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Medical Forum / Diseases and Disorders / Diabetes / October 2005

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vdpn - 21 Oct 2005 07:02 GMT
Hi, I am newly dx type 2 and trying to learn.

Just saw on TV about the need for cholesterol to help the pancreas to release
insulin. I am very interested in this since my LDL is way to low, and although
it always was low, the tremendous drop in LDL coincided with a sudden huge
increase in hemoglobin A1C and my fasting glucose level hence now the dx
diabetic.
So, my question is does anyone else have, or had, problems with to low LDL and
have you found a solution to this problem?
thanks, Vanny
Quentin Grady - 21 Oct 2005 10:31 GMT
This post not CC'd by email

>Hi, I am newly dx type 2 and trying to learn.
>
[quoted text clipped - 6 lines]
>have you found a solution to this problem?
>thanks, Vanny

G'day G'day Vanny,

Welcome to asd.  

We'll do our best to help you though you do set us a rather unusual
challenge.

The situation you describe isn't one that I am aware of being
discussed here previously.  It sounded almost so far fetched I
wandered if you were confusing HDL and LDL. Millions if not billions
of dollars is spent yearly on pharmaceuticals to lower LDL and raise
HDL. Wanting to raise LDL is some thing of a first.

It is well known that high triglycerides and low HDL correlates with
insulin resistance. The ratio of triglycerides to HDL, TG:HDL is a
marker for insulin resistance.

Whatever.

It seems cholesterol is important for some insulin receptors.
http://www.jbc.org/cgi/content/abstract/276/13/9670

On the other hand I've yet to turn up some recent research that could
have inspired the television documentary assuming LDL or total
cholesterol was important.

If you had the name of one of the researchers that would be a
tremendous lead.

IMHO how one came to be T2 is usually of less importance than
controlling the various aspects associated with being T2. Put simply,
on reflection you might like to consider your primary goal probably
isn't to raise LDL but to control fasting and post prandial blood
glucose levels like the rest of us.  Lowering triglycerides and
raising HDL might be a secondary goal.

Best wishes,

Signature

Quentin Grady       ^  ^  /
New Zealand,       >#,#< [
                   / \ /\    
"... and the blind dog was leading."

http://homepages.paradise.net.nz/quentin

vdpn - 22 Oct 2005 07:54 GMT
Thanks for the welcome and for your response

Trust me, not confusing HDL and LDL  My HDL is in the normal range, but in the low
end; also has been there for years. My triglycerides did jump for the same blood
test and is just outside the normal range now.
I
Researcher was DR. Jens Coorssen at  U of C Hotchkiss Brain Institute. No
documentary but the news health program usually has something about supposed
breakthroughs, whatever they happen to get hold of, and this was on the other day;
took about 3 minutes.

I understand treatment of diabetes is priority,  but if I can find out the cause
and treat that, to me that would be ideal. I just received paperwork from a
dietician. That diet will be impossible for me due to other illnesses and food
regulations. So, again if I can find the cause for me ( not saying it is the cause
for everyone) I am way better off.
So, anyone knows how I can increase my LDL???

Thanks, Vanny

>  Welcome to asd.
>
[quoted text clipped - 39 lines]
>
> http://homepages.paradise.net.nz/quentin
Quentin Grady - 22 Oct 2005 11:26 GMT
This post not CC'd by email

>Thanks for the welcome and for your response
>
>Trust me, not confusing HDL and LDL  My HDL is in the normal range, but in the low
>end; also has been there for years. My triglycerides did jump for the same blood
>test and is just outside the normal range now.

G'day G'day Vanny,

Thanks.  I wanted to make sure I wasn't launching myself on a wild
goose chase.

>Researcher was DR. Jens Coorssen at  U of C Hotchkiss Brain Institute. No
>documentary but the news health program usually has something about supposed
>breakthroughs, whatever they happen to get hold of, and this was on the other day;
>took about 3 minutes.

Coorssen J. gets something over 400 hits on

http://scholar.google.com

>I understand treatment of diabetes is priority,  but if I can find out the cause
>and treat that, to me that would be ideal. I just received paperwork from a
>dietician. That diet will be impossible for me due to other illnesses and food
>regulations.

That is weird. I thought one of the reasons folks went to dieticians
was to get dietary recommendations tailored to their medical
condition.  Ah, well.  Add that to the list of things I have believed.

>So, again if I can find the cause for me ( not saying it is the cause
>for everyone) I am way better off.

>So, anyone knows how I can increase my LDL???

