Early Stage Type II and Progression/Meds issues
jim
problem for another, so genralized conclusions about meds and
different foods seem foolhardy. Yes, certain risks are apparent for
different meds, but the actual experience for each individual person
varies greatly. So far, some 10 days into Actos, I have absolutely no
weight gain and no notable fluid retention. What I do have a very good
BG numbers. IF that continues, the fact that insulin resistance is my
primary issue (I am EARLY stage type II) and Actos specifiacally
targets that issue, makes Actos my drug of choice. Time will tell. I
might add that SOME postulate that when insulin resistance is the
primary problem (often with early stage type II people) it results in
overtaxing beta cells and that is what may cause further progression.
One theory, but if true, that would may Actos a good way to possibly
seriously inhibit long term progression in EARLY stage type II people.
Andrew B. Chung, MD/PhD
It remains wiser to eat less, down to the optimal amount to lose the
VAT in order to cure the insulin resistance:
http://HeartMDPhD.com/HolySpirit/Healing
May GOD bless you in HIS mighty way making you healthier (hungrier)
than ever:
http://HeartMDPhD.com/Press.asp
Prayerfully in Jesus' awesome love,
Andrew <><
--
Andrew B. Chung, MD/PhD
Cardiologist
jim
My A1c is 5.8 BEFORE any meds. My BMI is 28. So both are not issues.
Yes, diet and exercise have helped me lower my A1c from 6.8 to 5.8,
but a clamp test even with these good number showed my insulin
resistance, which you usually see with early stage type II. Beyond all
that is the usual progression and the attempt to 'head it off'. So
adding Actos with its lowering the resistance further and putting even
less stess on beta cells has a defensable position. Furthermore, so
initial early evidence indicates that Actos has the potential to stop
and possibly even reverse beta cell deterioration. All this is yet to
be conclusively proven, but the early evidence is there.
Andrew B. Chung, MD/PhD
Andrew, in the Holy Spirit, boldly wrote:
>
> > http://groups.google.com/group/alt.support.diabetes/msg/971f065c46038727?
>
> My A1c is 5.8 BEFORE any meds. My BMI is 28.
Optimal BMI for most people especially folks with insulin resistance
is 20.
"World's lie that hunger is bad" --> overeating --> VAT --> IR/MetS --
> T2DM
Additional suggested reading:
http://HeartMDPhD.com/Press.asp
May GOD bless you in HIS mighty way making you healthier (hungrier)
than ever.
jim
the optimal amount to lose the VAT actually "cures insulin
resistance"? That diet and excercise can help lower a1c numbers...no
doubt...but actually "curing insulin resistance", as you put it???
Furthermore while their is evidence in studies that progression can be
slowed (in many cases) by diet and exercise, what evidence is their
that it will definitively stop beta cell deterioration without a
doubt? May ask where your got the BMI number 20 from ?
On Jul 1, 3:11 pm, "Andrew B. Chung, MD/PhD" <lov...@thetruth.com>
wrote:
>> It remains wiser to eat less, down to the optimal amount to lose the
> VAT in order to cure the insulin resistance:
>
> http://HeartMDPhD.com/HolySpirit/Healing
>
> May GOD bless you in HIS mighty way making you healthier (hungrier)
> than ever:
>
> http://HeartMDPhD.com/Press.asp
>
> Prayerfully in Jesus' awesome love,
>
> Andrew <><
> --
> Andrew B. Chung, MD/PhD
> Cardiologist- Hide quoted text -
>
> - Show quoted text -
jim
Andrew B. Chung, MD/PhD
>
> May I respectfully ask what evidence is there that "eat less, down to
> the optimal amount to lose the VAT actually "cures insulin
> resistance"?
We now know the molecular mechanisms behind how the inflammatory
cytokines from VAT cause insulin resistance (IR/MetS).
It logically follows from this knowledge that removing the source
(VAT) of these inflammatory cytokines will result in a cure.
The only real solution to a problem is in addressing the cause of the
problem.
> That diet and excercise can help lower a1c numbers...no
> doubt...but actually "curing insulin resistance", as you put it???
While there is overeating, diet and exercise will not bring about the
complete loss of VAT.
Without the latter, insulin resistance persists.
