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Diabetes Developments - A blog on latest developments in diabetes by David Mendosa

Entries Tagged as 'Diabetes Complications'

The First Step to Take for Managing Blood Sugar

August 19th, 2013 · No Comments

The usual ways we have to bring our blood sugar levels down to normal work well. But they may not be the best means for about half of us who have diabetes and pre-diabetes.

The usual ways are diet, exercise, and reducing stress. These are the cornerstones of diabetes management, but anyone who has sleep apnea has to do more.

A great many of us who have diabetes also have sleep apnea, and a new study indicates that when we start to manage sleep apnea, we manage our diabetes better at the same time.

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Posted in: Diabetes Complications

Why People with Diabetes Need to Avoid Statins

June 23rd, 2013 · 4 Comments

Those of us who have diabetes have enough to be concerned about for me to be writing here about all those things that don’t help us. You won’t find me writing about any of those many supplements and miracle cures that won’t do anything for you except separate yourself from your money. You don’t need me to tell you that if it sounds too good to be true, it probably is.

Have you noticed that whenever you encounter a problem, the act of dealing with that problem can create more problems, unless you are especially careful? Those of us who have diabetes need to be especially careful of the drugs that our doctors prescribe, because any drug carries with it unwanted side effects.

Even the type of drug that more Americans and people around the world take has a long list of side effects. Statins, a class of drugs that lower low-density lipoprotein cholesterol (LDL), are commonly prescribed to people with diabetes and pre-diabetes when our lifestyle changes don’t achieve the LDL targets that our doctors like.

About 32 million Americans take a statin. One-fourth of us 45 and over do. One of the statins, Lipitor, is the all-time biggest selling prescription medicine in the history of the world with sales of more than $130 billion.

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Posted in: Diabetes Complications, Diabetes Medication

Solving the Problem of Treating Diabetic Neuropathy

June 16th, 2013 · No Comments

Being able to walk is something that all of us who have diabetes take for granted, at least until something makes it hard to do or even impossible. That something is often neuropathy, probably the most common complication of diabetes. But new treatments can prevent serious problems.

About 12 percent of us have neuropathy when we learn that we have diabetes, according to the Centers for Disease Control and Prevention at The Prevention and Treatment of Complications of Diabetes Mellitus. This U.S. government organization goes on to say that about 60 percent of us will have neuropathy after 25 years of living with diabetes.

The good news is that neuropathy isn’t inevitable, and the way to prevent it is clear, although not always easy. That way is to keep our blood sugar level normal, especially when our body gives us a warning.

That warning is often a foot ulcer. That was the way a friend of mine, Wayne Coggins, learned that he had diabetes. When I asked Wayne how he would describe himself, he replied, “I am pastor, counselor, and author … and newly discovered diabetic.” He founded Cornerstone Family Ministries in Kenai, Alaska, and wrote Adventures of an Alaskan Preacher.

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Posted in: Diabetes Complications

Cholesterol Myths

December 25th, 2012 · 2 Comments

The cholesterol issue is at the heart of every dietary recommendation for the past 30 years, says Dr. Jonny Bowden. “When you think about it — and I have thought about it — it has influenced everything we have been taught about what to eat and what not to eat.”

Together with Stephen Sinatra, M.D., a board certified cardiologist with more than 30 years of clinical practice, they wrote a new book, The Great Cholesterol Myth, which Fair Winds Press published on November 1. Alternatively, you can get a Kindle edition, which is what the publisher sent me for review.

Dr. Bowden has a Ph.D. in nutrition and is the author of 10 books with some of the soundest advice on what to eat that I have ever read. His book Living Low Carb is one of the very best books on the lifestyle that I follow and recommend. My only regret is that I failed to discover it when it came out, so I haven’t reviewed it. Dr. Bowden tells me, however, that a revised edition is in the works, and I will certainly review it as soon as I get my hands on it.

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Posted in: Diabetes Complications

A New Treatment for Neuropathy Pain

December 13th, 2012 · No Comments

If we’re lucky, we will get diabetic neuropathy in our lifetimes. Nearly 60 percent of people with diabetes in America have it after a quarter of a century.

Neuropathy may be the most common complication of diabetes and can make walking difficult as well as leading to even more serious problems like losing a limb. Diabetic neuropathy is damage caused to the nerves, and it can result in numbness, tingling, burning, and pain. Until now the painkillers that we could use don’t work well for everyone.

Now, however, a study from the University of Calgary shows evidence supporting a new drug therapy to treat diabetic neuropathy. The drug is called nabilone.

“My pain was so severe that I could barely walk a block,” says Leslie Bonenfant, who has type 2 diabetes and participated in the study. “After taking nabilone, I can manage my pain and I can function day to day,” she says.

Leslie Bonenfant (left) during a medical exam with Dr. Cory Toth

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Posted in: Diabetes Complications

Diabetes Can Be a Pain

October 8th, 2012 · No Comments

Diabetes doesn’t hurt. That’s one of the biggest problems we have in taking this insidious disease seriously.

