Obesity can prone an individual to diabetes mellitus 2 so read this now:

If you’ve got a big gut and you start doing sit-ups, you are going to get bigger because you build up the muscle. You’ve got to get rid of that fat! How do you get rid of fat? By changing your diet.

Jack LaLanne

Diabetes Mellitus (DM) is a complex chronic disease involving disorders in carbohydrate, protein, and fat metabolism and the development of macro-vascular, micro-vascular, neurological complications that don’t occur over a few nights or weeks or months.　 It is a metabolic disorder in where the pancreas organ ends up causing many disruptions in proper working of our body.　 The pancreas is both an endocrine and exocrine gland. 　The problem with diabetes is due to the endocrine part of the pancreas not working properly.　 More than 1 million islet cells are located throughout the organ.　 The three types of endocrine cells that the pancreas excretes into our blood stream are alpha, beta, and delta cells.　 The alpha cells secrete glucagon (stored glucose), beta secrete insulin, and delta secrete gastrin and pancreatic somatostatin.　　 A person with DM has minimal or no beta cells secreted from the pancreas, which shows minimal or no insulin excreted in the person’s bloodstream.　 Insulin is necessary for the transport of glucose, amino acids, potassium, and phosphate across the cell membrane getting these chemical elements into the cell.　 When getting these elements into the cells it is like the cell eating a meal and the glucose, being one of the ingredients in the meal, is used for energy=fuel to our body; the glucose inside the cells gets carried to all our tissues in the body to allow the glucose to be utilized into all our tissues so they can do their functions (Ex. Getting glucose into the muscle tissue allows the muscles to have the energy to do the range of motion in letting us do our daily activities of living, like as simple as type or walk).　 The problem with diabetes is the glucose doesn’t have the insulin being　sent into the bloodstream by the pancreas　to transfer the glucose across the cell membrane to be distributed as just discussed.　 Instead what results is a high glucose levels in the blood stream causing hyperglycemia.　 It should be apparent that when there is a deficit of insulin, as in DM, hyperglycemia with increased fat metabolism and decreased protein synthesis occur　( Our body being exposed to this type of environment　over　 years causes the development of many chronic conditions that　would not have　occurred if DM never took place in the body, all due to high glucose levels starting with not being properly displaced in the body as it should be normally.).

People with normal metabolism upon awaking and before breakfast are able to maintain blood glucose levels in the AM ranging from 60 to 110mg/dl.　 After eating food the non-diabetic’s blood glucose may rise to 120-140 mg/dl after eating (postprandial), but these then rapidly return back to normal.　 The reason for this happening is you eat food, it reaches the stomach, digestion takes place during digestion the stomach brakes down fats, carbohydrates, and sugars from compound sugars to simple sugars (fructose and glucose).　 Than the sugars transfer from the stomach into the bloodstream causing an increase in sugar levels.　　Now, your body uses the sugar it needs at that time throughout the entire body for energy and if still extra sugar left in the bloodstream that isn’t needed at that time to be utilized it now needs to go somewhere　out of the bloodstream to　allow the glucose blood level to get back between 60-110mg/dl.　 That extra glucose first gets stored up in the liver 60-80% and then gets stored in our fat tissue=fat storage=weight increase.　 Unfortunately this doesn’t take place with a diabetic since there is very little or no insulin being released by the pancreas and over time due to the high blood glucose blood levels (called hyperglycemia) problems arise in the body over years.　　 When diabetes occurs there is　a resolution and you have the disease the rest of your life.　 You need to　control your glucoselevel. 2 TYPES OFDM: a.)Diabetes I 　& b.) Diabetes ll.　We have risk factors that can cause disease/illness; there are unmodified and modified risk factors. With unmodified risk factors we have no control in them, which are 4 and these are: Heredity, Sex, Age, Race. 　Now modified risk factors are factors we can control, 3 of them that you can control is your weight, diet and health habits (which play a big role in why many people get diabetes II).　 Look at what the Mayo Clinic (www.mayoclinic.com /health/diabetes)says about risk factors: See Part 2 tomorrow! 😉

 “The liver also adapts to our dietary intake of cholesterol.  If we are consuming too much, the liver will produce less and if we are consuming too little cholesterol, our bodies will produce more.  Typically our bodies produce all of the cholesterol we need.   As long as our liver and gall bladder are functioning well, bile will remove excess cholesterol from the body.   Fiber in the diet prevents bile from being reabsorbed in the body.”

