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Obese diabetics at risk of kidney disease

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Are you suffering from Type 1 diabetes? You better watch that weight around your waist. Researchers from the   University of Washington, Seattle, have found that adults with Type 1 diabetes who are obese, especially those who carry excess weight around the waist, are at an increased risk of developing kidney disease. In fact, according to the study that was presented at the recently concluded World Diabetes Congress, for every four-inch

increase in waist circumference, the risk of microalbuminuria    small amounts of the protein albumin in urine, the first sign of diabetic kidney disease  increased by 34%. Microalbuminuria is not only an important sign of kidney disease but also a marker of increased risk for cardiovascular disease.

Dr Ian H de Boer from the university’s department of nephrology said,”For patients with Type 1 diabetes, obesity is an important risk factor for the development of kidney disease. Our study suggests that lifestyle interventions, such as exercise and diet, will be useful in preventing kidney and heart disease in this group of people.” The study will appear in
the January 2007 issue of the Journal of American Society of Nephrology.

According to the researchers, the risk of microalbuminuria was significantly higher for patients who were suffering from central obesity fat around the midsection.
The study says,”Weight gain and central obesity are associated with insulin resistance, hypertension and dyslipidemia in Type 1 diabetes.

These metabolic abnormalities are risk factors for kidney disease. Whether waist circumference is associated with microalbuminuria was examined among 1,279 participants who had Type 1 diabetes.”
“Over 93 of 1,105 participants with normal albumin excretion rate developed microalbuminuria over the 5.8 year period.

In conclusion, waist circumference predicts the subsequent development of microalbuminuria in Type 1 diabetes.”

Source:The Times Of India

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Ailmemts & Remedies

Angina

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Definition:  Angina pain develops when the muscles of the heart are not getting enough oxygen. This is usually caused by narrowing or blockages of the coronary arteries which deliver oxygen-rich blood to the heart muscle (known as coronary artery disease). So angina is a sign of heart disease……….click & see

If the blockage of a coronary artery progresses and becomes complete, then the blood supply to part of the muscles of the heart is lost, causing a heart attack. Angina is a warning sign that the heart is at risk of a heart attack, and should be taken very seriously. One patient in every ten will go on to have a heart attack within a year of diagnosis of angina.

When your heart isn’t getting enough blood and oxygen, the crushing, squeezing pain of angina is typically the result. Usually the pain begins below the breastbone and radiates to the shoulder, arm, or jaw, increasing in intensity until it reaches a plateau and then diminishes. The attack can last up to 15 minutes.

Angina may be an occasional problem or may rapidly increase in severity and duration until a heart attack occurs.

Although conventional medications for angina may help relieve the intense chest pain of this heart disorder, they do very little to halt the physiological mechanisms behind it. Vitamins, minerals, and natural remedies may actually improve the condition — or at least keep it from.

Symptoms:…….

Symptoms include:

*Crushing or squeezing chest pain.
*Weakness.
*Sweating.
*Shortness of breath.
*Palpitations.
*Nausea.
*Light-headedness.

When to Call Your Doctor
If you have any of the above symptoms for the first time.
If there is any change in the normal pattern of your angina attacks — for example, if they increase in frequency, intensity, or duration, or if they are brought on by new activities.
If an angina attack lasts more than 15 minutes, which may be a heart attack — call for an ambulance immediately.
Reminder: If you have a medical condition, talk to your doctor before taking supplements.

Causes and risk factors:
Angina is common – about eight per cent of men and three per cent of women aged between 55 and 64 have experienced it, and it becomes more common with age.

It’s most commonly caused by narrowing of the arteries which carry oxygen to the heart muscle by a process called atherosclerosis (sometimes known as hardening of the arteries). This is a common condition where fatty deposits or plaques build up in the coronary arteries. Symptoms don’t usually develop until there is at least a 50 per cent blockage of the artery.

