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Did you know that the issue of prediabetes and what it actually means for health is controversial among some physicians and medical groups? Elevated blood sugar was once considered a risk factor for type 2 diabetes, but now it has been elevated into a pre-disease called prediabetes. We are now told that 1 out of 3 Americans are pre-diabetic and 90 percent of us don’t even know it. The main issues are: What does a prediabetes diagnosis mean? Does prediabetes lead to diabetes? How frequently does this occur? Should one treat it with medications? When one thinks about risk factors - then they can usually be modified (e.g. diet, weight loss, exercise), but when something is called a pre-disease - then one thinks treatment (e.g. medicines).

Yes, we all agree that type 2 diabetes is a very serious health problem. But what about prediabetes? What is alarming to some researchers is that the definition of prediabetes has been broadened over the years to include millions more Americans. Also, what is considered prediabetes in the US may not be considered prediabetes in other countries. Keep in mind that the people most involved with promoting a broadening definition of prediabetes and promoting drugs to treat it, have a number of conflicts of interest (financial and scientific).

The site Health News Review covered the topic of prediabetes in Jan. 2017 in a post by Dr. Michael Joyce: BMJ:Can we trust the numbers that define pre-diabetes? Some quotes from that post: "...meta-analysis of the progression rates of pre-diabetes shows the majority of people did NOT go on to develop diabetes a decade later."  "...in an article published in the BMJ, the accuracy of screening for pre-diabetes with fasting blood sugar and glycated hemoglobin is brought into question." ... “Our research looked at both these tests for pre-diabetes and found that neither of them was accurate,” says lead researcher Dr. Trisha Greenhalgh .... "In short, both our ability to predict diabetes with blood tests alone, and do so accurately in people with borderline elevated blood sugars, is questionable. Nonetheless, results from these tests – sometimes interpreted without clinical context – are being used to medicalize a risk factor and create a new medical condition."  Yikes!

This past week another thought-provoking article discussed the topic of prediabetes. Note that some experts call the focus on aggressively treating prediabetes as "scaremongering", especially because those promoting aggressive treatment the most are those with conflicts of interest. Centers for Disease Control and Prevention (CDC) data show that progression from prediabetes to diabetes is actually less than 10% in 5 years, and other studies show even slower (lower) rates. And a comprehensive 2018 Cochrane review of studies found that "up to 59% of prediabetes patients returned to normal glycemic values over 1 to 11 years with no treatment whatsoever". (see below) Wow! Excerpts from the article by Charles Piller in the journal Science:

Dubious Diagnosis

A war on "prediabetes" has created millions of new patients and a tempting opportunity for pharma. But how real is the condition?

The most common chronic disease after obesity, afflicting 84 million Americans and more than 1 billion people worldwide, was born as a public relations catchphrase. In 2001, the PR chief of the American Diabetes Association (ADA) approached Richard Kahn, then the group's chief scientific and medical officer, for help with a vexing problem, Kahn recalls. ADA needed a pitch to persuade complacent doctors and the public to take seriously a slight elevation in blood glucose, which might signal a heightened risk of type 2 diabetes. Raising the alarm wasn't easy, given the condition's abstruse name, impaired glucose tolerance, and lack of symptoms ...continue reading "Controversies With the Prediabetes Diagnosis"

How many times have you heard to eat lots of fruits, vegetables, whole grains, nuts, legumes (beans), and seeds? Study after study finds that eating a diet rich in these foods is linked to all sorts of health benefits. A big reason is that they have lots of fiber - which feeds beneficial microbes in our gut. A recently published review of studies in the prestigious journal Lancet examined studies done over the past 40 years and found numerous health benefits.

The researchers found that people consuming high levels of dietary fiber and whole grains have a lower risk of death from heart disease (cardiovascular mortality) and death from any cause. They also have a lower incidence of heart disease, stroke, type 2 diabetes, and colorectal cancer (as compared to those eating less fiber). There was a dose-response effect - in other words, the more fiber eaten daily, the lower the incidence of these diseases and deaths. They also found that a high fiber diet is also linked to lower cholesterol levels, lower weight, and lower blood pressure.

This study viewed 25 to 29 grams per day as a high fiber diet, but said the findings suggest that higher levels of fiber would be even more protective. Which means put down that delicious white bread and sugary cereal and start eating whole grain foods! Nowadays the average person eats less than 20 grams of fiber per day, but guidelines say to eat at least 30 grams per day. The researchers pointed out that getting fiber from real food is best.

