Particularly when the so called "normals" in any
study include so many likely diabetics.

Susan

On Tue, 19 Jun 2007 14:29:53 -0400, Susan
<nevermind@nomail.com> wrote:

>That's the problem. Particularly when the so called "normals" in any
>study include so many likely diabetics.
>
>Susan

That point is one I think far too many researchers miss.
When they have an exclusion for diagnosed diabetics they
don't seem to test for IGT, IFG or other pre-diabetes signs.
Thus the results are skewed by the undiagnosed.


Cheers, Alan, T2, Australia.
d&e, metformin 1500mg, ezetrol 10mg
Everything in Moderation - Except Laughter.
--
http://loraldiabetes.blogspot.com/
http://loraltravel.blogspot.com/
latest: Slovenia

x-no-archive: yes

Alan S wrote:

> That point is one I think far too many researchers miss.
> When they have an exclusion for diagnosed diabetics they
> don't seem to test for IGT, IFG or other pre-diabetes signs.
> Thus the results are skewed by the undiagnosed.

When you consider that the Rancho Bernardo study found that 70% of women
and 48% of men weren't diagnosed by those measures, but were DM when
tested with 2 hr. pp, it's even worse than that.

I think they're including a lot of frank DMs.

Susan

Susan <nevermind@nomail.com> wrote in part:

>x-no-archive: yes
>
>Alan S wrote:
>
>> That point is one I think far too many researchers miss.
>> When they have an exclusion for diagnosed diabetics they
>> don't seem to test for IGT, IFG or other pre-diabetes signs.
>> Thus the results are skewed by the undiagnosed.
>
>When you consider that the Rancho Bernardo study found that 70% of women
>and 48% of men weren't diagnosed by those measures, but were DM when
>tested with 2 hr. pp, it's even worse than that.
>
>I think they're including a lot of frank DMs.

But it's still because it's a statistical issue. It isn't like diabetics (at
least type 2s) carry a protein marker or a virus. It's that having high bg
causes damage and people vary in the ways they control bg. No matter where
you draw a line for a particular measure or measures that make up a
diagnosis criterion, there will some people with lower numbers who get
diabetic symptoms/complications and some with higher numbers who don't.

But yeah, it's important to see how researchers excluded people when they
studied normals.
--
Jim Chinnis Warrenton, Virginia, USA

Susan <nevermind@nomail.com> wrote:
> x-no-archive: yes

> Robert Miles wrote:
>> An article on even pre-diabetes affecting heart disease
>> risk:
>>
>> http://www.healthday.com/Article.asp?AID=605667

> When you consider how many people with "pre diabetes" get retinopathy,
> nephropathy, peripheral neuropathy and CVD, it seems kind of stupid to
> keep calling it "pre" anything, doesn't it?

That's what's so neat about the scientific method. No matter how silly
are your current ideas, if you doggedly persist in the scientific
method the facts will eventually drag you round to a more sensible
viewpoint, no matter how much you kick and scream on the way.

That's why I haven't entirely lost faith in the ADA. They've already
spotted the pre-diabetes problem, as their recent position paper on
diagnosing and treating it showed. We just have to wait for the
implications to sink in, and if they don't, the repeated bludgeoning
with research results will sooner or later hammer them in. We just
have to wait :-)

--
Chris Malcolm cam@infirmatics.ed.ac.uk DoD #205
IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK
[http://www.dai.ed.ac.uk/homes/cam/]

Jim Chinnis <jchinnis@spamalum.mit.edu> wrote:
> Susan <nevermind@nomail.com> wrote in part:

>>x-no-archive: yes
>>
>>Alan S wrote:
>>
>>> That point is one I think far too many researchers miss.
>>> When they have an exclusion for diagnosed diabetics they
>>> don't seem to test for IGT, IFG or other pre-diabetes signs.
>>> Thus the results are skewed by the undiagnosed.
>>
>>When you consider that the Rancho Bernardo study found that 70% of women
>>and 48% of men weren't diagnosed by those measures, but were DM when
>>tested with 2 hr. pp, it's even worse than that.
>>
>>I think they're including a lot of frank DMs.

