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Alexa Alene | alexaalene120

Molecular Links

Dec 17th 2013 at 9:55 PM

Undoubtedly the greatest basketball coach of all time, the “Wizard of Westwood” accomplished what no other head coach had ever done before him, and most probably, what no other coach will ever do!!!!  As Head Coach of the UCLA  Bruins, Wooden won an unprecedented 10 National Championships and was named “National Coach of the Year” 6 times…but just as important, he was also a magnificent mentor to his players. So, how do these accolades for Coach Wooden coincide with the title of this article?!!!! 

For decades,  the majority of  Type 2, Non-Insulin-Dependent diabetics have been  brainwashed to believe that the only way to truly control their disease was by the use of [varying doses of] insulin. Now, this is not what I was taught…my professors called it “Non-Insulin Dependent Diabetes Mellitus” because if you are diagnosed with this ailment your body doesn’t require exogenous insulin…this is what NIDDM means!  In Type 2 diabetes, it is evident that something “molecular” transpires between fat cells and blood-sugar levels, since, (in many cases), the loss of a specific percentage of weight and/or body fat, (which varies from subject to subject), also improves and/or regulates blood-sugar levels, virtually normalizing  the resultant high blood-glucose levels and “temporarily” reverses this condition.

There are two distinct types of diabetes, Type 1 and Type 2…and just coincidentally, there are also two distinct types of pancreatic cancer; Pancreatic Adenocarcinoma and Pancreatic Neuroendocrine carcinoma.  We all know the difference between Type 1 and Type 2 diabetes; the former type is where the body’s immune system destroys specific cells (i.e., Beta (β-) cells) of the pancreas which produce insulin, and the latter is where the body presents what is known as “insulin resistance”. In Type 2, although the body is capable and usually does produce insulin, (where in Type 1 is doesn’t), the cells and tissues do not respond well, (if at all, many times), to endogenous insulin it produces.  In Type 2 diabetes, either cell receptors have “sunken” below the cellular membrane or the receptors themselves have been structurally altered, changed, or deformed, so that they no longer efficiently recognize insulin. Frequently, when a person loses 10-15 lbs of body fat, it is amazing how efficiently his or her body responds [again] to endogenous insulin production, normalizing blood-glucose levels. Once again, this might be due to the “sunken” insulin receptors surfacing and becoming available to “recognize” glucose.

About 95% of pancreatic cancer cases involve the exocrine component of the pancreas and is called ductal adenocarcinoma, whereas the other 5% of cases involves the endocrine component, arises from pancreatic islet cells, and is called neuroendocrine carcinoma. The later type is much less aggressive and has a much better prognosis for longer-term survival. [Islet cells are clusters of cells contained within the pancreas that produce hormones. There are several types of cells in an "islet", and examples are; Alpha cells (these produce glucagon which, when secreted, raises blood-glucose levels) and Beta (β-) cells (these produce insulin which, when secreted, lowers blood-glucose levels)] According to the American Cancer Society, about 20% of patients with exocrine pancreatic cancer live at least 1 year post-diagnosis, while less than 4% survive after 5 years post-diagnosis. For neuroendocrine pancreatic cancer, the overall 5-year survival rate is approximately 42%. For more information on these survival statistics and “stages”, go to; 

So…once again, how do the accolades for Coach Wooden coincide with the title of this article? Wooden never wanted his players on the basketball court, nor anyone just going through life itself, to ever let anyone make them believe that they couldn’t accomplish (even remarkable) things, just because the bearers of this doleful advise did not believe it themselves…this is one way that I interpret the Wooden quote. As a scientist I would be derelict to believe (or to say) that one can beat a disease such as pancreatic cancer or diabetes by a change in attitude, but a positive outlook and/or disposition along with an intelligent lifestyle of good dietary habits, exercise, and the avoidance of known causes of these diseases can change our physiology by actually  redirecting various molecular aspects of it. For instance, we do know… and thus, should accept the fact that there is a correlation/relationship between diabetes and pancreatic cancer. This is especially valid in the less deleterious form of pancreatic cancer (neuroendocrine) in correlation to Type 2 diabetes…many neuroendocrine tumors of the pancreas (PNETs) arise from the β-cells which produce and secrete insulin, and this only makes logistical sense. A significant study from the Mayo Clinic (Rochester, Minnesota) presented research data indicating that many patients with pancreatic cancer do develop diabetes months to even years before they are ever diagnosed with this dread disease [Pannala, R. and Basu, A., et al. (2009) "New-Onset Diabetes: A Potential Clue to the Early Diagnosis of Pancreatic Cancer".  Lancet Oncology, 10, 88].  This research paper brings up a number of important points…many of which are supported by other ancillary studies.  Because the incidence of pancreatic cancer is generally low, (as compared to that of breast or lung cancer, for instance), asymptomatic pancreatic cancer screening would not be very feasible, and would need to be restricted [in order to make it feasible] to only  those individuals considered “high risk”, (or at least “at risk”), candidates for pancreatic cancer.  Statistically significant scientific and medical data now shows that up to 80% of patients with pancreatic cancer are either hyperglycemic, (presents with a fasting blood-glucose of 100-125 mg (sugar)/dl (100ml/blood)), or are diabetic, (presents with a fasting blood-glucose of greater than 125 mg/dl), and when these patients undergo pancreatic-tumor resection, their diabetic status also improves. [Pancreatic-tumor (cancer) resection refers to tumor removal, Whipple's procedure, Central Pancreatectomy, etc...and/or other surgical techniques for pancreas preservation.]  Thus, what this shows is that diabetes [in these patients] appears to be caused by the pancreatic cancer sequelae themselves…and it is becoming clear that there is a strong molecular link between these 2  diseases.

Because the pancreas plays an integral role in the processes of digestion, absorption, and thus…in blood-sugar regulation…any loss and/or destruction of pancreatic tissue does indeed increase the risk for the onset of diabetes mellitus, as well as for the cellular/molecular aspects of malabsorption!  Just an Example: During the Whipple procedure,  parts of vital organs, such as those of the pancreas and bile duct, as well as all of the duodenum are removed and “re-sected” (so-to speak). Not to mention the importance of the pancreas, (whole or not), and the bile duct (a given!), besides the duodenum being the integral 1/3 upper sector of the small intestine (for absorption), the duodenum also appears to play an important role in regulating the motility of the stomach and upper G.I.tract.  Motility of the tract, (and it’s regulation), is  vital to proper and life-sustaining digestion, peristaltic movement down the G.I tract, absorption, and excretion. The molecular link/connection is quite transparent…and yes, we do have to look at the bigger molecular picture and not limit ourselves to the typical narrow window of thought which we are “trained” to do. Once again…“Do not let what you cannot do interfere with what you can do“…comes back into play.

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