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

November 24th, 2013 · 1 Comment

Like everyone else, those of us who have diabetes need to prepare for emergencies. But because we have more and different needs, we have to do more than just think about what could go wrong. Sadly, that’s what most people do.

Some people have set aside stores of food and water. But only about 10 percent of American households are prepared for an emergency. Yet climate change and increasing weather extremes are creating more and more emergencies.

The United States experienced an average of 50 natural disasters each year in the previous decade — more than 560 in total — according to the records that the Federal Emergency Management Agency, or FEMA, keeps of “major disaster declarations.” Already in the first three years and 10 months of this decade FEMA declared 280 major disasters, an average of more than 73 per year.

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The Trouble with Peanuts in Managing Diabetes

November 18th, 2013 · 3 Comments

If you have diabetes, beware of peanuts, peanut butter, and peanut oil.

Some people think that because most tree nuts, like almonds, are so healthy, that peanuts should also be good for us. But peanuts aren’t nuts at all. They are a legume, and unlike most nuts we can’t eat them raw.

Actually, we can’t eat them at all if we want to avoid some of the side effects that we can get from them. Some of these side effects can be quite serious.

I can think of only nine reasons why we have to avoid peanuts or anything made from them. Maybe you can think of more, but these eight might be enough to give anyone pause:

1. Peanuts have a lot of carbohydrates, which raise our blood sugar level. Take a look at the US Department of Agriculture’s National Nutrient Database, which is the gold standard of nutrient facts and is fortunately back online today now that the government shutdown has ended. When you exclude the water content in peanuts, they are 37 percent carbohydrate, 39 percent fat, and 24 percent protein.

“One tablespoon of natural, unsweetened peanut butter contains 3 grams of carbohydrate and will raise my blood sugar 15 mg/dl,” writes Dr. Richard K. Bernstein in the 2011 edition of his book Dr. Bernstein’s Diabetes Solution. “Imagine the effect on blood sugar of downing 10 tablespoons!”

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The Best Snack for Weight Loss and Diabetes

November 11th, 2013 · No Comments

Almonds are both my favorite snack and trail food. In fact, lately I seldom eat anything else between meals or on trails.

Unlike some other tasty nuts like cashews, almonds are much lower in carbohydrates, which are the part of our diet that is almost solely responsible for raising our blood sugar level. Nothing else in our diet is more important for managing our diabetes than keeping that level in check.

Some other nuts have a somewhat more favorable ratio of those super-healthy monounsaturated to polyunsaturated fats than almonds. But I avoid them as a matter of taste. I can eat macadamia nuts nonstop until the container is empty, but my body gets so full that I can easily put on a few pounds. On the other hand, I don’t particularly appreciate the taste of other healthy nuts like pecans or walnuts.

As a trail food nothing can compare with any sort of nuts. They can withstand rough handling in our packs and require no refrigeration. But when I’m at home, I keep my snacking almonds in the freezer. Raw almonds are sometimes too soft for my taste, but eating them right out of the freezer gives them that degree of crunch that I appreciate.

Two big reasons why almonds have become my only snack and trail food are weight loss and diabetes. After traveling almost all summer, I’m struggling to take off the last few pounds that I gained on my trips. I stick with almonds for my diabetes because they are one of the most carb-friendly snacks.

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The Top Ten Diabetes Terms

November 5th, 2013 · 4 Comments

This post is a text preview of a slideshow that my associates at HealthCentral will be preparing next week. This is my way of explaining the most important terms that we have to live with non-technically in 65 words or less each.

Insulin Resistance
When you need more insulin than the beta cells of your pancreas can provide, glucose builds up in your blood instead of going into the cells in the rest of your body. This resistance to your own insulin causes high blood glucose, which doctors call hyperglycemia. It can lead to prediabetes, which in turn can lead to diabetes, if you don’t change your lifestyle.

Type 2 Diabetes
When the cells of your body are resistant for several years to the insulin that the beta cells of your pancreas makes, they compensate by making more insulin. Eventually, however, they works so hard that they can’t keep up and begin to die off. That’s when you get type 2 diabetes, formerly called adult-onset diabetes. But now, even children are getting it.

Type 1 Diabetes
If you have type 1 diabetes (formerly called juvenile diabetes), you usually aren’t resistant to the insulin that your beta cells make. Instead, something else, perhaps an infection, kills most of the beta cells so the rest of the cells in your body get little or no insulin that your body makes. To make up for this lack you have to take insulin shots.

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Dangers of Sulfonylureas for Diabetes

October 28th, 2013 · No Comments

If you doctor started you on one of the sulfonylureas to manage your diabetes, you may be significantly more likely to die early than if you take metformin. Research presented on Wednesday showed that among more than 92,000 people in the United Kingdom with type 2 diabetes those who took only sulfonylureas were 58 percent more likely to die from any cause than those who took only metformin.

