Resurgence of Diabetes Complications

This is regrettable because treatments like metformin led to marked improvements for type II diabetics starting in 1995.

Back in the early 1990s, diabetics died 7 to 10 years sooner than non-diabetics and had a:^1,2

• 3.7-fold increased risk for sudden heart attack
• 14-fold increased risk for kidney failure
• 18.8-fold increased risk for lower-extremity amputation

Advances initiated in the 1990s resulted in these risk differences between diabetics and non-diabetics plummeting up to 68% by year 2010.^1,3 This translates into fewer blood-sugar-related complications.

New challenges have sabotaged these improvements.

A recent review reveals a resurgence of some diabetic complications in some populations between 2009 and 2015.

This uptick in diabetic disorders has begun to reverse decades of hard-won improvements as follows:^2,4,5

1. Lower-extremity amputations are soaring;
2. Emergency room visits caused by hyperglycemic (high blood sugar) crisis have almost doubled;
3. Hospitalizations due to hyperglycemic crisis increased by 73%;
4. Deaths due to hyperglycemic crisis increased by 55%.

Long-term improvements in Americans aged 18-64 for end-stage kidney failure, heart attack, and hospitalization for stroke, stalled after 2010.^2,5

None of this should surprise readers of Life Extension® magazine. We long ago predicted an epidemic of sugar-related diseases caused by factors that are finally being recognized by the medical establishment.

This editorial describes what’s behind the upsurge in diabetic complications and how to protect yourself.

Those afflicted with type II diabetes are frequently overweight or obese, and typically do not obtain adequate levels of physical activity.

This results in insulin resistance, a hallmark characteristic of type II diabetes.

Insulin resistance occurs when cells in muscle, the liver, and other parts of the body do not respond appropriately to insulin.

As a compensatory mechanism, the body increases the secretion of insulin from the pancreas, resulting in higher insulin blood levels.

But resistance to insulin means too much blood sugar remains in circulation. This leads to damage inflicted by high blood glucose levels, by after-meal glucose spikes, and by high insulin levels.

Microvascular diabetic complications develop as a result of years of poor glycemic control. This means that even before type II diabetes is clinically diagnosed, silent damage can result in loss of vision, kidney damage, and painful nerve disease (neuropathy).

There is little mystery behind the spiraling epidemic of diabetic complications.

Sky-High Obesity Prevalence

A staggering 42% of Americans are obese and nearly 32% are overweight.^6,7

Less than 30% of Americans are at a healthy weight. The new “normal” for Americans is overweight or obese.

Excess body weight and inadequate physical activity are associated with higher blood pressure, elevated lipids, and increased levels of chronic inflammation.

As the maps on page 9 depict, there is direct correlation between excess body mass and type II diabetes prevalence.

There is typically a lag between deteriorating glycemic control linked with excess body weight (and inadequate physical activity) and full-blown type II diabetes.

Yet during this prediabetic period, damage to the eyes, kidneys, and nerves begins.

What makes this regrettable is that poor glucose control, increasing blood lipids, and inflammation can be detected early with simple blood tests.

Stagnation in Preventive Care

A viewpoint article published in the Journal of the American Medical Association (JAMA) identified several factors contributing to surging increases in diabetes-related complications.²

In addition to high body mass and failure to control blood lipids and blood pressure, the JAMA authors believe there may be stagnation in overall preventive care, most prominently in young adults.

This eye-opening JAMA viewpoint states:

“After encouraging reductions in hemoglobin A1c levels among patients with diabetes through most of the 2000s, the proportion meeting individualized HbA1c targets declined...”²

This translates into fewer Americans achieving targeted glycemic control blood levels.

High “Normal” Glucose

Hemoglobin A1c is a blood test that measures long-term glucose control. To reduce risk of diabetic complications, optimal glycemic control is critical.

For younger patients with type II diabetes, more stringent glucose control can help reduce diabetes-related microvascular damage.

In addition, some observational data suggest that blood markers (glucose and hemoglobin A1c) in high “normal” ranges are associated with an increased risk for heart attack^8-17 and some types of cancer.^18-24

For older patients, frail patients, and those with type I diabetes, lower blood sugar targets must be balanced with the risk of hypoglycemia (low blood sugar).