Most people in the developed world will have some atherosclerosis by the time they reach mid-life (and often much earlier), but some conditions can make it worse including:

•High cholesterol levels in the blood (especially if there is an inherited tendency to high cholesterol or a strong family history of heart disease).
•Cigarette smoking.
•Diabetes mellitus.
•High blood pressure.
Other conditions can also interfere with the blood supply to the heart muscle and lead to angina. These include:

•Abnormal heart rhythms (for example when the heart beats so fast that it isn’t pumping blood efficiently around the body).
•Heart valve disease.
•Inherited structural abnormalities of the coronary arteries.
•Severe anaemia (where the blood count is so low that it cannot carry much oxygen to the tissues).
Other important risk factors for angina include obesity, and raised levels of chemical in the blood called homocysteine, or other chemicals involved with clotting.

In another condition, known as Prinzmetal’s angina or coronary artery spasm, the coronary arteries aren’t permanently blocked but intermittently narrowed by spasm. This often develops in the early hours of the morning and may last up to 30 minutes. Those affected may also complain of palpitations and abnormal heart rhythms, or have similar conditions linked to spasm of the arteries such as migraine or Raynaud’s phenomenon.

Events which put extra strain on the heart can make angina worse, such as:

•Fever.
•Infection and serious illness.
•Emotional stress.
•An overactive thyroid gland.
•Sudden extreme exertion.
But angina can come on at rest, even when a person is lying down in bed.

Diagnosis and modern treatment :
There are many problems which can be confused with angina, especially simply indigestion or gastro-oesophageal reflux. There may be no visible signs of angina so it’s important that tests are done to establish the diagnosis, to ensure the affected person gets the right treatment.

An electrocardiogram (ECG) is essential and may show typical changes but can be normal in angina. Blood tests can be done to check for causes such as anaemia and look for chemical enzymes (called Troponins) released from the heart if a heart attack has occurred. Other checks for cholesterol levels, blood fats, diabetes and thyroid disease may be done. In most areas of the UK these tests will be done at the local Rapid Access Chest Pain Clinic.

More complex tests such as an ECG during exercise, echocardiogram or other sophisticated x-ray tests may be recommended. However, NICE has recently produced guidelines which direct which tests should be done based on a statistical calculation of how likely to patient is to have angina. For example, invasive coronary angiography (where a tube is inserted into the coronary arteries and dye injected to produce x-rays pictures of the coronary arteries) is usually offered when there is a greater than 61 per cent chance of coronary artery disease.

Treatment of angina includes:

•Lifestyle advice to manage risk factors, such as weight loss, exercise, quitting smoking and a healthy diet.
•Medical treatment, including a drug called glyceryl trinitrate or GTN which can be taken repeatedly as a tablet put under the tongue or as a spray, and medical advice on what to do if pain persists (ie. if there is a risk of a heart attack).
•Assessment and treatment for coronary artery disease, including a variety of drug treatments to help open the arteries or treatments such as aspirin and a statin type drug which help to reduce the risk of a heart attack. More invasive treatments to open up the coronary arteries may be recommended especially when there is severe blockage. These are known as coronary revascularisation. The main two types are either coronary artery bypass grafting, or percutaneous transluminal angioplasty.

How Supplements Can Help
The supplements listed in the chart can all be used together or alone. They can also complement your prescription angina medications; never stop your heart medication without first consulting your doctor, however.
The antioxidant effect of vitamins C and E can help prevent cell damage: Vitamin C aids in the repair of the arteries injured by plaque, and vitamin E blocks the oxidation of LDL (“bad”) cholesterol, the initial step in the formation of plaque. In addition, some people with heart disease have low levels of vitamin E as well as the mineral magnesium, which may inhibit spasms of the coronary arteries.

Amino acids can benefit the heart in several ways. Arginine plays a role in forming nitric oxide, which relaxes artery walls. One study found that taking this amino acid three times a day increased the amount of time individuals with angina could exercise at moderate intensity without having to stop because of chest pain. Carnitine, an amino acid-like substance, allows heart muscle cells to use energy more efficiently, and another amino acid, taurine, may temper heart rhythm abnormalities.

