Morning Coffee intake Linked to Better Insulin Sensitivity: Study

 I do coffee all day, takes that long to get in a 12 cup pot of coffee. This won't change my habit, it's mainly to reduce my dementia and Parkinsons risk and no one knows the amounts for that.

I'm still doing a 12 cup pot of coffee daily to prevent Parkinsons and frailty! Much more important than any problems it can cause.

How coffee protects against Parkinson’s Aug. 2014 

Coffee May Lower Your Risk of Dementia Feb. 2013

Coffee drinkers rejoice! Drinking coffee could lower the risk of Alzheimer’s disease 

And this: Coffee's Phenylindanes Fight Alzheimer's Plaque December 2018

New research suggests drinking coffee may reduce the risk of frailty May 2025

I think I'm in this category:  I never get the jitters or flushed skin.

Genetics determine how much coffee you can drink before it goes wrong

I'm doing a 12 cup pot of coffee a day with full fat milk to lessen my chances of dementia and Parkinsons. Tell me EXACTLY how much coffee to drink for that and I'll change. Yep, that is a lot more than the 400mg. suggested limit, I don't care! Preventing dementia and Parkinsons is vastly more important than whatever problems it can cause! 

Of course, your fuckingly incompetent? doctor did nothing with this from 2 years ago! And still hasn't created a 24 hour coffee station

Dementia risk could drop by drinking just one shot daily of common beverage  August 2023

This line is great: The findings indicate that even the Espresso Martini cocktail contains the espresso's beneficial compounds - and can contribute to staving off dementia.

The latest here:

Morning Coffee intake Linked to Better Insulin Sensitivity: Study

METS-IR as an important predictor of neurological impairment severity in patients with severe cerebral infarction: a multicenter study based on the Chinese population

 You do realize that predictions like this ARE ABSOLUTELY FUCKING WORTHLESS FOR GETTING SURVIVORS RECOVERED! 

I'd have you all fired for not doing the research that would prevent this problem!

METS-IR as an important predictor of neurological impairment severity in patients with severe cerebral infarction: a multicenter study based on the Chinese population

Yaqi Hou^1†Xiaohua Wu^2†Yiheng Shi^3†Xiaotian Xu⁴Yu Zhang¹Lei Jiang¹Wei Wang⁴Yan Yang⁴Lanying Hu^5*

• ¹School of Nursing, Yangzhou University, Yangzhou, Jiangsu, China
• ²Department of Endocrinology and Hematology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu, China
• ³Department of Gastroenterology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou Jiangsu, China
• ⁴Department of Neurology, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu, China
• ⁵Department of Nursing, Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu, China

Background: Insulin resistance (IR) is linked to an increased risk of neurological impairment following a stroke and may contribute to poor neurological prognosis in affected patients. The metabolic score for the insulin resistance index, shortened as the METS-IR, generally serves as a surrogate index for IR. However, its association with the severity of neurological impairment in patients with severe cerebral infarction (CI) in neurological intensive care units (ICU) has not been fully established.

Methods: Patients with a diagnosis of CI, admitted to the neurological ICUs of Yangzhou University’s Affiliated Hospital and Xuzhou Medical University’s Affiliated Hospital, were included in the study. A multivariate logistic regression model and restricted cubic splines (RCS) were employed to explore the relationship between the METS-IR index and the severity of neurological impairment in these patients. The predictive capabilities of the METS-IR index and the triglyceride-glucose (TyG) index for outcome measures were compared through the ROC curve. Furthermore, a decision curve analysis was executed, and the integrated discrimination improvement (IDI) index was computed to evaluate the enhancements in predictive performance and clinical utility of various scoring systems with the inclusion of the METS-IR index. Subgroup analysis was conducted regarding age, BMI, and smoking status.

Results: The study ultimately included 504 participants. Adjusted logistic regression and RCS results showed that as the METS-IR index increases, the risk of neurological impairment in patients with severe CI consistently grows (P for overall = 0.0146, P-nonlinear: 0.0689). The METS-IR index’s predictive capability for neurological impairment (AUC = 0.669) was superior to that of the TyG index (AUC = 0.519).