Unpredictable Health Care Coverage

The JAMA Viewpoint authors describe how uncertainties related to health insurance coverage are causing diabetic complications to increase, especially in younger and lower-income groups.²

Even those with employer-paid insurance plans face higher deductibles that translate into potentially lethal delays in treating and pursuing preventive care in diabetic patients.

The JAMA authors express concern about the continually increasing price of insulin and other anti-diabetic drugs. These high drug prices lead some people to cut back on treatment.

The authors mentioned that perhaps most concerning are the social and economic factors behind the increase in middle-age mortality that may have preventable causes—including the complications of diabetes.

What’s Behindthe Resurgence?

Most of you remember a time when deciding whether to visit a doctor was not a major financial issue.

You may also recall being able to afford the prescribed diagnostic and medication.

As this nation suffocates under greater regulatory burdens, the cost of medical care is increasingly being borne by consumers who cannot afford it.

The tragic result is that gains made decades ago in protecting against diabetic complications have been thrown into reverse.

As more Americans develop diabetic disorders, the burden on today’s healthcare system worsens, and costs continue spiraling out of control.

I warned decades ago that this medical fiasco was imminent, in books, articles, and national media appearances. What I predicted is now recognized by mainstream publications like the Journal of the American Medical Association.

What’s particularly scary is that JAMA is only identifying a resurgence in complications among diagnosed diabetics.

It fails to mention that anyone with less-than-optimal glucose control is also at higher risk for blood-sugar-related disorders.

Free-Market Solutions

The cornerstone of a diabetes prevention or management program is frequent blood testing.

You need to know your glucose, fasting insulin and hemoglobin A1c levels.

With appointment delays, crowded waiting rooms, and high costs, it is challenging even for financially well-off individuals to get real-time updates on their underlying state of glucose control.

We at Life Extension® resolved part of the problem 24 years ago by offering comprehensive blood tests direct to consumers at low cost with convenient walk-in blood-draw stations in most regions.

If a blood test reveals higher-than-optimal ranges for a diabetic or metabolic marker (like C-reactive protein or dangerous lipids), retests for these specific markers can be done at affordable prices soon after corrective interventions (such as diet, nutrient, drug, behavior, and lifestyle modifications) are initiated.

Annual Lab Test Sale

The most popular blood tests utilized by our readers are the Male and Female Panels.

These comprehensive panels provide insight into one’s underlying state of health and provide a road map to better disease prevention.

Just once a year we discount the Male or Female Panel down to $224.

Commercial labs charge over $2,000 for these tests and do not provide follow-up answers to questions one might have about the results.

This year we add a magnesium test to the Male and Female Blood Panels to enable better individualized dosing of this vital nutrient.

To order the comprehensive panels described on the next page, call 1-800-208-3444 (24 hours) or log on to: www.LifeExtension.com/blood

For longer life,

William Faloon

 