But when we don’t manage our diabetes, some of its complications can be painful. And about 40 percent of us have acute or chronic pain. That’s the bad news.

This bad news comes to us in a new study of more than 13,000 adults with type 2 diabetes in the Kaiser Permanente, Northern California system. About 42 percent of them reported that they had acute pain and about 40 percent said their pain was chronic. The most common complication they mentioned was fatigue, about 25 percent, followed by neuropathy, about 24 percent.

The findings, “Symptom Burden of Adults with Type 2 Diabetes Across the Disease Course: Diabetes & Aging Study,” will appear in the Journal of General Internal Medicine and is now available online. The lead author is Rebecca L. Sudore, M.D., and her assistant sent me a copy of the full-text.

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Posted in: Diabetes Complications

How You Can Reduce Your Risk of Heart Attacks

July 19th, 2012 · No Comments

When you keep your blood sugar level as low as the levels of people who don’t have diabetes, your have little risk of having a heart attack. But when you let your sugar level rise just a little, that risk goes up a lot.

Healthy people who don’t have diabetes have a fasting blood sugar level of less than 6 mmol/l, according to researchers at the University of Copenhagen. That’s the equivalent of an A1C level of 5.4. The Journal of the American College of Cardiology just published their study in the issue for June 19/26, 2012.

The researchers drew on three observational studies that included 80,522 Danes. Observational studies cannot prove a cause, but the researchers went further. They used “a Mendelian randomization approach … to circumvent confounding and reverse causation.”

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Posted in: Diabetes Complications

Better Hydration for People with Diabetes

January 8th, 2012 · No Comments

Endurance athletes and hot yoga enthusiasts are hardly the only people who have to stay hydrated. Anyone who has a sweaty job needs to make sure to replenish the minerals lost at work. People like me who have diabetes need to be especially careful to stay in balance.

Even if you aren’t much of an athlete or work in a hot and humid place you can perspire a lot when you go to the tropics. I know from my current experience.

Right now I am writing from Caye Caulker, a tiny island in the Caribbean Sea off the mainland of the Central American country of Belize. I am here primarily to photograph birds, and that requires lots of hiking. The weather has stayed mostly at 80° hot and 95-100 percent humid.

To  stay hydrated I don’t just consume a lot of salt. That can help in an emergency. When I was a kid in high school, I had a summer job washing bottles in a dairy at the western edge of the Colorado desert. When I collapsed after a few days, my parents took me to our family doctor, who prescribed salt tablets. While I was able to go right back to work, this wasn’t an ideal solution.

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Posted in: Diabetes Complications

Treating Neuropathy

October 3rd, 2011 · 5 Comments

Ever since I learned about a new treatment for neuropathy at the annual convention of the American Diabetes Association in June, I have been trying to think of a good reason why not to write about it. I failed.

As a journalist, I am naturally skeptical. As Louis Menard wrote in the current issue of The New Yorker, “A person whose financial requirements are modest and whose curiosity, skepticism, and indifference to reputation are outsized is a person at risk of becoming a journalist.” That’s me.

I am skeptical of any purported cure for diabetes. I am even skeptical of new treatments for any of its complications. I am especially skeptical of the so-called “medical foods” that our companies keep dreaming up.

But I am also curious about anything new out there that really might be able to help us. And we do need help with diabetic neuropathy.

At least 60 percent of us have some degree of neuropathy. Diabetes raise our blood glucose level, and a high level of glucose in our blood can damage the nerves in our bodies. Often the nerves at the body’s periphery are the first to suffer with burning, shooting, or stabbing pains. Uncontrolled, the pain becomes severe.

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Posted in: Diabetes Complications

The Effect of Nuts on Your A1C

August 24th, 2011 · 2 Comments

Don’t go from the nourishment of nuts to chowing down on carbs. That’s the opposite of what I mean by the title of this article. I mean to suggest that substituting nuts in your diet for some of your carbs makes sense.

A study that will appear in the August issue of Diabetes Care, a professional journal of the American Diabetes Association, shows that eating nuts every day can help us manage our type 2 diabetes and prevent its complications. This research reports that eating just two ounces of nuts as a replacement for carbohydrates proved effective in managing our blood glucose and lipid levels.

Dr. Cyril W.C. Kendall of the University of Toronto, who is the corresponding author, sent me the full-text of the study, “Nuts as a Replacement for Carbohydrates in the Diabetic Diet.” The abstract of the study is online.

The lead author of the study is Dr. David J.A. Jenkins. That name is what brought the study to my attention because he created the most powerful tool to evaluate carbohydrates.

That tool is the glycemic index, which his 1981 article in the American Journal of Clinical Nutrition kicked off. Slow to gain traction here, the GI seems nowadays to be everywhere.

When I learned in 1994 that I had diabetes, I began following the glycemic index, and my first book lauded it. Since then, however, I have gone beyond that diet. And Dr. Jenkins also seems to have done so.

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Posted in: Diabetes Complications, Diabetes Diet

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