Type 2 Diabetes Mellitus

Type 2 Diabetes Mellitus is now clearly seen to be related to increasing consumption of modern sugar and cereal based diet. Often associated with other manifestations of metabolic syndrome, such as obesity, hypertension, cardiovascular disease and fatty liver, type 2 diabetes is increasing in frequency and in younger population. Type 2 diabetes is today one of the leading causes of morbidity and mortality in the world. Management of type 2 diabetes has for long been done with oral antidiabetic drugs and/or insulin injections. Recent studies showing the role of dietary factors have opened up the possibilities of successfully controlling or even reversing type 2 diabetes with a strict dietary restriction.

The effects of dietary Fructose and its relationship to insulin resistance/hyperinsulinemia and chronic diseases [See]

White rice and risk of type 2 diabetes: A Meta-analysis of prospective cohort studies has revealed that Asian (Chinese and Japanese) populations had much higher white rice consumption levels than did Western populations and that higher consumption of white rice is associated with a significantly increased risk of type 2 diabetes in Asian populations. Hu EA, Pan A, Malik V, Sun Q. White rice consumption and risk of type 2 diabetes: meta-analysis and systematic review. BMJ 2012;344:e2021 doi: 10.1136/bmj.e1454 [Full Text | Editorial | Report]

Sugar is Toxic: The growing scientific evidence, both epidemiological and mechanistic, very clearly shows that excess sugar induces all of the diseases associated with the metabolic syndrome, Robert H. Lustig et al write in Nature. See Lustig RH, Schmidt LA, Brindis CD. Public health: The toxic truth about sugar. Nature. February 2012;482:27–29. doi:10.1038/482027a [Link][Report | Report | Report | Report]

Dietary fructose linked to metabolic syndrome and diabetes mellitus: In a new study from Vanderbilt University in Nashville, Tennessee, a diet with 30 percent of total energy from fructose was given to 29 adult male rhesus monkeys aged 12 to 20 years for a period of 12 months. Starting at six months and by the end of the 12-month feeding study, ALL (100%) the monkeys developed certain metabolic syndrome components including body adiposity, insulin resistance, and dyslipidemia and four monkeys (15%) developed type 2 diabetes mellitus. [Bremer AA et al. Fructose-Fed Rhesus Monkeys: A Nonhuman Primate Model of Insulin Resistance, Metabolic Syndrome, and Type 2 Diabetes. Clinical and Translational Science. August 2011;4(4):243–252. Full Text | Report]

Kolderup A, Svihus B. Fructose Metabolism and Relation to Atherosclerosis, Type 2 Diabetes, and Obesity. Journal of Nutrition and Metabolism. 2015, Article ID 823081, 12 pages. https://doi.org/10.1155/2015/823081. Available at https://www.hindawi.com/journals/jnme/2015/823081/

Simopoulos AP. Dietary Omega-3 Fatty Acid Deficiency and High Fructose Intake in the Development of Metabolic Syndrome, Brain Metabolic Abnormalities, and Non-Alcoholic Fatty Liver Disease. Nutrients 2013;5:2901-2923; doi:10.3390/nu5082901. Available at https://www.researchgate.net/publication/253338685_Dietary_Omega-3_Fatty_Acid_Deficiency_and_High_Fructose_Intake_in_the_Development_of_Metabolic_Syndrome_Brain_Metabolic_Abnormalities_and_Non-Alcoholic_Fatty_Liver_Disease/download

Ang B, Yu GB. The Role of Fructose in Type 2 Diabetes and Other Metabolic Diseases. Nutrition & Food Science. May 2017;8(1):1-4. DOI: 10.4172/2155-9600.1000659. Available at https://www.researchgate.net/profile/Bernadine_Ang2/publication/316605499_The_Role_of_Fructose_in_Type_2_Diabetes_and_Other_Metabolic_DIseases/links/5b6eac6892851ca650552b96/The-Role-of-Fructose-in-Type-2-Diabetes-and-Other-Metabolic-DIseases.pdf

DiNicolantonio JJ, O’Keefe JH, Lucan SC. Added Fructose – A Principal Driver of Type 2 Diabetes Mellitus and Its Consequences. Mayo Clinic Proceedings. January 29, 2015. DOI:https://doi.org/10.1016/j.mayocp.2014.12.019. Available at https://www.mayoclinicproceedings.org/article/S0025-6196(15)00040-3/fulltext

