Chit-Chat

20th June 2014

Starting the Chit-Chat page on my 3rd anniversary of a drug free life. This page will be devoted to general subjects, although health related, but not particularly restricted to metabolism or disorders of it. I wonder if there is any illness not connected to metabolism.

Three years ago, this day, I was in Istanbul, Turkey, pretty badly struck down by my familiar “allergic bronchitis” and was merrily sucking in on puffs of a steroid powder prescribed by my Dr, here in Mumbai. Along with that were handsome doses of anti-biotics & baby aspirins just for the heck of it. Am I glad, that that phase of life is over for me. My very dear friend Shirish, is following me closely and has completed his 2 years of a drug free life. His doctor had prescribed him pills for his blood sugar & a statin for his high cholesterol. Thankfully Shirish is someone who completely trusted my advice & followed me very strictly & faithfully. within months of him making these lifestyle changes he didn’t need these pills either.  

It was not that I resolved that day, that I would no longer take any drugs. It was just that I was on a healing curve with my system and it has never asked for any medicine since then. Many of us pride ourselves on our knowledge of drug names & can rattle off a few of them along with the symptoms for which they are prescribed. In hindsight, I can also hold myself guilty of this crime. Believe me, this is not something to be proud of. The sooner we can give up this means of showing off, the better – for our own health & that of near & dear ones. We are just giving in to the desires of the drug companies, who can fly in their fancy private jets at the expense of global good-health.

Changing subjects, the world was witness to the launch of a new medical product this week – The Bionic Pancreas. Wow, what a name. I wonder who coined it, and what bonuses he/she got for the service. Many a diabetic life has been made easy with a product called an Insulin Pump which also acts as a CGM (Continuous Glucose Monitor). The pump monitors a user’s glucose level 24/7 and injects need based insulin whether the user is asleep or awake. However, if the user’s sugar is running low he has to feed himself some glucose tablets or a sugary drink to correct.

The Bionic Pancreas fixes that problem. It contains 2 chambers, one for the glucose & the other for the insulin. The scientists / technicians who thought of the product & improved on the pump are very gleeful & the pharma giants who are going to market it are happier still. But have they replicated the human pancreas ? Nowhere near it. In many posts I have mentioned that the pancreatic mass is 95% covered by beta cells that secrete insulin. The remainder alpha cells secrete glucagon, and the gamma cells secrete somatostatin. These are the 3 principal secretions of the pancreas, but there are many other secretions, playing equally important roles.

New research into the roles of insulin, it’s cell receptors, the transport pathways and the communications signaling has led to new insights into Insulin & Insulin Resistance. It is simply not just the glucose transporter that it was thought off for all these years. Insulin & Glucagon have a 24 hour on/off and counter reactive relationship with each other (please don’t confuse glucagon with glucose). Neither’s secretion is completely shut off at any given time. It’s more like a 95 - 5 % constant pattern. Pumping glucose in place of glucagon can have detrimental effects. If you refresh yourself with the post on “glucotoxicity”, you will remember that I talked of glucose throughput and resulting damage. 

Certainly the Bionic Pancreas will make life easier for the uncontrolled diabetics, who lack the self discipline to monitor their levels for their own good. Agreed, that this type makes up the majority of the diabetics in the world, and that is the reason, we see poor health reign supreme. This product therefore holds a lot of promise for some diabetics, until a better one comes along. 


    

9 comments:

  1. Dear Shyamji

    Thanks for another great post. And congratulations for remaining drug free for 3 years. That is quite an achievement.

    Meanwhile, I am also making progress, although for only 3 weeks rather than 3 years, but one has to start somewhere, right? My diabetes has been uncontrolled for almost 10 years. Inspired by your blog and the link to another site you provided me on the diabetes forum, I switched over to LCHF on 2JUN14. My FBG on that day was 228. Today, 24JUN14, it was 122. LCHF sounded so hard I felt it would be impossible for me to do. As a Bengali I love my fish and rice. But after 3 weeks, it has become relatively easy to just eat the fish and leave the rice. Entirely. Maybe carbs are a form of addiction like nicotine, the more you have it, the more you want it, and the less you have it, the less you want it. My sincere thanks to you for pointing the way. My doctor charges the equivalent of Rupees 9000 for every visit (I live outside India now) but I can't say I have derived any benefit from her advice. In fact on my visit yesterday, she spent about 15 minutes preparing a diet plan for me. For breakfast she suggested one chicken sandwich, and my response was to cut out the sandwich since it contains 2 slices of bread and go with a salad instead. A slightly strange situation where the patient is suggesting lower carbs than the doctor's recommendation. The really beneficial advice has been from your blog and the other website you recommended. Indirectly however, the regular visits to the doctor have been of benefit - psychologically, the knowledge that I was going to discuss by FBG and weight at the next visit to the doctor was a motivator to stick to LCHF. But if I were paying for the visits myself instead of my employer I am not sure I would have these visits. It seems to me that all the knowledge that one needs to manage diabetes is already easily available. Diabetes, it seems to me, is mostly a mind game. What we need to do is well known. The real challenge is actually doing it. This is the classic knowing - doing gap. Endocrinologists, it seems, have little to say on the issue of how to bridge the knowing - doing gap. Until a few weeks ago I was not familiar with the profession called "clinical psychologist". But from reading various articles on the net it seems they help patients with the mind game. if they can really help a diabetes patient better play the mind game, they may be the more important partner for a diabetes patient than an endocrinologist. This idea of the knowing - doing gap reminds me of a story from the Gita. At one stage Krishna attempts to explain dharma to Duryodhana. But Duryodhana interrupts and stops Krishna. He says, "You don't need to teach me dharma. I already know it. But I can't do it." So here's to actually doing it. Shyam ji, congratulations again on being drug free for 3 years. You have done it. Thank you for being an inspiration. Please continue to inspire us on the pages of this blog.

