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 →]

We know that the only person who can tell us what to eat and exercise is ourself. But most of us need a third leg of diabetes control — one or more of the prescription drugs — and we usually leave that decision up to our doctor.

Often this is a big mistake. Many of our doctors are too set in their ways. The problem is simply that doctors too are human.

Older doctors have practiced most of their lives with a Hobson’s choice of one oral diabetes drug. In 1957 the first sulfonylureas became available by prescription in the United States. Not until about 40 years later did the Food and Drug Administration approve a second diabetes drug, metformin.

Until we could get metformin, we did have the opportunity to take insulin instead of a sulfonylurea. And we had a lot of different sulfonylureas to choose from, making it appear that our choice was greater that it really was. Brand names include Amaryl, Glucotrol XL, Diaßeta, Glynase, Micronase, as well as Dymelor, Diabinese, Orinase, and Tolinase. Combination drugs like Metaglip, Glucovance, Avandaryl, and Duetact also are part sulfonylurea. [Read more →]

If we can easily test our blood glucose and cholesterol levels, why can’t we test the level of omega 3 fatty acids in our blood? Nothing — not cholesterol or even C-reactive protein levels — is better at predicting sudden cardiac death, which still causes about 60 percent of cardiac disease death in the United States, according to an analysis by Centers for Disease Control researchers.

For years this lack of an omega 3 blood test puzzled me. No more. It has finally arrived.

The HS-Omega-3 Index uses a standardized methodology to measure the percentage of eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA) in red blood cells. It also measures the ratio of omega 3 to omega 6.

Some cold water fish like salmon, mackerel, herring, albacore tuna, and sardines have a lot of this healthy omega 3 fat. I follow the standard recommendation to eat one of these fish at least twice a week. I supplement my fish with krill oil capsules for even more omega 3. [Read more →]

Since alliteration helps us to remember connections, we’re lucky that diabetes, depression, and the D vitamin all start with the same letter. We aren’t lucky that diabetes and depression are so closely connected, as I wrote in my essay on “Diabetes and Depression” here a year ago. But we’re in luck that vitamin D might treat both conditions, killing two birds with one stone, as our less technologically powerful ancestors used to say.

“About 70 percent of the population of the United States has insufficient levels of vitamin D,” says Adrian Gombart, a principal investigator with the Linus Pauling Institute at Oregon State University. “This is a critical issue as we learn more about the many roles it may play in fighting infection, balancing your immune response, helping to address autoimmune problems, and even preventing heart disease.”

People with diabetes may have even lower levels of vitamin D, according to a review last year in The Diabetes Educator. People at risk of diabetes and the metabolic syndrome (or syndrome x) also have low vitamin D levels.

Recent research found that 19 percent of people with type 2 diabetes probably suffer from major depression and an additional two-thirds of us have at least some depressive symptoms. People with diabetes are twice as likely to be depressed as other people.
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Are you suspicious of snake oil claims that something will treat a whole lot of health problems? I sure am.

The newest entry on the snake oil scene would seem to be vitamin D. I’ve lost track of all that this vitamin is supposedly good for — everything from building strong bones to protecting us from strokes and heart failure to reducing our risk of cancer and on to helping us regulate our immune system and control inflammation, our blood pressure, and even our blood glucose. Recently, some people are even recommending it for respiratory problems ranging from the common cold to the H1N1 (swine) flu virus.

If even half of this is true, vitamin D must be the biggest health discovery since aspirin. But so far we have only a few generally accepted uses of vitamin D.

We’ve known since the early 1920s that vitamin D cures rickets and other diseases that soften our bones, including osteomalacia and osteoporosis. The U.S. Food and Drug Administration in 1994 approved a vitamin D preparation to treat psoriasis. [Read more →]

American agriculture changed more in the past 50 years than it did in the previous 10,000 years since humans started cultivating grains and domesticating cattle, pigs, and poultry. This affects all Americans, but none more than those of us who have diabetes, which started its steep rise at about the same time that our farms became so much more efficient under the management of just a few huge multinational corporations.

This correlation certainly isn’t proof that modern agriculture caused the rise of diabetes. It remains, however, a likely suspect.

Neither can we fairly claim that the giant corporations that control most of American agriculture are the cause of anything more than being efficient. These companies are doing what companies are supposed to do — making a lot of money by doing what all companies try to do.

The root of the problem is our government. The federal government of the United States of America set the conditions under which the great consolidation of American agriculture took place. This is our “farm policy.”
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Whenever I become conscious of a word or concept new to me, I began to notice it everywhere. All of you probably have had this experience.

It is so common that we even have a nice big word for it thanks to the great Swiss psychiatrist Carl Jung: Synchronicity.

A couple of weeks ago a member of the diabetes support group that meets in my apartment loaned me a book called Bad Science. A practicing physician in the U.K.’s National Health Service and newspaper medical columnist named Ben Goldacre wrote it and Fourth Estate published it last year in the U.K.

The book is a detailed indictment of the British press for its woeful ignorance of some basic scientific concepts. Like one of my favorites, “regression to the mean.” This sounds complicated. But it is simply the fact that everything, including our health, has a natural cycle. Since we tend to see a doctor when we feel the worst, we think that his or her treatment helped us, while we would soon feel better no matter what the treatment was. [Read more →]

If you have high blood pressure, your doctor has probably told you a dozen times to cut way back on salt (sodium). But this works only for people who have a “salt-sensitive phenotype,” which results from both genetic makeup and environmental influences.

New preliminary research offers another strategy that might work for more of us. If we cut back on the fructose that we eat from added sugars, we may be able to control high blood pressure.

Most people with diabetes have high blood pressure, or to use the technical name, hypertension. High blood pressure is, after all, one of the key components of the metabolic syndrome, or syndrome x, that leads to diabetes.

When doctors talk about our blood pressure being high they mean a level of more than 120/80 mmHg. Those numbers are shorthand for a systolic or peak pressure of 120 and a diastolic or minimum pressure of 80 millimeters of mercury. [Read more →]

If you listen to all the so-called experts on nutrition, we can’t eat anything. But here’s the good news.

We can at least drink one thing, water. Nobody argues against water itself, although some of the experts tell us that it has to be filtered and we shouldn’t buy bottled water because it’s not well tested and all those bottles are bad for the environment. Maybe I shouldn’t even drink the sparkling water that I love. One correspondent told me that it will do terrible things to my body, like leaching out certain minerals. Another reminds me that the plastic bottles that it comes in also degrade the environment. Maybe I will have to buy a machine so I can make it at home if I can outlast the leaching.

Once upon a time I wrote that if you listened to all the experts, then water and fiber were the only things that we could safely consume. Now, however, it seems, according to one expert, that even additional fiber is bad for us. If you still believe that your body needs you to take fiber supplements, please read this post by Michael Eades, M.D. [Read more →]