General Session

  


Diabetes: an emerging epidemic
November 18-20, 2011




Diabetes qualifies as an epidemic in America. 

In 2005–2008, based on fasting glucose or A1C levels, 35 percent of U.S. adults ages 20 years or older had pre-diabetes—50 percent of those 65 years or older. Currently 10% of the population is diagnosed with diabetes but if the current trend continues, by 2050, the CDC estimates that between 20 and 30 percent of the population will have type 2 diabetes. Diabetes was the seventh leading cause of death in 2007, and is the leading cause of new cases of blindness among adults under age 75, kidney failure, and non-accident/injury leg and foot amputations among adults. About 24 million Americans currently have diabetes, and one-quarter of them do not know they have it.

During the course of the disease, many but not all patients develop co-morbidities of the disease: retinopathy, nephropathy, peripheral arterial disease and cardiovascular disease. Other less well-known co-morbidities: hypogonadism, specific nutrient deficiencies, and liver disease have been identified. Consensus on risk factors for the development of prediabetes and diabetes does not exist, and more education is needed on the relationship between nutrition, genomics, and diabetes risk. Knowledge gaps exist among physicians in identifying who is at risk, the management of insulin-requiring patients and the effective treatment of the complications of diabetes.

 

At the conclusion of this activity,
participants should be able to…

1. When presented with pre-diabetic or diabetic patients, counsel patients about nutrient deficiencies and nutritional and nutrient supplementation to improve patient outcomes.

2. Assess the change in blood and urine levels of specific environmental toxicants before and after medical sauna therapy. 

3. Consider integrative approaches for the treatment of diabetic ulcers so that complications of diabetes can be reduced or eliminated.

4. Identify environmental chemicals that may increase the risk for diabetes in the patient population, how these exposures occur, and the mechanisms for their metabolic effects.

5. Monitor and maintain optimal Vitamin D levels in the prediabetic/diabetic patient population.

6. When presented with pre-diabetic or diabetic, female patients, discuss the etiology of polycystic ovarian syndrome (PCOS) and implement integrative approaches as part of the patient treatment plan.

7. Recall the current research on the relationship of nutrition and genomics to risk factors for prediabetes/diabetes, and the relationship of the complex dynamics of nutrigenomics to appropriate interventions in the current epidemic of diabetes.

8. Implement the appropriate treatment modality when presented with hypogonadism in prediabetic or diabetic patients.

 
 
 
 
Up to 15.5 AMA PRA Category 1 Credits (TM)


GENERAL SESSION SCHEDULE

FRIDAY:
8-10 AM  Jeffrey Bland, PhD - Medicine in the 21st Century
10-11 AM  
BREAK
11-12 PM  Ted Schettler, MD - Environmental Diabetogens
12-1:30 PM  LUNCH
1:45-2:45 PM  Jonathan Wright, MD - Diagnosis of Type 2 Diabetes Before it Happens
2:45-3:45 PM  
BREAK
3:45-4:45 PM  John Cannell, MD - Vitamin D and Diabetes
4:45-5:15 PM  
Expert Panel

SATURDAY:
8-10 AM  Mona Morstein, ND- The Naturopathic Treatment of Diabetes
10-11 AM  BREAK
11-12 PM  John McDougall, MD - A General Doctor’s Experiences with a Low-Fat Diet and Diabetes
12-1:30 PM  LUNCH
1:45-2:45 PM  Marianne Marchese, ND - Polycystic Ovarian Syndrome: A Comprehensive Approach to Diagnosis and Treatment
2:45-3:45 PM  
BREAK
3:45-4:45 PM  Ken Stoller, MD - The Healing Chamber
4:45-5:15 PM  
Expert Panel

SUNDAY:
8-9 AM  Stephen Genius, MD - Sauna Detoxification of Persistent Pollutants Including Toxic Metals, Chlorinated Pesticides, and Others
9-10 AM  Edward Goldberg, MD - Testosterone and Diabetes
10-11 AM  
Paul Connett, PhD - Scientific and Ethical Concerns About Water Flouridation       
11-11:30 AM  
BREAK
11:30-12:15 PM  John Sherman, ND - Niacinamide: Its Effect on Osteoarthritis, Serum Lipids and Metabolic Syndrome
12:15-1 PM  Expert Panel



jeffrey bland, phd
Medicine in the 21st century

Friday 8 - 10 am

Integrative, Holistic, Complementary, Alternative, Functional...How will we describe medicine in the 21st. century? In this presentation we will explore the convergence of discoveries from molecular and cellular biology, physiology, environmental science, clinical medicine, information science, systems biology, nutritional biochemistry, pharmacology and the traditional healing arts to craft an understanding of where medicine is going, who will be its practitioners, how will it be delivered, and who will pay for it. From this perspective an assessment of what is available today to reduce the burden of disease will be presented. An integrated model of assessment and management for what appears to be divergent diseases including type 2 diabetes, coronary heart disease, osteoporosis, and cancers of the breast, colon and prostate will be described based upon a systems biology approach to medicine.