> But it's still because it's a statistical issue.

It's only a statistical issue because nobody yet fully understands the
detailed machinery of how it develops. Until they find that light
switch of understanding all they can do is grope in the dark with
statistics. Statistics are what you use in the first stages of a
scientific investigation of a medical problem, when you still don't
really know what's going on.

> It isn't like diabetics (at
> least type 2s) carry a protein marker or a virus.

They probably do. We just haven't stumbled over it yet.

> It's that having high bg
> causes damage and people vary in the ways they control bg. No matter where
> you draw a line for a particular measure or measures that make up a
> diagnosis criterion, there will some people with lower numbers who get
> diabetic symptoms/complications and some with higher numbers who don't.

> But yeah, it's important to see how researchers excluded people when they
> studied normals.

Basing your idea of normal healthy unimpaired function on statistics
is what you do in the early stages of a scientific investigation, when
you don't yet know what's going on.

--
Chris Malcolm cam@infirmatics.ed.ac.uk DoD #205
IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK
[http://www.dai.ed.ac.uk/homes/cam/]

Chris Malcolm wrote:
> convicted neighbor Susan <nevermind@nomail.com> wrote:
> > Robert Miles wrote:
> >> An article on even pre-diabetes affecting heart disease
> >> risk:
> >>
> >> http://www.healthday.com/Article.asp?AID=605667
>
> > When you consider how many people with "pre diabetes" get retinopathy,
> > nephropathy, peripheral neuropathy and CVD, it seems kind of stupid to
> > keep calling it "pre" anything, doesn't it?
>
> That's what's so neat about the scientific method. No matter how silly
> are your current ideas, if you doggedly persist in the scientific
> method the facts will eventually drag you round to a more sensible
> viewpoint, no matter how much you kick and scream on the way.
>
> That's why I haven't entirely lost faith in the ADA. They've already
> spotted the pre-diabetes problem, as their recent position paper on
> diagnosing and treating it showed. We just have to wait for the
> implications to sink in, and if they don't, the repeated bludgeoning
> with research results will sooner or later hammer them in. We just
> have to wait :-)

Wiser to lose the visceral adipose tissue (VAT) by eating less down to
the optimal amount to cure the metabolic syndrome (aka pre-diabetes or
IGT) rather than wait.

May GOD bless you in HIS mighty way making healthier (hungrier) than
ever.

Prayerfully in Jesus' awesome love,

Andrew <><
--
Andrew B. Chung, MD/PhD
Cardiologist

x-no-archive: yes

Jim Chinnis wrote:

> But it's still because it's a statistical issue.

Yes, I agree.

It isn't like diabetics (at
> least type 2s) carry a protein marker or a virus. It's that having high bg
> causes damage and people vary in the ways they control bg. No matter where
> you draw a line for a particular measure or measures that make up a
> diagnosis criterion, there will some people with lower numbers who get
> diabetic symptoms/complications and some with higher numbers who don't.

Do we know that?

At least if we drew the line much lower, the stats would be less
confused because the number of missed DMs would be much smaller.

Susan

Chris Malcolm <cam@holyrood.ed.ac.uk> wrote in part:

>Basing your idea of normal healthy unimpaired function on statistics
>is what you do in the early stages of a scientific investigation, when
>you don't yet know what's going on.

And sometimes the "early stages" go on for decades or centuries.
--
Jim Chinnis Warrenton, Virginia, USA

Susan <nevermind@nomail.com> wrote in part:

>x-no-archive: yes
>
>Jim Chinnis wrote:
>
>> But it's still because it's a statistical issue.
>
>Yes, I agree.
>
> It isn't like diabetics (at
>> least type 2s) carry a protein marker or a virus. It's that having high bg
>> causes damage and people vary in the ways they control bg. No matter where
>> you draw a line for a particular measure or measures that make up a
>> diagnosis criterion, there will some people with lower numbers who get
>> diabetic symptoms/complications and some with higher numbers who don't.
>
>Do we know that?

It's pretty obvious within the plausible range.

>At least if we drew the line much lower, the stats would be less
>confused because the number of missed DMs would be much smaller.

