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

Hot Plates for Slow Eating

January 14th, 2011 · No Comments

When I eat too fast, I eat too much. I knew that, but until now I haven’t been able to help it.

Now Juan Ramirez has come to my help. In March I wrote here about “Eating Too Fast” and some of the strategies I use. After that article, Juan wrote me about his invention to help us slow down at the table.

When we eat slowly, we can avoid overeating and therefore can control our diabetes better. But some of us eat fast because we like our meals to be hot rather than lukewarm. I know that’s my excuse.

Now, however, the great food cool off is no longer inevitable. I know this because I bought one of the “HotSmart Gourmet Plates” that Juan Ramirez invented and wrote me about.

“I am pre-diabetic myself and I am convinced that eating slowly works to avoid overeating, preventing obesity and type 2 diabetes,” Juan emailed me. “My heat-retentive plates keep food warm, need only one minute preheating, and stay hot for more than 30 minutes. The rim stays always cool for safe easy handling with your bare hands.”

This message grabbed my attention. I had to have one, but when Juan wrote me, he had one little problem. He was sold out of them at that time.

Recently he wrote to tell me that he was caught up with demand, and Amazon.com now has them in stock. “All you have to do is type HotSmart in the main page for all departments.” Or you can go to Amazon’s direct link for HotSmart Gourmet Plates.

Two of Juan’s websites explain the HotSmart plate in more detail. They are HotSmart Gourmet Plates and Lose Weight By Eating Slowly.

As soon as I got Juan’s message that Amazon had his plates back in stock I ordered one. Amazon sells them for $18.85 each.

Since then I have made a point of using my HotSmart plate for every hot meal that I eat now. It really works for keeping my food hot and keeping me from gobbling it down.

My guess is that like me you may have the secret little vice of eating too fast. If you do, eating off a HotSmart plate can help. While it won’t force you to slow down, it will take away any excuse you made to yourself to bolt your food down the hatch.

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: Food

Comparing Meter Accuracy

January 14th, 2011 · 24 Comments

Anyone who has been trying to control his or her diabetes for more than a few days often gets disappointed with checking blood glucose levels. Our disappointment is sometimes not how high those levels go but how erratic our meters and test strips seem to be behaving.

Meter accuracy is a pain — an emotional pain that can be more than the physical pain of lancing. Just which meter systems are accuracy?

That’s probably the question that people newly diagnosed with diabetes ask me the most. And now for the first time we have the beginning of an answer.

In my 15 years of following diabetes developments I haven’t seen a single scientific comparison of the blood glucose meters that we have to work with. Until now.
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Posted in: Testing

Meeting the tiniBoy Lancet Inventor in Korea

November 30th, 2010 · 1 Comment

Stanley Kim is a practicing physician in Southern California who recently invented the smallest and painless lancets for testing our blood glucose. I wrote about this invention here this August.

At that time Dr. Kim and I hadn’t met. I interviewed him on the phone from my home office in Colorado.

We had to travel all the way to South Korea to meet in person. We are in Busan, Korea’s second largest city with about 3.6 million residents. Specifically, we are both attending the International Diabetes Federation’s Western Pacific Region Congress along with about 3,000 other people who work with diabetes. This congress is taking place in Busan Exhibition and Convention Center (BEXCO) in the most modern part of the city near Haeundae, the most famous and frequented beach in all of South Korea.

As modern as Korea is — particularly in this part of the country — it is naturally quite different from what I normally experience in Colorado. But for Dr. Kim, Busan is quite familiar. He grew up in Busan and has a condo here.

Until I mentioned the meeting during the course of the interview for the article I wrote here in August, Dr. Kim didn’t know that it was happening in his hometown this year. He then arranged to attend the meeting. And at the last minute the conference organizers approved his poster presentation for the tiniBoy lancets. [Read more →]

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Posted in: Medication

Diabetes Support in Korea

November 30th, 2010 · 3 Comments

When Jeongkwan (Brian) Lee of the i-SENS planning division introduced me to Cheol Jean, Brian called him “the Korean David Mendosa.” Brian was being too generous to me.

Both of us have written about diabetes for years and have organized diabetes support groups. But Cheol Jean, whose business cards reads as Charlie Jean to make it easier for Westerners, has written four books about diabetes — twice as many as I have — and founded and leads a much larger diabetes support group.

Charlie Jean and I Meet

Brian and I arrived in Busan, Korea, on Sunday evening on the bullet train from Seoul. We are here to participate in the Eighth International Congress of the International Diabetes Federation’s Western Pacific Region at the Busan Exhibition and Convention Center (BEXCO).

I will be covering the IDF meeting for HealthCentral from Monday through Wednesday. About 3,000 people are here for the meeting in Busan, mainly from Korea, Japan, Canada, and Australia.

I am old enough to have remembered this now vibrant city from the Battle of the Pusan Perimeter. In August and September 1950 North Korean forces drove back the UN Command, which included thousands of American troops, and South Korean forces — together with millions of refugees — to the extreme southeast corner of the country around the port of Pusan. [Read more →]

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Posted in: Psychosocial

Test Strips and Meters from South Korea

November 30th, 2010 · No Comments

Greetings from the bottom of my heart and the top of Seoul. I am writing you from South Korea where I am for two weeks at the invitation of one of the largest blood glucose meter and test strip manufacturers in the world.

