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

The New York Times: “Is Sugar Toxic?”

May 21st, 2011 · 1 Comment

In 1961 I started to read The New York Times when I went to work in Washington. But its magazine always disappointed me.

Until Sunday. This week’s issue focuses on “Health and Wellness 2011.” All four of the magazine’s main articles are essential reading for everyone.

The cover story by Gary Taubes, “Is Sugar Toxic?,” makes the case against sugar. This isn’t his first time to tilt at the medical establishment in this magazine. Nine years ago his article, “What if It’s All Been a Big Fat Lie?,” began his crusade to expose the myth that fat was bad and carbohydrates are good.

His 2007 book, Good Calories, Bad Calories, built on that article so well that it convinced me and thousands of others to follow a very low-carb diet. In “Addicted to Carbs” I wrote here three years ago about how that book changed my life. With his book, Why We Get Fat: and What to Do About It, Taubes takes his argument to a wider, non-scientific audience.

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Posted in: Diabetes Diet, Exercise For Diabetes

Study: Healthy Fasting Reduces Risk of Heart Disease, Diabetes

May 11th, 2011 · 5 Comments

Regular readers may remember that I reported here on earlier studies about some benefits from intermittent fasting. But a study reported yesterday shows that fasting also lowers the risk of heart disease and diabetes and increases the good HDL cholesterol and reduces triglycerides, weight, and blood glucose levels. It also increases the bad LDL cholesterol.

Research cardiologists at the Intermountain Medical Center Heart Institute in Murray, Utah, reported these finds at the annual scientific sessions of the American College of Cardiology in New Orleans. Tomorrow’s issue of the Journal of the American College of Cardiology will print the results of this study led by Dr. Benjamin D. Horne, Intermountain’s director of cardiovascular and genetic epidemiology.

LDL went up by 14 percent and HDL by 6 percent. But the increase in cholesterol from fasting is probably not a bad thing, as Dr. Horne explains.

“Fasting causes hunger or stress,” he pointed out. “In response, the body releases more cholesterol, allowing it to utilize fat as a source of fuel, instead of glucose. This decreases the number of fat cells in the body. This is important because the fewer fat cells a body has, the less likely it will experience insulin resistance or diabetes.”

Dr. Horne’s team conducted two fasting studies. One included more than 200 people. Another included 30 people who only had water for 24 hours and then studied for another day. During this additional 24-hour period the researchers subjected the subjects to blood tests and other physical measurements.

Now I have the incentive to get back to intermittent fasting. Just as soon as I finish the fish in my fridge.

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: Diabetes Complications, Diabetes Diet

Embrace Diabetes Support Groups for a Healthy Lifestyle

May 11th, 2011 · 2 Comments

If you have ever participated in a diabetes support group, you probably know that it helps you to stay in control of your diabetes. While I don’t know of any research that will prove this, a new study shows that group support meetings offer remarkable benefits for people who have pre-diabetes. If group support helps people who have pre-diabetes, it is probably much more likely to help those of us who are already burdened with this condition. For most people I know who have pre-diabetes this is just one more thing to deal with. Sometime.

Those of us who have diabetes know that we have to deal with it. Every day. But some people who have diabetes still don’t take advantage of the support that other people can give them. For some of us diabetes is something to keep quiet about, either out of shame or concern that our employers might cause them problems. Or because their health insurance rates might go up.

Some of these concerns are certainly legitimate. But when we ignore the social advantages of sharing, we ignore the support we can get from friends in similar situations.

More and more of us are choosing a third alternative, online support. Groups like MyDiaBlog can help anyone with diabetes, even those among us who can’t or won’t share with local groups.

The study of people with pre-diabetes who have benefited from support groups that prompted these thoughts comes to us from Australia. Between 2005 and 2009 the Victorian Department of Health recruited 300 people from both the big city of Melbourne and the rural community of Shepparton to see if community meetings are as good for health as they are for making friends.

They are. The bottom line is that people who attended regular meetings had a 43 percent success rate in reversing their pre-diabetes within six months of learning that they had it. By comparison, only one quarter of the people who had learned that they have pre-diabetes in that time but only had the support of their doctor succeeded.

Swinburne University of Technology in Melbourne evaluated the study and reported it in the March 2011 issue of Swinburne Magazine. This article says that the Victorian Department of Health is taking these positive findings a step further by rolling out a state-wide program.

The question is whether people here who already have diabetes will take the further step to get valuable support from others.

