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Posts Tagged ‘scientific research’

On the Horizon: A Real Cure for All Cancers?

Introduction

The world of medicine is changing and nanotechnology is leading the way. The future of cancer diagnosis and treatment does indeed look bright.

Where cancer research and treatment is concerned there is clearly a need to develop new innovative diagnostic and therapeutic methods. During the last 10 years tremendous progress has been made in the development of new molecular imaging probes and therapeutic agents targeting cancer. One such field that has contributed greatly in the area of diagnostic and therapeutic methods is the field of nanotechnology (technology for use on the atomic or molecular level.)  For example, there are now nanoparticle enabled technologies that do a better job of detecting and treating cancer than ever before. There appears to be three goals of these newer technologies:

(1)   Early detection of the disease

(2)   Enhance the ability to monitor therapeutic response, and

(3)   Enable the ability to target delivery of therapeutic agents, like cancer killing drugs.

There are other uses of nanotechnology, but the purpose of this Blog is to focus on the use of nanotechnology in the treatment of the devastating disease of cancer. In my grandmother’s day a diagnosis of cancer was a death sentence. From personal experience, I know that in today’s world that is not necessarily true.

 

Connections

In 2004 I lost a kidney to kidney cancer. I nevertheless was one of the lucky ones because I am a kidney cancer survivor for 8 years now. Consequently, I have a personal stake in finding a cure for cancer (and reoccurrences of same). I was astonished recently (and got goose bumps all over) when I read about a 17- year old high school senior from Cupertino, California who may have found a way to cure cancer.

Her name is Angela Zhang. She has received a $100,000 scholarship for her science school project because of the extraordinary nature of what she was trying to put forth—a comprehensive self-contained way to use nanoparticles to isolate and treat all cancer tumors, while leaving healthy tissue and cells alone. The $100,000 Zhang earned comes with the first prize award in the Siemens Competition in Math, Science & Technology.

In my opinion, Angela Zhang is not necessarily a super-genius. But she is a very bright, precocious, and persevering young person who demonstrated an uncanny ability to logically synthesize existing research data, and ideas from specialized scientific fields. In this case, she researched the field of nanotechnology, and more specifically she emphasized synthesizing information from the sub-field of medical nanotechnology.

But, of course, what she did wasn’t only a clever assimilation of research ideas from the scientific literature. There was that hands-on 1,000 hours creating the nanoparticle, and figuring out how to integrate a drug delivery system at the micron level that could be closely monitored for its effects. And, she achieved a very important aspect of cancer treatment—delivering a cancer drug without damaging healthy cells and tissues.  Young people like Angela will one day be at the forefront of research trying to solve many of the complex health problems facing large populations of citizens everywhere. I am excited as an individual that serious medical problem-solving is now transitioning to the next generation who possess innovative ideas and who have the perseverance to build a scientific consensus around the most effective ways to diagnose and treat serious diseases.

Complex medical problems like cancer deserve a bit more in-depth reporting.  Therefore I will present this particular blog in three sections: (1) a review of worldwide and national statistics on the prevalence of cancer, (2) describe Angela Zhang’s science project and concepts, and (3) describe a promising future where nanotechnology is concerned.

Section 1

Cancer Statistics from the World Health Organization

Q: Are the number of cancer cases increasing or decreasing in the world?

A: Cancer is a leading cause of death worldwide and the total number of cases globally is increasing.

The number of global cancer deaths is projected to increase 45% from 2007 to 2030 (from 7.9 million to 11.5 million deaths), influenced in part by an increasing and aging global population. The estimated rise takes into account expected slight declines in death rates for some cancers in high resource countries. New cases of cancer in the same period are estimated to jump from 11.3 million in 2007 to 15.5 million in 2030.

In most developed countries, cancer is the second largest cause of death after cardiovascular disease, and epidemiological evidence points to this trend emerging in the less developed world. This is particularly true in countries in “transition” or middle-income countries, such as in South America and Asia. Already more than half of all cancer cases occur in developing countries.

Lung cancer kills more people than any other cancer – a trend that is expected to continue until 2030, unless efforts for global tobacco control are greatly intensified. Some cancers are more common in developed countries: prostate, breast and colon. Liver, stomach and cervical cancer are more common in developing countries.

A number of common risk factors have been linked to the development of cancer: an unhealthy lifestyle (including tobacco and alcohol use, inadequate diet, physical inactivity), and exposure to occupational (e.g. asbestos) or environmental carcinogens, (e.g. indoor air pollution), radiation (e.g. ultraviolet and ionizing radiation), and some infections (such as hepatitis B or human papilloma virus infection).

Key risk factors for cancer that have been identified are:

  • tobacco use – responsible for 1.8 million cancer deaths per year (60% of these deaths occur in low- and middle-income countries);
  • being overweight, obese or physically inactive – together responsible for 274 000 cancer deaths per year;
  • harmful alcohol use – responsible for 351 000 cancer deaths per year;
  • sexually transmitted human papilloma virus (HPV) infection – responsible for 235 000 cancer deaths per year; and
  • occupational carcinogens – responsible for at least 152 000 cancer deaths per year.

Cancer prevention is an essential component of all cancer control plans because about 40% of all cancer deaths can be prevented.