People from i-SENS Inc., a company headquartered in Seoul that designs and manufacturers blood glucose monitoring systems, asked me to visit them this fall. In fact, they originally invited me to come last October. But I had to postpone my visit because I had an emergency operation for twisted small intestines at the beginning of that month, and my surgeon said I couldn’t travel.
For the first few days of my trip I am staying on the top floor of a hotel in the Seongbuk district of Seoul, near the company’s headquarters. With 24.5 million inhabitants Seoul is the world’s second largest metropolitan areas in population (after Tokyo and ahead of Mexico City, New York City, and Mumbai, in that order). Seoul has been Korea’s capital for more than 600 years.
On Friday I left Seoul for the day to visit the new factory that i-SENS built in Wonju city four years ago to make test strips for its blood glucose meters. I went with my friend and hostess, Margaret Leesong. The i-SENS director of international business relations, Margaret visited me in Boulder a couple of years ago, when we had a great hike together in the foothills of the Rockies.

Margaret lived in the States from 1973 to 1978 and then again from 1988 to 1996, when she moved to Australia, remaining there until 2005. After her college years at Seoul National University, she earned a Ph.D. in biophysics from Purdue University in Indiana and then an LLB (law degree) from the University of Sydney. She speaks flawless English.
When Margaret met me at the hotel on Friday morning, we took a taxi to the bus station, where we took a two-hour ride to Wonju, a much smaller city of about 300,000 people in northeastern Korea. From there a staff member who helped us as driver and tour guide from the company picked us up and took us to the factory.

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Posted in: Medication

A Stand-Up Guy and His Desk

November 13th, 2010 · 2 Comments

When I tell you that I am a stand-up guy, I wouldn’t blame you for assuming that I was boasting. After all, part of the standard Mafia definition of this term is one who “can be trusted.”

While I do hope that you can trust me, I call myself a stand-up guy because one of my own posts here inspired me to stand up a lot more. So, when I say that I am a stand-up guy, this is a fact, not a boast.

In a post here, “Standing Up for Your Heart,” I reviewed a study by Alpa Patel, Ph.D., and her associates that explored the connection between sitting and mortality. They found that the amount of time people spend sitting is associated with an increased risk of death from heart disease, which happens to be the biggest complication of diabetes.

When I digested the impact of that study, it reinforced my long-standing plan of converting my computer time from sitting to standing. Dr. James Levine, a Mayo Clinic endocrinologist, was my original my model. Four years ago I wrote here about how he mounted his computer over a treadmill, and while he works, he walks at the rate of 0.7 miles per hour.

Even before reading the new study led by Dr. Patel, I had told Abhijit Mhapsekar, who programs my mendosa.com website, about walking on a treadmill while he worked. I knew that it would help heal his bad back. And Abhijit actually did get a treadmill with his computer mounted over a desk.

But I dawdled. My apartment doesn’t have enough room for a treadmill and treadmill desk in addition to the wonderful teak desk that I’ve had since 1969.

Instead, I priced stand-up desks on the Internet and a local store for me to use without a treadmill. Those desks run from $1,300 to $,2300. And they weren’t awfully stable.

Instead, I had a handyman make me a stand-up desk. It is as simple as possible: just two tracks screwed into the wall with three brackets that are adjustable (and I have already adjusted them), with a board 24 inches deep by 43 inches wide, large enough for one of my computers and accessories. The new desk ran me about $300 and is very stable. Anyone with more skill than I have could make one for much less.

When I commissioned my new stand-up desk, I expected to use it a small part of the time. In fact, I now use it much more than my old desk.

I also think more clearly when I am standing up. Judge for yourself. I wrote this standing.

As a writer, I have always known that I learn more from my articles than even the most diligent readers do. This is just like teachers learn more than their students because of all the preparation that goes into their lessons.

And as a caring person my goal in life is to help other people who like me have to live with diabetes. The Talmud says that “to save one person is to save the world,” and even if I haven’t moved you yet to stand up more, my review of Dr. Patel’s work already inspired both Abdijit and me to get off our butts more.

That’s not all. After I got my new stand-up desk I told Dr. Patel about it. “Congratulations! I hope to move from sitting on my exercise ball to a stand-up desk soon myself.”

Can I inspire you too?

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: Complications, Exercise

Promises to Myself

November 4th, 2010 · 1 Comment

I’m getting desperate. I’m stuck. To completely control my diabetes I know that I have to control my weight.

Like Robert Frost, “I have promises to keep and miles to go before I sleep.”

Today I make these promises to myself:

I promise to take or accept no snacks at supermarkets or my barbershop — not even meat or cheese.

I promise not to buy any food that doesn’t fit my eating plan.

I promise not to buy any food, no matter how good for me, that I can’t resist eating too much of, like macadamia nuts.

I promise to eat no more than I usually eat at home when I eat a meal out.

I promise to drink one liter of water before every meal.

I promise to eat dinner at least three hours before bedtime.