Theoretically this isn't hard.  Saturated fats have the reputation of
raising LDL levels.  This is one reason why many people restrict their
intake. Think of this as being like buying one of those cars that is
advertised "as is, where is" it is very much at your own risk.

More interesting questions might be,

A. which saturated fatty acid profile to choose.

and

B. which sources of saturated fats to choose.

Long ago I chose to include small quantities of goat and ewe cheese in
my diet.  Dairy products have fats with a higher levels of saturation
than most other sources.  Coconut is an exception. It is almost
entirely made up of saturated fats.  It isn't as simple though as
copying my choice. One has to look at regions where people apparently
have higher intakes of saturated fats without the expected increase in
coronary heart disease.  Some regions of France appear to fit that
description yet even there, there is controversy. Another is
Girona,Spain.

Look up the French Paradox on http://scholar.google.com 
It helps to eliminate a lot of sales scams if one uses scholar google.

In particular take the time to find out WHAT ELSE one must do if one
wishes to eat a diet high in saturated fat with relative safety.

After one gets bored at looking at the articles on red wine and
resveratrol click on Advanced Scholar Search and choose

Without the words    resveratrol   wine.

Med Hypotheses. 1997 Oct;49(4):313-8. Related Articles, Links  

The French paradox unmasked: the role of folate.

Parodi PW.

The French paradox relates to the paradoxical association of a diet
high in saturated fat and cholesterol with low coronary heart disease
mortality and is contrary to the 'lipid hypothesis'. France and other
regions with low heart disease mortality have a high consumption of
fruit and vegetables. Epidemiologic studies show fruit and vegetable
consumption is inversely related to coronary heart disease mortality,
but recent intervention studies do not support the theory that
protection is due to antioxidant vitamins. Fruit and vegetables,
however, are rich sources of folate. Folate lowers plasma homocysteine
levels. Even mild to moderate elevation in plasma homocysteine level
is a strong risk factor for arteriosclerosis of the coronary,
cerebral, and peripheral arteries. This should explain not only the
French paradox but also why known risk factors may explain as little
as 25% of the risk for coronary heart disease.

AND

Limitations on the adage "eat a variety of foods'?1,2
Ann M Coulston

"... the guideline is most commonly translated to mean "eat a variety
of foods." It is surprising that the analysis of food consumption data
from a large and varied group of adults found that increased variety
within food groups was associated with increased body fatness and
increased energy intake (1). The analysis indicates that for 8 food
groupings, increased variety correlated with increased energy intake,
including fruit and vegetables. Further analysis, controlled for age
and sex, found that vegetable variety was negatively correlated with
percentage body fat and variety from the combined group of sweets,
snacks, and condiments; variety in lunch and dinner entrées positively
correlated with percentage body fat."

Put simply, increasing the variety of vegetables keeps one thin.
Increasing the variety of sweets and snacks keeps one fat.

AND

After the French paradox comes the Italian enigma
Abergavenny Roger Dobson

"Frequent consumers of Italian pizza had less than half the risk of an
acute myocardial infarction compared with those eating pizza only
occasionally, says a research article in the European Journal of
Clinical Nutrition (2004:58;1543-6). Even those who ate fewer than
four portions a month seemed to gain some protection."

http://heart.bmjjournals.com/cgi/content/full/90/1/107
Is a jolly good read.

FWIIW, the areas of France that have featured in the "French Paradox"
may also be areas with a high intake of omega-3 from certain
vegetables and walnuts.

>Thanks, Vanny

Best wishes,
Signature

Quentin Grady       ^  ^  /
New Zealand,       >#,#< [
                   / \ /\    
"... and the blind dog was leading."

http://homepages.paradise.net.nz/quentin

Quentin Grady - 23 Oct 2005 00:05 GMT
This post not CC'd by email
On Sat, 22 Oct 2005 23:26:11 +1300, Quentin Grady
<quentin@paradise.net.nz> wrote:

>That diet will be impossible for me due to other illnesses and food
>>regulations.

G'day G'day Vanny,

There were a couple of other points that needed making.

1.  We don't know what other illnesses you might have so it could be
that we are still barking up the wrong tree.

2.  "Food regulations" doesn't translate into anything I can make
sense of.

While I have suggested cheese as a possibility I haven't the slightest
idea whether or not you are allowed by some external authority to eat
cheese.

3.  LDL is most dangerous when it is small dense and nasty.  This
happens when it is glycated, ie sugared and when it is oxidised.
The bottom line is one must FIRST get control of blood glucose and
secondly avoid activities such as smoking.