CANCER STATISTICS IN THE UNITED STATES

The Centers for Disease Control and Prevention (CDC) provided the following statistics on cancer prevalence in the United States:

Cancer is the second leading cause of death in the United States, exceeded only by heart disease. In 2007, more than 562,000 people died of cancer, and more than 1.45 million people had a diagnosis of cancer, according to United States Cancer Statistics: 1999–2007 Cancer Incidence and Mortality Data.

The cost of cancer extends beyond the number of lives lost and new diagnoses each year. Cancer survivors, as well as their family members, friends, and caregivers, may face physical, emotional, social, and spiritual challenges as a result of their cancer diagnosis and treatment. The financial costs of cancer also are overwhelming. According to the National Institutes of Health, cancer cost the United States an estimated $263.8 billion in medical costs and lost productivity in 2010.

Racial and Ethnic Differences

Cancer can affect men and women of all ages, races, and ethnicities, but it does not affect all groups equally. For example, African Americans are more likely to die of cancer than people of any other race or ethnicity. In 2007, the age-adjusted death rate per 100,000 people for all types of cancer combined was 216 for African Americans, 177 for whites, 119 for American Indians/Alaska Natives, 117 for Hispanics, and 108 for Asians/Pacific Islanders.

Effective Cancer Prevention Measures

Opportunities exist to reduce cancer risk and prevent some cancers. Cancer risk can be reduced by avoiding tobacco, limiting alcohol use, limiting exposure to ultraviolet rays from the sun and tanning beds, eating a diet rich in fruits and vegetables, maintaining a healthy weight, being physically active, and seeking regular medical care.

Research shows that screening for cervical and colorectal cancer at recommended intervals can prevent these diseases by finding lesions that can be treated before they become cancerous. Screening also can help find cervical, colorectal, and breast cancers at an early, treatable stage. Vaccines also can reduce cancer risk.

The human papilloma virus (HPV) vaccine helps prevent some cervical, vaginal, and vulvar cancers. The hepatitis B vaccine can reduce liver cancer risk. Making cancer screening, information, and referral services available and accessible to all Americans can reduce cancer incidence and deaths.

Where You Live Matters

The following looks at Cancer Death Rates (2007) for each of the states. The death rates found in various states may simply reflect differences in the number of deaths by ethnicity reported earlier. However, explaining death rates in terms of ethnicity per se is a lot more complicated involving personal habits of diet and exercise, access to effective cancer treatment and health care, exposure to carcinogins, and differential genetic make-up, attitudes toward disease prevention, and tobacco use.

U.S.Cancer Death Rates,* 2007

127.9–170.7 171.1–180.7 181.0–191.9 193.3–213.7
Arizona Iowa Alaska Alabama
California Kansas Georgia Arkansas
Colorado Maryland Illinois Delaware
Connecticut Massachusetts Maine District of Columbia
Florida Montana Michigan Indiana
Hawaii Nebraska Missouri Kentucky
Idaho New Jersey Nevada Louisiana
Minnesota Oregon New Hampshire Mississippi
New Mexico Rhode Island North Carolina Ohio
New York South Dakota Pennsylvania Oklahoma
North Dakota Washington South Carolina Tennessee
Texas Wisconsin Vermont West Virginia
Utah Wyoming Virginia

* Rates are per 100,000 people and are age-adjusted to the 2000 U.S. standard population. Incidence rates are for about 99% of the U.S. population; death rates are for 100% of the U.S. population.

Source: United States Cancer Statistics: 1999–2007 Cancer Incidence and Mortality Data, available at http://www.cgc.gov/uscs.

Section 2

Angela’s Concept

Many times in the past I read of some promising new cure for cancer by the medical or scientific community.  When the public reads such articles relating to the “cause(s)” of cancer or some special “new technique” of treatment, there is always an emotional reaction and the hope that maybe this time a real cure for this devastating disease has at last been found. Too many times in the past the media would blow any new ideas on causation or treatment all out of proportion. Reality would soon take hold again, and in a heartbeat the public would once again get its hopes dashed.

So why am I so enthusiastic, and not just reserved, scientifically conservative, and cautiously optimistic this time? Everything in my gut tells me this time it may be for real. Am I’m only reacting to all this emotionally, or do you feel something important is occurring that warrants further consideration? Either way, please read on.

This is what Angela, doing a first class piece of research, came up with:

She basically created in the laboratory a nanoparticle that kills cancer. The nanoparticle is delivered to tumors via the drug salinomycin where it kills cancer cells and deposits gold and iron-oxide materials to help with MRI imaging.

The key word to remember is nanoparticle. Angela’s project was named, “Design of Image-guided, Photo-thermal Controlled Drug Releasing Multifunctional Nanosystem for the Treatment of Cancer Stem Cells.” It was apparently as complex, thorough, and revolutionary as it sounds.

Zhang’s achievement is impressive due to the level of understanding required to create such a nanoparticle in the first place and also because she is only 17 years old. She had spent over 1,000 hours since 2009 researching and developing the particle, and wants to go on to study chemical engineering, biomedical engineering, or physics. Her dream job is to be a research professor. Because cancer stem cells are so resistant to many forms of cancer treatment, Angela felt that this was an area worth focusing on. Her nanoparticle is award-winning due to the fact it has the potential to overcome cancer resistance while providing the ability for doctors to monitor the effects of the treatment using existing imaging techniques.