Like carnitine, the nutritional supplement coenzyme Q10 enhances the heart muscle, reducing its workload, and the herb hawthorn improves blood flow to the heart. Essential fatty acids may be effective in lowering triglyceride levels and keeping arteries flexible.

What Else You Can Do
Eat a low-fat, fiber-rich diet; use canola or olive oil instead of butter.
Don’t smoke and avoid smoky places.
Learn to relax. Meditation, t’ai chi, and yoga may reduce angina attacks.
Join a support group. Determine what brought you to this point in your life and what you can do to begin reversing the disease.

Supplement Recommendations
Vitamin C
Vitamin E
Magnesium
Arginine
Carnitine
Taurine
Coenzyme Q10
Hawthorn
Essential Fatty Acids

Vitamin C
Dosage: 1,000 mg 3 times a day.
Comments: Reduce dose if diarrhea develops.

Vitamin E
Dosage: 400 IU twice a day.
Comments: Check with your doctor if taking anticoagulant drugs.

Magnesium
Dosage: 200 mg twice a day.
Comments: Do not take if you have kidney disease.

Arginine
Dosage: 500 mg L-arginine 3 times a day on an empty stomach.
Comments: If using longer than 1 month, add mixed amino acids.

Carnitine
Dosage: 500 mg L-carnitine 3 times a day on an empty stomach.
Comments: If using longer than 1 month, add mixed amino acids.

Taurine
Dosage: 500 mg L-taurine 3 times a day on an empty stomach.
Comments: If using longer than 1 month, add mixed amino acids.

Coenzyme Q10
Dosage: 100 mg twice a day.
Comments: For best absorption, take with food.

Hawthorn
Dosage: 100-150 mg 3 times a day.
Comments: Standardized to contain at least 1.8% vitexin.

Essential Fatty Acids
Dosage: 1 tbsp. flaxseed oil a day; 2,000 mg fish oils 3 times a day.
Comments: Take fish oils if you don’t eat fish at least twice a week.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resource:

http://www.bbc.co.uk/health/physical_health/conditions/in_depth/heart/angina.shtml
http://www.gulfmd.com/cardiology/Facts_About_Angina.asp
http://indiahealthtour.com/treatments/health-check-screening/treadmill-test-india.html

Your Guide to Vitamins, Minerals, and Herbs

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Federal Panel to Review Use of Artery Device

PFIZER’S decision last weekend to abandon a promising cholesterol drug is but the latest recent setback as the health care industry continues its assault on cardiovascular disease, which has remained the leading cause of death and disability in Western societies since World War I………....click & see

Another reminder of the difficulties will come this week in Washington. Thursday will be the first of two days of hearings by a federal advisory panel that is expected to recommend stricter regulation on the use of drug-coated stents, the medical device industry’s most popular tool for dealing with clogged heart arteries.

The panel will weigh evidence that the stents, which were developed to keep coronary arteries open after they have been cleared of plaque, can in some cases cause fatal blood clots months or even years after they have been put in patients.

“From where we sit, there are more questions than answers,” said Dr. Daniel G. Schultz, director of the Center for Devices and Radiological Health at the Food and Drug Administration, which is holding the hearings.

Wall Street is uneasy, too. The nation’s market leader in stents, Boston Scientific, whose stock was struggling under the weight of the company’s $27 billion takeover of Guidant in April, has experienced an additional 7 percent stock decline in the last three months  largely on rising concern among doctors and consumers about the long-term clotting risks.

The nation will spend close to $258 billion treating cardiovascular diseases this year, according to the American Heart Association, including $50 billion on devices and drugs.

But drug and device companies face a shifting landscape in which the traditional image of the heart and circulatory system   pipes and pumps where any clogging is a threat   has been replaced by a far more complicated picture. It is now clear that the human circulatory system can adapt to some types of clogging, but that patients can be killed without warning by the rupture of “vulnerable plaque”: fatty deposits containing a stew of cells that can cause rapid formation of a clot.

