Fatty liver disease is one of the most common complications of diabetes. About 50 to 70 percent of those of us who have diabetes may have this potentially dangerous complication. But now we may have a way to treat it and stopping it from progressing to liver failure.

The first time I wrote about fatty liver was in 2005 when I had it myself. Fortunately, I have since been able to reverse it with diet and exercise.

My late wife Catherine wasn’t so fortunate. Her fatty liver progressed to liver failure, which led to her death in early 2007.

Catherine had type 2 diabetes and was seriously overweight, and neither of us knew at the time that this is the cause of most cirrhosis of the liver. We had always assumed that drinking too much alcohol was the cause — but she never drank any.

Since then I’ve learned a lot about the dangers and other causes of fatty liver disease. Just recently, in fact, Swedish researchers reported that people with nonalcoholic fatty liver disease have a higher overall mortality rate compared with the general population. [Read more →]

Bayer Diabetes Care’s A1CNow+ monitor for us to test our A1C level at home carries the highest certificate of accuracy. As I wrote here in June, the NGSP (formerly the National Glycohemoglobin Standardization Program) certified this device as having documented traceability to the Diabetes Control and Complications Trial reference method, which established relationships between A1C levels and risk for complications of diabetes. The DCCT method is the gold standard for reliable A1C testing.

So I was surprised to read an article in the journal Clinical Chemistry indicating that this was one of the A1C testing devices that didn’t meet “the general accepted analytical performance criteria.” Two Dutch researchers led by Erna Lenters-Westra reported that the local distributor in the Netherlands of the A1CNow+ Bayer “concluded that the EP-10 [protocol] outcome data did not warrant progression” to the two other protocols the study used.

But the key sentence — buried in the full-text of the study and missing from the online abstract — is this, “The bias found with the EP-10 protocol of the A1CNow was probably due to EDTA interference problems.”

I had to ask Bayer representatives what all this means. This is what the company told me:

“Bayer has reviewed the Lenters-Westra study published in Clinical Chemistry that used Bayer Diabetes Care’s A1CNow+® monitor as part of their evaluation,” the company wrote back. “Bayer believes that the results that the study authors obtained did not accurately capture the proven performance of the A1CNow+ device due to use outside the manufacturer’s specifications [emphasis added]. [Read more →]

For people with diabetes the so-called “vital signs” that health care people talk about have to include our blood glucose level. So I couldn’t think of a better name for a blood glucose meter than “Vital.”

Arkray in Edina, Minnesota, seems to agree. At least that’s what the call their new meter. You may not be familiar with Arkray, but it is the world’s fifth largest manufacturer of diabetes self-monitoring systems. This company calls their new meter the “Glucocard Vital.”

The U.S. Food and Drug Administration approved the Glucocard Vital in November. Arkray just ramped up production and sent me one of the first of these meters, the newest meter on the market.

Yesterday I put my Glucocard Vital through its paces. It performed perfectly for me. Since I test so many blood glucose meters, I like to use them before ever looking at the user instruction manual.

I just pulled out one of the test strips, inserted it in the meter, which then turned out automatically with the battery already in place. Even the date was already correctly set. Later, of course, I did read the manual to see if it contains anything of importance that I need to tell you about.

The Newest Blood Glucose Meter

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A few days ago an Accu-Chek Aviva blood glucose meter arrived in my mail. The meter itself was nothing new. Three years ago when Roche Diabetes Care introduced the Aviva I wrote a glowing review of it, appropriately titled “Viva Aviva!“

What is new is the smallest item in all those papers that accompany a new meter nowadays. It’s a wallet-sized card that Roche calls the Accu-Chek Connect.

This is one powerful little card! For some people it means that we don’t have to pay more than $15 for each prescription we get for Accu-Chek Aviva test strips.

The Front of the Discount Card

The Back of that Card

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You won’t read it in the mainstream press. But the most significant study ever of the effect of saturated fat on our hearts appeared Wednesday.

In fact, I couldn’t find any mainstream articles about it today. Not one of the four sources that I rely on heavily for leads to new studies has carried a word about this one. In fact, another source, Google News, instead turned up articles headlined like “Reduce your intake of saturated fats or suffer a heart condition,” “Ban butter to save our hearts, says doctor,” and “Not all fats are equal – saturated fat is the real baddie.”

Not.

The new study should drive the last nail in the coffin of the supposed link between eating saturated fat and getting heart disease. Since heart disease is the most common as well as the most serious complication of diabetes, nothing could be more relevant to us.