I promise not to eat anything after dinner.

I promise not to eat any dairy (except for the one container of Greek yogurt now in my refrigerator).

I promise not to eat any grain or potatoes.

I promise not to eat any sucrose or fructose — not even spicy chai sweetened with honey (except the fructose that occurs naturally in up to one serving of fruit per day).

I promise not to use any oil with an unfavorable omega 3:6 ratio (except extra virgin olive oil).

Each of these public promises is binding on myself, David Mendosa, at least until I have lost the six more pounds that I want to lose so that I can get back down to a BMI of 19.5.

I promise to report back here when I have reached my ideal weight and that I kept these promises to do so.

Do you want to make any promises — either public or private — to help promote your weight loss and better health?

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: Food

Eating Blueberries with a Smile

November 4th, 2010 · No Comments

Those of us who have diabetes have something to smile about when we learn that a tasty food we love to eat but we thought was bad for us is actually good. As I ate my blueberries this week I experienced those smiles.

Nobody likes blueberries more than I do. But the few times I have eaten them lately have been guilty pleasures. That’s because blueberries are high in carbohydrates, which can wreck havoc with our blood glucose control.

Blueberries seemed to decrease inflammation when researchers tested them in animals. In spite of their carb content animals appeared to have lower BG levels when they ate their berries.

But until now we didn’t know much about what blueberries would do for people. So Drs. William Cefalu and associates set out to study what blueberries might do for us. They work at the Pennington Biomedical Research Center, a part of the Louisiana State University System.

They didn’t study people with diabetes. Instead, for six weeks they studied 32 obese people who have prediabetes, or insulin resistance.

So, is this work relevant to those of us who have gone all the way into diabetes? I think so, because the difference between prediabetes and diabetes comes down to whether we have burned out lots of the beta cells in our pancreas or not. Like us, people with prediabetes already have a lot of insulin resistance that can eventually burn out the beta cells.
This study meets the highest standards of clinical trials — it is a double-blind, randomized, and placebo-controled clinical study design. The Journal of Nutrition will publish their findings in its October 2010 issue. Meanwhile, however, the journal has already published the study, “Bioactives in Blueberries Improve Insulin Sensitivity in Obese, Insulin-Resistant Men and Women,” online. While only the abstract is free online, I got the full-text through my subscription.

The people in the study who ate the blueberries had significantly improved insulin sensitivity compared to those in the control group who weren’t so lucky. Changes in body fat, calorie intake, or inflammation were not at work here.

Researchers guess that the health benefits of blueberries might come from their phenolic bioactive compounds like anthocyanins, which are also anti-oxidant. They are red, purple, or like blueberries in particular, blue. Dark blue.

The people in the study got their blueberries from frozen powder in a smoothie. The control group got their smoothies without the blueberries but with the same taste and calories.

Not increasing our calories — and the amount of carbs we eat — is also our challenge when we add blueberries to our diet. After all, one cup of them has 12 grams of carbs, the maximum amount those of us who eat low-carb will want to have in any meal.

When we add blueberries to what we eat, we can remove something else. This way we can keep smiles on our faces as we consume a delicious and healthy food.

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: Food

Fish, Inflammation, and Insulin Resistance

November 4th, 2010 · No Comments

Omega-3 fats reduce chronic inflammation and insulin resistance. Now we know why.

Tomorrow the journal Cell will publish a report telling how researchers at the University of California, San Diego identified the molecular mechanism that omega-3 uses. The full-text of the article by Jerrold Olefsky, M.D., and his associates is online.

They found a key receptor on macrophages, which are specialized white blood cells that engulf and digest cellular debris and pathogens. Omega-3 fats activate this macrophage receptor with broad anti-inflammatory effects and improved insulin sensitivity.

When we have insulin resistance, insulin doesn’t regulate our blood glucose levels as well, and it often leads to type 2 diabetes. “Chronic, low grade tissue inflammation is an important cause of obesity-related insulin resistance,” the study states. As I have reported here previously, Dr. Olefsky has been working to see how we can “block or disarm this macrophage inflammatory pathway in humans,” preventing insulin resistance and type 2 diabetes.

Dr. Olefsky’s group used cell cultures and mice. They didn’t use people. But by using mice they were able to “knock out” or turn off specific genes. “Mice are currently the most closely related laboratory animal species to humans for which the knockout technique can easily be applied.” Doing this to humans would not be practical, and if it were, it wouldn’t be ethical.

I applaud this research. But not Dr. Olefsky’s proposed solution.

“These results,” the study says, “strongly argue that anti-inflammatory effects can ameliorate insulin resistance in obesity.” But then the study’s authors go on to say that this knowledge “may prove useful in the future development of new therapeutic approaches for the treatment of insulin resistant diseases.”

As I wrote in review of Dr. Olefsky’s earlier research, “He’s thinking drugs to reverse a sad situation.” He still is, but we can think diet now.

We can simply increase the level of omega-3 fats in the tissues of our bodies. Cold-water fish like salmon and sardines are the most effective. Fish or krill oil works too. But, as I have written here, we need to cut back on omega-6 fats first.

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: Food