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DIABETES AND HIGH BLOOD PRESSURE: THE ULTIMATE DEATH COMBO

OVERVIEW
According to recent studies, it has been shown that 64% of people with type 2 diabetes also suffer from hypertension.
This companionship is actually an ungodly one but sadly, in most cases where adequate management is not adhered to, the combo is just inevitable.
Many underlying pathophysiological mechanisms are associated with the duo, with a few seemingly plausible ones like: sodium-fluid retention, insulin resistance in the nitric-oxide pathway and stiffening of arteries.
Diabetes and hypertension are strongly interrelated and always predisposes individuals to other cardiovascular complications like atherosclerosis and arteriosclerosis.
In this article, we would throw light on both diseases, how to manage them, their symptoms and how to prevent one leading to the other.

IDENTIFYING DIABETES?
Diabetes is a complex condition that impairs the body’s ability to metabolize/use blood sugar in the body.
Globally, more than 422 million people are living with the disease. Currently, 1 out of every 17 adults are living with this disease in Nigeria.
Uncontrolled diabetes, either with medication or diet, or a combination of both therapies would lead to other disease complications like stroke and heart diseases.
There are three types of diabetes and they include: type 1 diabetes, type 2 diabetes and gestational diabetes.

TYPE 1 DIABETES: this is referred to as juvenile diabetes; more common among younger people. It occurs when the body fails to produce insulin. Sadly, people living with this type of diabetes have to stay on insulin for the rest of their lives to stay alive.

TYPE 2 DIABETES: this is the most common type of diabetes. It affects how the body uses insulin. The cells in the body do not respond to insulin effectively as they would always do in time past before the onset of this type of diabetes.
Less common types of diabetes include monogenic diabetes and cystic fibrosis-related diabetes.

HOW CAN I GET DIABETES?
The risk factors for type 2 diabetes include:
• If you are overweight (when your BMI is above 25 kg/m2)
• If one of your parents or ancestors has diabetes
• having a high-density lipoprotein (HDL) cholesterol level lower than 40 mg/dL or 50 mg/dL
• If there is an occurrence of high blood pressure in your family lineage
• having gestational diabetes or giving birth to a child with a birth weight of more than 9 pounds
• a history of polycystic ovary syndrome (PCOS)
• being of African-American, Native American, Latin American, or Asian-Pacific Islander descent
• being more than 45 years of age
• having a sedentary lifestyle

HOW WILL I KNOW THAT I HAVE DIABETES?
Type 2 diabetes always presents with symptoms and they include:
– excessive hunger
– excessive thirst
– excessive passing of urine; especially in the night time
– blurry vision
– you easily get tired
In some cases, symptoms might not be noticed on time.

Type 2 diabetes can be diagnosed also if an individual’s blood sugar levels are above 70-90 mg/dl. Normally, to test for diabetes, blood samples are needed. But recently, your tears could be used to test for blood glucose levels.

IDENTIFYING BLOOD PRESSURE
Hypertension is a common condition in which there is a long-term force of blood against your artery walls. This could also predispose the individual to other heart health problems.
Previous studies have recorded that hypertension (commonly called) is more prevalent in men than in women.

CAUSES OF HYPERTENSION
There are a number of risk factors which could lead to hypertension and they include:
• Age.
• Family history (hereditary)
• Ethnic background.
• Obesity and being overweight.
• Lack of physical exercise or activity.
• Smoking.
• Alcohol intake.
• Poor diet and high cholesterol.
There are no symptoms noticed with hypertension; reason why it is called the “silent killer”
People usually find out that they have hypertension when a doctor takes their reading with a sphygmomanometer.
An individual would be said to have hypertension if blood pressure levels are above 140/90 mmHg, in severe cases blood pressure levels might get to 180/120mmHg.

