Ashton Glover Gatewood, 31, a member of the Choctaw Nation and descendent of both the Chickasaw and Cherokee Nations, has long lamented the glaring lack of Native American physicians. So she decided to become one.
Gatewood is a student in the inaugural class of the first tribally affiliated medical school in the United States, the Oklahoma State University (OSU) College of Osteopathic Medicine at the Cherokee Nation. The school opened this fall on Cherokee land in Tahlequah, the capital of the Cherokee Nation’s 14-county reservation in the rolling hills of rural Oklahoma, about an hour east of Tulsa.
This article provides an overview of the clinical evidence on the poorer clinical outcomes of COVID-19 infection in patients with diabetes versus patients without diabetes, including in specific patient populations, such as children, pregnant women, and racial and ethnic minorities.
In the article above the researchers reviewed nearly 90 studies.
Type 2 diabetes (T2D) is defined by a single metabolite, glucose, but is increasingly recognized as a highly heterogeneous disease, including individuals with varying clinical characteristics, disease progression, drug response, and risk of complications. Identification of subtypes with differing risk profiles and disease etiologies at diagnosis could open up avenues for personalized medicine and allow clinical resources to be focused to the patients who would be most likely to develop diabetic complications, thereby both improving patient health and reducing costs for the health sector. More homogeneous populations also offer increased power in experimental, genetic, and clinical studies. Clinical parameters are easily available and reflect relevant disease pathways, including the effects of both genetic and environmental exposures. We used six clinical parameters (GAD autoantibodies, age at diabetes onset, HbA1c, BMI, and measures of insulin resistance and insulin secretion) to cluster adult-onset diabetes patients into five subtypes. These subtypes have been robustly reproduced in several populations and associated with different risks of complications, comorbidities, genetics, and response to treatment. Importantly, the group with severe insulin-deficient diabetes (SIDD) had increased risk of retinopathy and neuropathy, whereas the severe insulin-resistant diabetes (SIRD) group had the highest risk for diabetic kidney disease (DKD) and fatty liver, emphasizing the importance of insulin resistance for DKD and hepatosteatosis in T2D. In conclusion, we believe that subclassification using these highly relevant parameters could provide a framework for personalized medicine in diabetes.
Not just potential for personalized medicine in the treatment of diabetes but perhaps a framework for better risk stratification and selection in life insurance.
Intakes of Folate, Vitamin B6, and Vitamin B12 in Relation to Diabetes Incidence Among American Young Adults: A 30-Year Follow-up Study
RESULTS During 30 years (mean 20.5 ± 8.9) of follow-up, 655 incident cases of diabetes occurred. Intake of folate, but not vitamin B6 or vitamin B12, was inversely associated with diabetes incidence after adjustment for potential confounders. Compared with the lowest quintile of total folate intake, the multivariable-adjusted hazard ratios (95% CI) in quintiles 2–5 were 0.85 (0.67–1.08), 0.78 (0.60–1.02), 0.82 (0.62–1.09), and 0.70 (0.51–0.97; Ptrend = 0.02). Higher folate intake was also associated with lower plasma homocysteine (Ptrend < 0.01) and insulin (Ptrend < 0.01). Among supplement users, folate intake was inversely associated with serum C-reactive protein levels (Ptrend < 0.01).
CONCLUSIONS Intake of folate in young adulthood was inversely associated with diabetes incidence in midlife among Americans. The observed association may be partially explained by mechanisms related to homocysteine level, insulin sensitivity, and systemic inflammation.
Intakes of Folate, Vitamin B6, and Vitamin B12 in Relation to Diabetes Incidence Among American Young Adults: A 30-Year Follow-up Study — Diabetes Care 2020 Oct; 43(10): 2426-2434. https://doi.org/10.2337/dc20-0828
Folate is a B vitamin that occurs naturally in foods such as green leafy vegetables, citrus fruit, and beans. So eat your greens and beans. Taking a supplement can’t hurt either. My multivitamin has plenty of folate.
