A Breakthrough in Clinical Diagnosis

Over the last 20 years in my practice, I have been observing the glucose-insulin-heart disease connection. In 1999, together with Dr. Rachael and Richard Heller, I described it in detail, with all its implications for cardiovascular health, in a book that became a New York Times best-seller: The Carbohydrate Addict's Healthy Heart Program. We subtitled the book "Break Your Cardio-Insulin Connection to Heart Disease." It now happens that there is a real epidemic in America, a dual epidemic, of obesity and diabetes, which are at core insulin disorders that pose grave risk for the heart. I call this condition by a new name: diabesity. The American Diabetes and American Heart Associations have augmented the definition of diabetes to include its description as a cardiovascular disorder as well as an endocrine disorder because of the high incidence of cardiovascular disease, heart attack, stroke, and peripheral vascular disease in diabetic individuals.

Recent medical research has re-affirmed the strong connection between elevated glucose levels (hyperglycemia) and heart disease. The August 28th Lancet, the prestigious British medical journal, reported on a study that found that individuals who suffer a heart attack are three to four more times as likely to be diagnosed as diabetic or pre-diabetic. The conclusions in the study were based on new guidelines for diagnosing diabetes and pre-diabetes. The latter have not yet been universally received by the medical community, and as a result there is some confusion about the diagnosis of diabetes. Are we saying that a heart attack causes diabetes? Not at all. Most likely these patients were pre-diabetic prior to the heart attack and this condition was instrumental in causing progressive arteriosclerosis and coronary artery disease.

I have often pointed out the connection between insulin and heart disease in explaining the metabolic syndrome, a cluster of metabolic risks that includes glucose abnormalities along with hypertension, high triglycerides, and central obesity. A recent report out of the proceedings of the European Heart Society Congress offers evidence of this connection in a study that found women with hypertension to be three times as likely as others to develop diabetes.

It is apparent to me in my practice, and it is becoming more and more documented in the scientific literature that individuals with any type of heart ailment, be it a heart attack, stroke, peripheral vascular disease, angioplasty or bypass surgery experience, hypertension, or hyperlipidemia, will be found upon examination to have elevated glucose levels—that is, diabetes or pre-diabetes. The toxic effect of elevated glucose both in the chronic state and on occasions of post-prandial hyperglycemia is an accelerant to the aging process and a menace to the coronary arteries. The severe damage caused by hyperglycemia has been implicated in endothelial dysfunction, oxidative stress, inflammation, thrombosis, and glycosylation (the process in which glucose bonds with proteins and lipids). The latter glycosylation is extremely dangerous because it accelerates the production of Advanced Glycation End-products or AGEs. These are bi-products of high sugar which then attach to proteins and DNA to cause increasing blood vessel, nerve, and tissue damage.

Years ago, cholesterol became a household word because of the hundreds of millions of dollars spent on health education through the National Cholesterol Education Program of the Institutes of Medicine. Today glucose levels are just as important as cholesterol (hyperlipidemia) as a risk factor for heart disease; yet they are not given sufficient attention by medical practitioners. I am making it my mission to educate people as to the definitions of pre-diabetes and diabetes; I will be writing more about pre-diabetes and new treatment modalities to control it.

About Dr. Vagnini

Dr. Frederic J. Vagnini is one of the most unique physicians and health educators in the world. After graduation from St. Louis University School of Medicine in 1963, Dr. Vagnini underwent 8 years of post doctorate internship and residency. These years studying surgery, vascular, heart and lung surgery were spent at the Downstate Medical Center, Brooklyn, New York and Columbia Presbyterian Medical Center, New York. Following completion of training Dr. Vagnini served in the United States Army as a Lieutenant Colonel and subsequently entered into private practice on Long Island, New York.

For the next 25 years Dr. Vagnini practiced as a heart, lung and blood vessel surgeon. He has operated on thousands of patients with heart and blood vessel disease. As his career continued Dr. Vagnini became interested in Health Education, Preventive Medicine and Clinical Nutrition. Because of his vast experience in the area of heart disease and nutrition he became a frequent guest speaker and has appeared numerous times on local and national radio and television.

Dr. Vagnini is ELDR's chief medical advisor. He is the coauthor, along with our Editor Dave Bunnell, of the book Count Down Your Age (McGraw-Hill). To learn more about Dr. Vagnini, visit his website »

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posted at 04:13:33 PM