OSA and metabolic syndrome - medics

Moby · Post by **Moby** » Wed May 21, 2008 9:30 am

Hi all,

I attended an inservice course on diabetes yesterday, and we had an endocrinologist talk to us. He talked a lot about the 'metabolic syndrome", ie central obesity (now called the muffin shape rather than the apple shape, because it flops over at the top like a muffin!), central obesity, hypertension and diabetes.

I buttonholed him afterwards and asked him if he knew about an association between metabolic syndrome and obstructive sleep apnoea.

He said he and his colleagues were well aware of it and started to go all technical on me about how it works. I had to get back to the next session so I interrupted him and asked him what he was doing to get the word out.

He said that they were "kicking it into the residents" (new doctors) so they should know all about it.

I said there was widespread ignorance among nurses and the general public regarding the dangers OSA and he agreed, but said that was changing, his department is part of that change.

I thought the conversation was encouraging. I hope he includes OSA in his next talk about diabetes and metabolic syndrome.

Di

Di

BigMoose · Post by **BigMoose** » Wed May 21, 2008 11:09 am

Di I for one would be appreciative of any and all advice you might have on the connections between OSA and metabolic syndrome and insulin resistance. I read your exercise tips on another thread.

I am fighting with both, I'm 55 and have only had my CPAP for 2 months, but I am nearly type II with impaired postprandial glucose control caused by insulin resistance.

Form what my endo and his dietician have told me, my basal insulin level is elevated and acting like a "check valve". I can store fat, but cannot access it to burn it. My gluco-neo-genesis pathway is blocked by the elevated insulin level.

I have been fighting this for 10 years without gaining the foothold I need. When I "push" myself, I "hit the wall". We think I burn all stored glycogen, then can't access stored fat for energy... and hence can't get a "normal" weight loss plan going. The only thing that ever worked, and that was "sort of" was the Protein Sparing Modified fast.

As an example, I was doing "well" up until a 4 day business trip 3 1/2 weeks ago. I came home from that trip 12 lbs higher than when I left. It took 14 days to get the weight back to 3 lbs over my departure weight, and I have felt "uneven", spooky and "brittle" over that period. Words that try to describe a roller coaster, type of energy levels. BTW, my test strip glucose readings have been between 130 and 85 no really extreme swings were caught on the meter.

Any tips you might have would be greatly appreciated to tame the insulin resistance and head to normalcy. It seems you may have great insight into this phenomena...

NightHawkeye · Post by **NightHawkeye** » Wed May 21, 2008 11:21 am

BigMoose wrote:Any tips you might have would be greatly appreciated to tame the insulin resistance ...

Have ya tried cinnamon? Seriously ...

BigMoose · Post by **BigMoose** » Wed May 21, 2008 12:12 pm

I have never heard of cinnamon and IR before! I'll have to do some reading on the subject. Thank you!

Edit: Found a great article: http://care.diabetesjournals.org/cgi/co ... 26/12/3215

http://www.medicalnewstoday.com/articles/41026.php

Goofproof · Post by **Goofproof** » Wed May 21, 2008 12:38 pm

NightHawkeye wrote:
BigMoose wrote:Any tips you might have would be greatly appreciated to tame the insulin resistance ...
Have ya tried cinnamon? Seriously ...

I have 1000 mg a day, but didn't notice a difference, still taking massive levels of insulin. Jim

jomac30 · Post by **jomac30** » Wed May 21, 2008 12:48 pm

What is cinnamon supposed to do?

Goofproof · Post by **Goofproof** » Wed May 21, 2008 1:21 pm

jomac30 wrote:What is cinnamon supposed to do?

Cinnamon is supposed to help suport sugar metabolism, the recommended dose is 1,000 mg daily. I also take mega doses of vitamins, to try to burn more fuel. My main problem is I can't do anything physical, to burn fuel you need to be using muscles. Couch Potato mode, doesn't burn much fuel, neither typing with two fingers, but it helps.... Jim

Moby · Post by **Moby** » Wed May 21, 2008 9:51 pm

Hi BigMoose,

I will be glad to help you any way I can, but I am no expert.

Here is a link briefly explaining how blood sugar is regulated

http://www.endocrineweb.com/insulin.html

We all know about insulin and sugar, but glucagon is frequently forgotten.

There is a more detailed description of insulin/glucagon/glucose here

http://www.elp.manchester.ac.uk/pub_pro ... ncreas.htm

Glucagon is released when the blood sugar goes down. If you are insulin resistant the blood sugar doesn't go down because the sugar can't get into the muscle cells. If the blood sugar doesn't go down there is no glucagon released, so the body can't start using it's own stored energy sources.

Also, in insulin resistance, the muscles get tired quickly because they can't get fuel to work. That is, the sugar they need to fuel their work can't get into the muscle cells. Therefore the muscles quickly run out of energy and can't work very well.

OSA can cause insulin resistance for reasons I won't go into here. Treating the OSA will help you reverse it the insulin resistance, together with exercise and an appropriate diet. I'm in the same boat, as are very many of us with OSA.

That's enough for now. I must take a walk (walk the talk!)
Good luck.

[quote="BigMoose"]Di I for one would be appreciative of any and all advice you might have on the connections between OSA and metabolic syndrome and insulin resistance. I read your exercise tips on another thread.

I am fighting with both, I'm 55 and have only had my CPAP for 2 months, but I am nearly type II with impaired postprandial glucose control caused by insulin resistance.

