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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

Does Caffeine Cause Blood Sugar Changes?

May 17th, 2011 · 7 Comments

The first thing I did after reading the new study that caffeine can increase our blood glucose level was to switch to drinking green tea. The second thing I did was to switch again — this time to decaffeinated green tea.

I overreacted. Several years ago I had switched from coffee to Darjeeling tea, which has about half the caffeine per cup. While green tea has even less, I don’t like it much and only drink it rarely. I disliked the decaffeinated green tea so much that I threw out the package after taking the first sip.

Now, I’m almost entirely back to Darjeeling tea. People call it a black tea, although it is light-colored and is technically more oolong than black and is therefore lower in caffeine than true black teas.

While I control my blood glucose level, I’m not a purist. I have to enjoy everything that I eat or drink. While my diet includes no starch, sugar (no sucrose or high-fructose corn syrup), salt, or alcohol, except occassionally when I eat out, I don’t miss any part of this standard American, or SAD, diet. My recent A1C result was 5.3 percent.

Caffeine may well raise my blood glucose level. But after carefully reading the new study, I doubt it.

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Posted in: Diabetes Diet

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

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

Low-carb Chili

March 4th, 2011 · 1 Comment

Beef chili is the new comfort food. This simple and familiar meal gives many Americans a sense of well-being.

The combination of beef, beans, and spices is as American as apple pie and much healthier. Particularly out here in the West where I live, beef chili is as informal as the people, something that goes better with blue jeans than with a coat and tie or a string of pearls.

When I travel the small towns of the West, I can usually count on beef chili to be on the lunch or dinner menu. If I find it, you can count on me to order it.

I’ll do that even though I know that the typical beef chili will be too high in carbs and salt. I also generally avoid beans now that I follow the paleo diet. But beef chili deserves to be the exception that makes eating a comfort.

Now even when we travel, we no longer need to settle for second-rate chili that is loaded with carbs that are sure to raise the blood glucose level of anyone who has diabetes. We can take first-rate chili with us.

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Phil’s Paleo Diet

February 4th, 2011 · 14 Comments

My friend Phil is a member of the diabetes support group that has been meeting every month in my apartment for the past couple of years. We are a group of people dedicated to tight control of our diabetes. Most of us follow a very low-carb diet and that way have found much better health.

For the past half year or so I have been following a type of low-carb diet that I learned from Dr. Loren Cordain, a professor at Colorado State University, which is about an hour north of where we live in Boulder. Dr. Cordain’s book, the Paleo Diet, overlaps considerably with the standard low-carb diet for people with diabetes, Dr. Bernstein’s Diabetes Solution. Dr. Cordain graciously waived his usual speaking fee when I asked him to speak to our diabetes support group and other local groups at the local hospital.

Besides myself since then several members of our diabetes support group, including my primary care physician, have begun to follow both then low-carb and paleo way of eating. Another member of the group asked each of us to write about what we eat. Phil’s response was so good that I’m forwarding it here with his permission.

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Indigenous Diabetes

January 16th, 2011 · 3 Comments

Diabetes is the scourge of civilization. A disproportionate number of people living in the most advanced societies suffer from it.

But the people who suffer the most are the original inhabitants of the lands that the Western societies occupied. Whether they are the Native Americans, people of Canada’s First Nations, Australia’s Indigenous population, or other conquered peoples, the result everywhere has been the same — lots of diabetes.

The reason why is no mystery. The conquerors destroyed the indigenous cultures, often intentionally but with what they thought were good intentions. By punishing students in native schools for using their own language, by attacking native religion, and by extolling the wonders of Western food, the victors hoped to integrate the defeated into mainstream culture. Instead, they marginalized the defeated from both their own culture and from that of the West.

Decrying their food choices of the defeated misses the point, as Sousan Abadian elucidates in her Harvard University Ph.D. dissertation. The point is that they suffer what she calls “collective trauma.”

Craig Lambert interviewed her for his brilliant article, “Trails of Tears, and Hopes,” for the March-April 2008 issue of Harvard Magazine. You can read the PDF of the full article online.

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Posted in: Psychosocial

Another Nail in the SAD Coffin

January 14th, 2011 · 1 Comment

The standard American diet that our medical establishment so dearly loves is dying a slow, painful death. And it’s coming not a moment too soon. The diet’s death is arriving after it killed so many of us and crippled millions more with diabetes or obesity.

The Mediterranean diet is that standard American diet. Based on whole grains, low-fat dairy products, vegetables, fruit, fish, and oils and margarines, this diet fad owes everything to a gentleman named Ancel Keys. His masterpiece was the Seven Countries Study, which he launched in 1956 and published its results beginning in 1970.

The Seven Countries Study was, however, fatally flawed. Keys cherry picked data that fitted his preconceptions, ignoring data from more than a dozen other countries that wouldn’t support what he tried to prove. Our medical establishment believes to this day that he did prove the negative effects of fat on heart health. And thus the Seven Countries Study was the genesis of the Mediterranean diet that so many of us believe in to our detriment.

Fortunately for all of us, Gary Taubes has demolished this myth. His masterpiece is Good Calories, Bad Calories. I think everyone who can read English needs to master this work, which is far too detailed for me to even attempt to summarize here.
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