June Rousso June Rousso, Ph.D

In our body we have cholesterol which is a type of fat. In certain foods is cholesterol depending on the food you buy. Your total cholesterol includes LDL (low-density lipoprotein) and HDL (high density lipoprotein) cholesterol. Let’s differentiate the two, LDL is bad cholesterol because it can build up in the arterial walls and form plaque in time. That build up in the arteries will reduce blood flow and increase your risk to heart disease, especially eating frequently the wrong foods with high and bad cholesterol over years (Example. coronary artery disease, high blood pressure, and eating like this for years can lead to a heart attack or from s/s arising scarring the person to go to the doctor and find out they have blockages & need surgery. The s/s arising scarring the person can range from chest pain, and can be radiating down the arms, sweating profusely, weakness/fatigue increases in your life, dizziness, you feel like you’re going to fall or actually due to the fatigue/weakness=low B/P due to the blockage or the heart just working too hard in doing its function since the cardiac output is decreased from the blockage) Take one of my dear friends who I have known almost 35 years who was a workaholic 10to14hr/7 days a week for at least 25 years and this week he had to undergo surgery for a coronary artery blockage bypass for 5 vessels blocked 80% to 100%. He had a successful bypass done but now has a long rehab hall to get better due to high cholesterol eating, smoking (that both play an impact in plaque & tar build up in the vessels) but he also was obese about 50lbs. This could have been prevented if he changed his diet, watched his weight, and quit smoking years ago but that takes discipline, making sacrifices=all within your hands to allow for healthy habits now (prevention) or later when problems occur (treatment), if caught in time. There is a way out of this happening to you. HDL (high density lipoprotein) cholesterol is also known as good cholesterol because it is thought to help remove bad cholesterol from the body; if you decide the right foods in the right portions that will have more HDL than LDL in them. Differentiating the 2, now another component to keep in mind is risk factors that can put you at risk for heart disease and your doctor will determine what additional risk factors you have putting you at risk for heart disease. These risk factors can be modifiable (controllable by individuals) or non-modifiable (non-controllable by individuals).

Modifiable Risk Factors=High B/P, Diabetes, Low HDL=good cholesterol, High LDL=bad cholesterol, smoking, eating foods high in SATURATED FAT & CHOLESTEROL, lack of any activity in your life (your regular routine doesn’t count), & harmful use of alcohol.

Non-modifiable Risk Factors=4 types only which are: 1-Heredity (The higher the risk is when the heredity is closer to you in your family tree=Nuclear family–mom, dad, and siblings). 2-Age (Men aged 45y/o or older & Women aged 55 y/o or older) 3-Gender (It may affect your risk, for years heart disease was considered a man’s disease but we now know that heart disease is the leading cause of death for women as well as men. Although men tend to develop coronary artery disease earlier in life, after age 65 the risk of heart disease for both genders is equal.) 4-Race (Heart disease is higher among African Americans, Mexican Americans, American Indians, native Hawaiians, and some Asian Americans compared to Caucasians).

The answer to prevention or treatment of cardiac disease is changing or modifing your diet, if it’s unhealthy 100% or just partially. The answer includes exercise (from just walking or if you like working out, even better) and if needed medication but your doctor will decide. All these changes can modify your blood lipid profile=cholesterol control, which helps increasing your heart to a better tolerance with activity, stress and simply functioning. Recommended is going to a cardiologist for people diagnosed with heart conditions or your general practitioner with any illness/disease before making changes to help guide you towards the right choices. Your doctor can help you in determining which prevention or treatment plan is best for you.

Foods high in cholesterol=Fast foods, whole fat dairy products-milk/cheese/butter/mayonnaise/ bacon/processed deli meats/salad dressings and shortenings.

The key is to be living a healthy life. This consists of diet, exercise or activity and healthy habits learned and practiced routinely in your life that will help prevent or assist in treating cardiac disease. The better we treat ourselves regarding health the higher the odds we will live a longer and healthier life. There is not just one food to eat or one type of exercise to do or one healthy habit to keep you healthy, there’s choices. Come onto my website which is no fee, no charge, no hacking, just letting you check us out to look further in understanding how to take a shape for your life with Dr. Anderson and even myself as your health coach in helping you learn what healthier habits or changes you want for a healthier way of living. It allows you to make all the decisions in what you want to do regarding what to eat (diet), exercise/activity, and what healthy habits you want to add in your life. We just provide the information and healthy foods in your diet, if you decide you want it. You make all the choices. Wouldn’t you want less disease/illness for yourself and for others throughout the nation including the future generations. Thank you for lending me your ear in listening how we can help you get healthier and make a healthier USA. Click onto heathyusa.tsfl.com and I hope to hear from you soon.

