My good friend Bill Bestermann, MD, a preventive vascularist at the Holston Medical Group in Kingsport, TN, has published an important article in CardioRenal Medicine. This paper, a long time coming, is not research but a highly informed thought piece that explains a new, previously unappreciated potential mechanism for the diabetes drug Metformin. It has far reaching implications for the management of many chronic diseases.
Bill first introduced this concept here on C&C in a piece called Metformin, Asymmetric Dimethylarginine and Cancer: The Keys to the Kingdom or a Tool to Pick the Lock?. He began to think seriously about some of these issues a year and a half ago after learning that my wife Elaine had been diagnosed with primary peritoneal (ovarian) cancer. It goes without saying that I am deeply, personally grateful for this contribution.
What’s most important about this most recent paper is that it was rigorously reviewed for CardioRenal Medicine, and so has at least the initial imprimatur of scientific credibility. I hope it now gets the additional attention I believe it deserves.
I’d urge all my clinician colleagues to review it carefully. I believe you’ll be appropriately inspired by both its elegance and its profound clinical ramifications.
WILLIAM H. BESTERMANN
“Traditional wisdom can be long on tradition and short on wisdom”
My colleagues have asked me about an article in Diabetes Care that shows roughly a 40% reduction in cancer risk in patients who are on insulin and treated concurrently with metformin. The reduction in cancer risk was attributed to beneficial effects of metformin. This information is not surprising. We have already gone into the metformin and cancer story in this space.
Continue reading “Insulin and Increased Cancer Risk”
Brian’s Note: In the post below, Dr. Bestermann, a highly regarded vascular physician, has developed and posted a field-tested protocol for the treatment of vascular conditions deemed high priority by the Institute of Medicine.
This is a work in progress that is likely to undergo significant change as new data emerges. But it is here and available in hopes that clinicians will make use of it, patients will benefit from it, and that by sharing important information we can provide better care for lower cost.
Protocol Approach for:
Type 2 diabetes, prediabetes, hyperlipidemia, hypertension, CAD, cerebrovascular disease, PAD, congestive heart failure
WILLIAM BESTERMANN, MD
This protocol is field tested, weight-centric and has been used in my personal practice for ten years with ongoing adjustment to reflect newer knowledge and products, . Consistently applied, the protocol accomplishes risk factor control levels consistent with optimal medical therapy while facilitating weight loss and renal function improvement in most patients.
Continue reading “Protocol Approach for IOM Priority Vascular Conditions”