The Medicine Bag NewsOK.com Blogging Community

Researchers have seen that weight-loss surgery appears to cure type 2 diabetes, which they have attributed to the huge drop in pounds. After all, being overweight is a risk factor for diabetes, and losing weight can effectively take care of the problem.  

An article that appeared in a supplement to last month’s issue of Diabetes Care argues that the bowel is the site of mechanisms that lead to diabetes.

The study’s author, Dr. Francesco Rubino of New York-Presbyterian Hospital/Weill Cornell Medical Center, presents evidence on the mechanisms of diabetes control after surgery.

“Clinical studies have shown that procedures that simply restrict the stomach’s size (i.e., gastric banding) improve diabetes only by inducing massive weight loss. By studying diabetes in animals, Dr. Rubino was the first to provide scientific evidence that gastrointestinal bypass operations involving rerouting the gastrointestinal tract (i.e., gastric bypass) can cause diabetes remission independently of any weight loss, and even in subjects that are not obese,” according to a press release.

Rubino’s previously has shown that the main way gastrointestinal bypass controls diabetes is by skirting the upper small intestine — the duodenum and jejunum.

“It has become increasingly evident that the gastrointestinal tract plays an important role in energy regulation, and that many gut hormones are involved in the regulation of sugar metabolism,” according to the release.

Rubino’s findings suggest bypassing the upper intestine may work by reversing abnormalities of blood glucose regulation.

He guesses the upper intestine of diabetic patients may be the site where an “abnormal signal” is produced that causes or predisposes one to diabetes.

Gastrointestinal surgery offers the possibility of complete disease remission. This is a major shift in the way we consider treatment goals for diabetes. It is unprecedented in the history of the disease,” he said.

What do you think of using surgery to treat diabetes? Have you had an experience with it? Leave me a comment at http://blog.newsok.com/health.

Jeff Raymond, Medical Writer

The Fifteenth Annual Healthy Heart Fair will be from 9 a.m. to 1 p.m. Saturday at the Oklahoma City Community College Union Building, 7777 South May Avenue.

People from across the state are invited to have their cardiovascular health evaluated via a free health screening (fasting is not required for the screening) including cholesterol, blood pressure, glucose and body fat analysis. Attendees can also learn the signs and symptoms of an ailing heart while trained staff will be on-hand to give CPR classes.

An “Ask the Cardiologist” booth will be set up for those that need answers to their heart health questions.

Three one-hour presentations will also be given:

9:30 a.m.
Kris Mullins, M.D.
Heart Checkup: The Many Cardiac Tests Available at Integris Heart Hospital

10:30 a.m.
Terrie Gibson, M.D.
Herbal Medicines: Helpful or Harmful?

11:30 a.m.
Terrie Gibson, M.D.
Health Screenings: Which Ones to Get, Which Ones to Skip

The Healthy Heart Fair is sponsored by Integris Heart Hospital at Baptist Medical Center.

For health and medical news and commentary, visit The Medicine Bag blog at http://blog.newsok.com/health.

Jeff Raymond, Medical Writer

Looking forward to imbibing a few this holiday season? The National Headache Foundation has a few suggestions:

-If you drink, do so in moderation

-Try to sip your drink slowly

-Mixed drinks containing fruit or vegetable juices will probably have less effect than straight alcohol

-Avoid red wine, as it contains chemicals that may cause headaches

-Reduce the number of alcoholic beverages you consume

-Eat some honey or drink some tomato juice

-Drink fluids containing minerals and salts

-Drink a cup of coffee

-Take ibuprofen

-Alternate beverages between alcoholic and non-alcoholic beverages

-Eat greasy food before imbibing

The foundation suggests trying this “champagne fooler.”

-1 1/3 cups apple juice

-1 teaspoon lemon juice

-12 ounces club soda

Chill four glasses.  Mix together apple juice and lemon juice.  Add club soda and stir gently to blend.  Pour into glasses and serve immediately.  Yields four servings.

Jeff Raymond, Medical Writer

I spent a recent Monday in Tahlequah talking to Cherokee Nation staff about diabetes. As is often the case, I had to leave out a lot of stuff. So I thought I’d share some of it here.