4. While you have concluded that low LDL was the cause of your having
T2 diabetes this may only have been coincidence.  There is a neat
phrase used by lawyers meaning the trap where one falsely concludes
that A caused B simply because A happened before B.  The Bathhurst
saloon car race in Australia occurred before not long before hurricane
?Wilma? but didn't cause it.

5.  I haven't any proof that cheese is a safer form of saturated fat
source though it appears to be.  One claim I have seen made several
times about five years ago on the net is that there is no
epidemiological evidence that higher cheese intake increases the death
rate in equal energy diets.  This is despite the evidence that
saturated fats do and dairy products including milk do.  Such a claim
is like a red rag to a bull. If it was false someone would have jumped
it.  For those who like such things perhaps someone would like to take
the time to see if the claim that cheese doesn't cause coronary heart
disease stands up.  If I have time I might do it myself.  I might even
post the results though on principle I am a strong advocate on folks
taking responsibility for doing some of the hard yards themselves.

IIRC there was a French guy who was quite adamant that cheese as a
fermented product was as unlike milk as wine is unlike sugar.

6.  If you want to explore coconut then some different issues arise.
There have been Pacific island communities with high cholesterol who
ate coconuts, fish and taro who had very low rates of coronary heart
disease ... until they were introduced to flour and sugar.  Put simply
if you are considering going down this path be aware that those same
Pacific islanders now living in New Zealand have horrific rates of T2
diabetes and complications arising from it.  Some of them still eat
coconuts and cook with coconut oil but in combination a Western diet
including fast food deep fried in partially hydrogenated vegetable
oils, potato chips etc their health is a disgrace.

Hope this helps,

Best wishes
Signature

Quentin Grady       ^  ^  /
New Zealand,       >#,#< [
                   / \ /\    
"... and the blind dog was leading."

http://homepages.paradise.net.nz/quentin

oldal4865 - 21 Oct 2005 12:04 GMT
>Hi, I am newly dx type 2 and trying to learn.
>
[quoted text clipped - 6 lines]
>have you found a solution to this problem?
>thanks, Vanny

   I agree with Quentin's analysis.  In general,   cholesterol is affected
by diabetes rather than diabetes is "affected" by cholesterol.

I suggest that you:

    1.  Re-check your cholesterol numbers with your doctor.     I suggest
that it is more likely that your HDL has taken a sudden drop,  a drop which
is characteristic of developing diabetes.

   2.  Check the ratio of your triglycerides to your HDL.   When measured
in mg/dL  (units common in the U.S.),    ratios greater than 3 are very
often associated with Type 2 diabetes.     When present,  such high ratios
are "caused" by factors associated with the diabetes.

A high triglycerides/HDL ratio is dangerous.    The advice on lifestyle
usually given newly-diagnosed diabetics will reduce that danger,  e.g.

       a.  Lose fat lb.
       b.  Gain muscle lb.
       c.  Exercise every day
       d.  Reduce your carbohydrate intake,  eat slowly-digesting carb,
spread your daily carb over several small meals.

Regards
 Old Al
vdpn - 22 Oct 2005 07:55 GMT
> I suggest that you:
>
>      1.  Re-check your cholesterol numbers with your doctor.     I suggest
> that it is more likely that your HDL has taken a sudden drop,  a drop which
> is characteristic of developing diabetes.

Sorry, HDL is it's usual self; just in the range on the lower side. There is no
doubt about the LDL; always has been low, for many many years.

>  2.  Check the ratio of your triglycerides to your HDL.   When measured
> in mg/dL  (units common in the U.S.),    ratios greater than 3 are very
> often associated with Type 2 diabetes.     When present,  such high ratios
> are "caused" by factors associated with the diabetes.

Is that the total cholesterol?? we use a different measurement, but my total
cholesterol is also below the range, even though triglyceride went up a lot to
just over the range; used to be 1/4 way in the range, so that was up a lot for
me. According to my doctor that is normal with diabetes.

> A high triglycerides/HDL ratio is dangerous.    The advice on lifestyle
> usually given newly-diagnosed diabetics will reduce that danger,  e.g.
[quoted text clipped - 4 lines]
>         d.  Reduce your carbohydrate intake,  eat slowly-digesting carb,
> spread your daily carb over several small meals.

Ah, not that easy. Can't truly exercise due to illness for the last +10 years;
the first 2 spend totally bed ridden. Just got info on diabetic diet. That will
be impossible so the dietician will have fun finding something suitable for me.
Hope the 1 hour appointment is long enough. That makes it even more important
for me to see if increasing my LDL is going to work to delete the diabetes.
Really loves to hear someone idea's about increasing LDL levels.