Higher education committed suicide with its dual racketeering model. First was the college loan racket, in which schools colluded with the federal government to jam too many “customers” through the pipeline who didn’t belong there, and who buried themselves under a lifetime debt obligation they could never escape. The second was the intellectual racket of creating sham fields of study that contaminated all the other “humanities” with poisonous bullshit theory, and eventually even invaded the STEM disciplines. Covid-19 screwed the pooch on all that, scotching the four-year party-hearty in-residence part of the deal. For now, who needs an online class in Contemporary Sexual Transgression ($2000-a-credit) when you can just click on Porn-hub for free? Hundreds of colleges and universities will be going out of business in the years ahead.
By analyzing publicly available patient data from around the globe, Backman and his team discovered a strong correlation between vitamin D levels and cytokine storm — a hyperinflammatory condition caused by an overactive immune system — as well as a correlation between vitamin D deficiency and mortality.
In conclusion, we found significant crude relationships between vitamin D levels and the number COVID-19 cases and especially the mortality caused by this infection. The most vulnerable group of population for COVID-19, the aging population, is also the one that has the most deficit Vitamin D levels.
Vitamin D has already been shown to protect against acute respiratory infections and it was shown to be safe. It should be advisable to perform dedicated studies about vitamin D levels in COVID-19 patients with different degrees of disease severity.
Many years ago I approached my former personal care physician and asked to have my Vitamin D level checked.
“What the hell for?”
“I would like to know my Vitamin D blood level to see if I need to take a supplement.”
“Just get outside in the sun for around 20 minutes a day.”
“Just order the test.”
And he did. Less than a week later Doc called me back to let me know I had Vitamin D deficiency. I’ve been taking a daily supplement since.
Vitamin D deficiency is now recognized as a pandemic. The major cause of vitamin D deficiency is the lack of appreciation that sun exposure in moderation is the major source of vitamin D for most humans. Very few foods naturally contain vitamin D, and foods that are fortified with vitamin D are often inadequate to satisfy either a child’s or an adult’s vitamin D requirement. Vitamin D deficiency causes rickets in children and will precipitate and exacerbate osteopenia, osteoporosis, and fractures in adults. Vitamin D deficiency has been associated with increased risk of common cancers, autoimmune diseases, hypertension, and infectious diseases. A circulating level of 25-hydroxyvitamin D of >75 nmol/L, or 30 ng/mL, is required to maximize vitamin D’s beneficial effects for health. In the absence of adequate sun exposure, at least 800–1000 IU vitamin D3/d may be needed to achieve this in children and adults. Vitamin D2 may be equally effective for maintaining circulating concentrations of 25-hydroxyvitamin D when given in physiologic concentrations.
An interesting hypothesis that needs more research.
E. Laird, J. Rhodes, R.A. Kenny. Vitamin D and Inflammation: Potential Implications for Severity of Covid-19. Irish Medical Journal, 2020; 113 (5): P81 [link]
Petre Cristian Ilie, Simina Stefanescu, Lee Smith. The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality. Aging Clinical and Experimental Research, 2020; DOI: 10.1007/s40520-020-01570-8
The highest probability of reaching 90 years of age (longevity) was found for men and women drinking 5– < 15 g alcohol/day (or 0.5–1.5 glass/day); the exposure–response relationship was significantly non-linear in women.
Usual drinking pattern and binge drinking were not significantly associated with longevity, but the risk estimates indicate to avoid binge drinking.
The estimated modest risk ratios (RRs) should not be used as motivation to start drinking if one does not drink alcoholic beverages.
We found statistically significant positive associations between baseline alcohol intake and the probability of reaching 90 years in both men and women. Overall, the highest probability of reaching 90 was found in those consuming 5– < 15 g/d alcohol, with RR = 1.36 (95% CI, 1.20–1.55) when compared with abstainers. The exposure-response relationship was significantly non-linear in women, but not in men. Wine intake was positively associated with longevity (notably in women), whereas liquor was positively associated with longevity in men and inversely in women. Binge drinking pointed towards an inverse relationship with longevity. Alcohol intake was associated with longevity in those without and with a history of selected diseases.
The availability of up to the minute information, presented 24/7/365, could assist a democratic society in making the best choices in determining its future. That was the promise of cable news. Unfortunately, cable news has fallen short of its potential and has led to the further polarization of America. More than that, it has changed the way your brain works.
Does cable news change how your brain works?
Possibly. But I take no chances. I don’t watch cable news networks.
Daddy always told me you go to college so that they can teach you how to think.
Unfortunately nowadays institutions of higher “education” teach the young what to think, not how to think.