Posts made in July, 2012

It’s not the Calories, but the Type of Diet that Helps You Lose Weight

Posted by on Jul 31, 2012 in News | 0 comments

bagelMillions of overweight Americans would like to lose weight. Most people seem to think that just eating less calories is the answer.  For decades, this mannerism of thinking has been tried, but so far, the results have been abysmal. So far, no one has been able to fully explain why some people manage to lose weight and yet others can’t manage to shed any, despite taking in less calories. Now there is a new way of thinking when it comes to weight loss: eating the right foods is also important.

A recent study reveals that diets which restrict processed carbohydrates, such as bagels and breakfast cereals, may help sustain longer lasting weight loss compared to other diets. This study indicates that it’s the quality of calories entering the body that affect the number of calories going out.

In this study, obese individuals tried out three test diets for 4 weeks at a time. All the diets provided the same number of calories, but largely differed in their carbohydrate, fat and protein content. At the end of the study, individuals reported no overall changes in feeling hungry while being on the different diets. The researchers observed that both the low fat and an ultra-low carbohydrate diet did not fare well against that of a low glycemic index diet, one rich in carbohydrates that were slowly digested in the body. Such foods include whole grains, leafy vegetables, and fruits. In this case the low-glycemic index carbohydrate diet was not associated with any increased physiological evidence of stress to the body, but yet resulted in the greatest weight loss.

This study shows that eating a low fat diet for weight loss is a myth. The best diet for weight loss should focus on quality carbohydrates. This is applicable for all people who want to lose weight. Of course, it’s important to remember that some type of exercise is also necessary to sustain and maintain the weight loss.

Contributed by Dr. Steven Bhimji, M.D.
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Should I Buy an Insulin Pen?

Posted by on Jul 25, 2012 in News | 0 comments

Insulin pens are widely used in Europe, but much less so in the USA. Most are about the size of a marking pen and contain a cartridge that carries insulin. These pens are relatively easy to use and are portable. Some patients only use insulin pens while they are traveling and others use them routinely. All insulin pens require a pen needle that is sold separately. A new pen needle is recommended for each injection of insulin.

Disposable vs. Reusable

There are two basic types of insulin pens: disposable and reusable. The reusable pens must be loaded with an insulin cartridge before you can use it. In most cases, the cartridge will hold 100-300 units of insulin and last a few days. Once the cartridge is empty, it has to be disposed. They typically last a few years.

The disposable pens are prefilled with insulin and the whole thing is thrown out after use. These disposable pens usually contain 300 units of insulin and are sold in boxes of 5. The only advantage of disposable pens is that you don’t have to load the insulin cartridge. They’re also a lot more expensive than the reusable pens.

There are several brands of insulin pens and they cannot be interchanged. They can also vary in the amount of insulin available and how much dose is delivered. Most have a dial so you can set the dose and an indicator telling how much insulin is left.

Worth the Cost?

Insulin pens have the one advantage that you don’t have to draw any insulin each time. The pen is convenient for use and portable. Dose adjustment is easy because you only have to set the dial button.

However, insulin pens are not for all diabetics. They are much more expensive than the regular syringes and needles. A small amount of insulin in the pen is usually wasted because it’s not enough to be injected.

Moreover, insulin pens are only available for some types of insulin formula. If you need an insulin mixture, then you may need two insulin pens to administer each dose.

The cost of an insulin pen varies from $100-$150 depending on the brand. A vial of regular insulin only costs $20. While some private insurers will cover the cost of insulin pens, it’s not universal. Medicare for example does not cover the cost.

Before you rush out and buy an insulin pen, speak to your healthcare provider and get a second opinion from a diabetic user. New is not always better in medicine.

Contributed by Dr. Steven Bhimji, M.D.

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Does Race Affect Response to Weight Loss Surgery?

Posted by on Jul 23, 2012 in News | 0 comments

Many diabetics have undergone weight loss surgery procedures, but often the results have not been consistent. Some people have found surgery to be beneficial and others have found it to be a total waste of money.

Now a report from Duke University indicates that race may affect how some diabetics respond to weight loss surgery. In this small study, African American women experienced less weight loss than Caucasian women after gastric bypass surgery.

In the past other studies have also reported similar findings, hinting that African Americans tend to have resistance to weight loss when it comes both surgery and medications.

In this present study, the weight loss after gastric bypass surgery was much more significant in Caucasians compared to African Americans. Another interesting point was that the race difference in weight loss was more marked in non-diabetic women.

However, there are other data, which report the exact opposite. Some feel that perhaps that body composition is more important than race.

Unfortunately, despite the hype about bariatric surgery for weight loss and its benefits, the only things assured are that it’s an expensive undertaking and the complications can be devastating.

Contributed by Dr. Steven Bhimji, M.D.
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Is Psoriasis a Risk Factor for Developing Diabetes?

Posted by on Jul 18, 2012 in News | 0 comments

Psoriasis is a relatively common skin disorder in the North American population. Now there is some evidence that links severe cases of psoriasis as a risk for the development of type 2 diabetes.

This latest study from the University of Pennsylvania reveals that incidental diabetes is present in at least 14% of patients with this skin disorder.

Estimates suggest that close to 115,000 more patients are at risk for diabetes each year based on the severity of their psoriasis, however the mild cases of psoriasis are less likely to result in type 2 diabetes. At the moment, these are just observational findings and no direct link between psoriasis and diabetes has been established.
Nevertheless, these are not trivial findings because type 2 diabetes is a chronic disorder with numerous complications. Thus, patients with psoriasis should be highly encouraged to lower their risk of type 2 diabetes by making changes in their lifestyle and undergoing early screening for signs of insulin resistance.

Contributed by Dr. Steven Bhimji, M.D.
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Diabetic Drugs Linked to Macular Edema

Posted by on Jul 16, 2012 in News | 0 comments

Macular edemaThe latest research reveals that the diabetic drugs, rosiglitazone (Avandia) and pioglitazone (Actos), can significantly increase risk of macular edema (a condition where fluid accumulates under the retina of the eye) in type 2 diabetic patients. The latest study from Forest Hospitals Foundation in Nottingham, found that the risk remained 2-3 times higher for many years after use of these drugs.

The glitazone drugs activate certain receptors in the retina and may contribute to retention of fluid in the eye. Based on this research, it is advised that physicians be vigilant in examining type 2 diabetic patients who are on Actos or Avandia.

Causes of macular edema have been previously reported while using glitazones, but prior studies and clinical trials have produced conflicting results, while no direct link between the drugs has been established.

In any case, physicians need to evaluate diabetic patients for macular edema who take Actos. In the case of Avandia, the drug is still only currently available in the USA through a restricted access program.

Contributed by Dr. Steven Bhimji, M.D.
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