More specifically, Zhang developed a nanoparticle that can be delivered to the actual site of a tumor. Once there it kills the cancer stem cells. However, Zhang went further and included both gold and iron-oxide components, which allow for non-invasive imaging of the site through MRI and Photoacoustics. What makes this innovative approach so important is that normally cancer stem cells are very resistant to many forms of cancer treatment.

This can be a little difficult for non-scientists to understand, so I’ll do the best I can to explain her ideas and keep it simple. Angela’s basic idea was to mix cancer medicine in a polymer that would attach to nanoparticles. The nanoparticles in turn would then fasten themselves to cancer cells and show up on an MRI allowing doctors to know exactly where tumors are. An infrared light aimed at the tumors would then melt the polymer and release the medicine, killing the cancer cells while leaving healthy cells unharmed. When tested on mice the tumors almost completely disappeared. Although it will be years before scientists will be able to run tests on humans, the results do seem very promising.

 

I needed to understand some of the terminology myself particularly with reference to two important questions: What is a nanoparticle and what is a polymer?

What is a Nanoparticle?

A nanoparticle is an ultra fine unit with dimensions measured in nanometres (nm; billionths of a metre). Nanoparticles possess unique physical properties such as very large surface areas and can be classified as hard or soft. They exist naturally in the environment and are produced as a result of human activities. Owing to their submicroscopic size, they have unique material characteristics, and manufactured nanoparticles may find practical applications in a variety of areas, including medicine, engineering, catalysis, and environmental remediation. Examples of naturally occurring nanoparticles include terpenes released from trees and materials emitted in smoke from volcanic eruptions and fires. Quantum dots and nanoscale zero-valent iron are examples of manufactured nanoparticles.

What is a Polymer?

Polymers are made up of many molecules all strung together to form really long chains (and sometimes more complicated structures, too).

What makes polymers so interesting is that how they act depends on what kinds of molecules they’re made up of and how they’re put together. The properties of anything made out of polymers really reflect what’s going on at the ultra-tiny (molecular) level. So, things that are made of polymers look, feel, and act depending on how their atoms and molecules are connected. Some polymers are rubbery, like a bouncy ball, some are sticky and gooey, and some are hard and tough, like a skateboard.

Advances in polymer science have led to the development of several novel drug-delivery systems. A proper consideration of surface and bulk properties can aid in the designing of polymers for various drug-delivery applications. Biodegradable polymers find widespread use in drug delivery as they can be degraded to non-toxic monomers inside the body.

Novel supramolecular structures based on polyethylene oxide copolymers and dendrimers are being intensively researched for delivery of genes and macromolecules. Hydrogels that can respond to a variety of physical, chemical and biological stimuli hold enormous potential for design of closed-loop drug-delivery systems. Design and synthesis of novel combinations of polymers will expand the scope of new drug-delivery systems in the future.

Section 3

A Bright Future Ahead for Cancer Diagnosis and Treatment

The upshot of this Blog is to report that the future of cancer diagnosis and treatment looks very bright and promising. The thrust of this article is really about nanotechnology in medicine. The use of nanotechnology in medicine offers some exciting possibilities. Some techniques are only imagined, while others are at various stages of testing, or actually being used today.

Nanotechnology in medicine involves various applications of nanoparticles that are currently under development. Long term research involves the use of manufactured nano-robots. Their purpose is to make repairs at the cellular level (How exciting is that idea!).

// // Whatever you call it, the use of nanotechnology in the field of medicine could revolutionize the way we detect and treat damage to the human body and disease in the future, and many techniques only imagined a few years ago are making remarkable progress towards becoming realities.

Nanotechnology in Medicine Application: Drug Delivery

As I said earlier, one application of nanotechnology in medicine currently being developed involves employing nanoparticles to deliver drugs, but also heat, light or other substances to specific types of cells (such as cancer cells). Particles are engineered so that they are attracted to diseased cells which allow direct treatment of those cells. This technique reduces damage to healthy cells in the body and allows for earlier detection of disease.

// // Tests are in progress for targeted delivery of chemotherapy drugs and their final approval for their use with cancer patients is pending, as explained on CytImmune Science’s website. CytImmune has published the preliminary results of a Phase I Clinical Trial of their first targeted chemotherapy drug. For example, nanoparticles that deliver chemotherapy drugs directly to cancer.

Many researchers attach ethylene glycol molecules to nanoparticles that deliver therapeutic drugs to cancer tumors. The ethylene glycol molecules stop white blood cells from recognizing the nanoparticles as foreign materials, allowing them to circulate in the blood stream long enough to attach to cancer tumors. However, researchers at the University of California, San Diego believe that they can increase the time nanoparticles can circulate in the blood stream. They are coating nanoparticles containing therapeutic drugs with membranes from red blood cells and have shown that these nanoparticles will circulate in a mouse’s blood stream for almost two days, instead of the few hours observed for nanoparticles using ethylene glycol molecules.

