Diabetes Mellitus: A Diagnosis Too Late. (1 of 3)

In an article, “Retinopathy predicts coronary heart disease mortality’, ⁽¹⁾ Doctor G. Liew and his colleagues, cited that retinopathy was independently linked to the mortality rate of coronary heart disease, as much as that would diabetes mellitus independently be. In the meantime, they also pointed out that retinopathy was a stronger predictor for the mortality rate of coronary heart disease in those with diabetes mellitus than it was in those without. These findings imply that by the time when diabetes mellitus is diagnosed, the progression of vascular damages is far advanced, and that routine retinal check-ups especially those with thorough fundoscopic and high-tech examinations, started in the younger age, may contribute to early detection, prevention, and better management of coronary heart disease. Understandably, the examinations can directly monitor the progression of vascular damages or diseases. Various causes may result in retinopathy, ^[2] which, however, is mostly linked primarily or secondarily to vascular diseases such as arteriosclerosis, atherosclerosis, and hypertension.

Up to this date, studies have repeatedly identified that diabetes mellitus is the single disease frequently linked to other diseases including vascular diseases such as coronary heart disease ^[3] and retinopathy. ^[4] Thus, nearly all physicians have thought diabetes mellitus somehow promotes the development of other diseases. They should remember the direct link between the consumption of carbohydrates and the postprandial blood glucose level. Likewise, they must also keep in mind the positive association between the blood glucose level and both the serum triglyceride and VLDL-cholesterol levels. ^{[5, 6, 7]} Most importantly, they should not refer postprandial hyperglycemia solely to an abnormal blood glucose level at the end of a two-hour period after meal or of a glucose challenge test. Rather, postprandial hyperglycemia is the blood glucose level beyond a safe limit, say 120 mg%, at any time during the postprandial period. ^{[8, 9, 10, 11, 12, 13, 14, 15]}

Based on my continued extensive literature review and self-experimentations, postprandial hyperglycemia after each meal, even in case of the non-diabetic, is the main cause for the development of most, if not all, of diseases. In short, vascular damages or diseases, diabetes mellitus, and many other diseases are likened to the branches of a wild tree growing out of the ground where is nurtured with plenty of plant foods rich in carbohydrate. The name of the wild tree is “High Blood Sugar After Meals.” ^[16]

Robert Su, Pharm.B., M.D.

References:

1. Liew G. et al. “Retinopathy predicts coronary heart disease mortality.” Heart. British Medical Journal. 2009;95;391-394.

2. Venkatramani, J and Mitchell P. “Clinical review: Ocular and systemic causes of retinopathy in patients without diabetes mellitus.” British Medical Journal. 2004 March 13; 328(7440): 625–629.

3. National Institutes of Health. “Diabetes, Heart Disease, and Stroke.” National Diabetes Information Clearinghouse.

4. National Institutes of Health. “Diabetic Retinopathy.” Fact Sheet.

5. Hudgins LC, et al. “Human Fatty Acid Is Stimulated by a Eucaloric Low Fat, High Carbohydrate Diet.” Journal of Clinical Investigations, Volume 97, Number 9, Pages 2081–2091. May 1996.

6. Ma Y, et.al. ”Association between Carbohydrate Intake and Serum Lipids.” Journal of the American College of Nutrition,.Volume 25, Number 2, Pages 155-163. 2006.

7. Parks EJ and Hellerstein MK. “Carbohydrate-induced hypertriacylglycerolemia: historical perspective and review of biological mechanisms.” American Journal of Clinical Nutrition, Volume 71, Number 2, 412-433. February 2000.

8. Wong, VW, et al. “C-Reactive Protein Levels Following Acute Myocardial Infarction: Effect of insulin infusion and tight glycemic control.” Diabetic Care, Volume 27, Number 12, Pages 2971-2973, 2004.

9. Williams LS, et al. “Effects of admission hyperglycemia on mortality and costs in acute ischemic stroke.” Neurology Volume 59, Pages 67-71. 2002.

10. Das UN. “Is insulin an endogenous cardioprotector.” Critical Care, Volume 6, Number 5, Pages 389–393. July 31, 2002.

11. Selvin E, et al. ” Glycemic Control and Coronary Heart Disease Risk in Persons With and Without Diabetes.” Archives of Internal Medicine, Volume 165, Number 16, Pages1910-1916. September 12, 2005.

12. Meigs JB, et al. “Fasting and Postchallenge Glycemia and Cardiovascular Disease Risk: The Framingham Offspring Study.” Diabetes Care, a journal of the American Diabetes Association, Volume 25, Number 10, Pages 1845-1850, 2002.

13. Esposito K, et al. “Stress Hyperglycemia, Inflammation, and Cardiovascular Events.” Diabetes Care. Volume 26, Number 5, Pages 1650-1651. 2003.

14. Thomas MC, et al. “Early peri-operative hyperglycaemia and renal allograft rejection in patients without diabetes.” Nephrology (BioMed Central). Volume 1, Number 1. 2000. Published online October 4, 2000.

15. Aristedi R and Serafim K. “The Influence of Hyperglycemia on Neurological Outcome in Patients with Severe Head Injury.” Neurosurgery, Volume 46, Number 2, Pages 335, February 2000.

16. Su RK. “Figure 36: Diseases Caused By High Blood Sugar After Meal” Carbohydrates Can Kill. Pages 330.