Control Your Weight As You Quit SmokingNot everyone gains weight when they stop smoking On average, people who quit smoking gain only about 10 pounds You are more likely to gain weight when you stop smoking especially if you stop smoking when you have smoked for 10 to 20 years or smoked one or more packs of cigarettes a day. You can control life. Although you might gain a few pounds, remember you have stopped smoking and taken a big step towards a healthier life. What causes weight gain after quitting? When nicotine, a chemical n cigarette smoke, leaves your body, you may experience: Short-term weight gain. The nicotine kept your body weight low, and when you quit smoking your body returns to the weight it would have been had you never smoked. You might gain 3-5 pounds due to water retention during the first week after quitting. A need for fewer calories when quitting to smoke. After you stop smoking, you may use fewer calories than when you were smoking. Will this weight gain hurt your health? The health risks of smoking are far greater than the risks of gaining 5 to 10 pounds. Smoking causes more than 400,000 deaths each year in the United States. You would have to gain 100 to 150 lbs after quitting to make your health as high as when you smoked. The health risks of smoking and the benefits of quitting are listed below. The Health Risks of Smoking **Your Heart Rate Increases **You expose yourself to some 4000 chemicals in cigarette smoke and 40 of these chemicals cause cancer. **You are much more likely to get lung cancer compared to a nonsmoker. Men are 22 times more likely to develop lung cancer, while women who smoke are 12 times more likely. **You are twice as likely to have a heart attack as a nonsmoker. **You increase your risk for heart attack as a nonsmoker. **You increase your risk for heart disease, stroke, some types of cancer (lung especially), emphysema, chronic bronchitis, and other lung diseases. The Benefits of Quitting When you quit smoking your body begins to heal from the effects of the nicotine within 12 hours after your last cigarette. Your heart and lungs start repairing the damage caused by cigarette smoke. You breathe easier and your smoker’s cough starts to go away. You lower your risk for illness and death from heart disease, stroke, chronic bronchitis, emphysema, lung cancer, and other types of cancer. You contribute to cleaner air, especially for children who are at risk for illnesses because they breathe others cigarette smoke. Adapted from the National Cancer Institute’s “Smoking:Facts and Tips for Quitting”

“An endocrinologist is an expert at treating hormone-related conditions like Cushing’s disease.”

NOVARTIS

Complications of Cushings Syndrome include:

Diabetes (High or Low blood glucose levels)

Enlargement of pituitary tumor and other complications from the tumor growth

Fractures due to osteoporosis which are common in older people

High blood pressure which could be life threatening

Kidney stones from the increase in cortisol and other chemicals filtered through the kidneys

Serious infections which could lead to further secondary infections

Although diagnosis can be challenging, it is important being correctly diagnosed with Cushing’s disease is the first step toward regaining control of your health because an accurate diagnosis helps your doctor determine the best course of action. Cushing’s disease may be challenging to diagnose because of several factors:

Cushing’s disease does not cause the same symptoms in everyone

Cushing’s disease may cause the same symptoms as other medical conditions that are more common

The tumor that causes Cushing’s disease can be too small to be found on MRI scans

The tumor can become “inactive” so that it releases less cortisol at certain times

Inactive tumors can fool tests for Cushing’s disease that measure the levels of hormones in your urine, blood, or saliva

The process and tests used to diagnose Cushing’s disease

Ways to take control of your health once you are diagnosed

Cushing’s disease can be mistaken for other conditions

Doctors don’t always think to look for Cushing’s disease because it is rare and causes symptoms that can make them think you have a different condition. Because these other conditions are more common, your doctor will probably rule them out before testing you for Cushing’s disease. These conditions include:

-Pregnancy

-Depression or other psychiatric disorders

-Alcoholism

-Weight problems (obesity) caused by improper diet and/or exercise

-Poorly controlled diabetes mellitus

–Polycystic ovarian syndrome (PCOS)

How is Cushing’s syndrome diagnosed?

The process of diagnosing Cushing’s disease—There are generally 3 phases in the diagnostic process and you will likely see more than one doctor, including an endocrinologist.