From Science Daily: High intake of dietary fiber and whole grains associated with reduced risk of non-communicable diseases

People who eat higher levels of dietary fiber and whole grains have lower rates of non-communicable diseases compared with people who eat lesser amounts, while links for low glycaemic load and low glycaemic index diets are less clear. Observational studies and clinical trials conducted over nearly 40 years reveal the health benefits of eating at least 25g to 29g or more of dietary fiber a day, according to a series of systematic reviews and meta-analyses published in The Lancet.  ...continue reading "Eating Lots of Fiber Has Health Benefits"

New research is published every day, but only some studies are big research stories or game-changers. The following are what I consider some of the most memorable studies of 2018 – some in a good way, but some of the others have left me with a sense of horror. I think there will be follow-up research, so keep an eye out for more on these important topics.

Are we heading toward a time in the not so distant future when all men are infertile? (Due to exposure to all the endocrine disruptors around us.) Will All Men Eventually Be Infertile? This was posted September 5, 2018.

Researchers are now seriously investigating and finding evidence that microbes may be causing Alzheimer’s disease. This approach is rapidly finding support in the medical field, and may lead to possible ways to treat or prevent the disease. Possible Herpes Virus Link to Alzheimer’s Disease was posted July 13, 2018, and Herpes Viruses and Alzheimer's Disease on  June 22, 2018.

Type 2 Diabetes May Be Reversed With Weight Loss was posted August 10, 2018. This study and an earlier similar study from 2016 found that losing over 30 pounds over a short period can reverse type 2 diabetes - 46% in the 2018 study and 60% (in people who had it less than 10 years) in the earlier study.

More and more evidence is accumulating that certain diets are anti-inflammatory. Especially beneficial are diets rich in fruits, vegetables, seeds, nuts, legumes (beans), and whole grains - which also have a lot of fiber. This is exciting research because chronic low-grade inflammation is linked to a number of chronic diseases (heart disease, cancer, etc.). Fruits, Vegetables, and Whole Grains Lower Inflammation – posted August 1, 2018.

[Related to this last topic is one of the most eye-opening studies I have ever read on how what one eats has a quick effect on gut microbes and health of the gut (including inflammation of the colon): Changing Diet Has Big Effect On Colon Cancer Risk – posted April 28, 2015.]

A recent study adds to the list of health reasons to try to avoid type 2 diabetes if at all possible, such as making lifestyle changes (e.g. lose weight if overweight, improve diet,  exercise). Earlier studies found that the brain atrophies (decreases in volume) with type 2 diabetes, and that the presence of type 2 diabetes doubles the risk of dementia in older age. Yikes!

Similarly, Australian researchers in the recent study found that type 2 diabetes in older individuals is associated with decline in verbal memory and verbal fluency over a five year period, but the findings suggest that this may start in midlife.  This is because at the start of the study those with type 2 diabetes already showed signs of greater brain atrophy than those without type 2 diabetes. The type 2 diabetes group had "poorer cognitive function" at the start of the study, and then they continued to decline over the 5 year study time, but not at any greater rate than individuals without diabetes. In contrast to the decline in verbal fluency over the 5 year period in the diabetes group, the non-diabetes group actually showed an slight increase in verbal fluency each year.

Of the 705 persons in the study, the average age of the type 2 diabetes group was 68.2 years, while the non-diabetes group was 72.5 years - so can see that the diabetes group was generally younger. [Note that the brain shrinks a little as we age, and it's a normal part of aging, but you want to minimize it. The more "youthful" the brain, the better for cognitive functioning.

From Science Daily: In older people, type 2 diabetes is associated with a decline in brain function over 5 years, study shows

New research published in Diabetologia (the journal of the European Association for the Study of Diabetes [EASD]) shows that in older people living in the community, type 2 diabetes (T2D) is associated with a decline in verbal memory and fluency over 5 years ...continue reading "Type 2 Diabetes and the Brain"

Studies finding health effects from BPA keep appearing. BPA (bisphenol-A) is a chemical used in many everyday products (e.g. the lining of soda and food cans, store receipts) and so almost all humans are exposed to it daily. Researchers are getting increasingly worried about BPA and related chemicals (including substitutes for BPA such as BPS) because they are endocrine (hormone) disruptors with health effects in humans and animals. This chemical is so widely used that more than 7 billion metric tons of it are produced annually throughout the world.