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: Psychosocial

Preventing Blindness with Omega 3

April 28th, 2011 · No Comments

Diabetic retinopathy is a leading cause of blindness, one of the most serious complications of diabetes. But omega 3 fatty acids can help protect us from it. Fish oil, particularly from fatty fish like salmon and sardines, is our best food source of omega 3. Capsules of fish or krill oil are a good choice for people who don’t eat much fish.

Omega-3 fatty acids are highly concentrated in the retina, the light-sensitive tissue that lines the inner surface of our eyes. But the typical American diet is awfully low in omega-3 and high in omega 6, which competes with omega 3 to get into the cells of our bodies, as I wrote here last year.

We’ve known from studies of mice that omega 3 can prevent retinopathy. When researchers fed mice diets rich in omega 3, the mice had nearly 50 percent less pathologic vessel growth in the retina than mice fed diets rich in omega 6. But many of us, myself included, discount mice studies, because we are men and women, not mice, and all of us are much bigger and many of us are much brighter.Now a study from a research team at Children’s Hospitl Boston shows the way omega 3 protects mice — and hopefully us people — from blindness. A recent issue of Science Tranlational Medicine reported this study. The researchers isolated the specific omega-3 compound that has beneficial effects in mice. Technically, it is a metabolite of the omega-3 fatty acid DHA, known as 4-HDHA), and the enzyme that produces it (5-lipoxygenase, or 5-LOX.

For people with diabetes this is important research. “Between 40 to 45 percent of Americans diagnosed with diabetes have some stage of diabetic retinopathy,” according to the National Eye Institute. “The longer someone has diabetes, the more likely he or she will get diabetic retinopathy.”

Now, we have a much better chance of stopping diabetic retinopathy in its tracks. The first line of defense is our diet, specifically increasing the amount of omega 3 and reducing how much omega 6 fatty acids we eat.

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: Diabetes Complications, Diabetes Diet

Comparing Weight Loss on a Program or Alone

April 23rd, 2011 · No Comments

Almost all of us who have diabetes have to struggle with our weight. So, wouldn’t it be easier with a formal weight loss program?

Probably not, according to the results of a presentation to the Fourth International Congress of Behavioral Medicine in Washington, D.C. The National Weight Control Registry just brought this unpublished study to my attention.

The National Weight Control Registry is the largest prospective investigation of long-term successful weight loss maintenance. It tracks the progress of more than 5,000 people who have lost a lot of weight and have kept it off for a long time. I am one of those people whom it tracks.

Actually, I don’t consider that the registry’s standards are all that high. To join you only have to show that you have lost at least 30 pounds and have kept it off for at least a year.

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Posted in: Diabetes Diet

Why We Check Our Blood

April 18th, 2011 · 2 Comments

With all the emphasis on how we check our blood glucose levels using all the new meters that we can choose from, many of us who have type 2 diabetes forget or never learned why we check our levels. Anyone who has type 1 diabetes has to know why he or she checks as do those type 2s who uses insulin. Those of us who inject insulin check their levels so they can take more if their levels are too high or take a glucose tab or something similar if they are too low.But three-fourths of all type 2s don’t take insulin. Some of them still use the first oral medication, one of the sulfonylureas that can cause hypos, a level below about 70 mg/dl. Then they too will need to take something like a glucose tab to bring their level back to normal.

The overwhelming majority of all people who have diabetes rarely if ever get hypos. So why should they go through the trouble of checking their blood glucose? What can they do with that information?

If our doctors and nurses ever told us why, most of us have forgotten by now. As a result, a lot of people with diabetes don’t bother at all any more with blood glucose checks.

That’s a shame, because even people who don’t use insulin or one of the sulfonylureas, can benefit from checking if they do it at the right time.

The most right time is after eating a big meal, especially one that has a substantial amount of starch in it. Nothing raises our blood glucose level as much and as fast as starch — the stuff in potatoes and grains and grain products, like bread, bagels, pizza, or anything made from wheat flour.

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Posted in: Diabetes Testing

Which Blood for Checking Glucose

April 5th, 2011 · 2 Comments

The blood that we need to use to check our blood glucose levels may seem obvious. After all, it’s a check, not a test to pass or fail. We need to use our own blood, not blood borrowed from a friend or foe.

But until now some basic questions about blood glucose testing haven’t had a tested answer. They do now with the publication of a study in this month’s issue of Diabetes Care, a professional journal of the American Diabetes Association.

The abstract of the study, “Self-Monitoring of Blood Glucose: The Use of the First or the Second Drop of Blood” is free online. My friend Dr. Bill Quick, who also writes about diabetes for HealthCentral, sent me the full text of the study.