> Furthermore while their is evidence in studies that progression can be
> slowed (in many cases) by diet and exercise, what evidence is their
> that it will definitively stop beta cell deterioration without a
> doubt?
The beta cells are actually "deteriorating" (apoptosis) because of the
inflammatory cytokines coming from the VAT. These inflammatory
cytokines are causing accelerated apoptosis throughtout the body in
blood vessels and other tissues including other endocrine organs (ie
thyroid gland, adrenal glands, pituitary gland, etc)
> May ask where your got the BMI number 20 from ?
13 years of clinical experience.
May GOD bless you in HIS mighty way making you healthier (hungrier)
than ever:
http://HeartMDPhD.com/press.asp
jim
but is one of a number of plausable causes'. I have met with a top
diabetic researcher from Harvard (after volunteering for an extensive
study that provided me with much information about my particular case)
and we have discussed the possible causes...of which their may be not
one but many. She is involved in and privy to many leading edge
studies currently going on. Her experience goes back many many years.
Just as in cancer, the current research indicates a number of possible
causes which may vary by the individual and that is perhaps why
different foods and different meds may help or hinder different
people.
Has the BMI number come from any clinical research that correlated
various specific BMIs with insulin resistance levels in specific
individuals?
Thank you! I am trying to learn as much as possible from documented
studies as compared to anecdotal 'evidence'. Your input is valued.
On Jul 1, 3:44 pm, "Andrew B. Chung, MD/PhD" <lov...@thetruth.com>
wrote:
jim
diabetics undergo a 'clamp' test where you can make SOME determination
as to how much of an insulin resistance problem and how much of
insulin production problem an individual has. It is an expensive and
time consuming test , so rather than having a specific med appropriate
to an individual person's actual issuue(s) we have to deal with
metformin as the first line (long time known risk factors that are
minimal and tiny risk of low BG danger). Studies have show that it
helps slow progression. Diet and exercise have also shown to slow
progression. I can find no study that COMBINES the effect of diet,
exericise and metformin to show if the combination of all three
factors is adds a GREATER slowing of progression. 2+1 might equal 2 or
3 or 4 . The combined study has not been done to my knowledge. In my
case I had a clamp because I volunteered for a study. I did not know
that a clamp would provide me with the information it did when I
volunteered. I know that resistance is my primary problem, so for me,
Actos makes sense. It is RISKIER than metformin as it has not been
around nearly as long to prove its long term consequences.
> I understand your reasoning, but not why Actos, rather than metformin
> would be the logical drug of choice?
>
> Susan- Hide quoted text -
Nicky
>I know that resistance is my primary problem, so for me,
>Actos makes sense. It is RISKIER than metformin as it has not been
>around nearly as long to prove its long term consequences.
Jim, I still don;t follow your reasoning - Metformin is an
anti-resistance drug, as well as inhibiting excess hepatic activity,
and has a cardio-protective effect.
Nicky.
T2 dx 05/04 + underactive thyroid
D&E, 100ug thyroxine
Last A1c 5.6% BMI 25
Andrew B. Chung, MD/PhD
>
> With all due respect, the inflammatory" theory has not been 'proven
> but is one of a number of plausable causes'.
For those in the field of molecular medicine especially in the area of
vascular biology, the inflammatory cytokines coming from VAT is
proven.
> I have met with a top
> diabetic researcher from Harvard (after volunteering for an extensive
> study that provided me with much information about my particular case)
> and we have discussed the possible causes...of which their may be not
> one but many. She is involved in and privy to many leading edge
> studies currently going on. Her experience goes back many many years.
My PhD dissertation work and post-doctoral vascular biology research
work are in the area of genetics and molecular medicine with a focus
on the transcription factors involved in the response to the presence
of inflammatory cytokines. Indeed, I have personally cloned two of
the transcription factors, whose biochemical properties are critical
for understanding the gene regulatory aspects of the
pathophysiological response to the inflammatory cytokines coming from
VAT. This knowledge spans nearly 20 years and remains unpublished
because of professional rivalry issues (competing research groups
could outcompete the founding labs if the sequences were published) so
that only a handful of investigators at Emory know about this. LORD
willing, this will be the topic of one of many books I hope to write
in the future after Be Hungry, which is the first:
http://HeartMDPhD.com/Press.asp
> Just as in cancer, the current research indicates a number of possible
> causes which may vary by the individual and that is perhaps why
> different foods and different meds may help or hinder different
> people.