So far, though, there is no sure way to locate which plaques are about to rupture. Nor is there a proven drug or device for preventing their formation, dissolving them or sealing them off.

“Technology is pushing against the limits of our knowledge, and we are finding that to a certain extent, things are more complicated than we thought,   said Dr. Barry T. Katzen, director of the Baptist Cardiac and Vascular Institute at Baptist Hospital of Miami.

There are numerous forms of cardiovascular disease, which causes or contributes to the death of 2,500 Americans every day, according to the American Heart Association. While heart attack may be the most obvious dire outcome, symptoms as diverse as swelling of the feet, sexual dysfunction, stroke, kidney failure and chest pains are all common.

The death rate has been falling since the 1960s, a trend driven by the decline of smoking and more attention to healthier diets and lifestyles. But medical technology like heart pacemakers and defibrillators; blood-thinning and anti-clotting.
drugs; and, more recently, the cholesterol-fighting statin drugs have all helped, too.

Pfizer was chasing a potential blockbuster vision of reversing the progression of heart disease. Its drug torcetrapib stimulates production of a fat-grabbing protein   high-density lipoprotein, or HDL, the so-called good cholesterol. High levels of HDL can reverse plaque accumulation.

In theory, drug companies that are already working on closely related HDL stimulators may achieve torcetrapib’s benefits without its dangerous side effect of raising blood pressure. But Dr. Steven E. Nissen, chairman of cardiovascular medicine at the Cleveland Clinic, who was the lead investigator on an early clinical trial that highlighted the promise of torcetrapib, said researchers might now have difficulty enrolling patients in trials of related drugs.   It might kill the class,  he said.

Stents, meanwhile, are frequently used to relieve the disabling discomfort of angina rather than treat acute heart disease. They were introduced in the 1990s as an enhancement to angioplasty, a procedure in which a tiny balloon is inflated inside a blockage in a blood vessel to create a broader channel for blood flow. Bare-metal stents halved the frequency with which coronary arteries quickly clogged up again at the angioplasty site to about 20 percent.

Drug-coated stents, introduced in the United States in 2003, cut the reblockage frequency in half again and quickly grabbed close to 90 percent of the market because they saved patients the costs and risks of repeat procedures. Boston Scientific’s Taxus and Johnson & Johnson Cypher are the only drug-coated devices currently approved for sale, although Medtronic recently asked the F.D.A. to approve its Endeavor stent, and several other potential competitors are also developing products.

But now stent sales are falling in the United States and doctors report numerous calls from patients wondering whether the drug-coated devices are ticking time bombs. The risk may be slight, but it adds up to tens of thousands of heart attacks annually, because 600,000 Americans now receive coronary stents each year. And research suggests that such heart attacks kill as many as half of the patients who suffer them.

So far, the added risks of late clotting appear to balance the added risks of repeat procedures for bare-metal stents. That leaves unsettled the question of which device — the drug-coated or the bare-metal stent — might be safer in the long run.

One contentious issue the F.D.A. panel plans to discuss is the risk, benefit and cost of keeping patients indefinitely on a daily diet of aspirin and the anticlotting drug Plavix, to reduce the late clotting risk. Wall Street will also be watching closely to find out whether the panelists urge the F.D.A. to discourage the widespread “off-label” use of drug-coated devices in groups of patients who are in poorer health than those studied in the clinical trials.

One suggestion has been that the F.D.A. may require longer-term safety data for new stents. Because many of the new designs have features and early data suggesting they may be safer than Taxus or Cypher, however, some experts believe the F.D.A. will end up requiring more rigorous follow-up studies, rather than delay their entry into the market.

The new designs point to a persistent challenge for medical device regulators. Will changing technology render obsolete much of the safety data doctors are clamoring for about today’s devices before it can be compiled?

Source:New York Times

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Suppliments our body needs

Selenium

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What is selenium?

An essential trace element, selenium is nonmetallic, gray in appearance, and similar to
sulfur in its chemical composition. It is often available in single or multivitamin
supplements.

