With all the ways that we have now to treat fatty liver disease I don’t understand why any of us still have it. Yet most people with diabetes suffer from this potentially dangerous condition.

Now we have yet another tool in our arsenal against fatty liver disease. It’s a strange one. Not strange as in being unfamiliar, but rather strange as being surprising.

The new tool that may reverse fatty liver disease is vitamin E.

Years ago I had fatty liver disease myself. My late wife had it too. I was able to reverse it, but for her it eventually progressed to cirrhosis of the liver, which killed her three years ago.

Sadly, we didn’t know then how serious fatty liver disease could be and about all the ways to avoid it. I’ve written here how milk thistle and metformin can help. So too can eating a diet high in omega-3 fats. Exercise certainly works, as I know from my own experience. Even a little exercise helps.

The latest word on potential treatments for fatty liver disease saw the light of day a week ago in the advance online edition of The New England Journal of Medicine. Many people consider this the world’s leading medical journal. As of today only the abstract is free online, although I was able to download the full-text yesterday. The NEJM plans to publish the study in the printed journal tomorrow.

Researchers found that vitamin E improved the livers of people who had nonalcoholic steatohepatitis (NASH), which lay people like us know as fatty liver disease. In the study 247 adults with advanced fatty liver disease were randomly assigned to take vitamin E or a placebo (dummy pills) for nearly two years. They found that 43 percent of those treated with vitamin E showed significant improvement in their liver, while only 19 percent of those who received a placebo got better.

The dose was 800 IU of the natural form of vitamin E. The specific form was “RRR-α-tocopherol (formerly known as d-α-tocopherol) vitamin E,” according to the full-text of the research report. [Read more →]

Fatty liver disease is one of the most common complications of diabetes. About 50 to 70 percent of those of us who have diabetes may have this potentially dangerous complication. But now we may have a way to treat it and stopping it from progressing to liver failure.

The first time I wrote about fatty liver was in 2005 when I had it myself. Fortunately, I have since been able to reverse it with diet and exercise.

My late wife Catherine wasn’t so fortunate. Her fatty liver progressed to liver failure, which led to her death in early 2007.

Catherine had type 2 diabetes and was seriously overweight, and neither of us knew at the time that this is the cause of most cirrhosis of the liver. We had always assumed that drinking too much alcohol was the cause — but she never drank any.

Since then I’ve learned a lot about the dangers and other causes of fatty liver disease. Just recently, in fact, Swedish researchers reported that people with nonalcoholic fatty liver disease have a higher overall mortality rate compared with the general population. [Read more →]

“Please tell me where I can go for help for depression,” a correspondent wrote me a few days ago. “I have had diabetes a long time, and I am so tired of everything. Can you point me in the right direction for some help?”

I replied by suggesting five strategies that seem to work for me. For about two months after I had an emergency operation on October 1 while traveling, I wasn’t a happy camper. A friend told me that general anesthesia can cause depression, and a quick search of the Web confirmed it.

Two months must have been far too long for the anesthetic to hang around in my body. But for the past several weeks I have been continuously happy.

Maybe it’s because I’ve been getting out regularly for walks to some of my favorite winter destinations. Or maybe it’s because I’ve getting a lot more long-chain omega-3 fatty acids from fish (and a lot less omega-6). Possibly it’s the continued effect of the 10,000 IU of vitamin D I take every day. We have some evidence that each of these strategies help to counteract depression. [Read more →]

We now have a test that can determine hidden risks of heart attack and stroke. It’s called the PLAC Test and is the only blood test that the U.S. Food and Drug Administration has approved.

The PLAC test helps us identify hidden risks for heart attack and stroke by measuring for Lp-PLA2. This is the cardiovascular-specific inflammatory enzyme implicated in the formation of vulnerable, rupture-prone plaque.

The conditions that this test helps to identify are two of the country’s three most serious health problems. The American Heart Association estimates that at least 65 percent of people with diabetes will die from a cardiovascular event, such as a heart attack or stroke.

Fortunately, we have a simple blood test that goes beyond traditional risk factors to help identify those of us at increased risk of heart disease and stroke. ThePLAC Test, developed by diaDexus Inc. in South San Francisco, can help us assess our risk for both conditions.