Conclusion: From the study results, the METS-IR index can serve as an important predictor for neurological impairment in ICU patients with severe CI. It can aid in the identification and early intervention of neurological impairment in these patients.

Association of higher triglyceride–glucose index and triglyceride-to-high-density lipoprotein cholesterol ratio with early neurological deterioration after thrombolysis in acute ischemic stroke patients

 You do realize survivors want prevention of early neurological deterioration rather than this USELESS PREDICTION?  I'd have you all fired!

Association of higher triglyceride–glucose index and triglyceride-to-high-density lipoprotein cholesterol ratio with early neurological deterioration after thrombolysis in acute ischemic stroke patients

Mingzhu Deng^1†Kangping Song^2†Wei Xu^2†Guohua He²Jue Hu²Hui Xiao²Nina Zhou¹Sufen Chen²Guilan Xu²Yangping Tong²Dan Zhang²Zhen Wang^2*Fangyi Li^2*

• ¹Department of Neurology, Brain Hospital of Hunan Province, The Second People’s Hospital of Hunan Province, Changsha, China
• ²Department of Neurology, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, China

Background: Insulin resistance (IR) can predict the prognosis of patients suffering from cerebrovascular disorders. The triglyceride–glucose (TyG) index and triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio have been confirmed to be easy and reliable indicators of IR. However, the relationships between the TyG index or TG/HDL-C ratio and early neurological deterioration (END) after thrombolysis in patients with acute ischemic stroke (AIS) are uncertain.

Methods: A retrospective analysis of 1,187 patients diagnosed with AIS who underwent intravenous thrombolysis between January 2018 and February 2024 was performed. Post-thrombolysis END was defined as an increase in the National Institutes of Health Stroke Scale (NIHSS) score of ≥4 within 24 h after thrombolysis. Logistic regression analysis was performed to explore the relationships of the TyG index and TG/HDL-C ratio with post-thrombolysis END. Receiver operating characteristic (ROC) analysis was used to assess the ability of the TyG index and TG/HDL-C ratio to discriminate post-thrombolysis END.

Results: Among the 1,187 recruited patients, 179 (15.08%) were diagnosed with post-thrombolysis END, and 1,008 (84.92%) were diagnosed with non-END. A binary logistic regression model indicated that the TyG index (odds ratio [OR], 2.015; 95% confidence interval [CI] 1.964–2.414, p = 0.015) and TG/HDL-C ratio (OR, 1.542; 95% CI, 1.160–2.049, p = 0.004) were independent factors for post-thrombolysis END. The area under the curve (AUC) values for the TyG index, TG/HDL-C ratio, and TyG index combined with the TG/HDL-C ratio for post-thrombolysis END were 0.704, 0.674, and 0.755, respectively.

Conclusion: This study indicates that the TyG index and TG/HDL-C ratio can be used as prognostic factors to predict post-thrombolysis END.

Introduction

Acute ischemic stroke (AIS), which is caused by sudden arterial blockage and results in neuronal damage, is the most common type of stroke (1, 2). The preferred treatment for AIS is intravenous recombinant tissue plasminogen activator in the early phase (≤4.5 h) (3, 4). Nevertheless, a minority of patients continue to experience early neurological deterioration (END) in which neurological impairments and symptoms intensify within 24 h after thrombolysis (5). END is associated with an increased risk of mortality and morbidity, and previous studies have shown that END is relevant to unfavorable long-term outcomes in AIS patients (6, 7). Therefore, it is important to investigate the risk factors and measurable indicators of post-thrombolysis END in AIS patients.