Metabolic syndrome (aka insulin resistance) is nothing like cancer,
where there is an alteration in the genetic material of the abnormal
cells.
> Has the BMI number come from any clinical research that correlated
> various specific BMIs with insulin resistance levels in specific
> individuals?
The BMI is a rough approximation of the amount of VAT.
Waist to hip ratio (WHR) is a better estimate.
What we know is that while there is insulin resistance, there is still
VAT.
> Thank you!
You are welcome. Would redirect your thanks to GOD, Who is the Source
of all knowledge and wisdom so that we will both be that much more
blessed.
Be hungry.
Andy is Evil
@o61g2000hsh.googlegroups.com:
> With all due respect, the inflammatory" theory has not been 'proven
> but is one of a number of plausable causes'. I have met with a top
> diabetic researcher from Harvard (after volunteering for an extensive
> study that provided me with much information about my particular case)
> and we have discussed the possible causes...of which their may be not
> one but many. She is involved in and privy to many leading edge
> studies currently going on. Her experience goes back many many years.
> Just as in cancer, the current research indicates a number of possible
> causes which may vary by the individual and that is perhaps why
> different foods and different meds may help or hinder different
> people.
> Has the BMI number come from any clinical research that correlated
> various specific BMIs with insulin resistance levels in specific
> individuals?
> Thank you! I am trying to learn as much as possible from documented
> studies as compared to anecdotal 'evidence'. Your input is valued.
Andrew's input is not valued by the majority of sci.med participants as
Google will indicate. Then again maybe the arguments of someone willing
to set aside his scientific education and replace it with fundamental
Christian creationist mythology is just what you're looking for.
If you receive a copy of the peer review for Andrew's much spammed 2PD-
OMER "eating approach" do let us know ;-)
>>
>> > May ask where your got the BMI number 20 from ?
>>
>> 13 years of clinical experience.
Google Bob Pastorio's (reposted by "Flying Rat") after Bob's death to
discover how Andrew lost his first (and as far as we know only) job after
3 months.
>>
>> May GOD bless you in HIS mighty way making you healthier (hungrier)
>> than ever:
>>
>> http://HeawtMDPhD.com/press.asp
SCAM ALERT
SPAM
SPAM
SPAM
snip
>
Andy is Evil
(but he doesn't need to be)
ray
I'm glad it's working for you.
Wingmask
It wont matter in 30 years. So who cares.
Alan S
wrote:
Hi Jim
Glad to see it works for you.
Just a side comment. Most of the rest of your posts will
have been missed by those who automatically skip respondents
to Chung.
Cheers, Alan, T2, Australia.
d&e, metformin 1500mg, ezetrol 10mg
Everything in Moderation - Except Laughter.
--
http://loraltraveloz.blogspot.com/
latest: Kuranda Skyrail near Cairns
http://loraldiabetes.blogspot.com/
latest: Ki Si Ming
jim
Absolutely agreed that Actos has a short history and so the jury is
still out. However, the current studies indicate that IF you have a
problem with edema (so far no weight gain or any sign of bloating/
water retention in me...again so far...and you have a history of heart
failure, Actos is a big no no. On the other hand, for those who do not
exhibit those problems, Actos actually improves the lipid profile and
has ...so far...shown a serious decrease in heart attacks for those
with kidney/diabetic issues. Different people..different risk
evaluation.
As for metformin vs. Actos...my understanding is that Actos is much
more effective in treating insulin resistance.
Please read the full report in this link.
http://www.bloomberg.com/apps/news?pid=20601102&sid=a9QcNksRg_Tk&refer=uk
We need to learn from each other to help each other. Please...let us
all continue to look for studies and information that can help ALL of
us become better informed consumers. We need to be aware of risk/
benefits that apply to each of us individually. This is most difficult
with the constantly updated information. Let us
support...encourage..and give strength to each other through knowledge
based upon the best and latest information.