    Best
    Sanjeeb

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  2. Dear Shyam ji

    I was speaking to a friend today... roughly the same age as me, and also works in a bank. Same story as me... uncontrolled diabetes even though he knows fully well what a deadly disease this is as me. I also read from your post on inflammation that you too had uncontrolled diabetes for many years before you took charge of your disease.

    Given that you know so many patients through you blog, do you have a view on what are the main reasons why people are not in good control of their diabetes. Are there any common themes that you have observed?

    Best regards

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  3. Hello Sanjeeb,

    The main reasons for lack of good control on blood sugars are not very hard to find.

    (1) Bad mainstream medical & dietary advice.

    This has been fraught with bad science. Take the example of dietary cholesterol clogging your arteries. Haven't we always believed that ? Most doctors do. And if that were true, it would imply that drinking a lot of water would dilute your blood and you would die.

    Read the articles on Energy Balance & The Lipid Hypothesis. All of our eating habits have been guided for decades by these 2 theories. (a) Calorie in - Calorie out (b) Eat fat, store fat, get fat, get Cardiovascular problems. Unfortunately both of these hypotheses are completely off the mark, and have caused great disservice to mankind. They have promoted ill health - BUT a big market for the medical / pharma communities.

    (2) Carb addiction.

    Carbohydrates were rare in human history prior to the advent of agriculture. Since carbs are basically from the plant world, we ate very little of them. Nature intended it in that way. Since they are addictive & harmful, they were scarce. Modern human diet comes completely from factories. We buy all our eatables from super stores. What do corporations do when processing foods ? They add certain enzyme suppressants in food. Why ? Because these enzymes carry out very important signalling within the body. Leptin is one such enzyme, which signals the brain that you have had enough & it is time to stop eating. When leptin is suppressed, you want to eat more. And this is what they do. In a market economy led world profit is all that matters.

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  4. Great response Shyam ji. In this context the following is an interesting article. People can read the full article by clicking on the link but for easy reference I am quoting below the most egregious part of the article:

    QUOTE
    Sugar and Diabetes: Dispelling The Myth

    A person with diabetes is generally advised to avoid foods with a high sugar content and to maintain a diet and medication schedule that maintains as normal a blood sugar level as possible. Improved blood sugar control may reduce the chances that certain complications of the disease will develop. But just because the disease is characterized by an elevated blood sugar level and because lowering the blood sugar level is an important goal of therapy, a high-sugar diet does not cause the illness. An elevated blood sugar level is a result of having diabetes, not the cause.

    Assuming an elevated blood sugar level is the cause of diabetes is like assuming that coughing is the cause of pneumonia. And not only does sugar itself not cause diabetes, there is no convincing evidence that sugar causes other problems that it has been blamed for, such as hyperactivity. Many medical myths develop along these lines.

    Dispelling this myth regarding sugar may correct the assumption many people have about the development of diabetes — that people with this illness have brought it on themselves by eating the wrong kinds of foods. Although it is true that avoiding obesity may reduce the chances of developing type 2 diabetes, the specific types of foods you eat may play little or no known role. And not all persons with diabetes are overweight — that's another myth. For these patients, heredity and perhaps other undiscovered factors are more important.


    http://www.bettermedicine.com/topic/diabetes/sugars-role-in-diabetes?did=t6_outrss1&redirect=beme
    END QUOTE

    As I understand it he is basically saying that sugar is OK. That idea is so crazy that I thought this article must have been written by a paid PR person employed by the sugar industry. Imagine my shock when I noted that the article has in fact been written by someone with an MD from Harvard Medical School.

    I must be reading this wrong. What am I missing?

    Sanjeeb

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  5. Hello Shyam ji

    I just read the latest dietary guidelines of the American Diabetic Association. On the subject of carbs it says, "There’s no conclusive evidence regarding an ideal amount of carbohydrate intake for people with diabetes. We still have a lot to learn about carbohydrates and how different carbohydrates may affect blood glucose levels and glycemic control." While that is better than their 2008 guidelines which recommended a minimum of 130g of carbs every day (shocking !!!), I am disappointed that the new guidelines do not use stronger language against carbs. This just goes to prove your point about bad mainstream dietary advice. Really sad.

    Here's wishing you and all your readers good health.

    Sanjeeb

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    Replies
    1. They "still have a lot to learn" & we hope that they will learn from our first hand experiences.

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    2. Well said.

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  6. Hi Shyam..need your inputs on treatment/eradication of keloids thru Nutritional spplements..

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    Replies
    1. Replied separately Nitin. Hope that works

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