When we don’t get our blood glucose levels low enough or take the diabetes medicine that our doctors prescribe, they often complain about our noncompliance. Particularly when we follow a very low-carb diet and are unlucky enough to have a nutritionist on our medical team, she is almost certain to give us a hard time.

When doctors and nutritionists do that, they are forgetting their place. The doctor-patient relationship is a status thing. While medical professionals usually earn more money than we do, they work for us. We are the ones who make them well off, if not rich.

We hire our doctors. We can fire them too. Several years ago when Byetta first came on the market, I knew that taking it would help me control my blood glucose and lose weight. The doctor I saw at the time had never heard of Byetta, so he had to read up on it. When he did, he refused to give me a prescription for it because he was sure that I would lose only a few pounds. I fired him and proved him wrong after I hired a compliant doctor. [Read more →]

Just changing when you eat can has a big effect on how much you weigh. At least if you are a mouse.

A new study is the first causal evidence connecting meal timing and increased weight gain. The journal Obesity on September 3 published “Circadian Timing of Food Intake Contributes to Weight Gain” online in advance of print.

Only the abstract is available free. But lead author Deanna Arble of Northwestern University’s Center for Sleep and Circadian Biology sent me the full text and answered my questions.

For six weeks the researchers fed some of the mice only during their normal sleeping hours. Their weight gain was 48 percent. But the mice that they fed the same type and amount of food only during the hours that they were naturally awake gained just 20 percent.

[Read more →]

What I eat keeps changing all the time. Since I change regularly everything else that I do, this should be no surprise.

My breakfast starts with two glasses of GreensFirst. This is one breakfast that I can consume immediately after getting up from bed. The experts all tell me that we do better when we eat within an hour of arising, but that’s always been hard for me to get down. GreensFirst solves that problem beautifully.

I absolutely love this way to start the day! Much better than the two cups of coffee I used to start the day with. Now, I drink only decaf, and much less of that (I also stopped drink single malt Scotch whisky). I don’t drink any alcohol now. I stopped drinking regular coffee and alcohol to help control my headaches, which are now gone, but I am staying off of them for my health (and budget). So sometimes bad things can lead to good outcomes!

When I wrote the article about GreensFirst, I hadn’t experimented much with it. But since I keep changing, I now make it with protein powder and refrigerated sparking mineral water and really enjoy the fizz. Of course, I have to mix it up with a little bit of filtered tap water, because cold water doesn’t work as well. [Read more →]

The American Medical Association today published the results of a large and long study that is good news for anyone who has diabetes. The study shows that intensive control substantially lowers the risk of some serious complications of diabetes.

No surprise that intensive control works. But the surprise is how well it works.

The study followed 1,375 people with type 1 diabetes for 30 years of their diabetes. The complications measured were proliferative retinopathy, nephropathy, and cardiovascular disease. Conventional treatment led half of them to proliferative retinopathy, one-quarter to nephropathy, and 14 percent to cardiovascular disease.

Those in the intensive therapy group has substantially lower rates of these complications — 21 percent, 9 percent, and 9 percent respectively. Fewer than 1 percent became blind, required kidney replacement, or had an amputation because of diabetes during those 30 years. [Read more →]

Whenever my energy level is inexplicably low as it was on a hike last week, I consume more of the good fats. We get our energy either from carbohydrates or fat.

And now that I eat very few carbs to control my blood glucose level and my weight, I need to get most of my energy from the fat in my diet. But sometimes in my quest to control my weight I don’t get enough of either.

Big mistake.

But what are the good fats? They are those with the highest proportion of monounsaturated fatty acids, explains Dr. Dick Williams. He is a consultant to BalancePoint Health, a cholesterol, weight loss, and diabetes control program headquartered in Boulder, Colorado.

“When you stop burning carbohydrates for energy, you need to turn on your fat burner,” Dr. Williams told us at the most recent meeting of our local diabetes support group. “Some of the best examples of monounsaturated fats are avocados, olive oil, and nuts — especially almonds, pecans, and walnuts.” [Read more →]

The U.S. Food and Drug Administration is finally planning to require that our blood glucose meters will meet high standards of accuracy and precision.

Dr. Margaret Hamburg, the new head of the FDA, recently wrote the American Association of Clinical Endocrinologists, or AACE, that the agency is pressing the International Organization for Standardization, or ISO, to set higher standards of accuracy and precision. “If the ISO standard for accuracy is not revised, the agency…may instead recognize other (higher) performance standards for SMBG [self monitoring blood glucose] devices for management of diabetes,” according to a letter and attachment that she sent to AACE President Dr. Jeffrey Garber, and past presidents Drs. Daniel Duick and Richard Hellman. Dr. Hamburg’s letter was a positive response to a formal request that the AACE made to the FDA in May.

Anyone who has ever tested his or her blood glucose for more than a month or so must be appalled at how inaccurate our blood glucose meters are. In the past ten years or so I must have written a dozen articles pointing out how bad they are.

The FDA didn’t tip its hand yet by putting in writing to the AACE just what new standards it plans to require. But the agency did drop a hint.

About half of the last 31 blood glucose meters that the FDA approved for sale in the U.S. would meet performance standards within 10 mg/dl, when reading should be less than 75 mg/dl, and withing 15 mg/dl, when the reading should be above 75 mg/dl, according to the attachment Dr. Hamburg sent Dr.Garber. The FDA recognizes that when our blood glucose levels are below 75 mg/dl, accuracy becomes even more important.

This morning’s New York Times reported this big news for all of us with diabetes. Even though I subscribe to the print edition, I was out hiking in the Rockies today and haven’t read the paper yet. Thanks to two of my favorite diabetes professionals, Certified Diabetes Educator Karen LaVine and Dr. Richard K. Bernstein, for emailing me the link to that article. This is such good news that I needed to write about it today.

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.

Walking is the exercise of choice for most people, especially when we would rather be outdoors than in a gym. Walking is one of the best ways to prevent heart disease, the biggest problem that those of us who have diabetes face.

If all we want to do is strengthen our lower body, we need only comfortable clothes and supportive footwear. But walking does little or nothing to strengthen the muscles of our upper body.

Unless we walk with poles, like Ken Mundt does.

“The advantage is that I get a whole upper body workout,” he told me when I called him at his home in Seattle. “My chest muscles get a good workout, because I don’t slam my poles. I place them, and then I push.” [Read more →]

The price of blood glucose meters isn’t the problem. But the price of test strips sure can be.

The last time I looked, some of the leading manufacturers were charging us almost $1 per test strip. For those of us who don’t have health insurance and test a lot, that can get expensive pretty quick.

But now one of the most aggressive manufacturers has introduced a meter that uses even less expensive test strips than its previous best. It also has better specs.

The company is US Diagnostics Inc. in New York, N.Y. They call their new meter the Infinity, which I assume they mean to refer to quality and not price.

You may be able to get the meter at no cost, because meter manufacturers mostly work on the “freebie marketing” model where they give away one of their products to generate a continual market for another, generally disposable, item. A guy named King Gillette pioneered this approach to get us to buy his razor blades. [Read more →]