Increased fructose consumption from fruits increases metabolic syndrome risk: A cross-sectional population based study on 2537 subjects (45% men) aged 19-70 y has shown that higher consumption of dietary fructose may have adverse metabolic effects and increase the risks for metabolic syndrome. [Firoozeh Hosseini-Esfahani et al. Dietary fructose and risk of metabolic syndrome in adults: Tehran Lipid and Glucose study. Nutrition & Metabolism 2011, 8:50 doi:10.1186/1743-7075-8-50 Full text]

Malik VS, Hu FB. Fructose and Cardiometabolic Health. Journal of the American College of Cardiology. 2015;66(14):1615-1624. doi: 10.1016/j.jacc.2015.08.025 Available at https://www.jacc.org/doi/abs/10.1016/j.jacc.2015.08.025

Energy Drinks Pose Serious Health Risks for Young People: According to a review of scientific literature and Internet sources, published in Pediatrics, energy drinks that contain caffeine, taurine, sugars and sweeteners, herbal supplements etc., are regularly consumed by 30% to 50% of children, adolescents, and young adults and and are associated with risks for serious adverse health effects such as liver damage, kidney failure, respiratory disorders, agitation, confusion, seizures, psychotic conditions, nausea, vomiting, abdominal pain, rhabdomyolysis, tachycardia, cardiac dysrhythmias, hypertension, myocardial infarction, heart failure, and death. [See Seifert SM, Schaechter JL, Hershorin ER, Lipshultz SE. Health Effects of Energy Drinks on Children, Adolescents, and Young Adults. Pediatrics. 2011;127:511-528. DOI: 10.1542/peds.2009-3592. Free Full Text | Report]

Sugar sweetened beverages increase the risk of weight gain, development of metabolic syndrome and type 2 diabetes, meta analysis shows [See Malik VS et al. Sugar-Sweetened Beverages and Risk of Metabolic Syndrome and Type 2 Diabetes A meta-analysis. Diabetes Care November 2010;33(11):2477-2483 Free Full Text]

Sugar Sweetened Beverages Increase Diabetes Risk With or Without Weight Gain[See Full Text Diabetes Care, Report]

Sugar Sweetened Beverages Increase the Risk of Metabolic Syndrome, Diabetes and Obesity Vasanti S. Malik et al. Sugar Sweetened Beverages and Risk of Metabolic Syndrome and Type 2 Diabetes: A Meta-analysis Diabetes Care. August 2010;33(8) Full Text | Report]

Fructose (Fruit Sugar) is a more important cause for metabolic disorders like diabetes, hypertension, fatty liver disease, obesity

Overweight Kids Risk Weak Bones, Diabetes: Abdominal Fat May Play a Role in Bone Strength Norman K Pollock et al. Lower bone mass in prepubertal overweight children with pre-diabetes Journal of Bone and Mineral Research Jul 2010 Abstract | Report]

Modern day food causes all the ills: The highly processed, calorie-dense, nutrient-depleted diet frequently leads to exaggerated supraphysiological post-prandial spikes in blood glucose and lipids. This post-prandial dysmetabolism induces immediate oxidant stress, which increases in direct proportion to the increases in glucose and triglycerides after a meal. The transient increase in free radicals acutely triggers atherogenic changes including inflammation, endothelial dysfunction, hypercoagulability, and sympathetic hyperactivity. To attenuate the increase in glucose, triglycerides, and inflammation after a meal,  a diet rich in minimally processed, high-fiber, plant-based foods, including vegetables and fruits, whole grains, legumes, and nuts is recommended. Other dietary interventions that can significantly ameliorate postprandial dysmetabolism include intake of lean protein, vinegar, fish oil, tea, and cinnamon. Additional benefits may result from calorie restriction, weight loss and exercise. See O’Keefe JH, Gheewala NM, O’Keefe JO. Dietary Strategies for Improving Post-Prandial Glucose, Lipids, Inflammation, and Cardiovascular Health. J Am Coll Cardiol 2008; 51:249-255 Abstract at http://content.onlinejacc.org/cgi/content/abstract/51/3/249| Anti-Inflammatory” Diet May Improve Postprandial Glucose, Cardiovascular Health

