‘Science Says’ Sunday – Type 2 Diabetes

wp-15819059194468724035504692813866.jpg

Diabetes (or also known as “high blood sugar” disease)

Did you know that one of the diseases I study is type 2 diabetes? Type 2 diabetes falls within the general diabetes category, however, is not the only type of diabetes that humans get. Other types of diabetes include:

  • Type 1 diabetes (this is an autoimmune disease – a condition where your immune system mistakenly attacks your body),
  • Gestational diabetes (diabetes you get during pregnancy, which could sometimes also be type 2 diabetes during pregnancy),
  • Monogenic diabetes, or diabetes that is caused by a single gene defect or mutation (type 1 and type 2 are polygenic (poly=many, genic=genetic or related to genes), which they are related to a change, or defect, in multiple genes). Neonatal diabetes mellitus (NDM) and maturity-onset diabetes of the young (MODY) are the two main forms of monogenic diabetes. NDM occurs in newborns and young infants. MODY is much more common than NDM and usually first occurs in adolescence or early adulthood.

Today we’re going to go over type 2 diabetes, because it’s the most common type of diabetes, but we’ll cover other types of diabetes in later Science Sunday posts. We’re still in the middle of Heart Health Month, and I’m not sure if you are aware, but type 2 diabetes is a risk factor for heart disease. In fact, among people with diabetes, the most common causes of death are heart disease and stroke.
There are other conditions that can result from having diabetes, though. They include:

  • kidney disease
  • eye problems
  • dental disease
  • nerve damage
  • foot problems
  • heart disease
  • stroke

Perhaps you’ve read all of this and thought to yourself, okay, that’s great, but I still don’t really understand what diabetes is! Well, the National Institute of Diabetes and Digestive and Kidney Disease has a great way to describe it, so I’m going to summarize their explanation here! Diabetes is a disease that happens when your blood sugar is too high. The sugar in your blood is your main source of energy and comes from the food you eat. Insulin, a hormone made by an organ in your body called the pancreas, helps the sugar from food get into your cells so that it can be used for energy. Sometimes your body doesn’t make enough—or any—insulin or doesn’t use insulin well. When that happens, the sugar stays in your blood and doesn’t reach your cells. Over time, that large amount of sugar can cause health problems, among them, type 2 diabetes.

Phew! That was a lot! So, how do we prevent diabetes?? Is diabetes genetic? More importantly, if I get diabetes, can I reverse it and no longer have diabetes??

Yikes, that’s a lot too! Let’s start with whether diabetes is genetic. I mentioned that type 2 diabetes is a polygenic disease. While the concept of genetics is complicated, the short version of this is that while you may “carry” some genes that increase your risk for type 2 diabetes, having those genes alone does not alone mean that you will get diabetes. Type 2 diabetes also depends on other things. Here are some things that may increase your risk for type 2 diabetes (this means that each on its own cannot cause diabetes, but can increase your risk overall for type 2 diabetes):

  • are overweight or obese
  • are age 45 or older
  • have a family history of diabetes
  • are African American, Alaska Native, American Indian, Asian American, Hispanic/Latino (our research suggests being of Mexican background may increase your risk for type 2 diabetes by about 30%!) , Native Hawaiian, or Pacific Islander
  • have high blood pressure
  • have a low level of HDL (“good”) cholesterol, or a high level of triglycerides
  • have a history of gestational diabetes or gave birth to a baby weighing 9 pounds or more
  • are not physically active
  • have a history of heart disease or stroke
  • have depression
  • have polycystic ovary syndrome, also called PCOS
  • have acanthosis nigricans—dark, thick, and velvety skin around your neck or armpits

Remember, none of the factors above can cause diabetes on their own. Type 2 diabetes is also known as a “complex” disease, which means that sometimes, multiple things have to happen (the perfect storm of risk factors) in order for a person to develop type 2 diabetes.

So what can you do to prevent it?
To help prevent diabetes, the best things you can do are maintain a healthy weight, eat a healthy diet, and be more physically active! Definitely talk to your primary care doctor about managing the other things on the list above if any require medical treatment. Managing these things can help prevent type 2 diabetes. Also talk to your primary care doctor about any medications that may increase your risk for type 2 diabetes as well.

