This weekend my friend Mark and I drove about 120 miles from our homes in Boulder to Leadville in Central Colorado. Mark is a member of the diabetes support group that meets monthly at my apartment, and we are both avid hikers and nature photographers.

On Friday as we set off on the Turquoise Lake trail near Leadville, Mark checked his blood glucose. It was about 75 mg/dl so he ate a chocolate bar that he had in his pack.

“I figure that as long as I have to eat something to raise my level, I may as well eat something that tastes good,” he commented.

Maybe my body language showed my disagreement. So he asked me why I didn’t like his solution. [Read more →]

A year ago the U.S. Food and Drug Administration approved a new drug to treat type 2 diabetes. But few of us ever heard of it.

Until now. Studies presented at the annual convention of the American Association of Clinical Endocrinologists in Houston on Friday finally caught our attention.

The senior author of one of those studies spoke at length with me at the convention. Yehuda Handelsman, an endocrinologist in private practice in Tarzana, California, led a 16-week multi-center international study comparing how well Welchol (colesevelam HCl), Avandia, and Januvia did. In the study they randomized 169 people to evaluate the effects of these three oral diabetes medications on glycemic control and lipid profiles when added to metformin.
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When he examined the young lifeguard, he saw that almost every square inch of her body was well tanned. She had been wearing practically nothing when she worked at the beach.

Neil Binkley, M.D., told me about his patient because she had the highest physiologic level of vitamin D in her system of anyone he ever saw. Her level was 80 ng/ml.

I had to look up the word “physiologic” to make sure what Dr. Binkley meant. Physiologic in the sense that he’s using it is “something that is normal, neither due to anything pathologic nor significant in terms of causing illness,” according to a medical dictionary.
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Based on what I’ve read recently, some of which I have reported here, I’ve grown more and more wary of the wisdom of taking supplements. Few of the them seem to help.

And now comes a new study indicating that the two most common supplements can actually work against us. Those supplements are vitamins C and E.

It seems that we have a choice of exercising or taking large doses of those supplements. We know that exercise has lots of good effects like increasing our sensitivity to insulin, which is of great importance to all of us with diabetes.
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A single research report that found risks in one of the medications that we take to control our diabetes would warrant our attention. But when three separate studies find serious side effects from all our major drugs, the time is right for us to reconsider how we control our blood glucose levels.

Most of us think of our diabetes drugs, diet, and exercise as the three basic ways we do that. But drugs come first. Maybe they should come last, at least for all of us with type 2 diabetes, who unlike type 1s have a choice.

Since March 10, studies have called into question the side effects of metformin, the glitazones, insulin, and the sulfonylureas.
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Some of our doctors don’t help us when they use insulin as a threat: “Unless you reduce your blood glucose, I am going to have to put you on insulin.”

So it’s no surprise that many of us who have type 2 diabetes think we have failed when our doctors prescribe it. This comes from thinking of injecting insulin as a last resort.

It isn’t. More and more of us are now starting to take insulin as soon as our doctors have diagnosed our type 2 diabetes. Probably half of the men in my diabetes support group started taking insulin as a first choice.
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When I recommended here a month ago that we all get vaccinated against influenza this year, I had no idea how much controversy it would stir up. Some of the concerns are legitimate, but we have alternatives. Other concerns stem from irresponsible rants on the Internet that I’ve traced back to a totally discredited South Carolina doctor.

My article here last month jumped the gun. I knew that the flu authorities at the U.S. Centers for Disease Control and Prevention (CDC) wanted to talk with me so that I could help get the word out. But since CDC and the Health Central Network weren’t able to work out the arrangement in time, I wrote then because the flu season was already upon us.
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Maybe it won’t cure diabetes. But a compound slated to begin a new Phase 2b clinical trial early next year stands a good chance of knocking diabetes back into remission.

Almost never do I write about new drugs unless they are at least in in the final stage of development, a Phase 3 trial. The odds are against them.

Of 100 drugs for which developers submit investigational new drug applications to the Food and Drug Administration for approval, about 70 will successfully complete Phase 1 trials and go on to Phase 2. About 33 of the original 100 will complete Phase 2 and go to Phase 3. And 25 to 30 of the original 100 will clear Phase 3.
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You can skip your flu shot this year — if you would rather get sick than go to work. While you hope to recover in your bed at home alone, you can reflect that you are among the 5 percent of Americans who told surveyors that they made that choice.

While you’re at it, you might also want to consider that about 35,000 of us die and 225,000 get sick enough to need a hospital bed because of the flu. If you recover, you might think about trying to get a job that you hate less that the chance of getting the flu.

As many as one-fifth of us will get the flu this year. Most of those who will get it are among the 45 percent of Americans who will skip getting their annual flu shot. Their reasons for skipping the shot are just as good as those who might have to look for a new job in this difficult economy while waiting for Congress to extend unemployment benefits.
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People seldom make me angry any more. When another driver cut me off yesterday, I didn’t even flip him the finger or honk my horn. I just figured that he was in a bigger hurry than I was.

Recently doctors have determined that when we are younger and when we are older we are happier than when we are middle-aged. That can’t be generally true, because I still remember my miserable youth.

My life instead has been one of increasing happiness. I’m much more likely to shed tears of joy, as I did on the evening of November 4, than to weep with rage.
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