Osteoporosis treatment extends life

A study published in the Journal of Clinical Endocrinology and Metabolism (and summarized in the LA Times Booster Shots ) reports that bisphosphonate therapy reduces mortality in women and men. Mortality was not reduced by vitamin D + calcium therapy compared to no treatment. Bisphosphonates include Fosamax, Actonel, Atelvia, Boniva and Reclast. Even though these medications can cause a rare condition called osteonecrosis of the jaw the benefits of fewer fractures and longer life would appear to outweigh the risk of side effects.

Sprinting to prevent hypoglycemia

I found some interesting articles during a literature search on interval training. The most interesting was controlled observations that in type 1 diabetes, a 10 second all-out sprint either at the beginning or end of 20 min moderate exercise reduced hypoglycemia after exercise. The sprint did not prevent blood glucose from dropping during exercise.

Additional tidbits: (1) High intensity interval exercise (HIIE) releases more weight than prolonged low intensity exercise. This may be due to increased adrenaline and its tendency to burn fat. (2) HIIE improves aerobic performance as much as intermediate intensity exercise performed for a much longer time. (3) HIIE improves anaerobic capacity and this does not occur with intermediate intensity exercise.

If you are interested in adding HIIE to your exercise program it would be prudent to work with a trainer who has familiarity with this type of exercise. There are many web sites promoting various HIIE protocols. You want to pick one that has research data to demonstrate its efficacy.

Fake diseases?

From Endocrine Daily Briefing 16-Sep 2010. This is published by the Endocrine Society.

Endocrine Society Warns Public On Two Fake "Diseases."

In its "Booster Shots" blog, the Los Angeles Times (9/15, Maugh) reported that the Endocrine Society's Hormone Foundation is warning the public that two commonly discussed Internet "diseases" are in fact not real and were "apparently conceived only in an effort to sell products promoted to treat them." One is "adrenal fatigue," which promoters say can be treated with products that "often include extracts from human adrenal glands and hypothalamus that could be dangerous" and are not regulated by the FDA. The other fake condition is "Wilson's temperature syndrome...supposedly identified in 1990 by 'E. Denis Wilson M.D.' of Longwood, Fla.,'" who promotes various products, including "WT3," which could damage the heart and bones.

Endocrine discussion group

An open forum for discussion will be held live at my office Tuesday, May 25 at 5 pm.There is no fee. You do not have do be a patient at the practice to attend. Friends and relatives are welcome. I've just received the exercise equipment. I'm learning to program it and operate the metabolic cart so studies can be performed.

Changing human behavior

There are only three motivating factors that change human behavior; pain, fear or ambition. Which button do you want to push?-- Steve Hogg, 2007

I see people who need to change their behavior for the sake of better health. I look at these three factors and talk about the 'buttons' to find out what will help them do better. The hard part is identifying what buttons have been pushed in the past to put them on the course of poor nutrition and sedentary activity. Why these old buttons so much more powerful than the new buttons associated with their current state of compromised health? Or is it simply a matter of presently insufficient pain, fear and ambition to lead to change.

An interesting example are patients so fearful of hypoglycemia that they never let their blood glucose drop under 200 mg/dl. After a few years of this the pain of neuropathy, vision loss or kidney dialysis set in. Yet, even that level of pain does not outweigh the fear of hypoglycemia.

So, what motivates you? Why? I'd love to read your answers.

If you are taking 200 units of insulin a day...

and your A1c is still over 8%, maybe you're not taking the right type of insulin. First, see your diabetes educator to determine that you are eating and injecting appropriately. Taking your meal time insulin an hour after you eat is an easy way to keep your A1c over 9%.

If Everything is in order, maybe you need U500 R insulin. That's right, a 5x concentrated insulin. The vial is 20 cc so you effectively get 10 bottles of insulin for one copay. The retail price of $230 may seem high but that works out to $23 a bottle of 'ordinary' insulin. The high concentration given before meals can break through severe insulin resistance. Some people may still need a little basal insulin at bed time to keep the morning sugar in target range. You may need to ask around to find a doctor who is familiar with this insulin and will work closely with you to get optimal results.

Learn more about thyroid conditions

than you ever will in a 15 minute appointment. I am holding a conference to discuss thyroid conditions on March 23, 5 pm at Endocrine Associates. Bring your questions and I will bring answers. This is open to the public; you don't have to be a patient to attend.