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Diabetes Developments - A blog on latest developments in diabetes by David Mendosa
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Diabetes Eating on the Wild Side

August 20th, 2013 · No Comments

We are getting better at producing sweet tasting food. Farmers have been breeding ever more palatable fruit and vegetables for 10,000 years. Scientists have been speeding up this process for the past century.

Our food today is more pleasurable than what our ancestors had to eat. It’s generally more tender and less bitter. It is increasingly higher in sugar and starch.

But as we bred taste into our food we unwittingly bred out nutrition. Ever since we stopped foraging for wild plants, we have been getting fewer and fewer phytonutrients from our food. These are the compounds that could help us manage the diseases of civilization — diabetes, cancer, heart disease, and dementia.

It’s too late for us to return to foraging for more than a tiny part of what we eat. I sometimes pick wild raspberries and dandelion greens along a trail, but never get enough for a full meal.

Instead, we can choose those fruits and vegetables that retain much of the nutritional content of their wild ancestors. We can’t all go Stalking the Wild Asparagus that Euell Gibbons wrote about in his 1962 bestseller about living off the land. But we can go “eating on the wild side,” which Jo Robinson writes about in her new book of that title.

“We can choose those select varieties of fruits and vegetables that have retained much of the nutritional content of their wild ancestors,” Ms. Robinson writes. “One of the most important discoveries of twenty-first-century food science is that there are vast nutritional differences among the many varieties of a given fruit or vegetable.”

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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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Using Marijuana to Manage Diabetes

June 30th, 2013 · 4 Comments

When I stopped smoking marijuana, I got diabetes instead. Maybe the timing was just a coincidence, but a new study indicates marijuana and diabetes may be connected.

Between 1972 and 1984 I was a heavy marijuana user. But I wasn’t heavy. In fact, in 1972 under the influence of marijuana I was able for the first time to manage my weight while becoming much more active. Then, I became an editor of a business magazine where I sat on my butt for long working hours every day, stopped using pot, and gained back all the weight I had lost under the influence of that illegal drug.

I was addicted to marijuana. Stopping was one of the hardest things I ever did, but as my cough got worse over the years I knew that I had to stop to save my health.

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Why People with Diabetes Need to Avoid Statins

June 23rd, 2013 · 2 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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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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From the Garden

June 9th, 2013 · No Comments

From the Garden

In 2001, when Rich Pirog wrote that our food typically travels 1,500 miles from the farm where it is grown to where we actually eat it, he got many of us thinking about where our food comes from. I remember that thought reaffirmed my long-standing passion to eat locally grown food that might help me better manage my type 2 diabetes. And no food that I eat is more local than the vegetables I grow in my own garden.

Pirog, then the education coordinator at Iowa State University’s Leopold Center for Sustainable Agriculture, presented his research in an obscure report. But it attracted nationwide attention.

A “food mile” is the distance food travels from where it is grown or raised to where it is ultimately purchased. Pirog used this measurement as a simple metaphor to contrast local versus global food systems and their resulting fuel usage and levels of greenhouse gas emissions. However, he does recognize the limitations of focusing only on “food miles,” noting that food grown far away from our table isn’t always harder on the environment than locally grown food. Higher food miles for some foods don’t always translate into higher energy use, he says. And foods grown locally in greenhouses might use more energy than foods grown in open fields and transported across the country.

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Intermittent Fasting for Diabetes Control

June 7th, 2013 · 5 Comments

Intermittent fasting is older than civilization. Our paleolithic ancestors certainly practised it in times of scarcity whether they wanted to or not. And for centuries many people have fasted for cosmetic or religious reasons. But only now is intermittent fasting getting the respect that its health benefits for people with diabetes warrant.

Case in point: The current issue of The British Journal of Diabetes and Vascular Disease, a bimonthly peer reviewed journal read by scientists, diabetologists, endocrinologists, cardiologists, and vascular surgeons (and a few writers like me) includes a positive review of  “Intermittent fasting: a dietary intervention for prevention of diabetes and cardiovascular disease?

Publishers sometimes make the full-text of their most important articles free online. In this case the publisher announced that it would be “available to access for free for a limited period,” and as I write it is still free. In fact, it is currently this journal’s “most read” article.

The benefits of intermittent fasting for weight loss are established, according to the three authors of the new review. They are researchers at two universities in Birmingham, England. Intermittent fasting also helps reduce the risk of heart disease. Beyond these benefits, the researchers studied intermittent fasting to see how well it works to treat obesity and type 2 diabetes.

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Diet and Exercise for Diabetes Management

June 4th, 2013 · No Comments

One of the wisest researchers who I know writes that exercise won’t help us to lose weight. But in my experience it does, and weight loss is crucial for almost all of us who have diabetes, because our weight is a big factor in high blood sugar levels.

“Appetite and thus calories consumed will increase to compensate for physical activity,” writes Gary Taubes in Good Calories, Bad Calories. When I read the first edition of this book in 2007, it finally convinced me that I could control my diabetes and my weight on a very low-carb diet. It worked: my current A1C is 5.4 and my current BMI is 19.2. Both of these numbers are big improvements over what they were six years ago.

In his subsequent book, Taubes elaborated on his statement. This doessound persuasive.

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Eating Attentively to Manage Diabetes

June 2nd, 2013 · No Comments

Carefully counting calories can help those of us who have diabetes lose weight. But the discipline and effort involved in monitoring our calorie intake over a period of months or years is a lot of work, and few of us can keep it up for long. For this reason the average amount of weight that people lose typically slows down after a few months.

A huge proportion of people with diabetes need to lose weight. The percentage is far higher than that of the general population. For years before and after I learned in 1994 that I have diabetes, my own weight was far too high, and this probably had a lot to do with my getting diabetes in the first place and certainly made managing my diabetes a lot harder than it had to be.

Much easier and perhaps just as effective than counting calories are strategies focusing on attentive eating. We have several such tools at our disposal, several of which I have written about here previously. They include mindfulness training, slow eating, and food habituation (eating the same stuff day after day).

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Reducing the Mental Stress of Diabetes

May 16th, 2013 · No Comments

Having diabetes can be stressful both physically and mentally. We focus most of our attention on reducing our physical stress through medication, diet, and exercise.

We often ignore the tools at our disposal for reducing the mental stress that physical stress usually carries in its wake. The good news is that working with the tools at hand for dealing with mental stress are even easier to apply than those we have for dealing with physical stress. And some of these tools are free.

Earlier, I have written here how one of these tools, meditation, has reduced the mental stress that came with my diabetes diagnosis. Many thousands of other people have also benefited from the Mindfulness-based Stress Reduction program that Dr. Jon Kabat-Zinn started in 1979 at the University of Massachusetts Medical School. It is an eight week course combining meditation and yoga to help us cope with stress, pain, and illness by using moment-to-moment awareness.

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