Insulin resistance (IR) is considered the primary pathophysiology of metabolic syndrome (8), which is involved in the pathogenesis of cerebrovascular diseases, mainly through endogenous fibrinolytic dysfunction, thrombosis, elevated platelet activation, and inflammation (9). The hyperinsulinemic–euglycemic clamp test is the gold standard for assessing IR. However, the high cost of this measurement limits its wide-scale clinical applicability (10). In recent years, the triglyceride–glucose (TyG) index and triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio have been established as reliable, cost-effective, and easily accessible surrogate markers for IR (11–15). According to large cohort studies, the TyG index might be a useful IR biomarker for predicting the prognosis of stroke patients (16). A higher TyG index is associated with more severe END in AIS patients (11). Moreover, prior research has demonstrated that an elevated TyG index is associated with poor outcomes after thrombolysis (9, 17, 18). However, there are conflicting relationships between metabolic syndrome and outcomes after thrombolysis (19, 20). Therefore, the relationship between the TyG index and post-thrombolysis END deserves further investigation. The TG/HDL-C ratio is an easily accessible serum biomarker and may be utilized for assessing IR (13). Previous studies have shown significant associations between the TG/HDL-C ratio and incident cardiovascular disease (13, 21). Nevertheless, a recent large-scale cohort study revealed that there was no significant correlation between TG/HDL-C and worse cardiovascular disease outcomes (12). Furthermore, few studies have investigated the correlation between the TG/HDL-C ratio and post-thrombolysis END.

The early neurological outcome after thrombolysis is related to the long-term prognosis of patients (7, 22). The correlation between the TyG index or HDL-C ratio and post-thrombolysis END remains unclear. Therefore, we investigated the associations of the TyG index and TG/HDL-C ratio with the risk of post-thrombolysis END.

More at link.

Uncovered: Key to how exercise protects against consequences of aging

 

It is your doctor's responsibility to get you 100% recovered so you can do this exercise. YOUR DOCTOR'S RESPONSIBILITY!

Uncovered: Key to how exercise protects against consequences of aging

Monash University, Australia scientists have discovered an enzyme that is key to why exercise improves our health. Importantly this discovery has opened up the possibility of drugs to promote this enzyme's activity, protecting against the consequences of aging on metabolic health, including type 2 diabetes.

The proportion of people worldwide over 60 years old will double in the next three decades and by 2031, more than six million Australians will be over 65 years old. The incidence of type 2 diabetes increases with age so this aging population will also result in an increased incidence of the disease globally.

One of the main reasons for the increased prevalence of type 2 diabetes with age is the development of insulin resistance, or an inability for the body to respond to insulin, and this is often caused by reduced physical activity as we age.

However, the precise mechanisms by which physical inactivity facilitates the development of insulin resistance has remained a mystery.

Now researchers from Monash University in Australia have discovered how physical activity actually enhances insulin responsiveness and in turn promotes metabolic health. Importantly, the enzymes they have discovered that are key to this mechanism have the potential to be targeted by drugs to protect against consequences of aging such as muscle wasting and diabetes.

The team of scientists at the Monash University Biomedicine Discovery Institute (BDI), led by Professor Tony Tiganis, reveals that reductions in skeletal muscle reactive oxygen species (ROS) generation during aging is instrumental in the development of insulin resistance.According to Professor Tiganis, skeletal muscle constantly produces ROS and this is increased during exercise.

"Exercise-induced ROS drives adaptive responses that are integral to the health-promoting effects of exercise," he said.

In a paper published today (15 December) in the journal, Science Advances, the research team show how an enzyme called NOX-4 is essential for exercise-induced ROS and the adaptive responses that drive metabolic health.

In mice the researchers found that NOX4 is increased in skeletal muscle after exercise and that this then leads to increased ROS which elicits adaptive responses that protect mice from the development of insulin resistance, which otherwise occurs with aging or diet induced-obesity.

Importantly, the scientists have shown that the levels of NOX4 in skeletal muscle are directly related to age-associated decline in insulin sensitivity. "In this study we have shown, in animal models, that skeletal muscle NOX 4 abundance is decreased with aging and that this leads to a reduction in insulin sensitivity," Professor Tiganis said.