Unfortunately the US government keeps agreeing with the chemical industry that the chemical is "safe", and disregarding the results of studies finding health effects (reproductive effects, obesity, etc). Of course the chemical industry is fighting tooth and nail to discredit studies done by independent researchers - a lot of money is at stake.

The following are excerpts from an article describing the latest study finding health effects from low dose exposure from BPA - it altered the amount of insulin released by the person (and so perhaps influencing the development of type 2 diabetes). What was worrisome is that the dose is considered "safe" by the US government - and in the study people were exposed to it once, while in real life humans are exposed to such doses multiple times daily.

The good news is that BPA is excreted within a day, but the bad news is that we the keep being exposed to it. By the way, substitutes for BPA (such as BPS) are just as bad, and are also endocrine disruptors - after all, they're all related chemically. So buying BPA-free canned food or plastic won't help a person avoid endocrine disruptors - these also leach into food. From an article written by Lynn Peeples at Environmental Health News:

In a scientific first, researchers gave people BPA — and saw a link to precursor of type 2 diabetes

In a scientific first, researchers gave people BPA — and saw a link to precursor of type 2 diabetesThe controversial study suggests that BPA exposure deemed safe by the feds could alter the amount of insulin released and elevate people's type 2 diabetes risk. 

A first-of-its-kind study of a small group of people exposed to a very small amount of bisphenol-A (BPA) is raising questions about the federal government's stance that low doses of the common chemical are safe — as well as the ethics of conducting such an experiment on humans.

...continue reading "Exposure to BPA Has An Effect on Insulin Levels"

Another study finds that substantial weight loss can frequently reverse type 2 diabetes -  in 46% of people who had the disease 6 years or less. In the study (which was conducted in the United Kingdom) individuals were randomly assigned to different groups - either standard medical care for diabetes group or intense weight loss group (intense dieting in the first 4 months of the study), and then all were followed for 8 months (maintenance period). Those whose diabetes was reversed were all in the weight loss group and lost an average of 35 pounds during the weight loss (dieting) phase.

According to the researchers some of the non-responders (their diabetes did not reverse itself) just hadn't lost enough weight, but also tended to have diabetes a little longer (3.8 years) than the responder group (2.7 years).

Another similar earlier study also found that type 2 diabetes can be reversed in many after losing weight of about 31 pounds (600 to 700 calories a day) during an 8 week period. 40% of study participants overall reversed their diabetes, but 60% of those with short-duration of diabetes (under 10 years) reversed their diabetes. IN SUMMARY: Both of these studies had fantastic results in reversing type 2 diabetes after a large weight loss, which may lead to doctors suggesting weight loss as the number one thing to do after a type 2 diabetes diagnosis. From Science Daily:

Why weight loss produces remission of type 2 diabetes in some patients

A clinical trial recently showed that nearly half of individuals with type 2 diabetes achieved remission to a non-diabetic state after a weight-loss intervention delivered within 6 years of diagnosis. Now a study published August 2nd in the journal Cell Metabolism reveals that this successful response to weight loss is associated with the early and sustained improvement in the functioning of pancreatic beta cells. This finding challenges the previous paradigm that beta-cell function is irreversibly lost in patients with type 2 diabetes.  ...continue reading "Type 2 Diabetes May Be Reversed With Weight Loss"

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Titanium dioxide is an ingredient in many foods (including candy), non-prescription medicines, sunscreens, and other products. The titanium dioxide is used to make whites "whiter" and colors "brighter". But...  are titanium dioxide particles somehow contributing to the development of type 2 diabetes in people? The results of a small Univ. of Texas study suggest that titanium dioxide migrates to and is found in the pancreas in people with type 2 diabetes, but not in healthy persons (without type 2 diabetes).

Note that the small study examined only 11 pancreas specimens. But the researchers said the results raise the possibility that type 2 diabetes could be a titanium dioxide particle associated inflammatory disease of the pancreas. Similar to chronic crystal-caused inflammatory lung diseases like silicosis and asbestosis. Whew.

The following article (a press release) about the study does not mention that titanium dioxide particles can vary in size, with a large increase in the use of tiny nanoparticles (diameters less than 100 nm) in recent decades. (In contrast, larger titanium dioxide particles are usually  in the 200–300 nm range.)  But the actual journal article does discuss this - as well as pointing out health harms in animals and humans from all size particles of titanium dioxide. Titanium dioxide is inhaled or ingested, and both animal and human studies show that they enter the bloodstream, they cause inflammation, and even cell death. [Post about some nanoparticle titanium dioxide health concerns.]