Certain Advanced Glycation End products (AGEs) Increase the risk of Complications in Diabetes: New study at the Joslin Diabetes Center has revealed that patients of Type 1 diabetes with higher levels of carboxyethyl-lysine and pentosidine AGEs are 7.2-fold more likely to have any complication. Earlier studies had revealed that these AGEs are linked more to fructose. [Sun JK et al. Protection From Retinopathy and Other Complications in Patients With Type 1 Diabetes of Extreme Duration: The Joslin 50-Year Medalist Study. Diabetes Care 29 March, 2011;34(4):968-974. doi: 10.2337/dc10-1675 Full Text | Mikulíková K, Eckhardt A, Kunes J, Zicha J, Miksík I. Advanced glycation end-product pentosidine accumulates in various tissues of rats with high fructose intake. Physiol Res. 2008;57(1):89-94. Epub 2007 Feb 8. Full text | Krajčovičova-Kudlačkova M, Šebekova K, Schinzel R, Klvanova J. Advanced Glycation End Products and Nutrition. Physiol. Res. 2002;51:313-316. Full text]

Antibiotic Use May Fuel Modern Day Diseases: Increase in modern day diseases such as obesity, diabetes, allergies and asthma correlate with increasing use of antibiotics, that may be changing the gut milieu. [Blaser M. Antibiotic overuse: Stop the killing of beneficial bacteria. Nature 25 August 2011;476:393–394. Link | Report]

Five Lifestyle Changes Can Go a Long Way Toward Cutting the Odds of Type 2 Diabetes: A Population-based prospective cohort study that examined how combinations of lifestyle risk factors relate to the 11-year risk for incident diabetes (National Institutes of Health (NIH)–AARP Diet and Health Study) included 114 996 men and 92 483 women, aged 50 to 71 years in 1995 to 1996, without evidence of heart disease, cancer, or diabetes, with a follow-up survey in 2004 to 2006. Of these, 11 031 men (9.6%) and 6969 women (7.5%) developed new-onset diabetes. Normal weight (maintained a body mass index below 25), nonsmoking, physically active (at least 20 minutes of heart-pounding, sweat-inducing exercise three or more times per week), healthy diet [a diet with lots of fiber, little trans fat, few refined or sugary carbohydrates, and a high ratio of good (polyunsaturated) to bad (saturated) fats] and little to no drinking (two drinks or less a day for men, and one drink or less for women) were associated with least risk of developing diabetes mellitus. [Reis JP et al. Lifestyle Factors and Risk for New-Onset Diabetes. A Population-Based Cohort Study. Ann Int Med. September 6, 2011;155(5):292-299 Full Text | Report]

Nuts in Place of carbohydrates Helps Control Blood Sugar and Serum Lipids: Two ounces of nuts daily as a replacement for carbohydrate foods improves both glycemic control and serum lipids in type 2 diabetes.[Jenkins DJA. Nuts as a Replacement for Carbohydrates in the Diabetic Diet. Diabetes Care August 2011;34(8):1706-1711. Full text

Eating nuts every day helps control Type 2 diabetes and prevent its complications: New research from St. Michael’s Hospital and the University of Toronto has revealed that two ounces of nuts daily as a replacement for carbohydrate foods improved both glycemic control and serum lipids in type 2 diabetes. [Jenkins DJA. Nuts as a Replacement for Carbohydrates in the Diabetic Diet. Diabetes Care June 29, 2011 doi: 10.2337/dc11-0338 Full Text | Report]

Almonds may help reduce risk of type 2 diabetes and heart disease: Study shows that consuming an almond-enriched diet may help improve insulin sensitivity and decrease LDL-cholesterol levels in those with prediabetes. [Michelle Wien et al. Almond Consumption and Cardiovascular Risk Factors in Adults with Prediabetes. Journal of the American College of Nutrition. 2010;29(3):189-197. Abstract | Report]