Researchers are also continuing to look for more effective methods to target nanoparticles carrying therapeutic drugs directly to diseased cells. For example scientists are MIT have demonstrated increased levels of drug delivery to tumors by using two types of nanoparticles. The first type of nanoparticle locates the cancer tumor and the second type of nanoparticle (carrying the therapeutic drugs) homes in on a signal generated by the first type of nanoparticle (I thought this was brilliant).

If you hate getting shots, you’ll be glad to hear that oral administration for drugs that are currently delivered by injection may be possible in many cases. The drug is encapsulated in a nanoparticle which helps it pass through the stomach to deliver the drug into the bloodstream. There are efforts underway to develop oral administration of several different drugs using a variety of nanoparticles. A company which has progressed to the clinical testing stage with a drug for treating systemic fungal diseases is BioDelivery Sciences, which is using a nanoparticle called a cochleate.

Nanotechnology in Medicine Application: Therapy Techniques

What are some of the applications of nanotechnology related to therapy techniques? The following are some of the greatest scientific therapies currently being worked on:

  • Buckyballs that are used to trap free radicals generated during an allergic reaction and block the inflammation that results from an allergic reaction.
  • Nanoshells may be used to concentrate the heat from infrared light to destroy cancer cells with minimal damage to surrounding healthy cells. Nanospectra Biosciences has developed such a treatment using nanoshells illuminated by an infra laser that has been approved for a pilot trial with human patients.
  • Nanoparticles, when activated by x-rays, generate electrons that cause the destruction of cancer cells to which they have attached themselves. This is intended to be used in place of radiation therapy with much less damage to healthy tissue. Nanobiotix has released preclinical results for this technique.
  • Aluminosilicate nanoparticles can more quickly reduce bleeding in trauma patients by absorbing water, causing blood in a wound to clot quickly. Z-Medica is producing a medical gauze that uses aluminosilicate nanoparticles.
  • Nanofibers can stimulate the production of cartilage in damaged joints.
  • Nanoparticles may be used, when inhaled, to stimulate an immune response to fight respiratory viruses.

Nanotechnology in Medicine Application: Diagnostic and Imaging Techniques

Quantum Dots (qdots) may be used in the future for locating cancer tumors in patients and in the near term for performing diagnostic tests in samples. Invitrogen’s website provides information about qdots that are available for both uses, although at this time the use “in vivo” (in a living creature) is limited to experiments with lab animals. There can be a concern for toxicity based on the material quantum dots are made from. Because of this there is restriction involving the use of quantum dots in human patients. However, work is being done with quantum dots composed of silicon, which is believed to be less toxic than the cadmium contained in many quantum dots.

Iron oxide nanoparticles can also be used to improve MRI images of cancer tumors. The nanoparticle is coated with a peptide that binds to a cancer tumor, once the nanoparticles are attached to the tumor the magnetic property of the iron oxide enhances the images from the Magnetic Resonance Imagining scan.

Nanoparticles can attach to proteins or other molecules, allowing detection of disease indicators in a lab sample at a very early stage. There are several efforts to develop nanoparticle disease detection systems underway. One system being developed by Nanosphere, Inc. uses gold nanoparticles. Nanosphere has clinical study results with their Verigene system involving it’s ability to detect four different nucleic acids, while another system being developed by T2 Biosystems uses magnetic nanoparticles to identify specimens, including proteins, nucleic acids, and other materials.

Gold nanoparticles that have antibodies attached can provide quick diagnosis of the flu virus. When light is directed on a sample containing virus particles and the nanoparticles the amount of light reflected back increases because the nanoparticles cluster around virus particles, allowing a much faster test than those currently used.

Nanotechnology in Medicine Application: Anti-Microbial Techniques

One of the earliest nanomedicine applications was the use of nanocrystalline silver which is as an antimicrobial agent for the treatment of wounds, as discussed on the Nucryst Pharmaceutical website.

A nanoparticle cream has been shown to fight staph infections. The nanoparticles contain nitric oxide gas, which is known to kill bacteria. Studies on mice have shown that using the nanoparticle cream to release nitric oxide gas at the site of staph abscesses significantly reduced the infection.

Burn dressing that is coated with nanocapsules containing antibiotics. If an infection starts the harmful bacteria in the wound causes the nanocapsules to break open, releasing the antibotics. This allows much quicker treatment of an infection and reduces the number of times a dressing has to be changed.

A welcome idea in the early study stages is the elimination of bacterial infections in a patient within minutes, instead of delivering treatment with antibiotics over a period of weeks. You can read about design analysis for the antimicrobial nanorobot used in such treatments in the following article: Microbivors: Artificial Mechanical Phagocytes using Digest and Discharge Protocol.

Nanotechnology in Medicine Application: Cell Repair

Nanorobots could actually be programmed to repair specific diseased cells, functioning in a similar way to antibodies in our natural healing processes. Work is currently being done in a fantastic area of medicine. And that is the use of nanorobots in chromosome repair therapy.

Conclusions

These are exciting times to live in. Twenty years from now many of you reading this Blog may not be alive. But those of us who are older can take comfort in the knowledge that the health and well-being of our children and grandchildren does indeed look very promising. The scientific revolution rolls on, and society will certainly be a beneficiary from all of it.

