Importance of low-Grade Albuminuria

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Importance of low-Grade Albuminuria

The importance of low grade albuminuria is changing the world of understanding of the complications of diabetes.

Throughout my career I believed and understood from all my teachers that chronic diabetes renal disease begins in kidneys.

Cardiovascular disease was typically thought to originate and to progress as a separate entity. As these things are looked at today, it seems that these beliefs are entirely reversed. It is cardiovascular disease that is beginning and the kidney is best thought of as a ball of blood vessels, large and small, that get included in the vessels undergoing accelerated atherosclerosis so characteristic of diabetes.

The urinary albumen excretion is now accepted as an important marker for developing cardiovascular disease. The traditional upper limit of protein in the urine is 30 milligrams per deciliter. The levels above this but lower than a gram is microalbuminuria.

This association of protein excretion and cardiovascular disease is independent of kidney function. The treatment in my office is valsartan and an l-arginine complex ProArgi9 plus® that seems to quickly reverse this clinical situation.

Mayo Clinic Proc. July 2008 ;(7):806-812

LifeScan OneTouch Ultra test Strip recall!

This is limited to a very small number of strips limited to lot number 2829235, 25-count packages. If you only buy the 50 or 100-count packages, forget all this.

They with replace them without cost to you. Take them to your pharmacy for replacement or call LifeScan directly at 1-408-263-9789.

The reason for the problem is that some of the strips may measure too low. Frankly, if something has to be wrong this is the best side of the error. It is better to feel that you need a little glucose to be sure rather than an extra large bolus of insulin.

The integrity of LifeScan is unexcelled. Their commitment to excellent products is superb. Their response to “stuff happens” situations is always ethically on target. It has always been privilege to work with them in any situation knowing they will always do the right thing.

My Story

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Many people have emailed in to ask why I am so hot about l-arginine. I wrote a book about this called the “Uncommon Doctor” which you are welcome to buy, but let me summarize it.

At age 37 I had a CT scan of my abdomen to check out a vague abdominal pain. We saw no abnormalities except, as the radiologist said, “You have the arteries of an 80 year old man”.

My father had his first stroke, the big one that never allowed him to work again, at age 42 so I figured I was in the gun sight for my own vascular tragedy.

I was desperate to find something that worked. John Farquhar in preventative medicine at Stanford was my first stop – he doesn’t recall our meeting – but each time I see him I thank him for saving my life.

The real attack began when I started working with Victor Dzau and John Cook using l-arginine to reverse atherosclerosis. This was in the Division of Cardiovascular Research and allowed me to start very small amounts of l-arginine, with the idea that although the appropriate dose was not known, you have to start somewhere.

I had been very familiar with l-arginine and had used in for endocrine testing and research both in my first fellowship at Henry Ford Hospital and the second at UCSF. I even tried to see if we could use it orally for growth hormone and insulin testing. I always joke that if I had been smart enough I would have won the Nobel Prize in Medicine in 1998! It’s a thought anyway.

As you might guess, I became a student of l-arginine. I read all that the three Nobel Prize winners published and constantly strived to make whatever product I was using better. I tried to get 3 different pharmaceutical firms interested in the retail manufacture and distribution of the product but who wants to have a product they cannot patent?

I started myself and all my patients on l-arginine in 1991 and gradually improved the product. I never believed that I could reverse the atherosclerosis, all that calcified plaque, that concrete in my arteries.

Then I had another CT scan of my abdomen. “How did you do this?” the radiologist shouted at me. I told him but he, like me, was befuddled. “It’s impossible” I thought to myself. How can you get rid of the concrete lining the arteries? It’s magic!

With time and much study I realized that it could be done and I was doing this on all my patients as well. 80% of my patients at that time had diabetes and we had been in the sad place where we were referring 30% for cardiac problems until 1991. Now we have not referred any patients or admitted any patients in 17 years.

I turned to Network marketing, social networking, to get the product I needed for myself and my patients. I had no idea that U-Tube was a new social phenomenon that sprang from the concept of Network marketing nor did I realize the quality of the products was as good as any pharmaceutical company until I had toured Synergy.

Now I can bring together all that I need for my arteries and work on continuing the development of what is now the best antiaging product around. ProArgi 9 plus (how to purchase) fulfills all that I hoped for and will look for in the future.

This is my story and my time of a moment of strategic health. You need not be terrified of what is ahead for you because now the path is clear and safe. It’s your time.

Retinal Changes in Pre-diabetes, Pre-hypertension

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Diabetes Care October 2007, page 2708-2715 reported that new technologies are now picking up the retinal changes in the back of the eye that diagnose prediabetes and pre-hypertension.

We know that these two problems begin long before symptoms or signs of the disease. In the past we would consider this a victory for “strategic health” but little treatment to reverse this was suggested.

