If you are a fan of the cartoon character Homer Simpson, you have to wonder when FOX will run an episode entitled “Homer Gets Type 2 Diabetes”. In one episode of The Simpson’s, Homer even leaves an idyllic world in which he is rich and successful because there are no doughnut shops. Many American people with type 2 diabetes are nearly as addicted to the round breakfast delights as Homer Simpson is made out to be!

What is the reason for this addiction?

The reason type 2 diabetics find doughnuts addictive is to do with sensation and sensory memory. Eating a doughnut is an experience that fills your senses… and it’s round. Your field of vision is round, so when you pick up a doughnut, it is all you can see… especially since it has a little bull’s eye in the center.

A doughnut is an addictive combination of sugar and fat. The combination of sugar and fat triggers the production of dopamine in your brain. This brings about the same chemical change in your brain that occurs during gambling or sex.

What are doughnuts sweetened with?

Most doughnut makers sweeten the dough with high-fructose corn syrup, also known as HFCS. This kind of sugar short circuits the production of adiponectin, so you eat more and more food sweetened HCFS without a hormonal signal ever reaching your brain that your are full.

And because white flour is also used in the dough, doughnuts are a potent source of mu-opioids. These are fast acting chemicals that lock on to the same receptor sites in your brain that can be occupied by opium or morphine. You feel relaxed, there’s nothing in your body telling you that you can’t eat more and more, and you get a pleasant high for less than US $1.

This combination of effects leads to out of control blood sugar levels and weight gain. It’s also why many diabetics find doughnuts the hardest addiction to kick.

Can you kick the habit?

There are not yet any 12-step groups for doughnut addiction, but you can kick the habit. If some kind soul at your office brings in doughnuts once a week, find other productive things to do that won’t take you by the break room… well, at least not until all the doughnuts are gone.

If your morning routine includes a stop at the doughnut shop after your morning workout, take a different route home. Just say no to doughnuts. They are as dangerous for type 2 diabetics, their blood sugar levels and weight control, as any drug.

Visceral fat-associated alterations in adipokines may mediate the development and progression of atherosclerosis in people with Type 2 diabetes, Japanese study shows.

Visceral adiposity is reported to be an independent risk factor for coronary heart disease and Type 2 diabetes. Daisuke Koya (Kanazawa Medical University, Uchinada, Ishikawa, Japan) and co-workers conducted a study to simultaneously assess the association between visceral adiposity and vascular parameters in people with Type 2 diabetes.

They recruited 151 patients with Type 2 diabetes and 83 nondiabetic, age-matched controls without atherosclerotic disease.

Visceral fat area was evaluated on a CT scan, and 24-hour ambulatory blood pressure, and serum levels of adiponectin and tumor necrosis factor (TNF)-alpha were measured. The presence of atherosclerosis in the carotid arteries was determined by stiffness index beta, intima??”media thickness (IMT), and plaque formation.

“In addition to an increase in abdominal adiposity, we found that TNF-alpha/adiponectin ratio, HOMA-IR, and serum non-HDL-cholesterol were all higher in the diabetic subjects than in the nondiabetic subjects,” report the authors in the journal Diabetes Research and Clinical Practice.

Comparison of carotid atherosclerosis parameters between the diabetic and nondiabetic individuals revealed a thicker IMT, higher stiffness index beta, and more plaque formation in those with diabetes.

In the patients with diabetes, the determinant factors for each carotid atherosclerosis parameter differed: serum non-HDL-cholesterol was associated with IMT; visceral fat area (probably via an increase in TNF-alpha/adiponectin ratio) with stiffness index beta; and visceral fat area, HOMA-IR, and 24-hour systolic blood pressure with plaque formation. These associations were not demonstrated in the nondiabetic controls.

“Our data show that visceral fat-associated alterations in adipokines might be mediating the development and progression of atherosclerosis in Type 2 diabetic subjects,” conclude the authors.

“Improvement of visceral obesity in Type 2 diabetic individuals could be essential to prevent atherosclerosis,” they add.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009

Free abstract

Higher adiponectin levels are consistently associated with a lower risk for Type 2 diabetes in prospective studies of diverse populations, show results of a meta-analysis published in the Journal of the American Medical Association.

Adiponectin secretion is decreased in obesity and low levels of this anti-inflammatory and insulin-sensitizing cytokine are frequently implicated in the development of Type 2 diabetes.

To determine the strength and consistency of the relation between plasma adiponectin and risk for Type 2 diabetes, Rob van Dam (Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA) and colleagues conducted a systematic review and meta-analysis of prospective studies that evaluated adiponectin levels and incidence of Type 2 diabetes.

The authors searched the medical literature up to April 2009 for prospective studies in which adiponectin levels were measured in blood collected before the onset of Type 2 diabetes and which had a minimum follow-up of 1 year.

They identified 13 studies with a total of 14,598 participants and 2623 incident cases of Type 2 diabetes for inclusion in the meta-analysis.

A substantial inverse association between plasma adiponectin level and incidence of Type 2 diabetes was found, with a relative risk for Type 2 diabetes of 0.72 per 1 “log µg/ml increment in adiponectin levels.

This association was seen across diverse ethnic groups, including White, East “Asian, Asian “Indian, African “American, and Native “American populations.

The authors also found that the results did not differ substantially by adiponectin assay, method of diabetes ascertainment, study size, follow-up duration, body mass index, or proportions of men and women.

The research is important as adiponectin levels may be useful for identifying people most likely to benefit from interventions to treat dysfunctional adipose tissue and its metabolic complications, and may in the future be useful for prediction of Type 2 diabetes in addition to established risk factors.

“Although these epidemiologic studies cannot establish causality, the consistency of the association across diverse populations, the dose-response relationship, and the supportive findings in mechanistic studies indicate that adiponectin is a promising target for the reduction of risk for Type 2 diabetes,” conclude the authors.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009

Free abstract