Heart and Kidney Diseases and Type 2 Diabetes May Be One Ailment

https://www.scientificamerican.com/article/heart-and-kidney-diseases-plus-type-2-diabetes-may-be-one-illness-treatable/

by Brajeshwar • 7 months ago

73 47 7 months ago

SilverElfin2• 7 months ago

The ties are so strong that in 2023 the American Heart Association grouped the conditions under one name: cardio-kidney-metabolic syndrome (CKM), with “metabolic syndrome” referring to diabetes and obesity.

Seems like this is mostly an extension of the previously existing label of metabolic syndrome, now including kidney. Ozempic is mentioned and I take that to mean obesity is the cause. But are some of these ailments like diabetes reversible?

liveoneggs5• 7 months ago

I think it's saying that diabetes (T2 is reliably reversible) causes damage to the heart and kidney but sometimes the connection isn't made and they treat the kidney/heart symptoms without addressing the cause (T2D).

SilverElfin2• 7 months ago

Interesting I didn’t realize T2 is reversible. How do people do that - some kind of drug? Or just weight loss?

qart3• 7 months ago

Amy Bies was recovering in the hospital from injuries inflicted during a car accident in May 2007

When an article starts like this, I instantly close it and wait for proper sources. Anyway, the phrase "metabolic syndrome" has been gaining currency for the last few years. For those who don't want to read journal papers and meta-analyses, there are plenty of doctors and fitness coaches (on YouTube) who have made videos on how to get metabolic syndrome under control or even reverse it. And many of the doctors do a good job of filtering and summarizing the research.

jeffbee4• 7 months ago

When an article starts like this, I instantly close it

Why? You don't believe in car crashes or what?

gnatman• 7 months ago

I think they probably mean “article that’s meant to share research but mostly shares anecdotes”. It’s a common framing for this kind of thing though, so they probably have to close a lot of articles after the first sentence.

nh23423fefe2• 7 months ago

Someone who wants to tell you something true doesn't lead their communication with emotional distraction. Kinda like how someone who is asking a real question doesn't disguise the question as an insult.

pas2• 7 months ago

It's extremely lazy "writing".

Seems absolutely unnecessary, forced, immeasurably trite, off-puttingly boring, overused, so brazenly cliché that there has to be some kind of counter-intuitive selection going on, like with the email scammers that target those who are not immediately noticing the fraudulent intent.

... or simply our arrogance is showing, after all average minds discuss people, right?

barfoure• 7 months ago

You’ve got more patience than me. I read the title and decided I won’t bother reading the rest.

jeffbee4• 7 months ago

And then bragged about this.

epcoa• 7 months ago

The term Metabolic Syndrome X has been around for more than a few years, unless nearly 40 is few (and I absolutely relate to that sentiment), just saying that concept was revved up in the 90s and of course has been an academic discussion going back to the early 20th century.

https://www.ahajournals.org/doi/10.1161/01.atv.0000111245.75...

https://pubmed.ncbi.nlm.nih.gov/3056758/

vablings2• 7 months ago

Alongside all of these honest doctors and fitness coaches who espouse metabolic syndrome as the biggest health crisis of the 21st century there is a broad group of scammers and conmen who use the well backed science and literature to seed ground to push supplements and other crap. They seem to wrap the very basic medical truth of being overweight and inactive is horrific for your health in an onion of pseudoscience bullshit, so you buy the next best product high in "antioxidants" and "polyphenols"

The actual science is unimaginably boring. Do not be overweight on the BMI scale and do some moderate exercise for around 2 hours every week. This will drastically improve the health 1000x more than say the insane stuff that Brian Johnson is touting.

I hate modern fitness influencers and health wellness people in general. My head near about exploded when I saw a Tiktok from Jeff Nippard claiming that eggs increase your testosterone on a study with a sample size of FIVE PEOPLE.

tsimionescu3• 7 months ago

The actual science is unimaginably boring. Do not be overweight on the BMI scale and do some moderate exercise for around 2 hours every week.

Don't be depressed is also excellent advice for people with depression: if they can manage that, it improves their mood tremendously. Not catching colds also greatly reduces your chances of cold-like symptoms.

By which I mean, what you're saying is a truism, not medical advice. Keeping your BMI under control is a natural no-effort thing for some people, and a grueling lifelong struggle for others. Telling fat people to stop being fat is not "advice", it is exactly as helpful as telling sick people to stop being sick.

shevy-java• 7 months ago

It is all interconnected, but I am unsure about the claim made. The reason is simple: there can be numerous disease types. Person A may have different genetics than Person B, as one example, so responses of a body may be different for that reason alone; then there is lifestyle choice, health, age and so forth. So I don't agree with the claim in the title here that all is one ailment - that makes no sense to me.

bluGill• 7 months ago

We are reasonably confident that diabetes causes heart and kidney disease. However the converse - if I have heart disease (or kidney) I also have diabetes is not true: there are many possible causes of heart or kidney disease.

