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

Entries from June 2010

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Weight Control Registry

June 29th, 2010 · No Comments

The National Weight Control Registry is the best guide we have showing us how people actually lose weight and keep it off. These are the people who have succeeded in a major weight loss program and in keeping off the pounds.

Diabetes doctors typically tell us to loose 10 percent of our body weight. I know from my own experience that this helps to control our blood glucose level. And I know too that getting down to a normal body mass index, or BMI, is even better for maintaining a low A1C level.

The National Weight Control Registry started in 1994 and now tracks more than 5,000 people. And because I am one of them, the people at the registry sent me a copy of a publication that summarizes their findings as thanks for returning a one-year questionnaire. The article, “Long-term weight loss maintenance,” appeared in the American Journal of Clinical Nutrition.

To be included in the registry, people have to be at least 18 and have kept off at least 30 pounds for a year or more. I reached that milestone four years ago. And a couple of years ago my friend Gretchen Becker encouraged me to share my results with the registry.

I haven’t seen any statistics about how many of the people included in the registry have diabetes. But I know that my weight loss strategies have been different from most. Using Byetta got me started with my weight loss program, and a very low-carb diet intensified it.

Most people, however, say that they have lost weight by following a low-calorie, low-fat diet. Without question, weight loss means a low-calorie diet. Almost certainly, following a diet of any sort is also a key to success. In fact, participants who maintained a consistent diet during the week and year after year were much more likely to maintain their weight than those who varied their approach.

Other keys include:

Eating breakfast every day, followed by 78 percent of registry members.

High levels of physical activity. Fully 94 percent report that they get more exercise now than they did before they lost weight, and 90 percent report that on the average they exercise an hour a day. Walking is the most common activity, reported by 78 percent of the participants.

Regular weighing. More than 44 percent report that they weigh themselves at least once a day.

I know from my own experience that when my scales broke in February just before I went on a long trip that not weighing myself regularly was disastrous for my weight. In a three-month period I gained 12 pounds and am now fighting to take them off.

The really good news is that it gets easier. People who successfully maintained their weight loss for two to five years had a much greater chance of long-term success.

This is a mirror of one of my articles that Health Central published. You can navigate to that site to find my most recent articles.

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Posted in: Exercise, Food

My Favorite Snack

June 22nd, 2010 · 1 Comment

Like most people, especially those of us who have diabetes, I have to watch my weight all the time. That’s why my favorite dessert is one that doesn’t have any carbohydrates and only 30 calories.

It’s simple to make with only four ingredients besides water. Another good thing about these ingredients is that since they aren’t perishable, I always have them on hand. All the tools you need are a bowl, a measuring cup, and measuring spoons, a stove, and a freezer.

The only problem with this snack or dessert is that it doesn’t give me instant gratification, since it has to set for an hour. But I consider that a small price to pay for something tasty and filling that won’t attack my waist or my blood glucose level.

Most of us know my favorite dessert in a related, high-calorie form. And some of us think of it as a cheap substitute for a real dessert.

In the form of Jell-O, that’s true. And my favorite dessert is certainly inexpensive, but tasty enough for my taste buds, which haven’t touched Jell-O for years.

I’m talking about the generic form, gelatin. I start with a 7 gram packet of unflavored gelatin that the local Kroger chain sells in a box of 32 envelopes. All of the gelatin’s calories come from protein.

I add the contents of the packet to 4 ounces of cold water and then add 4 packets of SweetLeaf Stevia from Wisdom Brands. This non-caloric sweetener recently won GRAS (generally recognized as safe) approval from the U.S. Food and Drug Administration. Then in goes 1/8 teaspoon or a bit more of salt.

Meanwhile, I boil 8 ounces of water and add it to the gelatin along with 1/2 teaspoon or a bit more TrueLemon. Then I put it in my freezer for 55 minutes to an hour, when it’s ready to enjoy.

Vegetarians might want to use something besides gelatin, which is a protein derived from collagen. Alternatives are agar, seaweed, carrageenan, and konjac.

What are your favorite low-calorie and low-carb snacks and desserts?

This is a mirror of one of my articles that Health Central published. You can navigate to that site to find my most recent articles.

Posted in: Food

Making Blood Glucose Testing Fun

June 16th, 2010 · 1 Comment

If you didn’t think that testing your blood glucose could be fun, you probably haven’t tried Bayer Diabetes Care’s new Didget blood glucose meter.

I hope that you aren’t as poor a speller as I am. If so, you might have thought that Bayer named its new meter for the word that we use to denote a finger or a number. Both meanings make sense when we use fingersticks to test the level of our blood. But most people spell that word “digit.”