Phase 1: Confirm clinical suspicion-Your doctor will to a physical exam.

The doctor will measure if you have the symptoms that are known to be caused by hypercortisolism.
Your doctor may look for:

Purplish streaks on your body (called striae)

Weight gain

Fatty tissue around your mid-section

Thinning of your arms and legs

Fatty tissue that creates a hump on your back

Redness or roundness in your face

Bruises on your body

Thinning of your skin

Excessive facial/hair growth (hirsutism) if you’re female

Acne

Weakness

Medical conditions that are unusual for a patient’s age

— High blood pressure (called hypertension)

— Diabetes

— High cholesterol

— Osteoporosis

— Infection

— Heart disease

__Evaluation

What you can expect is your doctor will do a physical examine your entire body to look for specific physical signs of Cushing’s disease and may do tests to better understand your symptoms, what we call diagnostic tooling.

Phase II: Confirm hypercortisolism
Medical tests will be performed to measure the level of cortisol in the body. These tests should only be done when a form of Cushing’s syndrome(including Cushing’s disease) is highly suspected.

-24 hour urinary free cortisol (UFC) –

Measures the level of cortisol in your urine over a 24-hour period. If the levels are too high, then you may have Cushing’s disease or Cushing’s syndrome. This test is often used because it only measures the type of cortisol that causes Cushing’s disease, called “circulating cortisol,” and may be more accurate than other tests that measure cortisol levels

Because of the difficulty in obtaining 24-hour urine collections in many outpatients, some physicians use a l-mg overnight dexamethasone suppression test. For this test, the patient takes l mg of dexamethasone orally at 11 p.m., and the plasma cortisol level is measured at 8 a.m. the following day (normal value: 5 μg per dL or less [140 nmol per L]). The reported sensitivity of this test is 98 percent; the reported specificity is 80 percent.4

Obesity, chronic illness, chronic alcoholism and depression can cause false-positive results (pseudo-Cushing’s syndrome) on the 1-mg dexamethasone suppression test and mildly elevated free cortisol values on the 24-hour urine collection.19,21

If the result of the dexamethasone suppression test is abnormal or the 24-hour urinary free cortisol level is mildly elevated, a confirmatory test for Cushing’s syndrome is needed. The 24-hour urine collection for urinary free cortisol excretion can be used to confirm the result of the l-mg dexamethasone suppression test. Normal findings on both tests provide strong evidence against the presence of Cushing’s syndrome.4 However, when Cushing’s syndrome is still strongly suspected based on the clinical findings, negative tests should be repeated; the tests should also be performed again in three to six months.

Phase III: Determine if Cushing’s disease is the cause of hypercortisolism

-Adrenocorticotropic Hormone (ACTH) test-

Measures if the amount of ACTH in your blood is higher than normal.

If your ACTH levels are high or normal, then you may have a tumor that is producing ACTH.

ACTH-producing tumors are most often found on the pituitary (Cushing’s disease).

ACTH-producing tumors may be in other areas of the body (called ectopic Cushing’s syndrome) If your ACTH levels are low, you may have Cushing’s syndrome due to a different cause or another condition. Additional tests will be done to confirm whether or not you have Cushing’s syndrome

Treatment of cushings syndrome is by castigation of the under lying cause.

Treatments for Cushing’s syndrome are contrived to pass your body’s cortisol production to normal. By indurate, or even distinctly lowering cortisol levels, you’ll feel evident improvements in your signs and symptoms. Left untreated, however, Cushing’s syndrome can finally induce to death. The treatment choice depend on the cause. For example:

-If a tumour in an adrenal gland is the reason, an operation to withdraw it will cure the condition.

– For adrenal hyperplasia, both adrenal glands may require to be withdraw. You will then require to take lifelong replacement therapy of several adrenal hormones.

-Other tumours in the body that produce ‘ectopic’ ACTH may be able to be removed, depending on the kind of tumour, where it is, etc.

-Medication to block the production or consequence of cortisol may be an choice.

Cushing’s syndrome is a condition in which the body produces far too much cortisol. Cortisol is a hormone your body normally releases in response to stress, exercise, and waking up in the morning.

Written by Lydia Krause | Published onJuly 23, 2012
Medically Reviewed by George Krucik, MD

WHAT IS CUSHING’S SYNDROME

Cushing’s syndrome describes the signs and symptoms associated with prolonged exposure to inappropriately high levels of the hormone cortisol. This can be caused by taking glucocorticoid drugs, or diseases that result in excess cortisol, adrenocorticotropic hormone (ACTH), or CRH levels.