 

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Introduction

This is Part I of a two-part series on diabetes in America. Part I is intended to provide a portrait of this disease in terms of types of diabetes, the epidemiology of diabetes, its prevalence and who is at risk for the disease. I will also describe my personal experience with diabetes, and provide a better understanding of the roots causes of diabetes, based on our current state of knowledge.

 In Part II of this series I will describe the Vegan Diet, what it is, how it differs from other forms of a vegetarian diet and the many benefits of a Vegan diet, including reversing diabetes and related medical problems.

 As a society we’re closing in on the root causes of this disease and improving its management all the time. There is absolutely new hope for those who suffer from this disease, and there are great steps being launched to prevent it. Like any other thing we do in life—unlocking the mystery of diabetes requires two things: (1) research is the key and (2) human determination and intelligence are the underlying forces for turning that research key in the right direction.

For purposes of this Blog there are two components to understanding the disease of diabetes: (1) Understanding the epidemiological facts surrounding this disease, and (2) Understanding what may be the root causes of diabetes and how one in the 21st century might better treat and deal with this, at times, dreadful disease. Before launching into the epidemiological facts of the disease and its root causes, I would like to share with you my own experience with this disease. I will then launch into describing the types of diabetes, epidemiological facts, followed by its root causes.

Connections

I have a family history of diabetes.  My father had diabetes (he died at 57 in 1963) and my older brother (age 73) has diabetes. In terms of pre-diabetes, I was 37 years old when a test for glucose tolerance first revealed there was something wrong with my body’s ability to control blood glucose, i.e., blood sugar. This news gave me ample warning that one day I might develop diabetes. Nevertheless, I was slow to react to the news. I didn’t do anything in response to it like suddenly engage in daily exercise, or convert immediately to a more healthy diet. Instead, I continued on my “Fat-food Buffet of Life” with my own special, “See Food diet” i.e., whenever I saw food— I ate it. Eleven years later in 1991 at the age of 48, I paid the ultimate price—I was officially diagnosed with Type II diabetes.

I cleaned up my act for six weeks then fell back upon old habits. In the early to mid-1990s I struggled with seriously coming to grips with my own “up and down” approach to diet and exercise. I had all the excuses, and was lying to myself regarding my efforts to fight this disease. I was constantly struggling with inconsistency in both proper diet and exercise. And such inconsistency led to improvement one month, only to be followed by less successful control the next. As a result, in 1999, I finally had to go on medication (oral hypoglycemics) to get my blood sugar under better control. And, indeed, the medications actually did a very good job in helping me to maintain better blood sugar control.

 By this time I was actively engaged in utilizing the American Diabetes Association’s standard diet which emphasized a low-fat, more complex carbohydrate diet. That was a step in the right direction as it brought my HA1c down from a range of 8.5 to 9 to a better level, 7.5. However, animal protein was still part of the menu (generally, lean cuts of meat, as well as fish and chicken). And, in many recipes it still called for dairy products like eggs, cheese, yogurt and milk (my preference 1%).

In 2006, I started a low carbohydrate diet and would eat in restaurants a lot less often. I started to lose weight 8-12 lbs and was feeling I was really on the right track. My HA1c was bouncing up and down between 7.0 and 7.3. Nevertheless, up until August of 2009, I was still a couch-potato. I started a program of walking 30 minutes a day 5-6 times a week. Where I live there is a beautiful park so it was very pleasant to use the park as my walking course. In January 2010, I began to expand my exercise horizons. That is, I became a member of USA Track & Field and became actively involved in the Master’s Senior Olympics. I still continued, despite the low-carb diet, to use recipes that called for animal protein and fat along with additional fat consumption via the dairy products that I loved so much.

 I now want to tell you about a new way of eating that I think is an improvement for diabetics to follow. It is a Vegan Diet. At the beginning of 2011—I became a Vegan. It’s new to me, but it is a very ancient approach where plant protein sources are the mainstay of eating, not animal sources of protein. Instead of using the old food pyramid the Vegan diet utilizes just four food groups: grains, legumes, vegetables, and fruits.

 A Vegan diet is a stricter form of Vegetarianism, as the latter is a matter of degree to which certain foods are included or excluded regarding animal protein and various dairy products. Typical might be the ovo-vegetarian where dairy products, meat, fish, and fowl are excluded, however, they will still eat eggs. Instead of going into great detail on a Vegan Diet in Part I, I’d rather refer you to an excellent book on the subject that I acquired in December, 2010. The name of the book is, “Dr. Neal Barnard’s Program for Reversing Diabetes.”  This book will provide you with all the detail you need (including the research on which the book’s recommendations are based) in order to get started with a Vegan diet. And, as always, see your physician before embarking on any serious changes to your diet or activity level.

What I’d prefer to do with the rest of the Blog is, as they say, cut to the chase. The question running through your mind is, or should be—why should you do this? What’s so important about making a drastic change in the way one eats and going vegan?  To answer that question I’ll share with you research and the benefits of the vegan diet. For now, I just want to share with you my own personal experience with the vegan diet. For me, I’ve lost 1+1/2 lbs a week since the start of the new year; and my Lipid Profile is outstanding (Total Cholesterol is now 139, HDL is 45, LDL is 67, and Triglycerides are 135).