And the rate of complications for having diabetes would fall. You could set
the criterion as diabetes being a fbg over 60, f'instance. Then you'd miss
no one...
--
Jim Chinnis Warrenton, Virginia, USA

x-no-archive: yes

Jim Chinnis wrote:

> And the rate of complications for having diabetes would fall. You could set
> the criterion as diabetes being a fbg over 60, f'instance. Then you'd miss
> no one...

Yabbut, I don't think the point is to set it so low that everyone is DM
and ends up on drugs they don't need. :-)

Setting it at over 85 would go a long way, though.

Susan

On Wed, 20 Jun 2007 17:28:37 -0400, Susan <nevermind@nomail.com>
wrote:

>x-no-archive: yes
>
>Jim Chinnis wrote:
>
>> And the rate of complications for having diabetes would fall. You could set
>> the criterion as diabetes being a fbg over 60, f'instance. Then you'd miss
>> no one...
>
>Yabbut, I don't think the point is to set it so low that everyone is DM
>and ends up on drugs they don't need. :-)
>
>Setting it at over 85 would go a long way, though.
>
>Susan

I would even vote for 100.... 90 might be better.... 85? Not exactly
sure about that, without more data. Also, maybe some other biometric
data in conjunction with the raw BG measurements at the lower levels
would be helpful. Sorta like they assess heart attack risk and cancer
risk....


Will, T2

x-no-archive: yes

Will, T2 wrote:

> I would even vote for 100.... 90 might be better.... 85? Not exactly
> sure about that, without more data. Also, maybe some other biometric
> data in conjunction with the raw BG measurements at the lower levels
> would be helpful. Sorta like they assess heart attack risk and cancer
> risk....

Or maybe a range, like 85-95 would be a hyooge improvement. Trouble is,
it'd still miss folks with high PP numbers, as the study of adults over
50 has demonstrated.

The endo I saw last fall said most folks are DM for years before their
fbg starts to rise.

Susan

On Wed, 20 Jun 2007 17:54:22 -0400, Susan <nevermind@nomail.com>
wrote:

>The endo I saw last fall said most folks are DM for years before their
>fbg starts to rise.


Yes, yes, yes... That is exactly what happened to me, I think... I
started having severe foot and lower leg pain about five (5) years
before dx. Thinking back, even a couple of years before that, I
noticed the now-familiar feelings of high BG levels following certain
types of meals.

Will, T2

Me too, the neuropathy was the reason I was diagnosed in 98. Probably
had it for several years before then. I hope you have recovered fully
from your flu, Will.

Cheri


Will, T2 wrote in message ...

>Yes, yes, yes... That is exactly what happened to me, I think... I
>started having severe foot and lower leg pain about five (5) years
>before dx. Thinking back, even a couple of years before that, I
>noticed the now-familiar feelings of high BG levels following certain
>types of meals.
>
>Will, T2

On Wed, 20 Jun 2007 15:12:57 -0700, "Cheri" <gserviceatinreachdotcom>
wrote:

>Me too, the neuropathy was the reason I was diagnosed in 98. Probably
>had it for several years before then. I hope you have recovered fully
>from your flu, Will.
>
>Cheri

Thanks, Cheri...

I finally caved and went to the doc today... Yes, he said I have an
infection, and gave me some anitbiotics. I promise to be over it soon
:-)

I hope you are well.... Please don't get this bug. It has put a number
of people in the hospital over here...

Will, T2

Jim Chinnis <jchinnis@spamalum.mit.edu> wrote:
> Chris Malcolm <cam@holyrood.ed.ac.uk> wrote in part:

>>Basing your idea of normal healthy unimpaired function on statistics
>>is what you do in the early stages of a scientific investigation, when
>>you don't yet know what's going on.
>
> And sometimes the "early stages" go on for decades or centuries.

Of course. We only have limited brainpower and lifespans, and I can't
think of any good reasons why the universe should dumb itself down for
us.

--
Chris Malcolm cam@infirmatics.ed.ac.uk DoD #205
IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK
[http://www.dai.ed.ac.uk/homes/cam/]