References

1. Gregg EW, Li Y, Wang J, et al. Changes in diabetes-related complications in the United States, 1990-2010. N Engl J Med. 2014 Apr 17;370(16):1514-23.
2. Gregg EW, Hora I, Benoit SR. Resurgence in Diabetes-Related Complications. JAMA. 2019 May 21;321(19):1867-8.
3. Ali MK, Bullard KM, Saaddine JB, et al. Achievement of goals in U.S. diabetes care, 1999-2010. N Engl J Med. 2013 Apr 25;368(17):1613-24.
4. Geiss LS, Li Y, Hora I, et al. Resurgence of Diabetes-Related Nontraumatic Lower-Extremity Amputation in the Young and Middle-Aged Adult U.S. Population. Diabetes Care. 2019 Jan;42(1):50-4.
5. US National, State, and County Diabetes Data. 2020. https://www.cdc.gov/diabetes/data/index.html.
6. Available at: https://www.cdc.gov/nchs/fastats/obesity-overweight.htm. Accessed February 12, 2020.
7. Available at: https://www.cdc.gov/nchs/data/databriefs/db360-h.pdf. Accessed March 2, 2020.
8. Coutinho M, Gerstein HC, Wang Y, et al. The relationship between glucose and incident cardiovascular events. A metaregression analysis of published data from 20 studies of 95,783 individuals followed for 12.4 years. Diabetes Care. 1999 Feb;22(2):233-40.
9. Bjornholt JV, Erikssen G, Aaser E, et al. Fasting blood glucose: an underestimated risk factor for cardiovascular death. Results from a 22-year follow-up of healthy nondiabetic men. Diabetes Care. 1999 Jan;22(1):45-9.
10. Kurihara O, Takano M, Yamamoto M, et al. Impact of prediabetic status on coronary atherosclerosis: a multivessel angioscopic study. Diabetes Care. 2013 Mar;36(3):729-33.
11. Selvin E, Coresh J, Golden SH, et al. Glycemic control and coronary heart disease risk in persons with and without diabetes: the atherosclerosis risk in communities study. Arch Intern Med. 2005 Sep 12;165(16):1910-6.
12. Lamblin N, Cuvelier E, Gonin X, et al. Abstract 2372: Hemoglobin A1c Levels are Associated with Severity and Prognosis of Systolic Chronic Heart Failure in Non Diabetic Patients. Circulation. 2006;114(Suppl 18):II_486-II_7.
13. Lin HJ, Lee BC, Ho YL, et al. Postprandial glucose improves the risk prediction of cardiovascular death beyond the metabolic syndrome in the nondiabetic population. Diabetes Care. 2009 Sep;32(9):1721-6.
14. Levitan EB, Song Y, Ford ES, et al. Is Nondiabetic Hyperglycemia a Risk Factor for Cardiovascular Disease? Archives of Internal Medicine. 2004 Oct 25;164(19): 2147-55.
15. Kramer D, Raji A, Plutzky J. Prediabetes mellitus and its links to atherosclerosis. Curr Diab Rep. 2003 Feb;3(1):11-8.
16. Li Q, Chen AH, Song XD, et al. [Analysis of glucose levels and the risk for coronary heart disease in elderly patients in Guangzhou Haizhu district]. Nan Fang Yi Ke Da Xue Xue Bao. 2010 Jun;30(6):1275-8.
17. Onat A, Can G, Cicek G, et al. Fasting, non-fasting glucose and HDL dysfunction in risk of pre-diabetes, diabetes, and coronary disease in non-diabetic adults. Acta Diabetol. 2013 Aug;50(4):519-28.
18. Salinas-Martinez AM, Flores-Cortes LI, Cardona-Chavarria JM, et al. Prediabetes, diabetes, and risk of breast cancer: a case-control study. Arch Med Res. 2014 Jul;45(5):432-8.
19. Stattin P, Bjor O, Ferrari P, et al. Prospective study of hyperglycemia and cancer risk. Diabetes Care. 2007 Mar;30(3):561-7.
20. Muti P, Quattrin T, Grant BJ, et al. Fasting glucose is a risk factor for breast cancer: a prospective study. Cancer Epidemiol Biomarkers Prev. 2002 Nov;11(11):1361-8.
21. Schoen RE, Tangen CM, Kuller LH, et al. Increased blood glucose and insulin, body size, and incident colorectal cancer. J Natl Cancer Inst. 1999 Jul 7;91(13):1147-54.
22. Cust AE, Kaaks R, Friedenreich C, et al. Metabolic syndrome, plasma lipid, lipoprotein and glucose levels, and endometrial cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC). Endocr Relat Cancer. 2007 Sep;14(3):755-67.
23. Yamagata H, Kiyohara Y, Nakamura S, et al. Impact of fasting plasma glucose levels on gastric cancer incidence in a general Japanese population: the Hisayama study. Diabetes Care. 2005 Apr;28(4):789-94.
24. Onitilo AA, Stankowski RV, Berg RL, et al. Breast cancer incidence before and after diagnosis of type 2 diabetes mellitus in women: increased risk in the prediabetes phase. Eur J Cancer Prev. 2014 Mar;23(2):76-83.