This logic error is easy to make, and the headlines all too often imply it, but it isn't always true (sometimes it is).

itchyouch• 7 months ago

I generally agree. It's all interconnected, and we could point to a singular cause, but to treat them all as one and of the same class of disease seems reductive and not useful.

Though, to be play devil's advocate for a second, it does seem that diabetes is typically where the symptoms start, and we do understand that diabetes is fundamentally metabolic and/or functional dysfunction in 1 or more of 7-ish different areas.

I think it's the level of perspective zoom + timing we take that makes the article's assertion either useful or not.

If we zoom out, while catching disease early on, and we address the metabolic conditions via lifestyle and/or certain drugs like GLP1, then we prevent the need to intervene on the kidney and cardiac front.

But if we zoom in to a specific issue, after disease has progressed a profound amount, a GLP1 intervention may be too little, too late.

Hopefully though, this may help the messaging to folks that if they are contending with metabolic disease that presents as diabetes, introducing lifestyle and pharma interventions early may be helpful on the larger epidemiological front.

brandonb• 7 months ago

HbA1c, or just diabetes as a binary variable, has been one of the main inputs into predicting heart attack risk for a long time.

The main marker of kidney function, eGFR, was added with the AHA/ACC's PREVENT equations in 2023.

I wrote a bit about the science behind heart risk calculators, and their various inputs like cholesterol, blood pressure, A1c, eGFR, and so on here: https://www.empirical.health/blog/heart-attack-risk-calculat...

matthewaveryusa• 7 months ago

These three disorders could really be “CKM syndrome,” which can be treated with drugs like Ozempic

The article is trying so hard not to say that obesity is the cause. I call it the obesity pipeline: You start off young and obese and you don't have diabetes and it's all fine. Stay obese long enough and you get diabetes -> metformin. Stay in a diabetic state long enough and you get heart disease -> statins. These are obesity comorbidities.

tsimionescu3• 7 months ago

There is an alternative possibility: you start out with a metabolic disorder, that will eventually grow into diabetes. Along the way, it will make you obese and cause (directly or indirectly) heart and kidney problems.

Unfortunately, since Ozempic treats diabetes with or without obesity, and it also treats obesity without diabetes, it won't help us figure out if obseisty is a cause or a side effect of diabetes. But there really is little reason to pretend it's clear either way.

phil212• 7 months ago

History is a pretty strong indication that it’s clear to me.

I find it exceptionally hard to believe populations at scale went from relatively “normal” weights to obese as the majority due to an emerging novel metabolic disorder. All within 1 to 2 generations.

Much simpler explanation is that diets and lifestyles changed leading towards obesity. Whether or not a metabolic disorder happened somewhere in the middle there seems irrelevant to me. It’s very clear to me that obesity causes the issues and not the other way around.

I’m open to thinking differently about it, I just find the evidence uncompelling as someone who was obese the majority of my adult life. Given the unique circumstances of how I grew up and then later experienced life, I’m quite confident obesity is primarily caused by lifestyle. Put simply - put yourself in a situation where obesity becomes easy to achieve and the majority of people will become obese.

Humans being what they are will of course have myriad of outliers to refute the point, but outliers are uninteresting to discuss in this context.

Aloha• 7 months ago

I'm T2D - I've come to believe obesity is a side effect of diabetes, if I'm not on my medications, I can fast for 2-3 days before my blood sugar comes down, because my liver is constantly pumping out glucose into my system.

There is no doubt that hyper processed foods make this condition more likely, but its not just "you have weak willpower and got fat and sick" - I know a ton of fat people who do not have and will likely will never develop T2D.

e40• 7 months ago

What does metformin have to do with it? I'm not obese, but I'm on metformin.

lawlessone• 7 months ago

I think obesity just speeds up the onset, plenty of older skinny people with heart disease.

This is just my unqualified opinion to be clear

osdamv• 7 months ago

I can run 10 km, MTB 30 km, fat level at 18% and still have prediabetes.

Sometimes is just a bad roll on the genes.

arevno• 7 months ago

I know that by modern standards, 18% is better than average, but it's also still pretty fat for men. Men should strive for a 10-14% range. <10% is associated with hormone (specifically testosterone) deficiency, and >14% is both aesthetically disgusting, and bad for metabolic health.

Try losing more fat, to the 12% level, then check your biomarkers again.

tsoukase• 7 months ago

There are 90 year olds with 60 years of diabetes and no complications and 40 year olds with 3 years of diabetes and devastating complications. Same for heart and kidney disease. They cannot be put in the same basket. No matter how much they try to push GLP-1's for everything under the sun, they are not.

If they find the drug of immortality, I am sure they will name every disease "partial death".

Heart and Kidney Diseases and Type 2 Diabetes May Be One Ailment

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