Cause and Treatment of Diabetes Mellitus – lecture by Jerold Olefsky, M.D.

In this lecture, Dr Olefsky reports on a very large study that showed a lifestyle change, which included changes in diet and exercise, is an extremely powerful tool – actually stronger than drug therapy in preventing diabetes. This study was very large, screening more than 120,000 patients in 24 different medical/research centers. The results were so dramatic and significant that the study was stopped before its scheduled completion. Let me repeat — This very large study, in 24 different medical/research centers, showed diet and exercise was more significant in preventing diabetes than drug therapy!

Also, Dr. Olefsky discusses the major treatment after diabetes occurs to prevent the complications of diabetes, which is to reduce the glucose levels to as close to normal as possible. In this web site, I’ve included references to work by by other Nutrition and Medical experts that show a low fat vegan diet dramatically reduces glucose levels in diabetic patients, which is the desired effect for the major treatment of diabetes.

Neal Barnard, MD has conducted studies that show a low fat vegan diet is more effective than the diet recommended by the American Diabetes Association for reducing glucose levels.

Jerold Olefsky, M.D., is a professor at the University of California at San Diego Department of Medicine. He discusses new strategies for the prevention of diabetes in this lecture from the Meet the Dean from UCSD Health Sciences Series: “Health Sciences Journal” [3/2002].

I’ve listed the timelines for Dr. Olefsky’s comments in the video after the jump.

Video Timelines —

0:31 – Jerold Olefsky, MD – Professor of Medicine; Chief, Division of Endochronology and Metabolism; University of California at San Diego; School of Medicine

0:40 – general overview of the seriousness as well as the causes and treatment for different types of diabetes.

5:48 – impaired glucose tolerance – the condition between normal and actual diabetes. This is a pre-diabetes condition.

7:15 – 40% of people aged 66 – 74 have diabetes or impaired glucose tolerance

8:34 – physiologic science of diabetes and the importance of the three organs involved

10:47 – insulin resistance

11:39 – how you get diabetes over time

12:42 – how to acquire insulin resistance – overweight, sedentary lifestyle, eating a high fat diet, and aging

13:12 – estimate; 110 MILLION people in the US are insulin resistant

13:40 – estimate; every year about 6% of the US population will develop diabetes

14:00 – research into genetic cause and treatment of diabetes

17:08 – it is MOST important to prevent diabetes from occurring

17:31 – 7 year study to prevent diabetes; risk factors include obesity, distribution of obesity, physical inactivity, age, Ethnicity. Diabetes presents an increased risk of coronary heart disease, among other health problems.

21:45 – study know as – Diabetes Prevention Program, involved lifestyle change vs pharmacologic therapy. It involved 24 medical/research centers, and screened 120,000 people to find those with impaired glucose tolerance which is a high risk for developing diabetes. During screening, they actually found people who did not know they had diabetes.

Treatment groups –

  1. Given a placebo
  2. Given current anti-diabetes drug
  3. Given older (and subsequently discontinued) anti-diabetes drug
  4. Intensive lifestyle change, which included mild exercise and diet change to loose weight

26:11 – study was discontinued because results were so dramatic and effective.

  • The placebo group – 11% developed actual diabetes – higher than expected
  • The drug therapy group – had 30% reduction in rate of developing diabetes
  • The lifestyle change group – had 70% reduction in developing diabetes. (27:15 in timeline)

Exercise was average of 25 minutes walking or other mild exercise. The study participants lost an average of 10 pounds. These are moderate lifestyle changes that had a dramatic effect in the reduction of actually developing diabetes.

29:20 – Treatment Programs after diabetes occurs. Definition and importance of A1C protein.

30:40 – controlling glucose levels is most important to prevent the complications of diabetes. The closer the glucose levels come to normal, the greater the prevention of complications of diabetes.

33:00 – glycemic control can be done with poly-pharmacy; drugs to treat three organs, liver, pancreas, and muscles.

35:38 – Summary –

  1. prevent diabetes
  2. prevent the complications of diabetes after it occurs
  3. working toward finding the genes that cause diabetes to prevent it from occurring in the first place

36:35 – Questions and Answers – including symptoms, screening and treatment discussions