 In Part II of this series I will provide you with details on what a Vegan diet is all about, including all of its benefits that are known at this time. I want to add that it is also important for the general public as well (not just diabetics) to consider making dietary changes to the Western diet and way of eating. The health of the nation may well depend heavily upon making changes to the way we approach eating food.

Lobbyists in Washington are working very hard, on behalf of certain industries (dairy, cattle, fast foods, etc.) to keep things as they are and maintain a policy of praying at the altar of the all-mighty dollar. Your health and well-being isn’t even a tertiary consideration.

In ending Part I want to describe the root causes of diabetes. For hundreds of years diabetes was thought to be a very mysterious disease whose causes were unknown. Doctors, other health professionals, and those affected by the disease (including close family members) saw the havoc diabetes had on the lives of millions of people; but understanding how this disease comes about and how the human body works was quite another matter. However, in the last 10-15 years our knowledge on the causes of diabetes is beginning to form a picture. As said before, research is the major key to unlocking the mystery of diabetes. I don’t mean to oversimplify what I’m about to present—but I think it provides a clearer picture on the causes of diabetes. While not all pieces of the puzzle are known at the biochemical, cellular, and genetic levels, the following is what we do know.  

 Types of Diabetes

 There are basically three types of diabetes. They are Type 1, Type 2, and Gestational Diabetes. They are defined as:

 

Type 1This type of diabetes usually manifests itself in childhood or young adulthood. It used to be called childhood-onset or insulin-dependent diabetes. In Type 1 diabetes, something has damaged the pancreas’s ability to produce insulin; therefore there is a need to take insulin, usually by injection. As Dr. Neal Bernard explains in his book, Dr. Neal Bernard’s Program for Reversing Diabetes, it is an autoimmune disease because the damages done to the insulin producing cells of the pancreas are attacked by the body’s own white-blood cells, those substances that are supposed to fight bacteria and viruses. More will be reported later on what triggers that process.

Type 2—This type of diabetes affects 9 out of every10 individuals who are diagnosed with the disease. This used to be called adult-onset diabetes, or sometimes non-insulin-dependent diabetes. Most people with this form of the disease still produce insulin; the problem is that their cells resist it. Insulin tries to bring glucose into the cells, but the cells respond like a door with a malfunctioning lock. In response to these sluggish cells, your body produces more and more insulin, trying to overcome the resistance. If the body’s insulin supply cannot overcome the resistance, glucose simply builds up in your blood. More will be reported later on how to overcome insulin resistance.

Gestational Diabetes —This type of diabetes is similar to Type 2 except that it occurs in women during pregnancy. While it typically disappears after childbirth, it is a sign of insulin resistance, and that means that type 2 diabetes may be around the corner. Steps taken to prevent Type 2 diabetes may be useful also for those women who have gestational diabetes. Two things women should do post-pregnancy is continue monitoring their blood sugar, and give strong consideration to implementing a more healthy lifestyle, and especially—a more healthy diet.  As always, see your primary-care physician first.

The Epidemiology of Diabetes

Epidemiological Facts

 The data presented here are from the 2007 National Diabetes Fact Sheet (the most recent year for which data is available).

Total: 23.6 million children and adults in the United States—7.8% of the population—have diabetes.

Diagnosed: 17.9 million people

Undiagnosed: 5.7 million people

Pre-diabetes: 57 million people

New Cases: 1.6 million new cases of diabetes are diagnosed in people aged 20 years and older each year.

Total Prevalence of Diabetes

Under 20 years of age

  • 186,300, or 0.22% of all people in this age group have diabetes
  • About 1 in every 400 to 600 children and adolescents has type 1 diabetes
  • About 2 million adolescents aged 12-19 have pre-diabetes

Age 20 years or older

  • 23.5 million, or 10.7% of all people in this age group have diabetes

Age 60 years or older

  • 12.2 million, or 23.1% of all people in this age group have diabetes

Men

  • 12.0 million, or 11.2% of all men aged 20 years or older have diabetes

Women

  • 11.5 million, or 10.2% of all women aged 20 years or older have diabetes

 

Race and Ethnic Differences in Prevalence of Diagnosed Diabetes

After adjusting for population age differences, 2004-2006 national survey data for people diagnosed with diabetes, aged 20 years or older include the following prevalence by race/ethnicity:

  • 6.6% of non-Hispanic whites
  • 7.5% of Asian Americans
  • 11.8% of non-Hispanic blacks
  • 10.4% of Hispanics

Among Hispanics rates were:

  • 8.2% for Cubans
  • 11.9% for Mexican Americans
  • 12.6% for Puerto Ricans.

 

Morbidity and Mortality

Deaths

Diabetes was the seventh leading cause of death listed on U.S. death certificates in 2006. This ranking is based on the 72,507 death certificates in 2006 in which diabetes was listed as the underlying cause of death. According to death certificate reports, diabetes contributed to a total of 233,619 deaths in 2005, the latest year for which data on contributing causes of death are available.

 Complications

Heart Disease and Stroke

• In 2004, heart disease was noted on 68% of diabetes-related death certificates among people aged 65 years or older.

• In 2004, stroke was noted on 16% of diabetes-related death certificates among people aged 65 years or older.

• Adults with diabetes have heart disease death rates about 2 to 4 times higher than adults without diabetes.