Now we confirm these advancing diseases with the wave form analysis with the CardioVascular Profiler and begin treatment with ProArgi 9 plus immediately. The ProArgi9 plus reverses all the vascular problems of both diseases actually reversing both disorders as far as the vascular component is concerned.

This is not a cure, but a reversal. Diabetes is a multi-metabolic problem and with time different treatments will be needed. At least you will not be in the bad patch the group in Seattle was in when the diagnosis of their diabetes was first made when they had their heart attack.

L-arginine, the Trojan Horse

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An article to be published in the proceedings of the National Academy of Sciences shortly will present some research from Stanford University on the use of l-arginine to help fight resistant disease.

The l-arginine surrounds the antibiotic chosen, allowing this complex to get past the membrane pump that encloses the resistant cells. Eight l-arginine molecules surrounded Taxol, the drug used against ovarian cancer in mice.

L-arginine is common in metabolism throughout the body and therefore allowing the resistant cell to allow entry of this complex much like it was a “Trojan Horse”. This in effect “disguised” the Taxol allowing the entry into the resistant cell.

Taxol was used in this study but the authors felt other medications could be used as well.

Bariatric Surgery - A Cure for Diabetes?

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The September 18, 2008 medical newspaper Endocrine Today had on their front page, Bariatric Surgery – a cure for diabetes?

I have been involved with people needing to consider this type of surgery for their diabetes and other severe problems relating to their metabolism since 1965. The initial success in the first year has again given many people a reason to consider that new technology and understanding of the pathogenesis of diabetes might get better success that in the past.

I get to see people in their second year after surgery. Many have new metabolic problems in the area of vitamins (especially vitamin D) and most dreaded of all, the return of diabetes and weight gain.

The Chief Medical Editor of this publication, Alan Garber, MD included his perspective at the end of the article noting the durability of the antidiabetic effect remains uncertain. He noted the observation that when diabetes is diagnosed there is a progressive loss of beta cells, the cells that produce insulin. Thus in my experience as well as Alan’s, we have only delayed diabetes, not denied its presence.

Water Bottles and Diabetes 2

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Plastic water bottles, food containers, baby bottles and water containers contain bisphenol A, a chemical that suppresses a hormone that protects humans from heart attacks and diabetes 2.

Hundreds of studies have shown bisphenol A’s toxicity in developing tissue and tissue function. Reproductive problems, certain cancers and asthma have been shown to cause problems in lab animals.

Bisphenol A leeches from food and beverage containers and has been found in 93% of the urine samples in test patients. In the body it mimics estrogen and prevents natural estrogens from attaching to the estrogen site. When this happens in mice they become obese and insulin resistant.

Testing of fat tissue from bisphenol A affected humans reports suppression of the protective hormone adiponectin. Adiponectin protects against heart attacks and type 2 diabetes. Similar studies in mice indicate effects on the beta cells that create insulin resistance. This may well be a reason for children and adolescents’ obesity and early diabetes.

Environmental Health Perspective August 14, 2008.
Science News 9.29.2007
Science News 9.13.2008

Cardiometabolic Health Congress

There is a terrific Cardiometabolic Health Congress October 15-16 2008 * Sheraton Boston Hotel* Boston MA.

It will have great discussions with great leaders in Diabetes Care. New insights, Management issues, integrating new weight loss protocols into your practice will all be covered.

The Metabolic Syndrome with all its nasty ramifications is the focus. 37.5 hours of CME and 10 corporate-supported symposia for some in-depth information.

Jay Skyler, MD will tell you lots more!

See you there!

Diabetes Type 1 9.11.2008

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Nitric Oxide and Cancer 2.2008

This is probably unintelligible to most of you but this is a most important and current review on how l-arginine when use in large amounts can have a positive effect on multiple cancers.

I week ago I discussed parts of this with reference on how l-arginine works in different ways in different cancers and this abstract/paper expands on this theme.

The paper has not been printed yet but the references will probably lengthy. All this will need a great deal of further testing and clinical studies to figure out ultimate solutions, but look at the range of cancers addressed in this work.

It’s your time.

Dr. Joe

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Don't Take More Calcium

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NASH (Fatty Liver)

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Byetta Does Not Cause Pancreatitis

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Byetta Does Not Cause Pancreatitis

Review of the records of deaths from patients who died of pancreatitis seems to have no reason to believe that Byetta plays a role in their deaths.

Remember that the “FDA Amendments Act requires dissemination of safety data, including in cases where causality has not been definitely determined.”

These deaths were all in type 2 patients, a diabetes group that has three times more common incidence of diabetes when compared to the general population. One million patients have taken Byetta which gives a rate of 0.34 events per 1,000 patient years.

The causes of death were as follows.
• Morbid obesity with extensive gallstone disease.
• Patient had stopped taking Byetta some months before the pancreatitis.
• Two patients died of complications of gall bladder surgery.
• One died of recurrent leukemia 2.5 months after recovering from pancreatitis.