The seven Dutch diabetes professionals who researched basic questions about blood glucose testing recruited 123 people with diabetes. They checked the variability of their blood glucose testing results in four different situations:

1. When they did or did not wash their hands

2. After they handled fruit (specifically apples or bananas)

3. After washing their fingers that had touched the fruit

4. And two different amounts of pressure applied to their fingers — squeezing

Their conclusions were simple and straightforward. But now for the first time we have them based on the actual experience of real people who have diabetes:

1. We don’t have to waste a drop of blood to use a second drop — but only if we wash our hands first.

2. But when we aren’t in a position to wash our hands and they aren’t particularly dirty or exposed to something that has sugar in it, testing with a second drop of blood will work.

3. Which finger we use doesn’t matter.

4. When we apply heavy pressure — meaning squeezing a lot — we can get unreliable results.

“The first choice is to wash the hands with soap and water, dry them, and use the first drop of blood,” the authors wrote. “Firm squeezing of the finger should be avoided.” The authors admitted that they had a hard time defining the difference between firm and light squeezing.

Strangely, the study did not look at the old recommendation that we should use alcohol to clean our fingers. Maybe they read my review of the Clever Chek meter, which I wrote here in November 2007. I hope that I disposed of the myth that it’s better not to use alcohol.

“The [Clever Chek] packaging includes a box of ‘Alcohol Prep Pads,’” I wrote then. But, “Any alcohol on the skin may interfere with your test result, so the experts don’t recommend that you use alcohol prep pads routinely. Only where you don’t have warm water is it a good idea to use alcohol to clean the test area. And be sure to air dry it well before testing.”

Now, let’s all go and test our blood glucose with confidence that we know what we are doing.

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: Diabetes Testing

Diabetes Social Networking

March 27th, 2011 · No Comments

The social network space for people with diabetes lags well behind the Internet’s superb ability to provide information. Websites like HealthCentral far exceed the older sources of information that we have — including our health care teams, our books, and our magazines — in the quantity and often even the quality of information that we seek about diabetes.

But the Internet hasn’t been doing a good job in connecting the real people who have diabetes with other real people. Those of us who have diabetes often feel isolated from our communities because of the special need we have to control our condition. Many of us, particularly those who live in small towns or rural areas, don’t have anyone with whom to discuss our dietary, activity, and medication requirements.

Local support groups often fail to provide positive reinforcement when they exist at all. Many of us in fact lack that option within a reasonable driving distance.

Support and communication are functions that the Internet can provide to people with diabetes on a much larger scale than even the best local support groups. But even the so-called social networking sites are instead top heavy on information.

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Posted in: Psychosocial

My Goals

March 20th, 2011 · No Comments

Until now, I haven’t shared much of my goals. What I have shared is information — some of the things that I have learned about diabetes in the years since I was diagnosed with type 2 in 1994.

I also once shared my ideas on how to write, because that’s what I do. You can read my article, “My Style” here. And since photography is a passionate hobby of my I share my photo essays on my “Fitness and Photography for Fun” blog. I’m writing today from Florida where I visited our Dry Tortugas and Biscayne National Parks and today am photographing birds, alligators, and other wildlife in the Everglades National Park. I share my photo essays because I want to inspire everyone who has diabetes to get the activity we all need by doing what we love to do.

A Purple Gallinule This Morning

But until now, I haven’t really told you where I am coming from. A couple of people from Chicago named Jenny and Jannick dragged it out of me when they interviewed me last week. They posted the interview on their website, “Julio’s Sol, Our Dream is to Make Yours a Reality.” Their interview with me is on this web page.

Jenny and Jannick told me from the first that they wanted to interview people who had a passion driving their life. I told them when they interviewed me that my passion is helping people with diabetes. I hope that I am helping you.

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: Psychosocial

Testing Both Blood Glucose and Blood Pressure at Home

March 20th, 2011 · 10 Comments

Since three-fourths of those of us who have diabetes also have high blood pressure, a combined blood glucose and blood pressure monitoring device makes a lot of sense. Years ago I reviewed basic devices here, but now we have the
chance to use something that seems to approach the sophistication of the devices that nurses regularly use in doctors’ offices. And is probably even better.

The Fora D20 has a regular arm cuff attached to the device that measures either our BG or our BP. This gives me more confidence than the basic devices that previously were all that we had for monitoring our blood pressure at home.

I don’t automatically assume that doctors and their nurses can take better care of our medical needs than we can ourselves. Clearly, we have a greater interest in our own health.

But with blood pressure testing even more considerations come into play. We can do it better at home.

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Posted in: Diabetes Testing

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