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The use of sugar, sweeteners, and sugar substitutes has often been a topic of hot debate. Until recently, using sugar has been discouraged in diabetic meal planning. Current scientific studies have not supported the necessity of completely abstaining from sugar, and now it’s becoming widely accepted that sugar may be …

The increased prevalence of diabetes has paralleled a rise in consumption of n-6 (relative to n-3) fatty acids and trans fatty acids found in partially hydrogenated oil. 66-68 Both can change cellular membrane phospholipid composition and decrease fluidity—a state associated with altered insulin receptors, decreased insulin sensitivity, and subsequent insulin …

Blood sugar control: Exercise helps to lower blood sugar in two ways. First of all, exercise decreases insulin resistance, the hallmark of type 2 diabetes. Secondly, exercise increases glucose disposal. An exercising muscle simply uses more sugar than a resting muscle. Weight control: Besides burning glucose, exercise burns fat, which …

The endothelium’s functioning is not yet routinely tested. Most of the practical techniques for directly measuring this activity use ultrasound to measure movement of blood in an artery after the flow has been altered either by injecting drugs that would normally dilate it, or by blocking the flow with a …

As health care professionals we often struggle with the issue of patient compliance. Whether we are trying to instill the concept of carbohydrate choices or achieving regular exercise, it is often difficult for us to motivate our patients to practice what we may be preaching. Perhaps one of the most …

Resistance is Futile Two months ago I wrote a Viewpoint (will be reprinted in 2 weeks) about lipid accumulation in places where it ought not to be, such as liver and muscle, and how this can contribute to the development of insulin resistance and type 2 diabetes. That article also …

I am proud to have survived having diabetes for 52 years and 4 months. For most of those years about the only change in care that I noticed was that needles got smaller and sharper.

Insulin itself may contribute to obesity. A high first-phase insulin response to intravenous glucose has been shown to be a risk factor for long-term weight gain, and this effect is particularly manifested in insulin-sensitive individuals. 76 Also, compared to normal children, Pima Indian children with elevated fasting insulin gain more …

Each hour, 178 people die from complications set off by diabetes. For 80 percent of these patients the killer is atherosclerosis involving the large blood vessels supplying heart and brain. Patients with diabetes are four times as likely as nondiabetic individuals to die of an MI. With endothelial dysfunction a …

Nitric oxide (NO) A diabetic environment high in free radicals and low in antioxidants may disrupt endothelial function. A highly active regulatory organ, the endothelium senses and assesses signals to which it is constantly exposed by the blood, and responds by secreting factors that affect blood vessels’ tone and structure. …