Thanks for the response though, it is appreciated.

Vanny
oldal4865 - 22 Oct 2005 14:46 GMT
. . .(snip). . .

>>  2.  Check the ratio of your triglycerides to your HDL.   When measured
>> in mg/dL  (units common in the U.S.),    ratios greater than 3 are very
[quoted text clipped - 7 lines]
>
>>. . .(snip). . .

>> A high triglycerides/HDL ratio is dangerous.
>, , ,(snip). . .
>
>Vanny

There are two ways to measure cholesterol in common use.     One can report
the various fractions of a "lipid panel" in mg/dL or in mmol/L,  i.e.

Total Cholesterol
HDL
LDL
Triglycerides

If your lab uses mg/dL,   the dangerous ratio of triglycerides to HDL is 3.0
or more.    If your lab uses mmol/L,  the dangerous ratio of triglycerides
to HDL is 1.3 or more.

". . . .According to my doctor that is normal with diabetes. . ."

Yes, it's very common,  perhaps so common that it's normal.   However,  it's
also very dangerous.    Type 2 diabetics are in serious danger of death from
premature heart attack and that ratio is a "marker" for that risk.

Sorry that you can't exercise or control your diet as you would wish.
FWIW,   niacin helps with triglycerides.   Pantethine helps with HDL.

Regards
 Old Al
Nicky - 30 Oct 2005 17:25 GMT
> Just got info on diabetic diet. That will
> be impossible so the dietician will have fun finding something suitable
> for me.

That reaction is a very common one to the "standard" diets pushed by
dieticians. This one is of immediate use:
http://www.alt-support-diabetes.org/Newly%20Diagnosed.htm

> That makes it even more important
> for me to see if increasing my LDL is going to work to delete the
> diabetes.

That is not going to happen. Sorry, but whatever your cholesterol issues
(and you might want to check cholesterol and stroke in google, lots of
Japanese studies), it's not going to fix your diabetes. By diagnosis, you
probably have less than half your beta cells left; that's not usually a
recoverable position.

Nicky.

Signature

A1c 10.5/5.6/<6  T2 DX 05/2004
1g Metformin, 100ug Thyroxine
95/74/72Kg

Alan S - 31 Oct 2005 00:38 GMT
>Ah, not that easy. Can't truly exercise due to illness for the last +10 years;
>the first 2 spend totally bed ridden. Just got info on diabetic diet. That will
>be impossible so the dietician will have fun finding something suitable for me.
>Hope the 1 hour appointment is long enough. That makes it even more important
>for me to see if increasing my LDL is going to work to delete the diabetes.
>Really loves to hear someone idea's about increasing LDL levels.

Hi Vanny

I've read the other responses. Please post your actual
numbers (we go both ways here - so we can convert if
necessary:-)

Total
LDL
HDL
trigs
VLDL (if you know)
HbA1c
Fasting BGs
And any post-prandial BGs that you know. Also, give us an
idea of the diet you follow now, and what the restrictions
on diet and exercise are from your other ailments.

Like the others, I can't give much advice on raising LDL; I
have the opposite problem and take a statin to minimise it.

However, on diet, I strongly agree with the advice others
have offered - read the "test, test, test" advice by
Jennifer at
http://www.alt-support-diabetes.org/NewlyDiagnosed.htm

Welcome, and come back with lots more questions after you
read that.

Cheers Alan, T2, Australia.
Signature

I have no medical qualifications beyond my own experience.
Choose your advisers carefully, because experience can be
an expensive teacher.

Everything in Moderation - Except Laughter.

Andrew B. Chung, MD/PhD - 23 Oct 2005 18:30 GMT
> Hi, I am newly dx type 2 and trying to learn.
>
> Just saw on TV about the need for cholesterol to help the pancreas to release
> insulin.

Untrue.

> I am very interested in this since my LDL is way to low, and although
> it always was low, the tremendous drop in LDL coincided with a sudden huge
> increase in hemoglobin A1C and my fasting glucose level hence now the dx
> diabetic.
> So, my question is does anyone else have, or had, problems with to low LDL and
> have you found a solution to this problem?

Would suggest you discuss your concerns with your doctor.

> thanks

You are welcome, Vanny :-)


In Christ's love and service forevermore,

Andrew

--
Andrew B. Chung, MD/PhD
Board-Certified Cardiologist

**
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