Browsing Tag

Diabetes Management

The Trouble with Naps

My most recent post here reviewed a new study indicating that resting after meals is hard on the pancreas, could lead to diabetes, and could make existing diabetes worse. This is an interesting hypothesis and one that you can check out yourself.

But one of my correspondents suggests that the results might be related to the fact that overweight people who overeat at a meal are more likely to lie down. “Edgy thin people probably jog instead,” she says.

That’s a good suggestion, and I’m not sure that the authors of the new study controlled for weight. But now comes a closely related study that indirectly offers support for the hypothesis that lying down after we eat isn’t a good idea.

People in China in the 50s and over who regularly take naps after a meal increase their risk of diabetes by 28 to 36 percent, according to a study just published in Sleep, the official publication of the Associated Professional Sleep Societies, a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society. The authors of the study are associated with universities and hospitals in China and the U.K.

Correlation, of course, doesn’t prove causality. It is suggestive and may be a good suggestion to follow, because the only downside is probably being a bit tired, which in fact could lead to a better night’s sleep. Anyway, a little jog after a meal will do a lot more to reduce blood glucose than lying down ever will.

The authors of the study that I review last week are in Kazakhstan and Ukraine, while the new study is China-based. Some of the most interesting research on diabetes now seems to be coming from countries that hadn’t been at the forefront of diabetes research. This Internet age seems to be leveling the playing field.

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

by David Mendosa

Diabetes Diet

The Rest Trap

Learning that you have diabetes can be overwhelming. All at once your life has changed.

In fact that is really good. Now you can be healthier than you ever were — if you get more active, lose weight, take your medicine, and cut your stress.

Those are the essentials. The rest are optional tweaks and theory.

Like this one today. The journal Medical Hypotheses deals only in theory, as its title implies.

This journal has an “article in press” that it will publish soon. It’s not online yet.

One of the authors, Alexander Dynyak, M.D., lives and works in Almaty, Kazakhstan. If you don’t know where that is, join the crowd. But Kazakhstan is in Eurasia and is the ninth largest country in the world in land area. It is also the world’s largest landlocked country.

Another author, Andrey Dynyak, is currently pursuing his M.D. degree in Ukraine. Andrey also publishes their research findings on diabetesnewfrontiers.org and sent me a copy of the Medical Hypotheses study.

The study has the usual technical title: “Diabetes mellitus: Hypoxia of the islets of Langerhans resulting from the systematic rest prone on the back after a meal?” In plain English, that means that the islet cells in our pancreas might not get enough oxygen and cause diabetes if we lie down in the two hours after we eat.

Who would have thought of that! I certainly never did. But the islets are especially susceptible to oxygen deficiency. This study investigated whether the pressure on the pancreas of food in the stomach after a meal might be related to diabetes. To test their hypothesis, the authors surveyed people with diabetes compared with a control group. The people with diabetes numbered 91 and those in the control group numbered 20. Every one of the people with diabetes had been resting after eating at least three or four times each week. But only 2 of those in the control group, or 10 percent, did.

Then the researchers attempted to get the people with diabetes to change their resting behavior. The researchers recommended that the people with diabetes not lie down within two hours of a meal. That’s because this is the average time it takes for food to pass through our stomachs.

But only 20 percent of the people with diabetes were consistent in not resting during those two hours. Of those, however, the researchers found general improvements, an increased capacity for work, better blood glucose control, and less need for diabetes medication.

The article indicates that resting during the two hours after a meal might lead to diabetes. I wondered if this might, however, imply that people who already have diabetes should also avoid resting then.

“Yes, that is basically what it implies,” Andrey Dynyak replied. “In general, a passive rest within one to two hours after a meal in a recumbent position should be avoided. However, being more specific for diabetes, a passive rest after a meal prone on the back or reclined is what should be avoided.

“Unfortunately, it is becoming such a common and usual behavior that by many is regarded as normal. Fortunately, it is easy to test, and positive results can be seen shortly after changing this specific behavior.”

I think that these far-off researchers might be onto something. It’s definitely worth testing if you have been lying down during the two hours that it takes for your stomach to digest your food. It won’t make your life worse, and could well make it a lot better.

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

by David Mendosa

Diabetes Testing

Omega-3: Tested

No wonder that I’m so healthy and happy lately! I just got back the results of my omega-3 test, and they were quite satisfactory.