Why do you need it?
Selenium is needed to activate a number of hormones produced by the thyroid gland. It also activates an antioxidant enzyme called glutathione peroxidase, which may help protect the body from cancer, and has been shown to induce “apoptosis” (programmed cell death) in cancer cells. Selenium also plays a vital role in the functioning of the immune system. Studies have found that selenium supplementation stimulates the activity of white blood cells. It also enhances the effect of vitamin E, one of three vitamins that act as antioxidants.

How much selenium should you take?
According to the National Academy of Sciences, the recommended daily allowance (RDA) of selenium is as follows:

* Adult men: 55 micrograms/day
* Adult women: 55 micrograms/day
* Children aged 7-10: 30 micrograms/day
* Infants: between 10-15 micrograms/day
* Pregnant/lactating women: between 65-75 micrograms/day

What are some good sources of selenium?
Brazil nuts are the best source of selenium. Yeast, whole grains, garlic and seafood are also good sources. Some vegetables may contain considerable amounts of selenium depending on the content of selenium in the soil.Mustard seeds emerged from food ranking system as a very good source of selenium .

What can happen if you don’t get enough selenium?
While most people do not consume enough selenium on a daily basis, severe deficiency is
rare. Soils in some areas are selenium deficient, and people who eat foods grown primarily
on selenium-poor soils can be at greater risk for deficiency. The most notable condition
caused by selenium deficiency is Keshan disease, which causes an abnormality of the heart
muscle. Some studies have shown that patients with AIDS have abnormally low levels of
selenium. Other research has demonstrated an association between heart disease and depleted levels of selenium.

What can happen if you take too much?
Taking large amounts (more than 1,000 micrograms) of selenium per day can cause the loss of fingernails, teeth, and hair; nausea; and fatigue. In conjunction with iodine-deficiency induced goiter, selenium supplementation has been reported to increase the severity of low thyroid function.

Sources :ChiroFind.com

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The diet myth in diabetes

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The diet myth in diabetes and heart diseases has been exploded.

Studies by city doctors have revealed that rice and food cooked in mustard oil, in right proportion, do not harm diabetics and heart patients.

A diabetic can have carbohydrate and fat, but in the right quantity,   stated endocrinology head of SSKM Hospital Subhankar Chowdhury.   The belief that mustard and groundnut oil should be replaced with sunflower seed, sunflower and other oils with low saturated fat is also erroneous.

According to doctors, mustard and groundnut oil do not contain saturated fat, which is harmful for diabetics and those with heart diseases. Unsaturated fat is of two types   poly and mono. The two main ingredients of polyunsaturated fat are n3 and n6. A balanced quantity of each is required in a diet.The ideal n6-n3 ratio is 10:1. In sunflower seed, sunflower and other oils containing unsaturated fat, the ratio is 70:1.

This ratio causes abnormal blood lipid levels and blood clot,   explained Chowdhury.
Oil containing monounsaturated fat is also good for diabetics and heart patients, he added. “Mustard oil has a good proportion of monounsaturated fat and n3 type in polyunsaturated fat. Ideally there should be a mixture of both.

Diabetics should not avoid carbohydrates altogether, said doctors.   Carbohydrate is usually substituted with protein. But too much protein can damage the kidney in the long run. For a diabetic, the risk is higher as the organs are affected by the disease,    said a doctor.

A balanced and sensible diet with complex carbohydrates and high fibre content like whole grain, fruits and salads, vegetables and other items low in fat and cholesterol is the key to managing diabetes,  opined a city-based endocrinologist.

Nutritionists feel food with low glycemic index (those that are absorbed slowly and, therefore, maintain the blood sugar level) are good for diabetics.
Oatmeal, whole wheat flour, whole pulses, fenugreek seeds, flax seeds and leafy vegetables have low glycemic index,  said Vijaya Agarwal, consultant nutritionist at AMRI Hospitals.

Frequent meals are advisable for maintaining a proper blood sugar level, signed off Agarwal.

Source:The Telegraph (Calcutta,India)

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