Low Carbohydrate Diet May Reverse Kidney Failure in People With Diabetes: Researchers from Mount Sinai School of Medicine have for the first time determined that a specialized high-fat, low carbohydrate diet may reverse impaired kidney function in people with Type 1 and Type 2 diabetes. [Poplawski MM, Mastaitis JW, Isoda F, Grosjean F, Zheng F, et al. Reversal of Diabetic Nephropathy by a Ketogenic Diet. PLoS ONE 2011;6(4):e18604. doi:10.1371/journal.pone.0018604 Full Text | Older Study | Report | Report]

Omega 3 fats reduce diabetes risk: Two studies have reported that consumption of omega 3 fats reduces teh risk of diabetes mellitus [Brostow DP et al. Omega-3 fatty acids and incident type 2 diabetes: the Singapore Chinese Health Study.. Am J Clin Nutr July 2011 ajcn.009357. doi: 10.3945/​ajcn.110.009357 | Djoussé L et al. Plasma omega-3 fatty acids and incident diabetes in older adults. Am J Clin Nutr July 2011 ajcn.013334. doi: 10.3945/​ajcn.111.013334]

Mediterranean Diet Cuts Metabolic Syndrome Risk: A meta analysis of the results of 50 studies comprising more than 500,000 people has shown that the Mediterranean diet can reduce the risk of metabolic syndrome. [Abstract from Kastorini CM. The Effect of Mediterranean Diet on Metabolic Syndrome and its Components: A Meta-Analysis of 50 Studies and 534,906 Individuals. J Am Coll Cardiol. 2011;57:1299-1313. doi:10.1016/j.jacc.2010.09.073. | Report]

Mediterranean diet protects against type 2 diabetes: [See Full Text Diabetes Care, Abstract, Report]

Mediterranean Diet Might Delay Need for Drugs in Diabetes Full Text in Esposito K et al., Annals Int Med, 1 Sep, 2009; Medscape Article

Increasing daily intake of green leafy vegetables could significantly reduce the risk of Type 2 Diabetes: Increasing consumption of green vegetables, and not fruits, helps to reduce the risk of diabetes, a meta analysis finds See Patrice Carter et al. Fruit and vegetable intake and incidence of type 2 diabetes mellitus: systematic review and meta-analysis. BMJ 2010;341:c4229 Full Text | Editorial]

Low-carbohydrate diet has similar effects as low-fat diet in diabetes Full Text in Davis NJ et al., Diabetes Care, July, 2009

Low carbohydrate and high monounsaturated fat diets help weight loss and offer metabolic benefits
Brehm BJ,  D’Alessio DA. Weight Loss and Metabolic Benefits With Diets of Varying Fat and Carbohydrate Content: Separating the Wheat From the Chaff Nature Clinical Practice Endocrinology & Metabolism Available at http://www.medscape.com/viewarticle/569321

Type 2 diabetes in newly diagnosed ‘can be reversed’: A small study from Newcastle University, reported in Diabetologia, has found that an extreme eight-week diet of 600 calories a day can reverse Type 2 diabetes in people newly diagnosed with the disease. Although larger studies are needed, these findings are important. [BBC Report]

Metabolic disorders striking the young: Should the stress be on ‘Stress’ or on Food? Many reports emerging from India reveal increasing incidence of metabolic syndrome disorders in young children and many things such as stress at school, sedentary life style, computers, TV, genes and junk food have been blamed. Some have even advised the kids to stop schooling and do yoga for relaxation! Is it not ironical that the so called experts who sought changes in our school education, so as to make it less stressful, now blame the changed methodology for increasing stress? In blaming many things, the strongest reason is bound to be missed: and that reason is the FOOD! See The Young Are Ageing. Outlook Sep 13, 2010 Full Text | Delhi kids suffer from adult ailments! Wonder Woman Sep 8, 2010 Full Text]

Survival as a function of HbA1c in people with type 2 diabetes: a retrospective cohort study: Like the ACCORD Study, one more British study involving 47970 diabetics above the age of 50 years finds that low and high mean HbA1c values are associated with increased all-cause mortality and cardiac events, meaning that both uncontrolled disease as well as intensive treatment can kill. Craig J Currie et al., The Lancet, Early Online Publication, 27 January 2010

Pathophysiology of Insulin Resistance and Noninsulin Resistance Dependent Diabetes [See]

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