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Diabetes Developments - A blog on latest developments in diabetes by David Mendosa
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How Much Omega-3

October 11th, 2009 · 2 Comments

Considering all the supplements that most of us take, we have surprisingly little evidence that the overwhelming majority of them do anything for us. The two biggest exceptions are vitamin D and omega-3 oil, which I have written about here.

Even with these well-tested supplements, the experts have little advice to give us. Now, however, a team of scientists from the University of Lyon in France just reported on how much of one type of omega-3 oil to take so that we can prevent heart attacks and strokes, the major complication of diabetes. This is the first study to identify how much omega-3 oil we need to promote optimal heart health.

They studied DHA or docosahexaenoic acid, which some studies suggest have more potent and beneficial effects than the other omega-3 oil that we usually take, EPA or eicosapentaenoic acid, according to their research communication in September issue of The FASEB Journal,  which the Federation of American Societies for Experimental Biology publishes.

Only the abstract of the study is online. But one of the study’s authors, Evelyne Véricel, was kind enough to send me the full text. [Read more →]

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Posted in: Complications

Intensive Glucose Control Works

July 28th, 2009 · 2 Comments

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 →]

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Posted in: Complications

A Short Walk Goes a Long Way

July 8th, 2009 · 1 Comment

We can reverse one of the most common and insidious complications of diabetes when we walk just a little more. From 50 to 70 percent of people with type 2 diabetes and 95 percent of those who are obese have fatty liver. But up to 77 percent of people who have fatty liver don’t have any symptoms.

A study that the journal Hepatology just published in its July issue put 141 participants through an exercise program for three months. The participants had nonalcoholic fatty liver disease (NAFLD), sometimes called nonalcoholic steatohepatitis (NASH).

If it leads to cirrhosis of the liver, it’s fatal, unless you are lucky enough to get a liver transplant. Liver transplants may be available for people under 70 and my wife was only 69 when her doctor told her that she had cirrhosis. But he also told her that her weight makes a successful transplant unlikely, so two years ago she died from this awful complication of diabetes. [Read more →]

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Posted in: Complications, Exercise

New Way to Control Glycemic Variability

June 10th, 2009 · 6 Comments

The A1C is certainly the gold standard to see how well we are controlling our diabetes. But even gold isn’t good enough for us.

The A1C doesn’t show our glycemic variability. For those of us who have our blood glucose levels under reasonably good control, our glycemic excursions are even more important than our average level.

A low A1C level can mask a lot of lows and highs. The experts call these hypos and hypers “glycemic variability” or “glycemic excursions.” Our level can be all over the place, while our A1C looks fine.
[Read more →]

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Posted in: Testing

The Vitamin D Window

May 18th, 2009 · 7 Comments

When he examined the young lifeguard, he saw that almost every square inch of her body was well tanned. She had been wearing practically nothing when she worked at the beach.

Neil Binkley, M.D., told me about his patient because she had the highest physiologic level of vitamin D in her system of anyone he ever saw. Her level was 80 ng/ml.

I had to look up the word “physiologic” to make sure what Dr. Binkley meant. Physiologic in the sense that he’s using it is “something that is normal, neither due to anything pathologic nor significant in terms of causing illness,” according to a medical dictionary.
[Read more →]

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Posted in: Medication

Endocrinologists Meet

May 16th, 2009 · No Comments

This week’s convention of the American Association of Clinical Endocrinologists in Houston is winding down this afternoon. The Health Central Network sent me here to report on it.

About 1350 endocrinologists and related health professionals are here along with 88 companies exhibiting their products. The doctors presented 170 posters and 200 abstracts.

Now that I’ve gone to the meetings that I needed to attend and talked with the doctors I needed to interview, I’ve got time to start writing about them. In the next few days you can expect several articles that I am developing out of my interviews at the convention and separately with a company headquartered in Houston.
[Read more →]

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Posted in: People

Choosing Exercise or Antioxidants

May 13th, 2009 · 8 Comments

Based on what I’ve read recently, some of which I have reported here, I’ve grown more and more wary of the wisdom of taking supplements. Few of the them seem to help.

And now comes a new study indicating that the two most common supplements can actually work against us. Those supplements are vitamins C and E.

It seems that we have a choice of exercising or taking large doses of those supplements. We know that exercise has lots of good effects like increasing our sensitivity to insulin, which is of great importance to all of us with diabetes.
[Read more →]

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Posted in: Exercise, Medication

Diabetes Drug Dangers

April 19th, 2009 · 8 Comments

A single research report that found risks in one of the medications that we take to control our diabetes would warrant our attention. But when three separate studies find serious side effects from all our major drugs, the time is right for us to reconsider how we control our blood glucose levels.

Most of us think of our diabetes drugs, diet, and exercise as the three basic ways we do that. But drugs come first. Maybe they should come last, at least for all of us with type 2 diabetes, who unlike type 1s have a choice.

Since March 10, studies have called into question the side effects of metformin, the glitazones, insulin, and the sulfonylureas.
[Read more →]

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Posted in: Medication

Emotional Diabetes

March 9th, 2009 · No Comments

We think about controlling our diabetes with diet and exercise and usually with medication too. Seldom do we even consider the fourth leg.

But a study published in the latest issue of the Annals of Behavioral Medicine and a forthcoming one by a Ph.D. student who just wrote me emphasizes the importance of our emotions for controlling our diabetes. Emotional health and diabetes health are a two-way street — a bidirectional relationship. When our emotional level is positive, we can more easily control our diabetes. And when we control our diabetes, we feel better.
[Read more →]

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Posted in: Psychosocial

The Normal A1C Level

February 11th, 2009 · 500 Comments

You want to control your diabetes as much as possible. You wouldn’t be reading this if you didn’t.

So you regularly check your A1C level. This is the best measurement of our blood glucose control that we have now. It tells us what percentage of our hemoglobin — the protein in our red blood cells that carry oxygen — has glucose sticking to it. The less glucose that remains in our bloodstream rather than going to work in the cells that need it the better we feel now and the better our health will continue to be.

As we are able to control our diabetes better and better, the reasonable goal is to bring our A1C levels down to normal — the A1C level that people who don’t have diabetes have. But before we can even set that goal, we have to know what the target is.
[Read more →]

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Posted in: Testing