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Diabetes Management

Diabetes Diet

Eating Blueberries with a Smile

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 article is based on an earlier version of my article published by HealthCentral.

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Diabetes Diet

Fish, Inflammation, and Insulin Resistance

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 article is based on an earlier version of my article published by HealthCentral.

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People With Diabetes

Shameless Self-Promotion

If you decide that this post is shameless self-promotion, you would be half right. The people at Diabetes PowerShow say some nice things about me on their website.

But when they interviewed me last week, somehow I thought that I might have said a thing or two that would interest you. Since I went on and on for an hour and one-half, my message has to contain some meat.

You can go directly to their interview with me here. Fortunately, it’s only an audio interview, so you don’t have to watch me.

The Diabetes PowerShow team is four people with diabetes doing this work as a labor of love out of their Las Vegas studio. They interviewed me by phone, so I didn’t have to go to Vegas in the heat of the summer.

Producer Charlie Cherry, who has type 2, recruited me to the show after we met at the past two Social Media Summits hosted by Roche Diabetes Care. Charlie’s partners are a co-hosting couple, Chris Moore, who calls himself type 3, i.e. a spouse of someone with diabetes, and his wife Theresa, type 1. A fourth team member, Chris Daniel, also has type 1, but was missing in action.

When Charlie approached me to do the interview, the hot button that he pressed was for me to talk about my twin passions of photography and hiking. I write about them on my “Fitness and Photography for Fun” blog.

Near the end of the interview he asked me about those passions of mine. Before that we talked about my life with and without diabetes and my other passion, spreading the word about controlling diabetes, which I know can make us healthier and happier than ever before.

You can listen to my interview on your computer. But if you have an iPhone, an iPod, iPad, or other MP3 player, you have a better option. After you get iTunes on your computer, you can subscribe to Diabetes PowerShow for free and get all of the shows delivered automatically. This is better, because you can listen while you are on the go, instead of sitting at your desk.

I hope that at least one of you gets something out of listening. As I told Charlie by email, the Talmud says that “to save one person is to save the world.” That’s all I want to do with my life.

This article is based on an earlier version of my article published by HealthCentral.

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Diabetes Testing

Tiny tiniBoy Lancets

Even though Dr. Stanley Kim isn’t a diabetes specialist, he had plenty of motivation to invent the thinnest and shortest lancets ever. Dr. Kim is a hematologist and oncologist who is a member of the board of trustees of San Antonio Community Hospital in Upland, California, and president-elect of the hospital’s medical staff.


Stanley Kim, M.D.

The story started, he told me, about three years ago when he learned that he had type 2 diabetes. “The lancets that I used hurt too much for me,” he said. “I resisted whenever I had to check my blood glucose and knew that something wasn’t right.”

The story continued when he went to the hospital’s pediatrics and neonatal departments. “The lancets that they used were pretty thick, and the babies would cry. You could tell that the babies were suffering. So I thought that I could make a very thin and short lancet that wouldn’t hurt as much.”

Like firefighters who rescue people out of burning houses, this was something that he had to do. “This was my  motivation.”

Like most people, I learned about Dr. Kim’s lancets by word of mouth. A correspondent named Ashique Iqbal recently brought them to my attention. Dr. Kim has actually been marketing them since late October of last year, he told me.

“I never advertised them,” he continued. He did go to the Children with Diabetes Friends for Lifeconvention in late  June and early July 2010 at Disney World. “We tested 200 to 300 children, and they all said it was wonderful. It is now being sold mostly for children.

Dr. Kim calls his tiny lancets “tiniBoy” and says that although the tiniBoy lancet is very beneficial for diabetic kids and  babies, it still works well for adults like me, as I also do not like pain.

He currently markets then through the tiniboy.comwebsite and Amazon. A box of 100 lancets goes for $9.95, and Dr. Kim tells me that he is working to broaden his outreach through Medicare and private insurance. “We would like to be able to provide tiniBoy lancets for whatever the insurance would pay.”


Comparative Lancet Sizes

The tiniBoy lancets are compatible with most of the current lancing devices. The exceptions, Dr. Kim tells me, are the Accu-Chek Multiclix and Softclix devices.