"Triggering the activation of the adaptive mechanisms orchestrated by NOX4 with drugs, might ameliorate key aspects of aging, including the development of insulin resistance and type 2 diabetes," he said.

"One of these compounds is found naturally, for instance, in cruciferous vegetables, such as broccoli or cauliflower, though the amount needed for anti-aging effects might be more than many would be willing to consume."

To read more, click here

 

Proxy Measure of Insulin Resistance Predictive of Stroke

 If you have diabetes go directly to your doctor with this, get tested. And if found, DEMAND EXACT STROKE PROTOCOLS THAT PREVENT THIS UPCOMING STROKE.

Proxy Measure of Insulin Resistance Predictive of Stroke

 

Study found relationship between estimated glucose disposal rate and first-time stroke(Why just first time stroke?)

by Kristen Monaco, Staff Writer, MedPage Today September 29, 2021

Insulin resistance in people with type 2 diabetes was predictive of stroke, according to a Swedish nationwide cohort study.

Patients with type 2 diabetes with less insulin resistance as measured by estimated glucose disposal rate (eGDR) saw a significantly lower risk for any kind of first-time stroke over a median 5.6 years of follow-up, reported Alexander Zabala, MD, of the Karolinska Institute in Stockholm.

This association also appeared to be graded, with the less insulin resistance a person had correlating with an even lower risk for stroke in a fully adjusted model, Zabala said in a presentation at the virtual European Association for the Study of Diabetes (EASD) meeting.

For the analysis, insulin resistance was quantified using eGDR, calculated using the variables of waist circumference, presence of hypertension, and HbA1c. Zabala explained, however, that there is another version of this formula for eGDR that swaps out waist circumference for body mass index. And while insulin resistance can also be measured with the hyperinsulinemic-euglycemic clamp method, this method is not suitable for large-scale clinical use due to the high cost and invasiveness, he said. In addition, using eGDR as a proxy for insulin resistance can also be used in a type 1 diabetic population.

Compared with patients who had an eGDR of less than 4 mg/kg/min -- considered the highest grade of insulin resistance -- patients falling into the three categories of less insulin resistance had 23%, 32%, and 40% lower risks for stroke, respectively:

• eGDR 4-5.99 (HR 0.77, 95% CI 0.69-0.87)

• eGDR 6-7.99 (HR 0.68, 95% CI 0.58-0.80)

• eGDR 8+ (HR 0.60, 95% CI 0.48-0.76)

Some factors in the eGDR equation held a higher estimated relative risk for stroke, Zabala reported. Specifically, the presence of hypertension was the factor underlying insulin resistance that most strongly predisposed someone to a stroke. Following that, HbA1c was the second most important clinical factor in this equation, succeeded by waist circumference.

The benefit of less insulin resistance didn't stop at just stroke risk, he noted. The same patterns were also seen with all-cause mortality, with less insulin resistance associated with a significantly lower risk for death:

• eGDR 4-5.99 (HR 0.83, 95% CI 0.76-0.89)

• eGDR 6-7.99 (HR 0.77, 95% CI 0.69-0.77)

• eGDR 8+ (HR 0.72, 95% CI 0.59-0.88)

Nearly an identical pattern was seen when looking only at the risk for cardiovascular-related mortality as well, Zabala said. Compared with type 2 diabetes patients with the highest amount of insulin resistance, those falling into the lesser three categories of insulin resistance saw an 18%, 25%, and 35% lower risk for cardiovascular death, respectively.

The analysis included 104,697 people with type 2 diabetes identified through Sweden's National Diabetes Register. These data were combined with the country's Cause of Death Register, an in-patient registry, along with the longitudinal integrated database for health insurance and labor market studies.

Among this cohort, average age was 63 and about 46% were women. During the median 5.6 years of follow-up, there were a total of 4,201 incidences of stroke, representing 4% of this patient population. This included stroke, ischemic stroke, and hemorrhagic stroke; subarachnoid hemorrhages were not included.

Zabala said the relationship between insulin resistance and stroke risk was largely driven by ischemic stroke, as the risk for hemorrhagic stroke alone was not statistically significant.