Ever since 1953, when a physiologist named Ancel Keys, Ph.D., compared fat intake and deaths from heart disease in six countries, including the U.S., the American medical establishment has clung to an unproven belief that saturated fat was evil. But even by 1957 we should have known better, after Jacob Yerushalmy, Ph.D., established that Keys was guilty of the sin of cherry picking. While Dr. Keys used data from six country, he actually had statistics from 22 countries available. And when scientists analyzed those statistics, the apparent link between eating fat and heart disease disappeared. [Read more →]

We can’t be truly healthy if we are fat. That’s the bottom line of study reported online December 28 before it’s printed in Circulation, the journal of the American Heart Association.

Previous studies seemed to show that something called “healthy obesity” might exist. They indicated that obese people who didn’t have the metabolic syndrome — a pre-diabetic condition — weren’t at increased risk of heart disease.

But the new research indicates that those studies didn’t follow those people long enough. Only after about 15 years did their heart problems show up in an exceptionally long-term study of 1,758 Swedish men starting when they were 50. The study, “Impact of Body Mass Index and the Metabolic Syndrome on the Risk of Cardiovascular Disease and Death in Middle-Aged Men,” followed them for 30 years. [Read more →]

Diabetes Rising is a strange name for the most readable book ever written about diabetes. But diabetes is a strange disease, as Dan Hurley shows in the book that Kaplan published yesterday.

The publisher sent me galley proofs of the new book several months ago. I’ve been waiting to review it until it became generally available.

Of the hundreds of books on diabetes that publishers and authors send me every year, I don’t usually review any of them. I’ll keep one or two of them in my bookshelf for reference, but I give away the vast majority of them, usually to my local library.

Diabetes Rising is the exception because its author has exceptional qualifications to write about it. Dan Hurley is a medical journalist who regularly contributes to the science section of The New York Times as well as to many other major publications. He earned his other relevant qualification 34 years ago at the age of 18. That’s when he got type 1 diabetes. [Read more →]

“Please tell me where I can go for help for depression,” a correspondent wrote me a few days ago. “I have had diabetes a long time, and I am so tired of everything. Can you point me in the right direction for some help?”

I replied by suggesting five strategies that seem to work for me. For about two months after I had an emergency operation on October 1 while traveling, I wasn’t a happy camper. A friend told me that general anesthesia can cause depression, and a quick search of the Web confirmed it.

Two months must have been far too long for the anesthetic to hang around in my body. But for the past several weeks I have been continuously happy.

Maybe it’s because I’ve been getting out regularly for walks to some of my favorite winter destinations. Or maybe it’s because I’ve getting a lot more long-chain omega-3 fatty acids from fish (and a lot less omega-6). Possibly it’s the continued effect of the 10,000 IU of vitamin D I take every day. We have some evidence that each of these strategies help to counteract depression. [Read more →]

This morning I got my exercise by shopping for food. After the weekend I didn’t have anything in my apartment that I wanted to eat for lunch and dinner.

So I walked about four and one-half miles to the nearest natural foods store, which is a Whole Foods Market. I picked up salad greens for lunch, grass-fed ground beef for dinner, and a few other items that I needed. Then, I walked back home with my groceries in my daypack.

This was a winter walking destination for me. During the rest of the year I get my exercise every other day or so with a long hike in the Rocky Mountains that rise just west of here. Now, in the winter, I still get up there, but on my snowshoes and less often than the hikes at other times of the year. [Read more →]

Today people who have diabetes can be thankful that the United States doesn’t have a single-payer health care system. Based on two Canadian studies released today, most of us could face the prospect that our health insurance would soon cease to cover the cost of testing with blood glucose strips.

The studies both proposed that Canada could save money by cutting benefits to people with type 2 diabetes who are using drugs other than insulin. Last year 63 percent of people with diabetes in the province of Ontario who weren’t using insulin used on average 1.29 test strips per day. Although many of us would say that’s too little, one of the studies concluded that it’s too much.

The Canadian Medical Association Journal CMAJ on December 21 released these studies subject to revision. You can read the full-text of one study at “Blood glucose test strips: options to reduce usage.” The full-text of the other new study is at “Cost-effectiveness of self-monitoring of blood glucose in patients with type 2 diabetes mellitus managed without insulin.”

Each article recognizes that those of us who inject insulin have to test regularly to avoid hypos, if for no other reason. All type 1s and about one-fourth of type 2s inject insulin. [Read more →]