RELATIONSHIP BETWEEN HYPERTENSION AND DIABETES
The duo often occurs together and might even share common causes which include:
– Obesity
– Inflammation
– Oxidative stress
– Insulin resistance
As blood glucose accumulates in the body, some vital organs that help to maintain fluid balance are affected. Organs like the kidneys are more affected because they play an important role in making sure there is no fluid retention which leads to high blood pressure.
There are three ways in which high glucose levels in the blood can increase blood pressure:
• The blood vessels lose their ability to stretch.
• The fluid in the body increases, especially if diabetes is already affecting the kidneys.
• Insulin resistance which may involve processes that increase the risk of hypertension.
It is important to note that the duo could pose huge health complications which includes:
1. heart attack or stroke
2. decreased kidney function, progressing to dialysis
3. problems with the blood vessels in the eyes, leading to vision loss
4. peripheral vascular disease

CAN THIS BE PREVENTED?
Yes! Lifestyle factors are very crucial in the management of both diabetes and hypertension.
These lifestyle factors should be adhered to strictly in order to prevent the onset of the duo
1. A HEALTHY DIET: people who already live with diabetes or hypertension should seek advice from their dietitian to help manage their symptoms in order to avoid an escalating situation.
This advice would include:
– eating plenty of fresh fruits and vegetables
– focusing on high-fiber foods, including whole grains
– limiting (not avoiding) the amount of added salt and sugar
– avoiding or limiting unhealthful fats, such as trans fats and
– avoiding the intake of refined carbs.
2. AVOID ALCOHOL AND SODA DRINKS: high alcohol intake increases the risks of developing these diseases. Surprisingly, people always have the mind-set that alcoholic drinks are healthier options when compared to soft drinks. Both are actually not recommended if these diseases are present.
3. STOP SMOKING: smoking tobacco increases the risk of high blood pressure and diabetes. Smoking could lead to poor blood flow and could damage the heart and lungs.
4. MAINTAIN A HEALTHY WEIGHT: losing weight is actually helpful in preventing the onset of diabetes and hypertension. Losing 3-5% of your weight can improve blood sugar readings.
5. BE ACTIVE: at least 150 minutes of intense exercise could help lower blood pressure levels and blood glucose levels as it helps in good blood circulation.
Note that only diet would not help in the management of diabetes and hypertension or the duo. Medications also are important factors in the management.
Also note that herbs, supplements and concoctions won’t help to eradicate this duo but might even pose greater health risks to the individual.

TAKE HOME
High blood pressure and type 2 diabetes often occur together and tend to share same risk factors.
It’s very important to pay attention to lifestyle modifications if you are living with both diseases or just one of them.
In the management, it’s important to have a doctor and dietitian co-manage your symptoms as diet and medication play a huge role in the management of these diseases.

  1. SOURCES: https://www.medicalnewstoday.com/articles/317220#outlook
    https://www.webmd.com/diabetes/high-blood-pressure#:~:text=Diabetes%20damages%20arteries%20and%20makes,heart%20attack%2C%20and%20kidney%20failure.
    https://www.tandfonline.com/doi/abs/10.1080/20786204.2004.10873136

 

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LifeStyle

GOUT

OVERVIEW
Ever felt a reddish and tender pain on your big toe or even both?
If yes, then you should go through this article.
Gout is a type of arthritis that forms as a result of formation of crystals in and around the joint.
It is actually the most common type of inflammatory arthritis. It affects one join at a time (especially the joint at the big toe).
Gout is actually an ancient disease; the Egyptians actually noticed it first.
Gout mostly occurs when there are excess amounts of uric acid deposited in the urine and kidneys.
There is no cure for gout, but it can be managed effectively with the right approaches.
It is most common in the big toe, and is also common in the mid foot, ankle, and knee

WHAT SYMPTOMS SHOULD I LOOK OUT FOR?
Acute gout flare mostly come as a rapid onset of pain at the site of the affected joint followed by warmth, swelling, reddish discoloration, and marked tenderness.
Sometimes most people, the pain is so intense that even if a paper touches it, you feel so much paper.
Symptoms in the affected joint(s) may include:
• Pain, usually intense
• Swelling
• Redness
• Heat

CAUSES
the accumulation of uric acid known usually as hyperuricemia is the cause of gout. When this happens, uric acid crystals are formed then they build up in joints, fluids and tissues.
What increases your chances for gout?
You’re more likely to develop gout If the following is present:
• Being male
• Being obese
• Having certain health conditions, including:
• Congestive heart failure
• Hypertension (high blood pressure)
• Insulin resistance
• Metabolic syndrome
• Diabetes
• Poor kidney function
• Using certain medications, such as diuretics (water pills).
• Drinking alcohol. The risk of gout is greater as alcohol intake goes up.
• Eating or drinking food and drinks high in fructose (a type of sugar).
• Having a diet high in purines, which the body breaks down into uric acid. Purine-rich foods include red meat, organ meat, and some kinds of seafood, such as anchovies, sardines, mussels, scallops, trout, and tuna.