• The risk for stroke is 2 to 4 times higher among people with diabetes.

 

High Blood Pressure

• In 2003–2004, 75% of adults with self-reported diabetes had blood pressure greater than or equal to 130/80 mmHg, or used prescription medications for hypertension.

Blindness

• Diabetes is the leading cause of new cases of blindness among adults aged 20–74 years.

• Diabetic retinopathy causes 12,000 to 24,000 new cases of blindness each year.

 Kidney Disease

• Diabetes is the leading cause of kidney failure, accounting for 44% of new cases in 2005.

• In 2005, 46,739 people with diabetes began treatment for end-stage kidney disease in the United States and Puerto Rico.

• In 2005, a total of 178,689 people with end-stage kidney disease due to diabetes were living on chronic dialysis or with a kidney transplant in the United States and Puerto Rico.

 Nervous System Disease (Neuropathy)

• About 60% to 70% of people with diabetes have mild to severe forms of nervous system damage.

Amputation

• More than 60% of non-traumatic lower-limb amputations occur in people with diabetes.

• In 2004, about 71,000 non-traumatic lower-limb amputations were performed in people with diabetes.

Cost of Diabetes

$174 billion: Total costs of diagnosed diabetes in the United States in 2007

  • $116 billion for direct medical costs
  • $58 billion for indirect costs (disability, work loss, premature mortality)

After adjusting for population age and sex differences, average medical expenditures among people with diagnosed diabetes were 2.3 times higher than what expenditures would be in the absence of diabetes.

The American Diabetes Association has created a Diabetes Cost Estimator that takes the national cost of diabetes data and provides estimates at the state and congressional district level.

Factoring in the additional costs of undiagnosed diabetes, pre-diabetes, and gestational diabetes brings the total cost of diabetes in the United States in 2007 to $218 billion.

• $18 billion for the 6.3 million people with undiagnosed diabetes
• $25 billion for the 57 million American adults with pre-diabetes
• $623 million for the 180,000 pregnancies where gestational diabetes is diagnosed

For Additional Information

These statistics and additional information can be found in the National Diabetes Fact Sheet, 2007, the most recent comprehensive assessment of the impact of diabetes in the United States, jointly produced by the CDC, NIH, ADA, and other organizations.

 The Root Causes of Diabetes

 Many people believe that genetics plays the most important role in determining who gets diabetes and who doesn’t. We now know that this isn’t necessarily the case. Why? It’s because environmental factors and human behavior also play a significant role in diabetes. For example, there have been many studies conducted on Twins particularly in psychology so that greater knowledge could be found that better explained heredity versus the environment.  And many Twin studies have been conducted in the field of medicine as well.

Twins have the same genes. Yet, if one twin is diagnosed with diabetes, the other twin should develop the disease if genes are so determinative of disease causation. This however is not the case. The other twin only has a 40% chance of developing diabetes.

Other factors are involved. And, whether someone lives a long life obviously depends on both individual behavior and environmental factors.

Individual behavior, of course, really matters. Recently, the exercise and fitness icon/guru Jack Lalaine died at the age of 96. Jim Fixx, the famous runner of the 1980s, should have died earlier in life if genetics determined everything (His father died of a heart attack at 43). By my standards Jim Fixx also died young; he was only 52 years old. But he still outlived his father by 9 years because of his personal fitness as a marathon runner.

What implication then does environment and behavior, as causal factors, have on the prevalence of diabetes?  As most of you probably know epidemiology is the study of the prevalence and incidence of disease. It is a kind of sociology of medicine where large population studies take place. And, like the research field of psychology or sociology, the research conducted in epidemiology is extraordinarily important.

What I’m presenting in this Blog is only a short summary overview of the causation of diabetes.  

 Epidemiological Clues to Diabetes Begin to Form 

The most common treatment approach for decades has been the diabetic diet and exercise. Lots of exercise is always good and the exercise revolution went into high gear four decades ago. Besides exercise (30 minutes a day most days of the week) the basic recommendation of the medical community was to follow the ADA’s diabetic diet that included very little sugar and limited starchy foods such as bread, potatoes, rice, and pasta. This was logical since starch breaks down into sugar in your digestive track. Diabetic diets generally cut calories so one could simultaneously lose weight and limit certain fats. This would help to reduce heart disease and other complications. Over time however weight loss was generally modest and the diet itself was not enough to bring blood sugar down under excellent control.

 The first clue that something was amiss came from the field of epidemiology based on studies from other cultures. Large population studies revealed that diabetes was rare in Japan, China, Thailand, and other Asian countries. It was also found to be quite rare in parts of Africa. Such studies were showing something else. That is, people in countries where diabetes was rare or uncommon were not following anything like the diabetes diet. The typical Asian diet (and in Africa) did not avoid carbohydrates and included rice and other grains, starchy vegetables, bean dishes, and noodles.

 Despite eating lots of carbohydrates (much more than among North Americans or Europeans) diabetes was relatively rare. Among the Japanese eating their traditional Japanese diet the prevalence of diabetes is 1 percent. Among Americans the prevalence is 30 percent. However, when Japanese move to North America their risk of acquiring diabetes dramatically increases as does their risk of heart disease, obesity, and other medical problems.

