More on the Metabolic Syndrome

By Dr. A. R. Scopelliti

Apr

3

Metabolic syndrome, (obesity, hypertension, dyslipidemia and hyperglycemia AKA diabetes), remains a concern in regards to increasing health risk within the United States population.  For the first time in recorded history, our current generation is projected to have a shorter life expectancy than the prior generation.  This is a projection from the New England Journal of Medicine in 2005 based on the current epidemic.  And things have only gotten worse since then.  Metabolic syndrome with its associated cardiovascular disease, stroke, blindness, amputations, etc., accounts for the majority of healthcare dollars currently being spent.  Still worse, current medical treatments focus only on symptoms, which actually make the syndrome worse.  Hyperinsulinemia causes the pancreas to secrete increased amounts of insulin in response to elevated blood glucose.  However, practitioners typically focus on glucose levels or hemoglobin A1c, and prescribe drugs which actually increase insulin levels even further.  In a typical case, a patient would present with obesity, hypertension, diabetes and elevated blood lipids.  The patient would be told to lose weight by eating more fruits and vegetables and to cut down on fats and cholesterol and to do some light exercise as a standard first-line therapy of lifestyle changes.  This certainly stands the test of reason.  The problem is that under this regimen, the syndrome actually worsens.  Eventually antihypertensive medication is prescribed as are drugs for diabetes.  Soon the patient finds themselves on 6 or more drugs with no improvement in their status.  The underlying problem is that nothing has been done to address their insulin resistance.  A more appropriate course of treatment in this scenario would be the use of a muscle sparing protein diet and more importantly carbohydrate restriction, consisting mainly of fiber and vegetables, keeping in mind that all carbohydrate, with the exception of fiber, will eventually be turned into blood glucose either quickly or slowly.  By restricted carbohydrate intake, insulin secretion can be reduced and thus reducing insulin sensitivity/resistance.  In doing this, weight loss can occur and the patient’s syndrome can actually reverse.  If you suffer from any of the symptoms associated with metabolic syndrome, you should consult with myself and/or your family physician before undertaking any therapeutic regimen as in extreme cases drug therapies may be appropriate to reduce risk of stroke and/or other consequential risks.

Blood Pressure, Diabetes and the Metabolic Syndrome

By Dr. A. R. Scopelliti

Nov

7

Each week I see patients who have recently been examined by their primary doctors and are told that have findings of high blood pressure, elevated blood sugar or both. They are ill advised to return for followup in 8 weeks for a second test. I am not suggesting that it is wrong to followup when you have such finings. It is however foolish to make no management recommendations and expect a different outcome on a subsequent visit. Often on the next visit medication will be prescribed as now there is a trend and not just a single visit finding which may have been just coincidence. It is necessary to show a trend vs. a single visit reading to prescribe drug therapies unless hypertension is severe. It is reasonable that if someone is found to have high blood pressure, or, blood work reflects elevation in blood glucose, that rather than simply recording such data for record keeping that lifestyle modifications would be immediately discussed and proposed as being not only appropriate but necessary. Again, it could be argued that simply having an elevation in blood glucose does not mean that you are diabetic. Currently the diagnosis of diabetes is based on a blood test called the Hemoglobin A1c. However, if your blood test is demonstrating elevation in glucose, you are currently in a prediabetic state that needs to be addressed, not just monitored until such point that you definitely have diabetes, as is the case with an enormous number of Americans. If you have either elevated blood glucose or high blood pressure there are definitive lifestyle changes that you need to be making, now, not later. These changes do not merely mean kicking back and awaiting a drug therapy. It is this combination of blood glucose elevation and hypertension that constitutes the metabolic syndrome, a leading cause of disabilities, stroke, heart disease and death in this country, and it is getting worse each year despite drug therapies. When I meet with my patients I routinely discuss all aspects of their health. Most patients come to see me for dizziness and balance problems as well as other brain based disorders, but this doesn’t mean that I can’t help them get their life back if they are dangerously hypertense or prediabetic. In fact, I believe it is my job.