If you need a refresher, the story is here.

Dr. David Randall, chief of podiatry for the tribe, estimated 5 to 10 percent of diabetics are at risk of developing foot ulcers, about one-fifth of which lead to amputation.

Randall also said he thinks many people in the tribe’s 14-county jurisdictional area see others undergo procedures related to diabetes or suffer from its complications, increasing awareness of the disease and how to take care of oneself. He pointed out the tribe’s employee wellness program and the positive signs he has seen among his patients, most notably a “significant decrease” in amputations.

Diabetes Program Director Teresa Chaudoin said practically every Cherokee has a diabetic in the family. When she came to work for the tribe in 2001, her focus was largely clinical — after all, it was the most pressing. Later, she dove into prevention. Now the tribe has dietitians at each of its clinics and reports more people are able to manage their blood sugar.

“We’ve worked here to build a comprehensive, integrated program,” she said.

Lisa Pivec, director of community health promotion for the tribe, emphasized that losing weight, stopping smoking, eating well and taking appropriate medications worked to reduce chronic illnesses other than diabetes.  One of the tribe’s wellness initiatives, called Wings, began with walking and running but now includes bowling, stickball, dancing and other activities.

Wings members, of which there are more than 1,000, receive admission to 24 races a year. Members have reported a one-point drop in body mass index over nonmembers. Sounds like very little, but big health improvements can be in small numbers. Planned activities often suit the tribe’s rural citizens.

“A lot of our communities are very rural and they may need structured events,” Pivec said.

For health and medical news and commentary, visit The Medicine Bag blog at http://blog.newsok.com/health.

Jeff Raymond, Medical Writer

This has to be one of the greatest ideas in the history of food: vitamin-fortified coffee.

I couldn’t wait for the embargo to lift Tuesday morning on this press release so I could write about it. I appreciate fortifying bread and cereal with folic acid, and the importance to pregnant women of getting enough of it, so coffee seems like a natural choice.

Folic acid deficiency leads to devastating birth defects.

My question is: Why hasn’t anyone done this before? I guess it could be like fortifying cigarettes — you don’t want to encourage use of some things because they’re made more nutritious. Still, with half the world’s population addicted to coffee, like me, enriching it with all manner of nutrients seems a no-brainer. Maybe there were technical issues.

According to a press release, beginning in early 2008, food technology company Voyava Republic will add 80 micrograms — one-third of the recommended daily allowance — of folic acid to its SPAVA coffee line.

In doing so, SPAVA will become the first coffee line to fortify its beans with folic acid.

CEO Michael Sweeney unveiled the product today in New York City at the National Coffee Association’s fall conference.

“SPAVA’s ground-breaking fortified coffee announcement marks the latest significant step in the food fortification movement, which has benefited the health of U.S.consumers for decades – from the addition of iodine to salt in 1924 to prevent goiter, to the addition of vitamin D to milk for calcium and phosphorus absorption. Long recognized as an essential nutrient for women, folic acid intake was recently linked with lower breast cancer rates among post-menopausal women in a study published this summer by the American Journal of Clinical Nutrition,” according to the release.

SPAVA uses a patent-pending technology to “imbue” Arabica beans with supplements such as gingko biloba and echinacea.  The company said the ”innovative coffee line” aims aims to improve physical and mental health, and deliver benefits for joint health, memory, immunity, metabolism and stress relief.

SPAVA appears in health food stores around the country. It sells for $9.99 to $12.99 per 12-ounce bag. To learn more, visit www.SPAVAcoffee.com.

To me, there are four epochs in the history of food for human consumption:

1. Hunter-gatherers establish agriculture, anchoring them to one place and ending nomadic lifestyles

2. Discovery of cooking

3. Use of preservatives and, later, refrigeration

4. Vitamin-fortified coffee

Jeff Raymond, Medical Writer

I appear to be the lone holdout on this little experiment of ours. Maybe the others are smarter than I am.

Day number two was a reversal of day number one. My mischievous brain apparently wanted to outsmart itself, de-placeboing the placebo.