Dr. Kim’s technical review of the tiniBoy lancets appears in the January  28, 2010, issue of Clinical Medicine Insights: Endocrinology  and Diabetes. You can read the abstract online at “A Pain-free Lancet  with a Small Needle for Glucose Measurement.”

But perhaps even more persuasive are the positive comments by people with diabetes who have purchased tiniBoy lancets from Amazon. My guess is that you have as much motivation to switch to these tiny lancets as the Amazon reviewers and Dr. Kim had.

This article is based on an earlier version of my article published by HealthCentral.

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Diabetes Testing

A New Talking Meter

At least 38 companies now offer us meters that we can use to test our blood. I list and link them in my web page “Blood Glucose Meters,” Part 14 of the On-line Diabetes Resources.

Almost all of those 38 companies sell their meters in the U.S., and most of them have several different meters for sale here. So why would we ever need a new one?

For one thing, meters are getting better. While they still aren’t good enough, higher standards of accuracy and precision may be coming soon, as I wrote here a year ago.

Instead, meter manufacturers focus on adding features. Many of these features are just nice bells and whistles. But one feature is essential for some of us.

Since loss of vision is all too common a complication of diabetes, many of us need a blood glucose meter that will talk to us. Not only people who are totally blind but the much larger number of us who have limited vision need a meter that they can listen to rather than look at.

Actually, we have had talking meters for many years. Diagnostic Devices in Charlotte, North Carolina, has offered two different Prodigy meters for at least five years, as I indicate on my “Blood Glucose Meters” web page. Diabetic Supply of Suncoast in Vega Baja, Puerto Rico, offers two different versions of the Advocate blood glucose meters that talk. Last year Omnis Health in Natick, Massachusetts, became the third company to currently offer a talking meter, the Embrace Blood Glucose Monitoring System.

And now here is BioSense Medical Devices in Duluth, Georgia, with another talking meter, the Solo V2. We all the choices already available, does anyone need the new meter?


The Solo V2 Talking Meter Continue Reading
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Diabetes Complications

Standing Up for Your Heart

You don’t have to exercise to help your heart. Sure, exercise will probably make your heart last longer, but it’s not the only thing you can do to avoid the biggest complication of diabetes.

Just standing up — otherwise known as giving your butt a rest — now seems to work independently of physical activity to reduce your chance of dying from heart disease. A new study that the American Journal of Epidemiology published online in advance of print on July 22 indicates that the less leisure time we spend sitting the better it is for our hearts.

You can read the abstract of the study, “Leisure Time Spent Sitting in Relation to Total Mortality in a Prospective Cohort of US Adults,” online. The lead author, Alpa Patel, Ph.D., of the American Cancer Society’s epidemiology research program, sent my the full-text of the study when I requested it.

Dr. Patel and seven of her associates explored the connection between sitting and mortality by analyzing the survey responses of 123,216 people who had no history of cancer, heart attack, stroke, or emphysema or other lung diseases. These were people who enrolled in the American Cancer Society’s 1992 Cancer Prevention II study.

The researchers examined how much time those people sat down after work as well as how much exercise they got between 1993 and 2006. The results were clear.
How much time they spent sitting was associated with an increased risk of death from heart disease for both men and women. Women — but not men — who sat less had a smaller risk of dying from cancer.

Women who reported that they sat for more than six hours a day during their leisure time versus those who sat for fewer than three hours a day had a 37 percent higher death rate from all causes. For men it was about 18 percent higher.  After adjusting for the amount of physical activity these people got, the researchers found that the association remained virtually unchanged.

But when people sat more and exercised less, the difference was even greater. Women had a 94 percent highr death rate from all causes. For men it was 48 percent higher.

“Several factors could explain the positive association between time spent sitting and higher all-cause death rates,” Dr. Patel says. “Prolonged time spent sitting, independent of physical activity, has been shown to have important metabolic consequences, and may influence things like triglycerides, high density lipoprotein, cholesterol, fasting plasma glucose, resting blood pressure, and leptin, which are biomarkers of obesity and cardiovascular and other chronic diseases.” Continue Reading

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