ARE THERE POSSIBLE TRIGGERS?
Sometimes these crystals might not go into your joint cavities, and sometimes they might. Possible reasons why they would include:
• a knock or injury to the joint
• an illness that may make you feverish
• having an operation
• having an unusually large meal, especially a fatty meal
• drinking too much alcohol
• dehydration
• starting urate lowering therapy, especially at a high dose, or not taking your treatment regularly each day.

ARE THERE TREATMENT OPTIONS?
Oh sure!
With self-management and medications, gout can be effectively treated. You can achieve this If you:
1. Manage the pain of a flare: Treatment for flares consists of nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, steroids, and the anti-inflammatory drug colchicine
2. Get physically active: every minute of activity counts. It is at least better than doing nothing. It is recommended that you do at least 15 minutes of physical activities daily.
3. Eat a healthy diet: foods high in purines are most commonly the triggers for gout flares. Avoiding them could totally help to alleviate pains and soreness in gout. Foods that has high levels of purines includes red meat, seafood like shellfish, limit the intake of alcohol or totally give it up.
4. Protect your joints: low impact types of exercises which won’t lead to joint injuries are preferred. Swimming, bicycling and skipping are actually very good options for exercises.

SOURCES: https://www.webmd.com/arthritis/ss/slideshow-gout
https://www.hss.edu/conditions_gout-risk-factors-diagnosis-treatment.asp
https://www.nhs.uk/conditions/gout/
https://www.versusarthritis.org/about-arthritis/conditions/gout/

 

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General Research

IS OBESITY RELATED TO CANCER

Does Body Weight Affect Cancer Risk?

Being overweight, obese or having a BMI over 30kgmsq (since the society wants to scrap out the word obese) seems to be  linked to an overall increased risk of cancer. According to research from the American Cancer Society, excess body weight is thought to be responsible for about 11% of cancers in women and about 5% of cancers in men in the United States, as well as about 7% of all cancer deaths.  

Being overweight or obese is clearly linked with an increased risk of 13 types of cancer, which includes:

  • Breast cancer (in women past menopause)
  • Colon and rectal cancer (diet related)
  • Endometrial cancer (cancer of the lining of the uterus)
  • Esophagus cancer (diet related)
  • Gallbladder cancer (diet related)
  • Kidney cancer (diet related)
  • Liver cancer (diet related)
  • Ovarian cancer
  • Pancreas cancer (diet related)
  • Stomach cancer (diet related)
  • Thyroid cancer (diet related)
  • Multiple myeloma
  • Meningioma (a tumor of the lining of the brain and spinal cord). Notice that there is a correlation with diet and almost 80% of all stated cancers. Most part of your body more vulnerable to cancers are the ones exposed to whatever dietary choices you make.

Being overweight or obese might also raise the risk of other cancers, such as:

  • Non-Hodgkin lymphoma
  • Male breast cancer
  • Cancers of the mouth, throat, and voice box
  • Aggressive forms of prostate cancer

The bond between cancer and  body weight is stronger for some cancers than for others. For example, excess body weight is thought to be a factor in more than half of all endometrial cancers, whereas it is linked to a smaller portion of other cancers.

Understanding the link between body weight and cancers is quite complex and might tip you off balance a bit. For example, while studies have found that excess weight is linked with an increased risk of breast cancer in women after menopause, it does not seem to increase the risk of breast cancer before menopause. Reasons best known to science (giggles).

The time of an individual’s life in which they gain weight might also affect cancer risk. Being overweight during childhood and young adulthood might be more of a risk factor than gaining weight later in life for some cancers. For example, some research suggests that women who are overweight as teenagers (but not those who gain weight as adults) may be at higher risk for developing ovarian cancer before menopause.

More research still needs to be carried out to back up some of these claims 

 

How might body weight affect cancer risk?