 Unfortunately for Japanese living in their homeland, the American way of eating has finally come to them; they now have Burger King, McDonalds, and KFC. Meat, cheese, and other greasy foods, and other Western eating habits, are replacing rice and vegetables.  It turns out that the genes that allow diabetes to occur are surprisingly common among the Japanese, but as long as they stuck to their traditional diet, the disease was held mostly in check.

 The inescapable fact is that the problem is not a diet of lots of carbohydrates (sugar and starch). The causal problem is actually how the body processes them. Type 1 diabetes has an additional problem that I explain below.      

Cause of Type 1 Diabetes

It turns out Type 1 diabetes occurs because of what might be called “friendly fire.” This is the current explanation:

For many years researchers have known that type 1 diabetes occurs when the immune system attacks and destroys the insulin-producing cells in the pancreas. Your immune system, of course, is your defense against viruses, bacteria, and cancer cells. It is not supposed to attack your own healthy tissues, but that is exactly what occurs in type 1 diabetes.

As you probably know your immune system is made up of specialized white blood cells. Evidently, some of the cells engulf invading germs and digest them. Others make antibodies—molecules that attach to invading organisms like harpoons and identify them for other immune cells to attack. If you have Type 1 diabetes, your immune system has made a major error. It has attacked and destroyed your insulin-producing cells, making it what scientists call an autoimmune disease.

Everyone’s question has been—why does this occur? In 1992 a team of Canadian and Finnish researchers reported on an important discovery in the New England Journal of Medicine. They examined the blood samples of 142 children newly diagnosed with Type 1 diabetes. They found that each of the children had antibodies that were primed to attack cow’s milk proteins.

These antibodies had apparently arisen in response to cow’s protein in their infant’s formula, but the antibodies were also capable of attacking the body’s insulin producing cells in the pancreas. A portion of the cow’s milk protein turned out to be an exact match for a portion of human insulin-producing cells. The antibodies thus ended up attacking the children’s insulin-producing cells. This biochemical reaction led to the children being diagnosed with Type 1 diabetes.

Cause of Type 2 Diabetes

 

All humans need energy to live. Consequently, every cell in the body needs energy, including cells in our large muscle groups. How do our cells get this energy? Normally, the foods we eat provide that energy. The food is then converted to blood glucose (blood sugar) and leads to circulation in our blood stream. The pancreas produces a hormone called insulin, and sends it into your bloodstream to travel to the various cells of the body. Insulin then attaches to a receptor on the cell’s surface and causes the cell membrane to permit blood glucose to enter. In Type 2 diabetes this system doesn’t work very well. The insulin gets to each cell; however, when it arrives, it has trouble unlocking the door to each cell and then the cell fails to permit the glucose to enter. Since glucose cannot get into the cells, it then builds up in the bloodstream. This condition is called Insulin Resistance.

The mystery of Type 2 diabetes has always been to find out why Insulin Resistance occurs. We now have a pretty good idea of the cause. So, what is the cause of Type 2 diabetes? Insulin’s ability to work is blocked in the human cell (like gum jamming up a lock as the metaphor suggests) by actual FAT. The cell’s receptors are blocked or jammed by fat. Normally small amounts of fat are stored for energy in an emergency in each cell. However, in a diet (like the Western diet high in fat and cholesterol) excessive fat builds up in each cell creating the jamming process that prevents glucose from entering. If fat, called intramyocellular lipid, accumulates inside the cell, it interferes with insulin’s intracellular signaling process. Tiny organelles, called mitochondria, are supposed to burn fat. But their failure to keep up with the accumulating fat may be the origin of Type 2 diabetes. Fortunately, evidence shows that diet can reduce the amount of fat inside the cell. And, once excess fat is removed, insulin resistance greatly improves by once again allowing blood sugar to enter the cell.

My initial reaction to all this new information was to ask myself why not, rather than diet, find a way to simply increase the important mitochondria in the body first? Bright ideas aren’t quite so bright sometimes, especially when talking about bio-chemistry of the human body. What happens is that, through diet, one can easily add excessive fat (as we do in the American diet).  Traces of fat begin accumulating many years before diabetes manifests itself. Our genes in the body at the cellular level are a blueprint for mitochondria.

It turns out fatty foods actually do more than add excessive fat to each cell—they also interfere by turning off the genes that would help them create mitochondria and thus burn fat. The genes become disabled and do not allow the cells to produce the needed mitochondria. Your ability to eliminate fat inside your cells seems to slow down when you eat fatty foods. Continue this faulty intracellular activity long enough, and guess what—you end up being diagnosed with Type 2 diabetes.  

At the Imperial College of Medicine in London, researchers studied a group of individuals following a vegan diet. They compared the participants to others who were similar in age and body weight but were not following a vegan diet. When the researchers measured the intramyocellular lipid in each participant’s calf muscles, they found it was 31 percent lower in the vegans than in the omnivores. These findings strongly suggest that a vegan diet may significantly alter the problem of insulin resistance.

In Part II of my series on Diabetes in America, I will present details on what a vegan diet is. If you combine exercise with the vegan diet, you will possess two tools to create a permanent one-two punch that will knock diabetes to the canvas while the referee for a healthy life counts it out.

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