Form what my endo and his dietician have told me, my basal insulin level is elevated and acting like a "check valve". I can store fat, but cannot access it to burn it. My gluco-neo-genesis pathway is blocked by the elevated insulin level.

I have been fighting this for 10 years without gaining the foothold I need. When I "push" myself, I "hit the wall". We think I burn all stored glycogen, then can't access stored fat for energy... and hence can't get a "normal" weight loss plan going. The only thing that ever worked, and that was "sort of" was the Protein Sparing Modified fast.

As an example, I was doing "well" up until a 4 day business trip 3 1/2 weeks ago. I came home from that trip 12 lbs higher than when I left. It took 14 days to get the weight back to 3 lbs over my departure weight, and I have felt "uneven", spooky and "brittle" over that period. Words that try to describe a roller coaster, type of energy levels. BTW, my test strip glucose readings have been between 130 and 85 no really extreme swings were caught on the meter.

Any tips you might have would be greatly appreciated to tame the insulin resistance and head to normalcy. It seems you may have great insight into this phenomena...

Goofproof · Post by **Goofproof** » Wed May 21, 2008 10:28 pm

Moby, Thanks for the very good links. Jim

Even a "Old Dog", has things to learn.

Moby · Post by **Moby** » Thu May 22, 2008 2:36 am

Thanks Jim,

I am still getting my head round it, and forget it nearly as quickly, so it is good for me to run through it again here.

The main thing I picked up and am using is that the exercise in short bursts is just as good as prolonged exercise for insulin resistance.

I think that is so encouraging. Just a few leg raises watching TV are *good* for me, and help me do a bit more tomorrow.

I remember how bad I felt a year ago in the interval between diagnosis and getting on therapy. I went to the gym to get an physical assessment and nearly burst into tears when the guy told me we needed to go upstairs first. The stairs looked impossible. But yesterday I climbed seven flights to my workplace and only needed to stop for breath once, and that was just 30 seconds. Slow progress, but progress in the right direction.

Moby · Post by **Moby** » Thu May 22, 2008 3:15 am

This link goes into a bit more detail, and also touches on why insulin resistance causes us to lay down fat (lipids).

http://www.medbio.info/Horn/Time%203-4/ ... asis_2.htm

the more fat we lay down, the more insulin resistant we become, as fat in the cells make the "doorways" to the insulin more clogged up and gluggy.

However, the good news is that exercising forces open more doorways, and keeps them open for several hours.

In a non insulin resistant person, sugar in the blood opens the existing door long enough to bring the blood sugar level down to normal. But for all of us exercise makes the muscle cells create more doorways, and then the doors just don't close straight away but keep on gobbling up the sugar as fast as they can.

Si

BigMoose · Post by **BigMoose** » Sat May 24, 2008 6:50 pm

Moby, thanks much! I was on the road for a few days and missed your posts, excellent reading, and your description of "lack of endurance" fits me to a tee. I was driving back from Pennsylvania today with my daughter, and she kept encouraging me to "take it in small steps" Dad, but keep trying. Your advice about "bursts of exercise" will be taken to heart and put into practice.

The article above is a real eye opener to me. I was not fully versed on the role of alpha cells and the secretion of glucagon as a axis to insulin. The best med I had ever been on was Glucophage (Metformin) I will have to read as to it's specific actions, as I was able to loose 1 1/2 lbs a week on it without trying while it moderated my glucose excursions. It was great, but it severely irritated my digestive system and I had to go off of it.

Thank you again for taking the time to post the details you did. It is sincerely appreciated. Regards, BigMoose

Moby · Post by **Moby** » Sat May 24, 2008 7:30 pm

Hi BigMoose,

Sounds like you have a great ally in your daughter.

Here is the most concise link I could find about Metformin.

Good luck with the short bursts of exercise. I have a room to paint, so guess I'll get mine today!

regards

Di

Moby · Post by **Moby** » Sat May 24, 2008 7:36 pm

oops link

http://www.drugdigest.org/DD/Comparison ... 12,00.html

di

NightHawkeye · Post by **NightHawkeye** » Sun May 25, 2008 12:14 pm

BigMoose wrote:I have never heard of cinnamon and IR before! I'll have to do some reading on the subject. Thank you!

Edit: Found a great article: http://care.diabetesjournals.org/cgi/co ... 26/12/3215

http://www.medicalnewstoday.com/articles/41026.php

From the first study referenced above:
CONCLUSIONS—The results of this study demonstrate that intake of 1, 3, or 6 g of cinnamon per day reduces serum glucose, triglyceride, LDL cholesterol, and total cholesterol in people with type 2 diabetes and suggest that the inclusion of cinnamon in the diet of people with type 2 diabetes will reduce risk factors associated with diabetes and cardiovascular diseases.

From the second reference:
Two studies presented at Experimental Biology 2006 provide new evidence for the beneficial effects (and biochemical actions) of cinnamon as an anti-inflammatory agent and support earlier findings of its power as an anti-oxidant agent and an agent able to lower cholesterol, triglycerides, and glucose, and improve how well insulin functions.

In a related study, extracts of cloves also were found to improve the function of insulin and to lower glucose, total cholesterol, LDL and triglycerides in people with type 2 diabetes. Earlier studies had shown these positive effects in laboratory studies; the study presented at Experimental Biology provides the first evidence of these beneficial effects in humans taking the equivalent of one to two cloves per day.

Regards,
Bill

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