On Jul 1, 5:53 pm, Susan <neverm...@nomail.com> wrote:
> x-no-archive: yes
>
>
>
>
>
> jim wrote:
> > Susan, I had the same question. Here lies one 'problem'. Very few
> > diabetics undergo a 'clamp' test where you can make SOME determination
> > as to how much of an insulin resistance problem and how much of
> > insulin production problem an individual has. It is an expensive and
> > time consuming test , so rather than having a specific med appropriate
> > to an individual person's actual issuue(s) we have to deal with
> > metformin as the first line (long time known risk factors that are
> > minimal and tiny risk of low BG danger). Studies have show that it
> > helps slow progression. Diet and exercise have also shown to slow
> > progression. I can find no study that COMBINES the effect of diet,
> > exericise and metformin to show if the combination of all three
> > factors is adds a GREATER slowing of progression. 2+1 might equal 2 or
> > 3 or 4 . The combined study has not been done to my knowledge. In my
> > case I had a clamp because I volunteered for a study. I did not know
> > that a clamp would provide me with the information it did when I
> > volunteered. I know that resistance is my primary problem, so for me,
> > Actos makes sense. It is RISKIER than metformin as it has not been
> > around nearly as long to prove its long term consequences.
>
> Jim, I understand that you had a clamp study and found out that you're
> insulin resistant.
>
> I think the problem with Actos is that it's been around a short time and
> is already known to promote edema and congestive heart failure.
> Metformin has been around a much longer time, improves insulin
> sensitivity as a powerful antioxidant.
>
> Susan- Hide quoted text -
>
> - Show quoted text -
.
jim
positive answer in studies...IF you significantly reduce insulin
resistance, does that stop/reverse deterioration of beta cells and can
that halt progression? Is the initial insulin resistance causing the
beta cells to deteriorate, or is more going on? Does early aggressive
intervention against insulin resistance an important thing to do with
long term benefits? Do we avoid meds as long as possible using only
diet and exercise..or do we aggressively medicate to decrease
resistance as early as possible and as much as possible in spite of
low a1c numbers without meds but with diet and exercise alone? There
lies a BIG unanswered question. Some early data indicates that Actos
can have an effect on beta cell retention. Perhaps that is tied to its
action against insulin resistance. Perhaps. So the metformin vs. Actos
question is a difficult one to conclusively decide based upon known
risk factors for each individual and the difference in their
effectiveness in insulin resistance alone.
On Jul 1, 11:30 pm, jim <jim...@netzero.net> wrote:
> Hi Susan!
> Absolutely agreed that Actos has a short history and so the jury is
> still out. However, the current studies indicate that IF you have a
> problem with edema (so far no weight gain or any sign of bloating/
> water retention in me...again so far...and you have a history of heart
> failure, Actos is a big no no. On the other hand, for those who do not
> exhibit those problems, Actos actually improves the lipid profile and
> has ...so far...shown a serious decrease in heart attacks for those
> with kidney/diabetic issues. Different people..different risk
> evaluation.
> As for metformin vs. Actos...my understanding is that Actos is much
> more effective in treating insulin resistance.
>
> Please read the full report in this link.http://www.bloomberg.com/apps/news?pid=20601102&sid=a9QcNksRg_Tk&refe...
> .- Hide quoted text -
jim
stands. He takes comments and reconfigures them to ways that he wants
and and answers questions . For example, I said that just as in cancer
where a number of different causes (mechanisms) may very well be
invovled, so I was told the same may very well be true of diabetese.
He twisted it so that his response was to an assertion that I never
made...equating the two diseases in a way that I never did. He wrote
about his studies not being published because of jealousy. Good
excuse. He jumps from a molecular conclusion that he asserts he made
about the action of inflammation, to a conclusion that it is THE cause
the deterioration of many organs. A broad assumption. Yes...some
evidence exists that inflammation may very well be ONE cause among
many. May. The jury is out.
On Jul 1, 7:31 pm, Alan S <loralgtweightandca...@gmail.com> wrote:
>.
>
> Just a side comment. Most of the rest of your posts will
> have been missed by those who automatically skip respondents
> to Chung.
>
> Cheers, Alan, T2, Australia.
> d&e, metformin 1500mg, ezetrol 10mg
> Everything in Moderation - Except Laughter.
> --http://loraltraveloz.blogspot.com/
> latest: Kuranda Skyrail near Cairnshttp://loraldiabetes.blogspot.com/
> latest: Ki Si Ming
Alan S
wrote:
>I have already seen that Chung answers in ways that do not justify his
>stands. He takes comments and reconfigures them to ways that he wants
>and and answers questions . For example, I said that just as in cancer
>where a number of different causes (mechanisms) may very well be
>invovled, so I was told the same may very well be true of diabetese.