So the first question is - will these same results also be found in a larger group of people? And then the big question is - how come it's in the pancreas of those with diabetes and not those without diabetes? Is their diet different? Medicine use? Occupations? Or...? From Medical Xpress:

Possible link found between diabetes and common white pigment

In a pilot study by a team of researchers at The University of Texas at Austin, crystalline particles of titanium dioxide—the most common white pigment in everyday products ranging from paint to candies—were found in pancreas specimens with Type 2 diabetes, suggesting that exposure to the white pigment is associated with the disease

...continue reading "Titanium Dioxide and Diabetes Link?"

There has been a lot of concern with the rising incidence of type 2 diabetes in the US and other countries. Along with that is an interest in blood glucose levels after meals (postprandial blood glucose response or PBGR). Glucose is a type of sugar that slightly rises after a meal, and some types of foods rise it more than others. It is thought that big spikes in glucose levels in the blood are unhealthy for both long-term health and also if one has diabetes.  A nicely done Canadian study (people randomly assigned to groups) found that swapping out half of a portion of starchy potatoes or rice with lentils reduced levels of blood glucose levels by 20% (when replacing rice) to 35 % (replacing potatoes).

What foods are pulses? Pulses are dried seeds of legume plants, and include all lentils, dry beans, and dry peas. This includes, baked beans, all lentils (red, green, yellow, brown), chickpeas (garbanzo beans), black-eyed peas, runner beans, fava beans, kidney beans, lima beans, haricots, cannellini beans, pinto beans, etc. They provide fiber in the diet and are a great source of proteinFrom Science Daily: Lentils significantly reduce blood glucose levels

Replacing potatoes or rice with pulses can lower your blood glucose levels by more than 20 per cent, according to a first-ever University of Guelph study. Prof. Alison Duncan, Department of Human Health and Nutritional Sciences, and Dan Ramdath of Agriculture and Agri-Food Canada, found that swapping out half of a portion of these starchy side dishes for lentils can significantly improve your body's response to the carbohydrates. ...continue reading "Eating Lentils Has Health Benefits"

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The last post was about several reviews of vitamin D studies, and how when people are put randomly into different groups and then followed for a while - that the studies generally are not finding the same wonderful effects of higher levels of vitamin D in the blood that observational studies are finding - instead finding no effect or mixed results. Some issues with observational studies: the groups are self-selected, some are a one time snapshot of a person (thus one can't tell what happens over time); and can't prove cause and effect (can only say there is an association or link). [See all posts about vitamin D.]

But anyway, today's post is about some more vitamin D studies, all published in 2018. All of them find health benefits from higher blood levels of vitamin D. What is an ideal level of vitamin D varies from study to study, and some are observational - thus can only say "find an association with" in the findings. The fifth study finds beneficial effects from higher doses of vitamin D, and the participants were randomly assigned to the groups (good!). Click on links to read details. All excerpts are from Science Daily:

Vitamin D deficiency linked to greater risk of diabetes

An epidemiological study conducted by researchers at University of California San Diego School of Medicine and Seoul National University suggests that persons deficient in vitamin D may be at much greater risk of developing diabetes. The findings are reported in the April 19, 2018 online issue of PLOS One ...continue reading "Five Studies Looking at Vitamin D and Health"

Once again a study found that a high fiber diet feeds beneficial gut microbes and causes changes in the gut microbe community (the microbiome). What's new in this study is that eating the high fiber diet had health benefits for people with type 2 diabetes - that it lowered their blood sugar levels (better blood glucose control), resulted in  greater weight loss, and better lipid levels. And that when these gut microbes were transplanted into mice - they had similar health effects (better regulation of blood sugar). Which showed it was the microbes that caused the beneficial effects.

What foods are high-fiber foods? Fruits, vegetables, whole grains, nuts, seeds, and legumes (beans). [See Feeding Your Gut Microbes] From The Scientist:

High-Fiber Diet Shifts Gut Microbes, Lowering Blood Sugar in Diabetics

A diet high in fiber can reshape the gut microbiome, helping people with type 2 diabetes stay healthy. A study published yesterday (March 8) in Science found that when patients with the condition ate a high-fiber diet, they had an abundance of microbial species that helped to reduce blood sugar and regulate weight compared with cohorts who ate a less fiber-rich diet ...continue reading "High Fiber Diet Is Beneficial For Those With Type 2 Diabetes"