The majority of the cohort had a moderate amount of insulin resistance, he noted. Among the total patient population, 24,706 had the highest degree of insulin resistance (eGDR<4); while 40,187 had an eGDR of 4-6; 21,042 had an eGDR of 6-8; and 18,762 had an eGDR of about 8.

Zabala said that not surprisingly, patients with the greatest amount of insulin resistance tended to have a longer duration of diabetes, higher HbA1c levels, higher systolic blood pressure, and were more likely to be treated with a combination of insulin and oral glucose-lowering therapies.

Study limitations, he said, included that the researchers were not able to adjust for specific type of diabetes medications, such as SGLT2 inhibitors, GLP-1 receptor agonists, or DPP-4 inhibitors.

• 

  Kristen Monaco is a staff writer, focusing on endocrinology, psychiatry, and nephrology news. Based out of the New York City office, she’s worked at the company since 2015.

Disclosures

Zabala and co-authors reported no disclosures.

Primary Source

European Association for the Study of Diabetes

Source Reference: Zabala A, et al "Insulin resistance and risk of first stroke in type 2 diabetes: a nationwide cohort study" EASD 2021; Abstract 4.

Pioglitazone after Ischemic Stroke or Transient Ischemic Attack - insulin resistance

In case you need to know this.
http://www.ncbi.nlm.nih.gov/pubmed/26886418

Kernan WN¹, Viscoli CM, Furie KL, Young LH, Inzucchi SE, Gorman M, Guarino PD, Lovejoy AM, Peduzzi PN, Conwit R, Brass LM, Schwartz GG, Adams HP Jr, Berger L, Carolei A, Clark W, Coull B, Ford GA, Kleindorfer D, O'Leary JR, Parsons MW, Ringleb P, Sen S, Spence JD, Tanne D, Wang D, Winder TR; IRIS Trial Investigators.

Author information

Abstract

Background Patients with ischemic stroke or transient ischemic attack (TIA) are at increased risk for future cardiovascular events despite current preventive therapies. The identification of insulin resistance as a risk factor for stroke and myocardial infarction raised the possibility that pioglitazone, which improves insulin sensitivity, might benefit patients with cerebrovascular disease. Methods In this multicenter, double-blind trial, we randomly assigned 3876 patients who had had a recent ischemic stroke or TIA to receive either pioglitazone (target dose, 45 mg daily) or placebo. Eligible patients did not have diabetes but were found to have insulin resistance on the basis of a score of more than 3.0 on the homeostasis model assessment of insulin resistance (HOMA-IR) index. The primary outcome was fatal or nonfatal stroke or myocardial infarction. Results By 4.8 years, a primary outcome had occurred in 175 of 1939 patients (9.0%) in the pioglitazone group and in 228 of 1937 (11.8%) in the placebo group (hazard ratio in the pioglitazone group, 0.76; 95% confidence interval [CI], 0.62 to 0.93; P=0.007). Diabetes developed in 73 patients (3.8%) and 149 patients (7.7%), respectively (hazard ratio, 0.48; 95% CI, 0.33 to 0.69; P<0.001). There was no significant between-group difference in all-cause mortality (hazard ratio, 0.93; 95% CI, 0.73 to 1.17; P=0.52). Pioglitazone was associated with a greater frequency of weight gain exceeding 4.5 kg than was placebo (52.2% vs. 33.7%, P<0.001), edema (35.6% vs. 24.9%, P<0.001), and bone fracture requiring surgery or hospitalization (5.1% vs. 3.2%, P=0.003).
Conclusions In this trial involving patients without diabetes who had insulin resistance along with a recent history of ischemic stroke or TIA, the risk of stroke or myocardial infarction was lower among patients who received pioglitazone than among those who received placebo. Pioglitazone was also associated with a lower risk of diabetes but with higher risks of weight gain, edema, and fracture. (Funded by the National Institute of Neurological Disorders and Stroke; ClinicalTrials.gov number, NCT00091949 .).