Lp-PLA2 is an enzyme in the blood primarily associated with low-density lipoprotein (LDL, the “bad” cholesterol). LDL carries Lp-PLA2 to the walls of coronary arteries. There the enzyme can activate an inflammatory response, making plaque more prone to rupture. [Read more →]

Obstructive sleep apnea is one of the most common complications of diabetes, especially among people who are overweight. A recent study of 306 obese people with type 2 diabetes who wanted to lose weight found that more than 86 percent of them had sleep apnea.

The standard treatment for sleep apnea is wearing a CPAP machine for continuous positive airway pressure when we sleep. People who don’t control sleep apnea are much more likely to have high blood pressure, strokes, impaired quality of life, and a shorter life.

When I had sleep apnea, I was afraid that it will kill me. My sleep apnea was so severe when I did a sleep study in a hospital that they found I had 84 apneic episodes per hour. Before I wore a CPAP machine, I knew that I risked falling asleep at the wheel, as I wrote five years ago in Diabetes Wellness News. [Read more →]

For months the question has been whether we could gear up production of vaccine for the H1N1 flu virus — formerly swine flu — fast enough. Now that the first doses have reached some distribution centers this week, we have the answer to that question.

This answer leads to the next question that we all have to face. Should we get the vaccine?

The Centers for Disease Control and Prevention, or CDC, says that people “at increased risk of severe illness” most need the H1N1 vaccine. One of these groups includes people with diabetes.

This makes sense. Those of us who have diabetes can get very sick and may even have to go to a hospital. Our impaired immune system makes us more vulnerable to getting a bad case of the flu.

Just getting sick can raise our blood glucose level. Then, it can stop us from eating right, and that further affects our blood glucose. [Read more →]

Considering all the supplements that most of us take, we have surprisingly little evidence that the overwhelming majority of them do anything for us. The two biggest exceptions are vitamin D and omega-3 oil, which I have written about here.

Even with these well-tested supplements, the experts have little advice to give us. Now, however, a team of scientists from the University of Lyon in France just reported on how much of one type of omega-3 oil to take so that we can prevent heart attacks and strokes, the major complication of diabetes. This is the first study to identify how much omega-3 oil we need to promote optimal heart health.

They studied DHA or docosahexaenoic acid, which some studies suggest have more potent and beneficial effects than the other omega-3 oil that we usually take, EPA or eicosapentaenoic acid, according to their research communication in September issue of The FASEB Journal,  which the Federation of American Societies for Experimental Biology publishes.

Only the abstract of the study is online. But one of the study’s authors, Evelyne Véricel, was kind enough to send me the full text. [Read more →]

Preliminary research seems to show that a little known type of cholesterol might be the biggest threat to our heart health, the most severe complication of diabetes. Even worse than LDL cholesterol is something called oxycholesterol.

The 238th National Meeting of the American Chemical Society heard study leader Zhen-Yu Chen, Ph.D., of the Chinese University of Hong Kong point out the problems with oxycholesterol. We can expect published research to follow, but the chemical society’s Michael Bernstein tells me that, “There is no formal published paper connected to this study.”

Dr. Chen told the chemical society which foods have the highest levels of oxycholesterol. Fried and processed food — particularly fast-food — contains high amounts of oxycholesterol, he says. Avoiding them and eating a diet that is rich in antioxidants can reduce our levels of this really bad cholesterol.

Dr. Chen’s research team measured the effects of a diet high in oxycholesterol on hamsters, which scientists often substitute for humans in in cholesterol research. Cholesterol in the blood of the hamsters fed oxycholesterol rose up to 22 percent more than hamsters eating non-oxidized cholesterol. The hamsters fed oxycholesterol also had more cholesterol lining their arteries and a tendency to develop larger deposits of cholesterol. These fatty deposits increase the risk for heart attack and stroke. [Read more →]

Those of us who have diabetes and don’t get enough vitamin D can’t process cholesterol normally. It builds up in our blood vessels, increasing our risk of heart attack and stroke.

Now, however, new research has identified how low vitamin D levels link to heart disease risk and a good way to fix the problem. The solution is simply to increase our levels of vitamin D. Researchers already knew that low levels of vitamin D nearly double our risk of cardiovascular disease. Since this is the major complication of diabetes, this research takes on great importance for us.

The American Heart Association’s professional journal Circulation published the study in its August 25 issue. Only the abstract is free online. But the principal investigator, Carlos Bernal-Mizrachi, M.D., kindly sent me the full text of the research report. He is an assistant professor of endocrinology, metabolism and lipid research at Washington University in St. Louis, Missouri. [Read more →]