Questions from OneHealth

There are some observations from animal health that poses questions for human medicine and in some cases possess challenges to the current paradigm.

For example, let’s take gingivitis. We think of gingivitis as a degenerative disease,  caused by bacteria. But dogs get gingivitis,  with all the attendant sequelae, including tooth loss. But the speed at which the disease progresses is much faster than in humans.

Why would that be? If the disease were caused by bacteria,  the rate of progression should be the same in people and in humans.

This makes one wonder if gingivitis is actually an host mediated disease. Host mediated diseases proceed much more quickly in dogs than in humans. For example, dogs develop osteoarthritis much faster than in people. Same with cancer.

Another interesting thing about gingivitis is that it had been associated with heart disease and metabolic syndrome in humans. It had been a long running debate whether gingivitis causes heart disease and diabetes or whether it is merely an epiphenominon.

In cats,  it is established that if  your have a cat that has diabetes and gingivitis, you can improve the diabetes by removing all the teeth. This suggests that the relationship is causal.

I was telling this too my friend,  Sandy, who is an endocrinologist. She told me that some old time endocrinologists would,  I  children,  remove all of their teeth if they developed diabetes.  Some things that the old timers did often turn out to habe sms biological basis,  and I can only wonder if this is one of them.

Speaking of diabetes, there is another lesson we might be able to learn from veterinary medicine.

Horses often get metabolic syndrome. They become be insulin resistant. But their pancreas is usually able to keep up with the increased demand so while they develop high insulin levels,  they don’t actually develop high blood sugar levels.

But… they nonetheless develop some serious sequelae groom the condition,  including laminated, a life threatening condition.

There had been a long running debate about whether the long term complications of diabetes is groom the high sugar or high insulin levels. Mostly, the debate had come down in favor of the sugar proponents.

But we know that in horse,  that is not the case,  that high insulin levels by itself is bad. And we know that in humans, some studies have shown that diabetics treated with intensive insulin therapy die at a higher rate than that treated with less insulin (DCCT study). That data had been largely ignored,  because it cuts against the grain of traditional thinking.

But there is a growing minority of scientists who think that insulin is a bad actor. They ate going as far as to call a version see of disease associated with obesity such as metabolic syndrome (diabetes, heart disease, hypertension, stroke), certain types of cancer,  Alzheimer’s disease, etc. insulin associated diseases.

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