Finally, if you have diabetes, can you reverse it or cure it??
That’s a loaded question and the answer will vary depending on who you ask. It’s important to know that there is no cure for type 2 diabetes. Recent scientific studies suggest that it’s possible to “reverse it”. That’s a bold claim considering, but what can happen is that through diet changes and weight loss, you may be able to reach and hold blood sugar at normal levels, without medication. This, however, may not mean you’re completely cured. It’s very important to recognize and know that type 2 diabetes is an ongoing disease.
For additional information, check out the info pages for the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, American Diabetes Association, the Centers for Disease Control, and the National Heart Lung and Blood Institute.

Sources for today’s post:
https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes
https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf
https://www.nature.com/articles/s41598-018-35707-7
https://www.ncbi.nlm.nih.gov/pubmed/31857443
https://www.nhlbi.nih.gov/health/educational/healthdisp/pdf/tipsheets/What-Is-Diabetes.pdf

‘Science Says’ Sunday – Heart Disease

wp-15812896680947735071136458082865.jpg

February is Heart Health Month and so in today’s ‘Science Says’ Sunday post, I’m sharing some facts about heart health!

Did you know that heart disease is the number one killer for both men and women in the US? Among women, heart disease kills more women than all cancers combined. Still, for decades, heart disease has been considered a disease that mostly men get/have. The reality is that heart disease occurs in high numbers for both men and women, and women have poorer results after having heart disease than men. Interestingly, heart attacks happen in men at younger ages than they do in women, but when women do have heart attacks, women are less likely to survive than men. We don’t really understand why middle-aged men have more heart attacks than women in the same age group. But in general unhealthy habits—including smoking and stress—may be part of the reason. In women, heart disease risk appears to rise after menopause; experts believe that in younger women, naturally occurring hormones may play a protective role.

We also know that some race/ethnicities are at greater risk for heart disease, but why? For women, the reasons are complex. Some factors include: 

  • Black women are more likely to have hypertension compared to non-Hispanic White and Mexican American women.
  • Diabetes prevalence is much higher in Black and Mexican American women compared to non-Hispanic White women.
  • Risk factors such as overweight, obesity, and physical inactivity are greater among Black and Hispanic women, than among White Non-Hispanic women. Most of the data in the US has focused on the largest group of Hispanic/Latinos, which is largely comprised of Mexican Americans. The Hispanic/Latino population is incredibly diverse, however, comprised of Mexican Americans, but also Cubans, Puerto Ricans, Dominicans, Central and South Americans, among others. Results from the Hispanic Community Health Study/Study of Latinos tells us that the burden of cardiovascular disease risk factors can vary greatly across subgroups of Hispanic/Latinos. 

Here is an acronym that can help you remember some of the key things to help prevent heart disease: GO RED. 

G: GET YOUR NUMBERS

Ask your doctor to check your blood pressure and cholesterol.

O: OWN YOUR LIFESTYLE

Stop smoking, lose weight, exercise, and eat healthy.

It’s up to you. No one can do it for you.

R: REALIZE YOUR RISK

We think it won’t happen to us, but heart disease kills one of three women and one in four men.

E: EDUCATE YOUR FAMILY

Make healthy food choices for you and your family.

Teach your kids the importance of staying active.

D: DON’T BE SILENT

Tell every man and woman you know (but especially women, so we can change the perception that it’s only a man’s disease) that heart disease is our No. 1 killer.

Whether you are a man or woman, know that you should be aware of your risk for heart disease and work to lower that risk as much as possible. Heart disease—and the conditions that lead to it—can happen at any age. High rates of obesity and high blood pressure among younger people (ages 35-64) are putting them at risk for heart disease earlier in life. Half of all Americans have at least one of the top three risk factors for heart disease (high blood pressure, high cholesterol, and smoking). 

Take control of your health and risk and remember GO RED!!