I felt nothing from my 12 sprays, six in the morning and six in the afternoon, apart from a possible stomach ache. I guess my brain decided it wouldn’t react this time, knowing that it was bamboozled the day before.

Fool me once, shame on you. Fool me twice, shame on me.

I imagine my neurons look and talk like cartoon slugs. Imagine a slow drawl — how a slug would talk — and you’ve got the idea. As for the vitamins, they are French — think Peter Sellers as Inspector Clouseau.

Neuron: (Looking up, tired) What are you doooooing?

Vitamin: (Assuming a Fighting Irish pose) Trying to infiltrate you.

Neuron: (Yawning) I know what you’re up to. Goooooo awaaaaaaay. (Looking back at the electricity crackling by) I have work to doooooo.

 Vitamin: (Annoyed) Harrumph. I am valuable and a beautiful, complicated chemical. I am worth $7.99.

I think my experiment will end today. I’ll keep some B12 tablets around (since I already have them) until my brain forgets about all this.

Jeff Raymond, Medical Writer

I’m a bit chagrined. A medical professional I know told me the tiredness I felt about 4 p.m. yesterday was not a crash from droplets of vitamin B12 wearing off but instead the dreaded placebo effect.

The best studies are double-blind, meaning neither doctors nor study participants know whether they have received a trial medicine or a placebo — often a sugar pill. Those who receive the placebo sometimes experience effects similar to those who receive medication.

UCLA even has an institute dedicated to researching the placebo effect.  The UCLA Neuropsychiatric Institute in 2005 published a study in the journal “Neuropsychopharmacology” that examined susceptibility to antidepressant side effects.

According to an institute press release, the study was the first to link brain function and medication side effects, and to show a relationship between brain function changes during brief placebo changes and later side effects during treatment with medication.

The study compared brain function changes in healthy research subjects with no history of depression while taking an antidepressant versus placebo.

Researchers found changes in brain function in the prefrontal region during the one-week placebo “lead-in” were related to side effects in subjects who received an antidepressant, according to the release.

I’m not sure if the study makes my point, but it sounds interesting. Widely cited research from the institute in 2002 showed a number of placebo-receiving, depressed subjects reacted similarly to those who received antidepressants.

Whoa.

The way I see it, whether my brain goes AWOL, pumping endorphins out because that’s what it’s supposed to do, or the spray actually works, I guess I’m indifferent. But I can’t say I’m surprised. On the other hand, I’m not totally convinced this stuff doesn’t have some kind of effect somehow.

Jeff Raymond, Medical Writer

Three co-workers — Brian Sargent, Susan Simpson and Lindsey Goodier — and I have decided to be guinea pigs for four herbal sprays The Oklahoman received Monday.

As anyone who has read this blog knows, we receive a lot of unsolicited, random stuff — usually books, but not always. So far, the sinus cleanser was the strangest, but the herbal sprays and herbal cholesterol pills were close.

To test the effectiveness of these products, we decided to split them up. Susan took “Crave Control.” I took “Energy Shots.” Lindsey took “Immune Boost” and Brian took “Sleep Now.”

NutraMist advertises the sprays as a way to cure “pill fatigue.” Seems like a fair enough reason. But do they work?

Before I get to that, a little information about my selection: I have taken vitamin B12 supplements before, so I know they can make a person perk up. It helps maintain healthy nerve and red blood cells.  The body stores B12, mainly in the liver. Vegetarians are at risk of developing vitamin B12 deficiency because it is present in meats. Deficiencies are possible but are usually associated with too little meat/fortified food intake or poor absorption. 

The recommended daily allowance is 2.4 micrograms a day for adults. The vitamin is considered to be generally nontoxic, even at high levels.

For more information on B12 and deficiencies, check here.

So, two hours after spraying the grape-flavored mist six times in my mouth, I am more awake and energetic than before. I suppose I should be  — the spray is 25,000 times the daily value. The formula also contains ginseng and green tea.

If a person is inclined to use supplements, which I’m generally not, these are pretty handy.

Jeff Raymond, Medical Writer

2:23 p.m.

Feeling a bit of a crash from the vitamins. Sprayed another six. This should last me through the rest of the evening. Tallyho!

Jeff Raymond, Medical Writer