Excess body weight may affect cancer risk in a number of ways, some of which might be specific to certain cancer types. Excess body fat might increase cancer risk by affecting:

  • Inflammation in the body
  • Cell and blood vessel growth
  • Cells’ ability to live longer than they normally would
  • Levels of certain hormones, such as insulin and estrogen, which can fuel cell growth
  • Other factors that regulate cell growth, such as insulin-like growth factor-1 (IGF-1)
  • The ability of cancer cells to spread (metastasize)

Does losing weight reduce cancer risk?

Research on how losing weight might lower the risk of developing cancer is limited. Still, there’s growing evidence that weight loss might reduce the risk of some types of cancer, such as breast cancer (after menopause) and endometrial cancer.

Some body changes that occur as a result of weight loss suggest it may, indeed, reduce cancer risk. For example, overweight or obese people who intentionally lose weight have reduced levels of certain hormones that are related to cancer risk, such as insulin, estrogens, and androgens.

While we still have much to learn about the link between weight loss and cancer risk, people who are overweight or obese should be encouraged and supported if they try to lose weight. Aside from possibly reducing cancer risk, losing weight can have many other health benefits, such as lowering the risk of heart disease and diabetes. Losing even a small amount of weight has health benefits and is a good place to start.

It’s important to lose body weight, but much more important to lose body fat rather than just water fat (glycogen stores). So rather than cutting out carbs with chain saws and axes, reduce the amount of trans fat and ensure you take in quality nutrients. 

 

The science around it all

Overall, the majority of hypotheses proposed over the past 20–30 years have been based around the physiological functions and pathological correlations of compounds intimately involved in general metabolism of adipose tissue or its regulation by systemic factors and the relevance of those compounds to cell proliferation or development that could contribute to abnormal proliferation and migration leading to oncogenesis (development of tumors). The more recently developed concepts to be described below adopt a wider perspective in which the interface between adipose metabolism, inflammation and carcinogenesis is mediated by newly uncovered links involving biochemical pathways which open new perspectives on the obesity/cancer relationship in a more holistic, biologically integrated manner.

 These ideas include the inflammation-induced activation of the kynurenine pathway and its role in feeding and metabolism by activation of the aryl hydrocarbon receptor (AHR) and by modulating synaptic transmission in the brain. Evidence for a role of the kynurenine pathway in carcinogenesis then provides a potentially major link between obesity and cancer. A second new hypothesis is based on evidence that serine proteases can deplete cells of the tumour suppressors Deleted in Colorectal Cancer (DCC) and neogenin. These enzymes include mammalian chymotryptic proteases released by pro-inflammatory neutrophils and macrophages.

The kynurenine pathway represents the dominant pathway of tryptophan catabolism, accounting for the disposal of around 95% of the tryptophan not used for protein synthesis.

According to a research carried out by Jin in 2015, he stated and i quote that “the relevance of the kynurenine pathway is that not only do its components affect the regulation of metabolism, feeding and body mass, largely via the modulation of NMDA receptor activity, but they are also implicated in aspects of carcinogenesis’. Expression of the central enzyme of the pathway – kynurenine-3-monooxygenase (KMO) is greater in human hepatic carcinoma cells than controls and is known to influence cell proliferation and migration.

Other factors like insulin resistance, high glucagon and leptin levels (in obese and diabetic patients), adipokines (adiponectin) which is reduced in obese patients, highly concentrated levels of ceruloplasmin in adipose tissues of obese patients, might also increase an obese patients risk to several types of cancer. 

 

Dietary consideration 

Bowman-Birk inhibitors are relatively small proteins found in plant based foods, highly stable within the intestine and generally resistant to heating and cooking, which are known to be absorbed from the intestine into the blood. 

Several studies suggest that the presence of bowman’s birk inhibitors (BBI) are capable of inducing apoptosis in human breast carcinoma. The BBI is also capable of suppressing carcinogenic processes that include colon, oral leukoplakia, esophageal tumors, leukemia, prostatic hyperplasia and breast cancer (quite elusive though).

An overall healthy diet and lifestyle cannot be over emphasized, whether you choose a ‘only plant based diet’ or you choose to do a variety, make sure you do the right thing for your body MODERATION! 

 

Sources: https://www.nature.com/articles/cddiscovery201567

https://www.cancer.org/cancer/cancer-causes/diet-physical-activity/body-weight-and-cancer-risk/effects.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5952217/

 

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