>He twisted it so that his response was to an assertion that I never
>made...equating the two diseases in a way that I never did. He wrote
>about his studies not being published because of jealousy. Good
>excuse. He jumps from a molecular conclusion that he asserts he made
>about the action of inflammation, to a conclusion that it is THE cause
>the deterioration of many organs. A broad assumption. Yes...some
>evidence exists that inflammation may very well be ONE cause among
>many. May. The jury is out.
Mate, the jury on Chung returned a verdict long ago. He's
insane, literally.
It's pretty basic - most kf him but also those who respond
to him.
Best wishes.
jim
I am brand new here. I have not had a chance to read your blog, but
thank you for sharing. I have alot to learn! Great confusion and
concern about what is not known. Wishing that meds decisions were
easier to make. I am gratedul for the honest opinions expressed as
well as for the openess that I found in the doctors that I have
consulted. They often discuss their own way of deciding and have told
me how, in my case, they balance pros and cons. I listen...and then
TRY to evaluate and decide what risk/benefit I should take based upon
the information that they have provided for me. I have found them
often grappling with the same debate that I have. Honest discussion.
Helpful, but wish that things were clearer.
Wishing all of us good health and happiness. Tens years from now we
may look back and say that why did I do X...or be grateful that I did
X. We know what we know when long term information is available...just
as researchers and doctors do. I cannot expect them to guess what
future studies will show.
Andrew B. Chung, MD/PhD
>
> I have already seen that Chung answers in ways that do not justify his
> stands. He takes comments and reconfigures them to ways that he wants
> and and answers questions . For example, I said that just as in cancer
> where a number of different causes (mechanisms) may very well be
> invovled, so I was told the same may very well be true of diabetese.
> He twisted it
There was no twisting. What you wrote was given verbatim.
Your false witness is forgiven by me.
> so that his response was to an assertion that I never
> made...equating the two diseases in a way that I never did.
Actually, the mechanism of cancer is well understood to involve
somatic mutations. The latter would be the cause. This automatically
negates your assertion that type-2 diabetes would have multiple causes
as does cancer.
> He wrote
> about his studies not being published because of jealousy.
Rivalry is not jealousy.
> Good excuse.
Fact is not excuse.
> He jumps from a molecular conclusion that he asserts he made
> about the action of inflammation, to a conclusion that it is THE cause
> the deterioration of many organs.
Incorrect as you have written. Would suggest you reread the post to
understand that the multi-organ problems of a type-2 diabetic is
coming from the pro-inflammatory effects of the cytokines from VAT
rather that from the fasting hyperglycemia.
The proof is had by observing that folks with IR/MetS have multi-organ
problems **before** there is fasting hyperglycemia.
Bottomline:
You are untruthful.
You know not what you are doing because you have the world's great lie
that hunger is bad in your heart taking away your free will choice to
be truthful:
http://HeartMDPhD.com/Press.asp
May GOD bless you in HIS mighty way making you healthier (hungrier)
than ever.
jim
Chung I forgive YOUR continued untruths and misleading, definitive,
creative and unsubstantiated conclusions. Your ego is getting the best
of you at great expense of the truth. As others have done...I now will
ignore you. They are correct.
redr...@juno.com
> Absolutely agreed that Actos has a short history and so the jury is
> still out. However, the current studies indicate that IF you have a
> problem with edema (so far no weight gain or any sign of bloating/
> water retention in me...again so far...and you have a history of heart
> failure, Actos is a big no no. On the other hand, for those who do not
> exhibit those problems, Actos actually improves the lipid profile and
> has ...so far...shown a serious decrease in heart attacks for those
> with kidney/diabetic issues. Different people..different risk
> evaluation.
> As for metformin vs. Actos...my understanding is that Actos is much
> more effective in treating insulin resistance.
>
>
Jim
The data showing that Actos reduces heart attack risks is preliminary
at this point. A lot of studies are conducted and not all are of equal
quality. The data on Actos needs more confirmation.
Metformin also has some impact on insulin resistance and it does work
on the liver to prevent excessive glucose production (it reduces
hepatic insulin resistance). There is salso some data that metformin
might reduce both cardio and even cancer (this data is weak) risks.
