Diabetes Rising is a strange name for the most readable book ever written about diabetes. But diabetes is a strange disease, as Dan Hurley shows in the book that Kaplan published yesterday.
The publisher sent me galley proofs of the new book several months ago. I’ve been waiting to review it until it became generally available.
Of the hundreds of books on diabetes that publishers and authors send me every year, I don’t usually review any of them. I’ll keep one or two of them in my bookshelf for reference, but I give away the vast majority of them, usually to my local library.
Diabetes Rising is the exception because its author has exceptional qualifications to write about it. Dan Hurley is a medical journalist who regularly contributes to the science section of The New York Times as well as to many other major publications. He earned his other relevant qualification 34 years ago at the age of 18. That’s when he got type 1 diabetes.
Whenever I become conscious of a word or concept new to me, I began to notice it everywhere. All of you probably have had this experience.
It is so common that we even have a nice big word for it thanks to the great Swiss psychiatrist Carl Jung: Synchronicity.
A couple of weeks ago a member of the diabetes support group that meets in my apartment loaned me a book called Bad Science. A practicing physician in the U.K.’s National Health Service and newspaper medical columnist named Ben Goldacre wrote it and Fourth Estate published it last year in the U.K.
The book is a detailed indictment of the British press for its woeful ignorance of some basic scientific concepts. Like one of my favorites, “regression to the mean.” This sounds complicated. But it is simply the fact that everything, including our health, has a natural cycle. Since we tend to see a doctor when we feel the worst, we think that his or her treatment helped us, while we would soon feel better no matter what the treatment was.
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.
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.
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.