The Didget is the first blood glucose meter that connects directly to the Nintendo DS and DS Lite gaming systems. Lots of American kids have an Nintendo, but unfortunately I’m not a kid, so I don’t.

Bayer just sent me at no charge their newest meter, which the U.S. Food and Drug Administration cleared for sale on March 12. Unaccountably, however, the company forgot to include an Nintendo, so I’m still not having any fun testing my blood.

Bayer’s New Didget Meter

But if you have an Nintendo in your home as well as a child with diabetes, this could be the way to go. It awards points that kids can use to unlock new game levels and customize their gaming experience.

Kids ages 4 to 14 are the target audience. The Didget comes with a full-length Nintendo adventure game, “Knock ‘Em Downs World’s Fair.” You can even use the Didget meter separately without using an Nintendo, if you don’t have one yet. My guess, however, is that this wouldn’t be as much fun. Soon it will also connect to Bayer’s Didget World, a password-protected Web community where kids can create their own page and spend points that they earn when they consistently monitor their levels.

The Didget meter uses Bayer’s Contour test strips and takes just 5-seconds and 0.6 microliters of blood. It is now available for purchase in the United States through CVS.com, Drugstore.com, and Walgreens.com. The suggested retail price is $74.99. If it gets your child to test his or her blood glucose more often, this is cheap fun.

This is a mirror of one of my articles that Health Central published. You can navigate to that site to find my most recent articles.

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Posted in: Testing

Vitamin E for Your Fatty Liver

June 16th, 2010 · No Comments

With all the ways that we have now to treat fatty liver disease I don’t understand why any of us still have it. Yet most people with diabetes suffer from this potentially dangerous condition.

Now we have yet another tool in our arsenal against fatty liver disease. It’s a strange one. Not strange as in being unfamiliar, but rather strange as being surprising.

The new tool that may reverse fatty liver disease is vitamin E.

Years ago I had fatty liver disease myself. My late wife had it too. I was able to reverse it, but for her it eventually progressed to cirrhosis of the liver, which killed her three years ago.

Sadly, we didn’t know then how serious fatty liver disease could be and about all the ways to avoid it. I’ve written here how milk thistle and metformin can help. So too can eating a diet high in omega-3 fats. Exercise certainly works, as I know from my own experience. Even a little exercise helps.

The latest word on potential treatments for fatty liver disease saw the light of day a week ago in the advance online edition of The New England Journal of Medicine. Many people consider this the world’s leading medical journal. As of today only the abstract is free online, although I was able to download the full-text yesterday. The NEJM plans to publish the study in the printed journal tomorrow.

Researchers found that vitamin E improved the livers of people who had nonalcoholic steatohepatitis (NASH), which lay people like us know as fatty liver disease. In the study 247 adults with advanced fatty liver disease were randomly assigned to take vitamin E or a placebo (dummy pills) for nearly two years. They found that 43 percent of those treated with vitamin E showed significant improvement in their liver, while only 19 percent of those who received a placebo got better.

The dose was 800 IU of the natural form of vitamin E. The specific form was “RRR-α-tocopherol (formerly known as d-α-tocopherol) vitamin E,” according to the full-text of the research report. [Read more →]

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Posted in: Complications

Who the Empowered Health Seekers Are

June 2nd, 2010 · No Comments

The odds are that you haven’t yet fully empowered your search for good health. I know this about you because a couple of months ago HealthCentral surveyed 2,888 of its registered members who have one of eight chronic conditions, including diabetes, and who completed the study. And in this respect at least people with diabetes are just like the people with the other seven chronic conditions.

HealthCentral CEO Christopher M. Schroeder and James E. Burroughs, associate professor of commerce at the University of Virginia, presented their findings at the DTC National Conference in Washington, D.C. earlier this month and shared them with me. After asking the people in the survey all sorts of standard psychological assessments, they found that about 30 percent of us take an active role in our health care plan. If you are in this group, one of your characteristics is that you are energized and engaged when you need to learn new tasks or master new subjects — you are what the survey calls a person with a need for cognition. If you are an empowered health seeker, the other characteristic you have is self-confidence — you have, in the formal terminology of the survey, high self-efficacy.

You can click to view the study, “Understanding What Motivates the Empowered Patient,” here. Mr. Schroeder and Professor Burroughs prepared it in association with Ted Smith, Ph.D., HealthCentral’s executive vice president for research.

My posts here at HealthCentral and your many comments are just one small corner of this huge health resource. HealthCentral is a collection of condition and wellness websites providing clinical information, tools, and mobile applications. Its sites provide a platform for more than 3,000 bloggers, 200 expert patients, and more than 12 million monthly visitors sharing real-life experiences about specific conditions. [Read more →]

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Posted in: Psychosocial