Its safety profile is better.
The clamp is a good measure, but the final test should be what impact
a particular threapy has on your BS and A1c. I would personally have
gone with Metformin to see if I can get good control with it. If not,
consider Actos. But its your decision to make and your doctor's
guidance.
redr...@juno.com
> I should add that a crucial question remains...with hints of a
> positive answer in studies...IF you significantly reduce insulin
> resistance, does that stop/reverse deterioration of beta cells and can
> that halt progression? Is the initial insulin resistance causing the
> beta cells to deteriorate, or is more going on? Does early aggressive
> intervention against insulin resistance an important thing to do with
> long term benefits? Do we avoid meds as long as possible using only
> diet and exercise..or do we aggressively medicate to decrease
> resistance as early as possible and as much as possible in spite of
> low a1c numbers without meds but with diet and exercise alone? There
> lies a BIG unanswered question. Some early data indicates that Actos
> can have an effect on beta cell retention. Perhaps that is tied to its
> action against insulin resistance. Perhaps. So the metformin vs. Actos
> question is a difficult one to conclusively decide based upon known
> risk factors for each individual and the difference in their
> effectiveness in insulin resistance alone.
If you're really interested in beta cell retention, the data indicates
that Byetta has a much stronger impact than Actos. Of course, its even
newer.
jim
more studies...for sure. Time will tell. Meanwhile...we do the best we
can with what we know now. If only we'd have more definitive long term
answers to make things clearer for all of us! Let's all keep our
antennas out for any new information that can be relied upon to help
us make better informed decisions. This is a wonderful group and I
only hope that together we can help make our collective future bright,
healthy, productive and useful for all of mankind. Have a wonderful
day!
Andrew B. Chung, MD/PhD
> Andrew, in the Holy Spirit, boldly wrote:
>
> > http://groups.google.com/group/alt.support.diabetes/msg/dc940e24be1b8d11?
>
> Chung I forgive YOUR continued untruths and misleading, definitive,
> creative and unsubstantiated conclusions.
It remains my choice to continue writing truthfully.
> Your ego is getting the best of you at great expense of the truth.
It remains my choice to continue to die to self daily.
Where there is no self... there is no ego.
It would be my wish that you knew the truth, Who is LORD Jesus Christ.
Meanwhile, you have satan's greatest lie that "hunger is bad" in your
heart:
http://HeartMDPhD.com/Press.asp
> As others have done...I now will ignore you.
You have the free will that GOD has generously given all souls per HIS
infinite and perfect will even though you have less because of the lie
in your heart.
> They are correct.
Without the LORD, your beliefs are meaningless (Ecclesiastes).
The brethren of LORD Jesus Christ are neither perfect nor more
special...
... we are simply forgiven by GOD:
http://www.interviewwithgod.com/forgiven/
May you wisely choose to be forgiven too by publicly declaring that
"Jesus is LORD:"
http://HeartMDPhD.com/HolySpirit/TheWay
bj
news:1183403223.5...@m36g2000hse.googlegroups.com...
> Thank you for your continued input and information. We need to see
> more studies...for sure. Time will tell. Meanwhile...we do the best we
> can with what we know now. If only we'd have more definitive long term
> answers to make things clearer for all of us!
>
We will -- when it's been long enough to *be* long term!
Of course, what some people do is refuse to take anything until it's been on
the market for some time, i.e. "long term" in their opinion, with the
reports & studies to go by, & depending on what they personally feel is
"long-enough term".
:-)
bj
Alan S
I'm one of those; however, for some people the need to find
solutions that aren't being found by other means can lead to
early use of meds.
Alan S
wrote:
Welcome.
Good to see you. My comments were a minor warning on trolls
and kooks. Do what you wish, but there are certain posters
that end up in most people's killfiles. Chung, ironjustice
and Jai Maharaj are three obvious ones.
Crossposts that are across this core group of diabetes
groups are no problem:
alt.support.diabetes
misc.health.diabetes
alt.food.diabetic
alt.support.diabetes.uk
However, crossposts that include other groups such as
sci.med.cardiology are usually (not always) trolls or kooks.
That's been my experience anyhow.
I'll look forward to seeing your other posts in other
threads. Tell us a little more about your diabetes situation
and how you are managing your own d&e.