When we want to use a natural no calorie sweetener, we have had only a Hobson’s  choice. Until now.

But about two weeks ago another natural no calorie sweetener began to be available in supermarkets and supercenters like Wal-Mart and Target. This new sweetener is ready to challenge stevia, which previously had been our only such choice. Nectresse (pronounced neck-TRESS) is the name of the new sweetener.

I have started using Nectresse myself, and while I have a few reservations about it, this new sweetener promises to be big. It comes from McNeil Nutritionals, which also markets Splenda, the nation’s top selling low calorie sweetener.

Another reason why I’m sure that Nectresse will be big is the marketing muscle behind McNeil Nutritionals. This rather low-profile company is one of about 230 subsidiaries of Johnson & Johnson. Another J&J subsidiary that many of us are familiar with is LifeScan, which makes the OneTouch meters and test strips that many people with diabetes use.

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To think like a pancreas is to come as close as possible to matching your insulin level to what your body actually needs. This is what your body would do automatically if you didn’t have diabetes. But with a little help from insulin injections or an insulin pump and a lot of guidance about how to use insulin you can do it.

Guidance aplenty is what Gary Scheiner serves up in the completely revised and updated second edition of his most appropriately titled book, Think Like a Pancreas. When I reviewed the first edition in 2004 for my “Diabetes Update” newsletter, it was great, but this edition is both better and more comprehensive. It can guide its readers to learn how to match the amount, timing, and type of insulin that they take to their needs.

The proper timing of insulin injections has always seemed to be to be one of the trickiest aspects of insulin use. That’s why in 2007 I asked Gary to write a little article about it for my website. His article, “Postprandial Hyperglycemia: It’s All in the Timing,” covers the basics of insulin timing. But Think Like a Pancreas covers it completely.

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If you take insulin injections to manage your diabetes, you know how important it is. You also know that taking the right amount at the right time is tricky.

If you are using an insulin pump, you know that you can get even better control over your diabetes. Research studies show that people on pumps have lower A1C levels, fewer hypos, and less variability in their blood sugar than those who use multiple daily injections. A pump provides precise delivery of insulin, more flexibility, and greater convenience. But pumping insulin can be even trickier than injecting it.

Anyone who uses an insulin pump or is considering one needs to read Pumping Insulin by John Walsh and Ruth Roberts. They have just come out with the fifth edition of this key guide. You and I know that when you do something five times you must be awfully good or awfully bad at it. I can’t think of any other book for people with diabetes that has gone through five editions and very few that are this good.

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If my article on Chia Seeds that I wrote here in 2007 didn’t convince you to eat them regularly, probably nothing will. Of the more than 600 articles that I’ve written here, that article is probably the one that received the most attention. Certainly it has received the most comments — 134 so far — and almost all of them are positive.

But now I am trying again. And this time I have more support from the man who rediscovered this ancient Aztec superfood. He also developed the system currently used to harvest and clean chia seeds.

Dr. Coates Races

That man is Wayne Coates, Ph.D., professor emeritus in the Office of Arid Land Studies at the University of Arizona. His latest book is Chia: The Complete Guide to the Ultimate Superfood. This 190-page trade paperback is available on his website for $12.95.

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All of us who have diabetes need some devices to help us manage. But each of us need different devices.

Every one of us needs a blood glucose meter. Some of us need continuous glucose monitors, insulin pens, and insulin pumps. But depending on our individual differences we need different makes and models of these devices.

We are lucky to have a wide variety of devices to choose from. About 40 companies offer us about 100 different blood glucose meters. These meters are more and more sophisticated, but the shear number of choices we have can be daunting while still being a good thing for our individuality.

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We will soon be able to take the first new diet drug since 1999 when the U.S. Food and Drug Administration approved Xenical, known generically as orlistat. The FDA approved the new drug, Belviq, known generically as lorcaserin hydrochloride, on June 27. The manufacturer, Switzerland’s Arena Pharmaceuticals, hopes to have it on the market here early next year.

But those of us lucky enough to have type 2 diabetes already had our choice of three diabetes drugs that help us manage our blood sugar and happen to help us lose some weight. While people who used these drugs in clinical trials typically didn’t lose quite as much weight as those who used Belviq, the unwanted side effects of the three diabetes drugs tend to be much less serious.

Taking Belviq won’t be a free ride. The FDA approved it for people willing to eat less and exercise more.

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If we hit diabetes hard at first, our bodies will keep on making insulin for a long time.

That’s the gist of study by researchers at the University of Texas Southwestern Medical Center. The full text of the study, which will appear in the July issue of Diabetes Care, is online at “β-Cell Function Preservation After 3.5 Years of Intensive Diabetes Therapy.”

Their research shows that when people who just found out that they have type 2 diabetes take either insulin injections or a combination of three oral medications right away they manage their diabetes better. With either of these two intensive treatments our beta cells keep on making the insulin we need for as long as the researchers studied us, three and a half years.

But the standard guidelines recommend going much slower. They suggest a stepwise approach.

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A new medication that those of us who have type 2 diabetes take only once a week can bring our A1C levels way down. It can also help us to lose weight, something that almost everyone who has type 2 diabetes needs to do.
But predicting who will lose weight isn’t easy. Only one thing stood out in the clinical trials.

The new medication is Bydureon, which we have been able to get in our pharmacies for only the past four months. But Amylin Pharmaceuticals, which developed Bydureon, presented a study at the American Diabetes Association’s annual convention earlier this month that shows both glycemic and weight loss control data for people taking Bydureon for the past four years. Those were the people taking the drug in the clinical trials leading up to the U.S. Food and Drug Administration’s approval at the beginning of this year, as I wrote here in “Bydureon Approved Today.”

Bydureon is the latest in a new class of drugs called GLP-1 receptor agonists. Its generic name is exenatide, and it has the same active ingredient as Byetta, which we have been able to get since June 2005 and requires twice-daily shots.

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People who have diabetes and are severely overweight are deciding more and more often that bariatric surgery is just the thing for them. Although it is expensive and like any surgery it can have complications, the amount of weight that they lose is usually dramatic and their diabetes often completely disappears.

Some people, including a couple of my friends, have had wonderful results from bariatric surgery. But not everybody benefits.

If you are morbidly obese, I’m sure that you have considering bariatric surgery. But how can you tell what the chances are that it will work for you?

A study presented yesterday at the annual meeting of the American Society for Metabolic and Bariatric Surgery can help you decide. Richard A. Perugini, M.D., a bariatric surgeon at the University of Massachusetts Medical Center in Worcester, was the lead study author and presented the findings of his team at the annual meeting. The abstract of the study, “Predictors for Remission of Type 2 Diabetes Mellitus Following Roux En Y Gastric Bypass,” is online.

Graphic of a Roux-en-Y gastric bypass connection
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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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