Monday, January 8, 2018

Kidney Disease Can Lead to Diabetes, Not Just the Other Way Around

Kidney disease increases the risk for diabetes, a new study finds. Medical experts already knew that the reverse is true – that diabetes increases the risk for kidney disease. The authors of the new study, though, found that kidney dysfunction can lead to diabetes – and, that a waste product called urea plays a role in the two-way link between the two diseases.

Urea comes from the breakdown of protein in food. Kidneys normally remove urea from the blood, but poor kidney function can lead to increased levels of urea.

The study involved the analysis of medical records over a five-year period for 1.3 million adults who did not have diabetes. About 9% had elevated urea levels, a sign of reduced kidney function. That’s the same rate as in the general population, according to the researchers.

People with high urea levels were 23% more likely to develop diabetes than those with normal urea levels, the study found. The results were published online recently in the journal Kidney International.

“The risk difference between high and low levels is 688 cases of diabetes per 100,000 people each year,” said study senior author Dr. Ziyad Al-Aly. He’s an assistant professor of medicine at Washington University School of Medicine in St. Louis.

“When urea builds up in the blood because of kidney dysfunction, increased insulin resistance and impaired insulin secretion often result,” Al-Aly said.

The findings about the role of urea could help in efforts to improve treatment and possibly prevent diabetes, the researchers said. Urea levels can be lowered in a number of ways, including medication and diet.

Friday, January 5, 2018

Seniors Don’t Need Calcium, Vitamin D Supplements

Seniors are wasting their time and money taking calcium and vitamin D supplements to ward off the brittle bones of old age, a new review concludes.

It turns out there’s little evidence supplements protect against hip fractures and other broken bones in older folks, according to data gathered from dozens of clinical trials.

“The routine use of these supplements is unnecessary in community-dwelling older people,” said lead researcher Dr. Jia-Guo Zhao, an orthopedic surgeon with Tianjin Hospital in China. “I think that it is time to stop taking calcium and vitamin D supplements.”

Zhao and his colleagues combed through medical literature to find clinical trials that previously tested the usefulness of calcium and Vitamin D supplements. They wound up with data from 33 different clinical trials involving more than 51,000 participants, all of whom were older than 50 and living independently.

Most of the clinical trials took place in the United States, the United Kingdom, New Zealand and Australia Zhao said. The dosage of the supplements varied between the clinical trials, as did the frequency at which they were taken.

The pooled data revealed no significant association between calcium or vitamin D supplements and a person’s risk of hip fracture or other broken bones, compared with people who received placebos or no treatment at all.

Potential dietary sources of these nutrients prove one of the weaknesses of the evidence review, argued Dr. Daniel Smith, an assistant professor of orthopedics at the Icahn School of Medicine at Mount Sinai in New York City. “While this study addresses concerns regarding calcium and vitamin D supplementation, it fails to address or even consider whether the patients in question are obtaining either adequate calcium and vitamin D intake in their diets or sunlight exposure, obviating the need for supplementation,” Smith said.

Wednesday, January 3, 2018

2017 Blog Summary

I posted 147 blogs in 2017. I began writing my blog late in 2013 and will exceed 600 total posts sometime this month.

For me, the most important benefit is personal. Reviewing studies keeps me abreast of the latest health research. As a result, I’m a better physician, providing a higher level of service to my patients. I hope that you also glean information to guide you in making health decisions.

Reviewing my blogs for the past year always brings some surprises and some fond memories. I really enjoyed researching and writing the series on food allergies. I try to strike a balance between criticism of our current health care system and positive steps you can take to improve your own health.

This year it appears I’ve done a pretty good job in that department. Tied for first were blogs about diet and blogs about drugs. Together, they accounted for a full third of my blogs. Medical testing was the next most popular topic, followed by supplementation and hormone imbalance. Each accounting for 10% of my blog material. I also covered exercise, autoimmune disease, medical procedures, and cardiovascular disease repeatedly.

I was surprised that infection, genetics and toxicity in the environment were not more popular. Look for more blogs on these topics this year. In fact, emerging studies are showing a strong correlation with these factors and chronic diseases like ALS (Lou Gehrig’s disease), MS (multiple sclerosis), RA (rheumatoid arthritis) and AD (Alzheimer’s disease).

You can view any of my blogs since 2013 just by scrolling through the years and months in the right-side column. If you prefer, you can also search by key word. Just enter your topic in the left-hand upper corner and press enter.