Living with Diabetes, Spice Things Up

By Dr. A. R. Scopelliti

Nov

29

Diabetes mellitus is a chronic metabolic disorder affecting about 6% of the population worldwide with its complications, and is rapidly reaching epidemic scale. Diabetes mellitus has long been known to be a cause of dizziness, associated with sudden changes in blood sugar levels too high or too low.  Metabolic syndrome is associated with insulin resistance, elevated glucose and lipids, inflammation, decreased antioxidant activity, increased weight gain, and increased glycation of proteins. Cinnamon has been shown to improve all of these variables in both animal and human studies. In addition, cinnamon has been shown to alleviate factors associated with Alzheimer’s, ischemic stroke and studies also show that components of cinnamon control new blood vessel formation associated with the proliferation of cancer cells. Human studies involving control subjects and subjects with metabolic syndrome, type 2 diabetes mellitus, and polycystic ovary syndrome all show beneficial effects of whole cinnamon and/or liquid extracts of cinnamon on glucose, insulin, insulin sensitivity, lipids, antioxidant status, blood pressure and on lean body mass. However, not all studies have shown these positive effects of cinnamon, and type and amount of cinnamon, as well as the type of subjects and drugs subjects are taking, are likely to affect the response to cinnamon use. There are however no studies suggesting adverse affects of cinnamon use. In one study, the median lethal dose of cinnamon could not be obtained even at 20 times (0.4 g/kg body weight) its effective dose. With the high margin of safety of cinnamon, it appears useful as a potential therapeutic candidate for the management of diabetes.  As such, the use of cinnamon may be important in the alleviation and prevention of the signs and symptoms of metabolic syndrome, type 2 diabetes, and cardiovascular and related diseases.  I have been recommending its place in the diet for years to my patients, particularly those whom are diabetic or suffering with the aforementioned disorders.

Extensive research within the past two decades has revealed that obesity, a major risk factor for type 2 diabetes, atherosclerosis, cancer, and other chronic diseases, is a pro-inflammatory disease. Several spices have been shown to exhibit activity against obesity through antioxidant and anti-inflammatory mechanisms. Among them, curcumin, a yellow pigment derived from the spice turmeric (the main ingredient in curry powder), has been investigated most extensively as a treatment for obesity and obesity-related metabolic diseases. These curcumin-induced alterations reverse insulin resistance, hyperglycemia, hyperlipidemia, and other symptoms linked to obesity. Other structurally homologous nutraceuticals, derived from red chili, cinnamon, cloves, black pepper, and ginger, also exhibit effects against obesity and insulin resistance.

Sugar, A Cause For Dizziness?

By Dr. A. R. Scopelliti

Jul

27

Diabetes is becoming more common and more of a medical problem than ever before.  I am specifically referring to type 2 diabetes, which is invariably brought on entirely by ones eating habits.  This is why it has earned the designation “adult onset diabetes”.  The “juvenile” type, or type 1, occurs at an early age for other reasons entirely.  So let’s discuss type 2, since that is the big problem and since it is entirely in your control to remedy.  Quite simply, type 2 diabetes occurs associated with obesity.  For each pound of “extra” weight one carries, risk of diabetes rises, exponentially.  As an example, someone 30 pounds overweight has a 4000% increased risk in becoming diabetic.  (This is not a typo).

Heart disease and peripheral artery disease are the biggest complications that people face with uncontrolled diabetes. Approximately 65% of death from diabetes is due to heart disease and stroke.  Peripheral artery damage or nerve damage, also from uncontrolled diabetes, can lead to foot problems that can lead to amputations. More than 60% of leg and foot amputations not related to an injury are due to diabetes.  Diabetes is the leading cause of blindness in this country. Other problems include glaucoma, cataracts and diabetic retinopathy.  Studies show that regular eye exams and timely treatment of diabetes-related eye problems could prevent up to 90% of diabetes-related blindness. Recent studies correlate metabolic syndrome with marked increase in total fructose intake in the form of high-fructose corn syrup, beverage and table sugar.  Metabolic syndrome is a name given to a group of risk factors including heart disease.  If you learn to read labels, you will find that many products now contain high fructose corn syrup.

Dizziness, a common problem in and of itself, is often associated with deregulation of sugar.  Sugar levels, both too high, and too low, will lead to dizziness. Your body does a delicate balancing act trying to maintain as steady a level of blood sugar as possible.  You can help this cause  by maintaining a healthy diet that does not cause blood sugar levels to suddenly go through the roof, or conversely, waiting all day to eat causing them to plummet.  More information on healthy eating tips can be found on my website.  Much of the dizziness which I see clinically is ether caused by or complicated by extreme variations in blood sugar levels.

Of equal importance is exercise.  Humans were not meant to be sedentary, which unfortunately, is how many Americans spend their day. Exercise should be performed at the highest level of your ability.  If you are unsure of your ability, you should discuss it with your doctor.