The research is in an abstract, “Association between first-line monotherapy with sulfonylurea versus metformin and risk of all-cause mortality,” presented at the annual meeting of the European Association for the Study of Diabetes in Barcelona, Spain. The findings are preliminary because they haven’t been published in a peer-reviewed journal. And since the findings come from an observational study, the higher risk of death might be that doctors prescribed a sulfonylurea to sicker people. Another concern might be that Bristol-Myers Squibb, which sells Glucophage, a brand of metformin, provided financial support for the study.

Lots of us still take one of the sulfonylureas, which was the first oral drugs to help us manage type 2 diabetes. For more than half a century we have been using them — a class of drugs that includes Amaryl (glimepiride), Glucotrol XL (glipizide), and glyburide.

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The Key Diabetes Test Bites the Dust

October 27th, 2013 · 4 Comments

A spokesperson for Bayer Diabetes Care today confirmed that the company will stop making the device that is the best way we have to check our key blood glucose level.

When I called Susan Yarin, the spokesperson for Bayer’s diabetes care business, I asked her about the rumor that Bayer would stop making the A1CNow device at the end of the year. This device is the only way that we have to check our A1C levels at home and get immediate results.

“It’s not a rumor,” Ms. Yarin replied. “I can confirm it.”

She told me that Bayer would be closing down the facility that produces the A1CNow at the end of the year. A1CNow units “will be available as long as supplies are available.”

I told her that I was dismayed and that, since I check my A1C level on the first day of every month, I had just ordered A1CNow+ units that Bayer makes for professionals. This is the same as the A1CNow SelfCheck that Bayer makes for patients and sells in pharmacies, except the professional version includes 10 tests while the patient version includes two tests. I purchased the 10-pack kit (1 monitor and 10 test cartridges) from A1CTest for $129.00 plus $8.95 shipping and handling. That works out to $13.80 per test. Most pharmacies sell the A1CNow SelfCheck for about $30, which is $15 per test plus tax.

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A New Audible Meter for People with Diabetes

October 19th, 2013 · No Comments

Most blood glucose meters are either pretty basic and inexpensive or offer lots of features at considerable cost. But one meter comes with a low price tag and yet does more than any other.

For those of us who have limited vision or are blind this meter is a godsend. It is the second generation Solus V2 meter from BioSense Medical Devices in Duluth, Georgia.

I reviewed its predecessor, the Solo V2, three years ago at “A New Talking Meter.” BioSense changed the name slightly and improved a fine meter even more. The V2 in the name of both the original and new meter refers to vision and voice, not version. In fact, however the Solus V2 is also the second version of the talking blood glucose meter from BioSense.

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Diabetic Grain Brain

October 11th, 2013 · 6 Comments

Later this month a renowned neurologist will publish an important book about how wheat, carbs, and sugar are destroying our brains. While all of us have some interest in our brains, what could this have to do with diabetes?

The connection is actually too close for comfort. Having diabetes doubles your risk for Alzheimer’s disease, the most dreaded form of dementia. In fact, many people, like Mark Bittman in The New York Times, are beginning to say that Alzheimer’s is type 3 diabetes. You may also want to read “Alzheimer’s Disease is Type 3 Diabetes” in the Journal of Diabetes Science and Technology.

Adding dementia to the well known list of complications of diabetes is enough to give anyone pause. But not to worry. Diabetes doesn’t cause anything, as I wrote here two years ago at “Diabetes Causes Nothing.” Well managing diabetes is the leading cause of nothing. Poor management causes all of these complications. Including Alzheimer’s.

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Painless Diabetes

October 3rd, 2013 · 6 Comments

The trouble with diabetes is that it doesn’t hurt. Because it is painless, most people who have diabetes think that they can ignore it. After all, anything that is serious would hurt a lot, right?

Wrong.

The pain comes later with the complications of diabetes that come in its wake, sometimes years later. Some of these complications hurt a whole lot. Think of the continuous pain of diabetic neuropathy, one of the most common complications of diabetes. Or think of the sharp pain when you get a heart attack.

Diabetes is the most insidious disease anyone can get. A dictionary definition of insidious is one that develops “so gradually as to be well established before becoming apparent.”

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The Bad Fats for Diabetes

September 30th, 2013 · No Comments

All of us know that we need to avoid the bad fats. But nobody is quite certain yet which of the fats are bad for us. A new study of saturated fats helps to clear up the confusion.

Bad fats are those that are bad for our hearts. Nothing is more important for those of us who have diabetes, because heart disease is the most serious and common complication that we face.

The scientific community does agree that one type of fat is quite bad for our hearts. The bad guys are the trans fats that we made in large amounts in the previous century from partially hydrogenated vegetable oil. In 2001 a large study that I reviewed then began to wake us up to the dangers of this artificial fat. These findings and subsequent government pressure on manufacturers and the spread of knowledge has substantially reduced the amounts of trans fats in the American diet.

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