Lecture Learrning Objectives:

    • Discuss prevalence of prediabetes/diabetes in light of recent criticism of CDC prevalence of diabetes figures as only a reflection of lowering of diagnostic criteria (see article CDC Factsheet info:http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf)

    • Discuss mechanisms of blood sugar dysregulation as they relate to tsunami of pre-diabetes/diabetes both from a nutritigenomics perspective and the obvious (diet/nutritional deficiency)

    • The environmental perspective (endocrine disruptors, heavy metals, pesticides) will be covered in other lectures by experts in that field (Ted Schettler) so he doesn't have to cover that

    • Discuss recommendations for aggressive screening and treatment of prediabetes as well as measures that can be taken with current diabetics to stabilize or prevent complications (vascular, neurological)


    marianne marchese, nd
    PolycYstic ovarian syndrome: a comprehensive approach to diagnosis and treatment

    Saturday 1:45 - 2:45 pm

    Dr. Marchese will discuss PCOS etiologies including the insulin resistance, hormonal deregulation link. She will discuss differential diagnosis, evaluation, environmental links, botanical and nutraceutical treatments, and conventional interventions as well.


     



    kenneth stoller, md
    THE HEALING CHAMBER

     

    Saturday 3:45 - 4:45 pm

    A timeline of hyperbaric medicine will start off the lecture and move into a summary of evidence based reviews relevant to treating problem wounds including Randomized Controlled Trials for diabetic ulcers. Questions such as What Is the Likelihood of Benefit from HBO in Diabetic Wounds and when to treat will be answered. Lastly, since HBOT heals all wounds and does so using the same mechanisms in treating diabetic wounds, what other wounds can it treat and what is the reason this therapy is so underutilized.



    stephen genuis, md
    sauna detoxification of persistent pollutants

     

    Sunday 8 - 9 am

    Several recent public health studies have confirmed that toxicant bioaccumulation has become a pervasive problem a clinical challenge that has increasingly been associated with myriad health sequelae including immune system dysregulation, autoimmunity, and diabetes. The investigation of modalities to facilitate excretion of toxicants in order to diminish clinical illness and reverse immune compromise is an emerging area of study. This lecture will provide an overview of detoxification measures and discuss recent research that explores the efficacy of thermal depuration through sauna therapy as a modality to achieve toxicant excretion of many toxic chemical compounds.

     


    john cannell, md
    Vitamin d and diabetes

     

    Friday 3:45 - 4:45 pm

    We will start with a basic overview of vitamin D physiology and pharmacology, emphasizing issues that are frequently misunderstood.

    Then we will talk about recent studies that indicate vitamin D is involved in not only the autoimmune illness, type one diabetes, but in type-2 diabetes as well. Vitamin D deficiency is common and the extent of such deficiency depends entirely on how you define it. Recently the Food and Nutrition Board surprised almost everyone by saying that a 25-hydroxy vitamin D level of 20 ng/ml is healthy. Most vitamin D researchers have written that the lower limit of good health is at least 30 ng/ml and perhaps 40 ng/ml. For example, the Endocrine Society recently issued a long-anticipated report saying that levels should be between 30 and 60. The Vitamin D Council believes that the current science supports a level of between 40 and 60 ng/ml, the range found in people who work outdoors.

     

    Type-1 diabetes has a strong latitudinal gradient. That is, it is uncommon around the equator but becomes increasingly common the further away from the equator one live. Vitamin D is no understood to be crucial for the immune system to prevent the type of mistakes that lead to type one diabetes. Unfortunately, it is unlikely that increasing vitamin D in type 1 diabetics will lower their insulin needs, a recent study showed that eye complications are more common in those with lower vitamin D levels.

     

    Type-2 diabetes is increasingly common due to the epidemic of obesity. However, data from large population studies show that vitamin D levels are closely associated with type 2 diabetes, those with the highest levels being the least likely to get it.

     

    Finally we will talk about supplement plans and how to treat vitamin D deficiency patients, especially obese patient, with vitamin D.


    ted schettler, md
    environmental diabeTogens

    Friday 11 am - 12 pm
    In vitro and in vivo laboratory studies, as well as a growing body of epidemiologic literature link exposures to a variety of environmental chemicals to increased risk of diabetes and obesity. Developmental exposures during windows of metabolic programming may be particularly important. This presentation will review this data and discuss the implications for clinicians and the need for further research.


     


    mona morstein, ND
    THE NATUROPATHIC TREATMENT OF DIABETES

    Saturday 8 - 10 am
    Naturopathic Medicine addressed diabetes care through a very effective mixture of diet, lifestyle changes, supplementation and prescription drugs, as necessary. This lecture discusses the dangers of uncontrolled diabetes, and then specifically, comprehensively discusses various treatments and the science associated with their efficacy.


     



    jonathan wright, md
    DIAGNOSIS OF TYPE 2 DIABETES BEFORE IT HAPPENS

    Friday 1:45 - 2:45 pm

    This presentation covers body signs, symptoms, lab evaluation, and effective treatment with diet, exercise, supplementation and new information about the very effective botanical  extract, berberine, in the prevention  of  diabetes and reversal of pre-diabetes. 
     




    Sponsored by the American College for Advancement in Medicine

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    Additional General Session Speakers:

    John McDougall, MD
    A General Doctor's Experiences with a Low-Fat Diet and Diabetes
    Saturday 11 am - 12 pm

    John Sherman, ND
    Niacinamide: Its Effect on Osteoarthritis, Serum Lipids & Metabolic Syndrome
    Sunday 11 am - 12:15 pm

    Edward Goldberg, MD
    Testosterone and Diabetes
    Sunday 9 - 10 am

    Paul Connett, PhD
    Scientific and Ethical Concerns about Water Flouridation
    Sunday 10 - 11 am