This comes with hopes that your summer is going well for you with your family, friends, and loved ones.  It can be renewing to spend some extra time with those we love around holidays.

This month, I am doing something new - I have invited my new colleague at Gordon Medical, Dr. Alan McDaniel, to be the guest writer of this month's edition.  He has done extensive research in many areas of medical practice, but I particularly wanted him to share with you his perspective on Insulin Resistance.  It is a topic that you have heard me address before in my newsletter and in our office visits, and it is one that affects the vast majority of us as we go through mid-life.  Dr. McDaniel shares below his perspective.  Hopefully, by putting in place some of the preventative measures, you can take steps to further prevent this imbalance from adversely affecting your health.

Welcome, Dr. McDaniel!!

Insulin resistance and the Metabolic Syndrome

You probably noticed there are a lot of overweight people these days.  If you are over 40, there's a pretty strong chance you are one of them - but why?  And how about those commercials on the television about droopy, tired-out men with low testosterone; or the ones for women with PMS - did you wonder where these problems came from?  Are you puzzled that so many people are fatigued? ...have to take drugs every day for high cholesterol and blood pressure? ...or by the fact that women are now so commonly having heart attacks?  All of these problems are set up by the genetic program for insulin resistance.  Fortunately, this is one genetic issue we can do a whole lot about!   

Epidemiologists report some 40% of Americans have inherited the so-called "thrifty genes."  These genes convey many gifts of great value to people living in hardship conditions: They are energy-efficient, using less and storing more (thrifty) and so are resistant to starvation.  Their clan will enlarge faster and have stronger warriors.  Thrifty genes let women become pregnant at a younger age and then deliver larger babies, who live to become bigger adults (and pass the genes to us, their descendants!).  When people had a "primitive" diet and lifestyle - and rarely lived to 40 years old - the thrifty genes had virtually no "down-side."  The same genes give us insulin-resistance.

Resistance to what?  Insulin is a metabolic hormone, a biochemical "messenger," released when we eat.  It signals a variety of our body's cells to do many things.  Its most important action is stimulating our muscle cells to take in large amounts of sugar from the bloodstream.  At least 80% of each meal is soaked up this way, which controls our blood sugar.  The thrifty genes diminish the effectiveness of this insulin-signal (i.e. insulin resistance): More insulin than normal is needed to regulate blood sugar.  The resistance slowly worsens, too.  If insulin resistance becomes so profound that blood sugar can no longer be controlled, type-2, "adult-onset" diabetes is the ultimate result. 

These days, people carrying the thrifty genes are developing diabetes at an accelerating rate.  Is that so bad?  Yes, I'm afraid so: Becoming diabetic shortens the average person's life expectancy 14 years - even with good treatment.  That treatment has many costs, too.  A diabetic spends about ten times more money for personal medical expenses over her shortened lifetime.  Don't wonder if insurance pays for that; rather, think of what it means in terms of personal suffering!  The high blood sugar of diabetes is not the only cause of this damage. 

We have realized that many complications associated with diabetes develop long before the blood sugar has gone high - some are noted in the first paragraph.  These are caused by the effects of high insulin.  Collectively, they are called the Metabolic Syndrome, which can be deadly even if diabetes never develops!  Did you notice I mentioned that insulin signals a variety of cells to do many things?  Don't feel badly if you missed that; for years, we docs didn't get it, either.  This is the key point: There is no resistance to these other signals, the effects of which become grossly exaggerated when people have to make unusually large amounts of insulin to control their blood sugar.  

Insulin resistance effects us all our lives, even influencing our birth weight.  Childhood ADD and atypical-bipolar disorder may be related.  Teenage menstrual problems and PCOS are clearly associated.  Real Trouble most often shows up in our forties, though.  At this time, many problems related to the "biological clock" come knocking, including sex hormone changes, thyroid disorders and the cumulative effects of stress, nutritional problems and ill-suited lifestyle choices.  Sadly, each of these can worsen the others and a snowball becomes an avalanche. 

Fortunately, lots can be done to help.  There are four ways to render insulin resistance harmless.  Our modern diet and lifestyle are the reasons insulin resistance has gone from beneficial to "bad news" and it is here we should start.  Medical research confirms combining a proper diet and a healthy life-style including adequate sleep and modest exercise is ten-times more successful than taking prescription medications.  A successful diet must honor both the Glycemic Index and the new Insulinemic Index.  It is not "no-carb" or "low-carb" but features lots of "slow-carbs."  Add a few well-chosen dietary supplements and you may anticipate a longer, healthier life. 

Of course, the sooner you get started, the easier it will be to fulfill your potential for health and longevity.  We can be grateful that the human body is quite "forgiving" once you start treating it right - it is rarely "too late."  Even people with full-fledged type-2 diabetes can improve so much that their blood tests will give no clue they ever had a problem.  We have learned this information just in time, as Metabolic Syndrome and diabetes have become epidemic in the U.S.  It is a great privilege and pleasure to be able to coach motivated patients back to good health.

If you are continuing to struggle with Insulin Resistance and Metabolic Syndrome you should consider making an appointment with Dr. McDaniel. 

On August 3,  Dr. McDaniel and I will be presenting a public lecture on hormones, entitled " SEX (hormones),  DRUGS (therapy),  and  ROCK & ROLL (living a vital life)" sponsored by HealthFirst! Pharmacy.  We hope you will join us and bring your significant other and/or friends for this informative evening! See the ad below for more details.

For more information on another powerful tool to trim the tummy, click here!

Eating and enjoying lots of summer veggies - hope you are, too!!!

I appreciate the prompt way many of you when requested, follow-up with a quick e-mail to update me on signs and symptoms via the internet. It's a helpful way for me to address your questions and concerns accurately and in a timely manner so that your progress can continue. 

But, as with most things in life, finding balance with this considering all the patients in my practice is a challenge.  As you know, I review your e-mails with your chart open and give a reply based upon review of your present situation and the issue at hand.  This requires time on my part as well as Lizzie's  to address the inquiry, document it and take any action that is needed for labs or pharmacy changes- time that we have to squeeze in during our busy clinic days.  This time has to be charged for just like my time with you at an office visit.
 

Because of increasing demand for this service, the charges are increasing effective August 1, 2011 and will now range between $20 to $50 depending on the length of time involved with getting you the reply.  If you e-mail a report on your status or request any feedback from me other than simple clarification of directions from your recent visit, please know that you will be charged within this price range without additional notice. 
 

If you e-mail with an immediate need that calls for quick attention and turnaround or that requires a more involved communication with you than an e-mail can provide, I will request we handle this through a short phone consult as soon as possible.  Please respect that this is only for truly urgent issues. Lizzie will be in touch with you to get you into the schedule. 

I thank you in advance for walking through the process of keeping my practice in the flow of service.  I try to practice what I preach-daily balance, health and harmony.  This requires a willingness to review all aspects of my work day as things evolve and grow. I will always share any policy changes with you in advance and remain open to your feedback.