Elevated 2-Hour Glucose Predicts Cardiovascular Events

Good news for those with coronary artery disease. This study explored the prognostic value of three screening tests in patients with CAD – fasting glucose (FPG), 2-h postload glucose (2h-PG) from an oral glucose tolerance test (OGTT), and glycated hemoglobin A1c (HbA1c).

Results indicate that, in patients with CAD, 2h-PG can provide valuable prognostic information on the risk of future cardiovascular events. In addition, increases in HbA1c and 2h-PG can signal a greater risk for diabetes.

This study confirms, in a large cohort of people with CAD and without diabetes, the role of 2-hour glycemia during an oral glucose tolerance test (OGTT) as an independent risk factor for a future cardiovascular event.

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A Diet for Patients With Chronic Pain

Patients with chronic pain need a high-protein-intake diet, with avoidance of carbohydrate-induced episodes of hypoglycemia and weight gain.

Many serious conditions and diseases, including hyperlipidemia, obesity, congestive heart failure, and renal failure, have their own recommended diet. Considerable scientific information and clinical observation have accumulated in recent years that chronic pain, particularly the debilitating, severe form that requires opioid treatment, needs a “chronic pain” diet. To date, however, no chronic pain diet has been officially recommended. Therefore, the goal of this article is to provide pain practitioners with a pain diet.

The fundamental principle of the diet is that patients with chronic pain need a high-protein–intake diet with avoidance of carbohydrate (sugars and starches)-induced episodes of hypoglycemia and weight gain. It also is intended to promote strength, movement, energy, and mental function. The dietary supplements also recommended are intended to assist regeneration of tissue and prevent osteopenia and osteoporosis.

 The diet recommended here is, with some exceptions, akin to the low-carbohydrate (Atkins) diet that is used in many weight control programs. It does not eliminate carbohydrates but attempts to restrict them by emphasizing protein intake.

The problem with reducing weight in patients with chronic pain is multifaceted. Chances are, patients can’t move or exercise enough to lose much weight. Medication that will relieve pain, whether an opioid, sedative, muscle relaxant, or antidepressant, may suppress the body’s metabolism and cause weight gain. Anorexiants may be of little assistance because the patient with pain may be eating very little. If the protein diet recommended here doesn’t cause weight loss, I recommend adding a stimulant such as phentermine.

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