 

Sources for this week post came from:

https://www.heart.org/

https://www.cdc.gov/heartdisease/index.htm

Inequality Report: Heart Disease and Women (2017)

https://www.nhlbi.nih.gov/health-topics/education-and-awareness/heart-month/help-prevent-heart-disease

 

 

https://healthmetrics.heart.org/wp-content/uploads/2017/06/AHA_GRFWInequalityReport2.1.pdf

https://healthmetrics.heart.org/wp-content/uploads/2017/06/AHA_GRFWInequalityReport2.1.pdf

https://healthmetrics.heart.org/wp-content/uploads/2017/06/AHA_GRFWInequalityReport2.1.pdf

https://healthmetrics.heart.org/wp-content/uploads/2017/06/AHA_GRFWInequalityReport2.1.pdf

https://healthmetrics.heart.org/wp-content/uploads/2017/06/AHA_GRFWInequalityReport2.1.pdf

https://healthmetrics.heart.org/wp-content/uploads/2017/06/AHA_GRFWInequalityReport2.1.pdf

‘Science Says’ Sunday – Traumatic Brain Injury

wp-15806982838458475412318522202271.jpg

Traumatic Brain Injury (TBI)

TBI has been in the news a lot lately and since it is Super Bowl Sunday (go Niners!), I thought I’d touch on this subject today!

 So, what is TBI? Basically, it’s a brain injury. Injuries that can be caused by hard blows to the head or body. Serious TBI can cause bruising, bleeding, or tearing. Most TBIs happen as a result of sports injuries, car accidents, or other physical activities (like you’ve heard about happening to our military troops). People often wonder how this happens; the physical injury can lead to a back and forth motion of the brain inside of the skull. The back and forth motion leads to the injury of the brain. That’s known as the primary injury. Secondary injury results when the brain becomes so injured that it leads to swelling. The swelling can lead the brain to become grow larger than the space inside the skull, which can lead to stopping oxygen flow to the brain. This secondary injury leads to more serious and potentially permanent damage.

What are the symptoms of TBI? According to the Mayo Clinic, symptoms can range from mild to severe, including:

  • Mild: person is awake; eyes open. Symptoms can include confusion, disorientation, memory loss, headache, and brief loss of consciousness.
  • Moderate: person is lethargic; eyes open to stimulation. Loss of consciousness lasting 20 minutes to 6 hours. Some brain swelling or bleeding causing sleepiness, but still arousable.
  • Severe: person is unconscious; eyes do not open, even with stimulation. Loss of consciousness lasting more than 6 hours.

So how does TBI differ from concussions and chronic traumatic encephalopathy (CTE)?? Concussions, contusions, and hematomas for example, all fall within the TBI definition. They are different types of traumatic brain injuries. Most recently, you may have heard a lot about CTE, especially if you know about football players like Aaron Hernandez. CTE is very much an area of active research, so we still don’t know a lot about it. According to researchers at Boston University, CTE is a progressive disease where the function of the brain becomes progressively worse over time. This has been identified in individuals, especially boxers, as early as the 1920s, but has gained the interest of the public in the context of football. Most common, CTE is found in people with a history of repetitive TBI (often athletes), including symptomatic concussions as well as concussions from hits to the head that do not cause symptoms. It’s important to note that CTE is not limited to current professional athletes; it has also been found in athletes who did not play sports after high school or college. The changes in the brain can begin months, years, or even decades after the last brain trauma or end of any exposure to sports.

How would you know if you have TBI or CTE? Also, can I get CTE after a single TBI?? After an injury to the head or body (e.g., if involved in an accident or sports injury such as a tackle in football for example), if a person experiences any of the symptoms listed above, the person may have a TBI. CTE usually involves chronic, repetitive injury, and according to scientists, “at this time the number or type of hits to the head needed to trigger degenerative changes of the brain is unknown. In addition, it is likely that other factors, such as genetics, may play a role in the development of CTE, as not everyone with a history of repeated brain trauma develops this disease. However, these other factors are not yet understood.”

For more information, consider the resources provided below:

https://www.bu.edu/cte/about/frequently-asked-questions/

https://www.mayoclinic.org/diseases-conditions/traumatic-brain-injury/symptoms-causes/syc-20378557

https://www.cdc.gov/traumaticbraininjury/index.html