David Nathan, Chief of the Diabetes Unit at Massachusetts General Hospital sees any cause is “not clear.”

“I’ve had 550-plus patients on Byetta and not a hint of pancreatitis,” Joseph Prendergast, founder and medical director of the Endocrine Metabolic Medical Center, told BioCentury. “I would think that we must get the information on those people who died, all their previous history, how it was used, and what kind of physician was using it.”

He added: “I don’t consider it to be a problem, and I surely don’t consider it to be related to the drug.”

Kenneth Burman, chief of the endocrine section at Washington Hospital Center, Washington, DC also did not find a reason to attribute pancreatitis to Byetta. The other endocrinologists at his center have not hesitated to use Byetta as before.

BioCentury Vol 16, #39, Pg. A15-16

We Hear You

Issue #1: I Can't See the Videos
Dr. Prendergast records his video messages using the HelloWorld suite of services (http://www.helloworld.com). When he records his messages, he has to option to save them in several formats (Windows Media Player, QuickTime, Flash). When he began posting the videos, he used the Windows Media Player format. Immediately all the Apple users called and wrote to ask why they could not see the videos.

At that point, he switched to QuickTime. QuickTime is known for it's ease of use across multiple platforms and is offered as a FREE download for all platforms and operating systems. The windows format didn't offer a solution for Apple users and the Flash format required a browser plug-in that sometimes required a bit of technical savvy to be successful. Once this change to QuickTime was implemented, not one complaint was received from Dr. Joe's viewers.

Two months ago HelloWorld went through a massive upgrade to their suite of programs. Although they did not change the formats available to save video messages, we have received complaints that many viewers can not see them. Every one of your complaints has been passed along to the support staff at HelloWorld asking for advice. So far, every response has basically been: make sure you have the latest version of QuickTime as they also released a new version recently.

We will continue to pressure HelloWorld for an explanation and resolution. Until we get one, here is the reality:

• Dr. Joe's e-newsletters require that you have the latest version of QuickTime (free).
  
• QuickTime has resources on their web site about their free player that may help you troubleshoot your issue.

Issue #2: I Can't Hear the Videos
Dr. Joe records these videos from both his laptop and his office computers. The office has a desktop computer that has a high quality camera and microphone connected to it via cable. It seems when he records his messages there, the volume levels work for all viewers.

When Dr. Joe records his videos using his laptop computer the volume is lower. We have checked into all the settings on that laptop and we have set all to the highest levels available on the machine. We have tested many different computers and different platforms and on all of them, if the speakers were turned up we could hear Dr. Joe's message. In one instance, we also had to go into the computer's audio settings to increase the volume, and then it was too loud.

We will see about improving the sound on Dr. Joe's laptop, but again, until that happens, here is the reality:

• You will need to turn your speakers up.
• You may need to change the audio settings on your computer, or you may need to change the settings on your sound card.

If you don't know how to make these changes, consult your local computer expert. Best Buy offers the Geek Squad and all Apple Stores have a Genius Bar.

Issue #3: I Don't Like Videos, I Want to Read Dr. Joe's E-News
One of the reasons we all follow Dr. Joe in his work is because he is an innovator. He is interested in what's new. He is interested in the latest technology and how it can be used to treat his patients more effectively and educate them more efficiently. Using video to convey his message allows the viewer to listen to how it is presented and glean the true meaning of his words. What he chooses to emphasize, when he uses sarcasm, these can be lost in the printed word.

The video format also is much easier for Dr. Joe. It takes him less time to create these video messages than it does to type them. In one 2 minute video message, he can impart interesting information that would otherwise take several pages of typewritten text. This would take time away from patient care, research, and other projects.

Finally, Dr. Joe's E-News is a newsletter for people with diabetes or interest in diabetes. One of the complications of diabetes is retinopathy which, in it's severest stage, can mean blindness. Many people with diabetes have trouble reading and have appreciated the change of format.

Issue #4: Why Don't I Get a Response When I Reply to E-News with a Question or Comment on the Blog?
The email address that is used to send out Dr. Joe's E-News is used for that purpose only. If you reply to Dr. Joe's E-News, your message is filtered and/or discarded. If you have a question, you can always contact the office. Dr. Joe and his staff are tightly scheduled but they do their best to keep education a priority.

The comments submitted to the Dr. Joe's E-News Blog are posted on the blog (unless inappropriate). If Dr. Joe is able to respond to the comment or question, his response is posted on the blog. If you are hoping for a response to your question, just check back periodically to the page you commented on. You can always contact the office with your questions too.

Dying From Drugs at Home

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Tarnished Science

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Evidence Based Medicine

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Vitamin D and Mortality

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MODY Under Diagnosed

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The First Symptom is Death

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