^{Cushing’s syndrome appears when the body’s tissues are display to immoderate levels of cortisol for long periods of time.}

There are two types of the disease and they are known as exogenous and endogenous. Exogenous Cushing syndrome is caused by something outside of the body, like when hormones are given to a patient during a RX for another condition. Endogenous is caused by natural causing problems within the body. Endogenous is likely to be hereditary and not caused by an outside force like a steroid complex.

Causes of Cushing Syndrome

The most common cause of Cushing’s syndrome is ^{exogenous administration of glucocorticoids prescribed by a health care practitioner to treat other diseases (called iatrogenic Cushing’s syndrome}). This can be an effect of corticosteroid treatment of a variety of disorders such as ^{asthma and rheumatoid arthritis, or in immunosuppression after an organ transplant.}

Administration of synthetic ACTH(adrenocorticotropichormone) is also possible, but ACTH is less often prescribed due to cost and lesser utility. Although rare, Cushing’s syndrome can also be due to the use of medroxyprogesterone In this form of Cushing’s, the adrenal glands atrophy due to lack of stimulation by ACTH, since glucocorticoids downregulate production of ACTH. Cushing syndrome in childhood usually results from use of glucocorticoid medication.

^{Endogenous Cushing’s syndrome results from some derangement of the body’s own system of secreting cortisol. Normally, ACTH is released from the pituitary gland when necessary to stimulate the release of cortisol from the adrenal glands.}

 In pituitary Cushing’s, a benign pituitary adenoma secretes ACTH. This is also known as Cushing’s disease and is responsible for 70% of endogenous Cushing’s syndrome.^[3]

 In adrenal Cushing’s, excess cortisol is produced by adrenal gland tumors, hyperplastic adrenal glands, or adrenal glands with nodular adrenal hyperplasia.

 Tumors outside the normal pituitary-adrenal system can produce ACTH (occasionally with CRH) that affects the adrenal glands. This etiology is called ectopic or ^{paraneoplastic Cushing’s disease} and is seen in diseases like ^{small celllung cancer.[15]}

 Finally, rare cases of CRH-secreting tumors (without ACTH secretion) have been reported, which stimulates pituitary ACTH production.^[16]HYPERLINK “http://en.wikipedia.org/wiki/Cushing%27s_syndrome” \l “cite_note-Voyadzis_JM.2C_Guttman-Bauman_I.2C_Santi_M.2C_Cogen_P._2004_212.E2.80.936-16” [16]

Pseudo-Cushing’s syndrome

Elevated levels of total cortisol can also be due to estrogen found in oral contraceptive pills that contain a mixture of estrogen and progesterone, leading to ^{Pseudo-Cushing’s syndrome. Estrogen can cause an increase of cortisol-binding globulin and thereby cause the total cortisol level to be elevated. However, the total free cortisol, which is the active hormone in the body, as measured by a 24 hour urine collection for urinary free cortisol, is normal.}

Epidemiology

^{Iatrogenic Cushing’s syndrome (caused by treatment with corticosteroids) is the most common form of Cushing’s syndrome.}

Symptoms of Cushings Syndrome

Symptom of cushings syndrome include fat deposits close to the face neck and trunk; weariness; muscular weakness; salt and water retention; acne; leisurely bruising; menstlruall irregularities; and signs (in women) of virilisation, such as increase of the voice, commute in body, shape, loss of scalp hair, and extend in facial and ^{body hair. Complications of cushings syndrome include advanced blood pressure, The symptoms and signs of cushings syndrome induced by a chronic redundant of corticosteroid hormones in the blood. The redundant may be acquired by a tumour of the outer part (cortex) of the adrenal gland, or may be referable to over inspiration of the adrenal glands by a tumour the pituitary gland.}

Many children and teenagers with Cushing’s syndrome will exhibit various of the following:

 extreme ^{weight gain}

 growth retardation

 missed periods in teenage girls

 excess hair growth

 acne

 reddish-blue streaks on the skin

 high blood pressure

 tiredness and weakness

 either very early or late puberty

Adults with the disease may also have symptoms of intense weight gain, redundant hair growth, high blood pressure, and skin difficulties. In addition, they may show:

 muscle and bone weakness

 moodiness, irritability, or depression

 sleep disturbances

 high blood sugar

 menstrual disorders in women and diminished fertility in men