In December I wrote in “Testing Omega 3” about the HS-Omega-3 Index that uses a standardized methodology to measure the percentage of eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA) in our red blood cells. It also measures the ratio of omega 3 to omega 6. In that article I gave a brief review of some of the reasons why I think that omega-3 is crucial to our diet — and deficient in the diet of most people who have diabetes.

On January 27 I ordered my test from GeneSmart, and I got my results in today’s mail.

A “desirable” level on the HS-Omega-3 Index is over 8 percent. My level came back as 12.6 percent.

A desirable ratio of omega-6 to omega-3 is under 5 to 1. My ratio is 2.1 to 1.

The only advice that GeneSmart was able to offer me was to maintain my intake of the omega-3 fatty acids, EPA and DHA. I will.

But in the packet they did include a nice set of tables about fish and their omega-3 content. Here is a copy:

Click on the image above to enlarge

I get my omega-3 levels from eating fresh or frozen (not farmed) cold-water fish about five times a week. I prefer king salmon and Chilean sea bass — technically Patagonian toothfish — which tastes a whole lot better than it sounds. I usually add canned salmon, sardines, or albacore tuna — packed in water, not oil — to my salad at lunch. Sometimes I add a small can of anchovies, which I have been able to find only packed in oil, which I drain off. I also supplement my omega-3 from krill oil, which I wrote about here exactly two years ago at “Krill Oil.”

by David Mendosa

Diabetes Testing

Testing the Tests of A1C

Bayer Diabetes Care’s A1CNow+ monitor for us to test our A1C level at home carries the highest certificate of accuracy. As I wrote here in June, the NGSP (formerly the National Glycohemoglobin Standardization Program) certified this device as having documented traceability to the Diabetes Control and Complications Trial reference method, which established relationships between A1C levels and risk for complications of diabetes. The DCCT method is the gold standard for reliable A1C testing.

So I was surprised to read an article in the journal Clinical Chemistry indicating that this was one of the A1C testing devices that didn’t meet “the general accepted analytical performance criteria.” Two Dutch researchers led by Erna Lenters-Westra reported that the local distributor in the Netherlands of the A1CNow+ Bayer “concluded that the EP-10 [protocol] outcome data did not warrant progression” to the two other protocols the study used.

But the key sentence — buried in the full-text of the study and missing from the online abstract — is this, “The bias found with the EP-10 protocol of the A1CNow was probably due to EDTA interference problems.”

I had to ask Bayer representatives what all this means. This is what the company told me:

“Bayer has reviewed the Lenters-Westra study published in Clinical Chemistry that used Bayer Diabetes Care’s A1CNow+® monitor as part of their evaluation,” the company wrote back. “Bayer believes that the results that the study authors obtained did not accurately capture the proven performance of the A1CNow+ device due to use outside the manufacturer’s specifications [emphasis added]. Continue Reading

by David Mendosa

Diabetes Testing

Glucocard Vital

For people with diabetes the so-called “vital signs” that health care people talk about have to include our blood glucose level. So I couldn’t think of a better name for a blood glucose meter than “Vital.”

Arkray in Edina, Minnesota, seems to agree. At least that’s what the call their new meter. You may not be familiar with Arkray, but it is the world’s fifth largest manufacturer of diabetes self-monitoring systems. This company calls their new meter the “Glucocard Vital.”

The U.S. Food and Drug Administration approved the Glucocard Vital in November. Arkray just ramped up production and sent me one of the first of these meters, the newest meter on the market.

Yesterday I put my Glucocard Vital through its paces. It performed perfectly for me. Since I test so many blood glucose meters, I like to use them before ever looking at the user instruction manual.

I just pulled out one of the test strips, inserted it in the meter, which then turned out automatically with the battery already in place. Even the date was already correctly set. Later, of course, I did read the manual to see if it contains anything of importance that I need to tell you about.

The Newest Blood Glucose Meter

by David Mendosa

Diabetes Testing

Prescription Discount Card

A few days ago an Accu-Chek Aviva blood glucose meter arrived in my mail. The meter itself was nothing new. Three years ago when Roche Diabetes Care introduced the Aviva I wrote a glowing review of it, appropriately titled “Viva Aviva!“

What is new is the smallest item in all those papers that accompany a new meter nowadays. It’s a wallet-sized card that Roche calls the Accu-Chek Connect.

This is one powerful little card! For some people it means that we don’t have to pay more than $15 for each prescription we get for Accu-Chek Aviva test strips.

The Front of the Discount Card

The Back of that Card

by David Mendosa

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