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

My Neuropathy

June 22nd, 2009 · 20 Comments

A few days ago when I finally was able to see a neurologist for the headaches that started four months ago, the first part of his examination was of my feet. I had heard of referred pain, but this seemed extreme to me, and I told him so.

The doctor replied that he would get to my head. In the meanwhile he gave me a complete examination. He used a tuning fork, similar to what musicians use. I could feel it as he went down my legs. But when he got to each of my feet, I felt nothing.

Then he worked down my legs to my feet with the side of a pin. Again, my feet I had no sensation.

He told me that I had peripheral neuropathy. And I could see it for myself. None of my other doctors had ever told me that before. [Read more →]

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Posted in: Complications

Triglycerides and Neuropathy

May 30th, 2009 · 4 Comments

Until now our doctors have lacked an effective way to predict who is at the greatest risk of neuropathy. Usually we find out too late — when irreversible nerve damage has already occurred.

Diabetic neuropathy is the most common microvascular complication we have. More than half of all people with diabetes develop neuropathy. It is a complication in both type 1 and type 2 diabetes.

In the past few years the U.S. Food and Drug Administration approved two drugs — Cymbalta and Lyrica — for managing the pain of diabetic neuropathy. These drug help many of us. But wouldn’t it be a lot better for us if we could prevent diabetic neuropathy?
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Posted in: Complications

Early Warning for our Hearts

May 24th, 2009 · No Comments

We now have an early warning that can help people with diabetes prevent heart attacks and strokes. Until now, for many people the first symptom of a heart attack has been having one.

I don’t think that I have ever written about the complications of diabetes without offering some way to deal with them. That would be just too negative for either you or me, and I am not going to start being negative now.

Heart attacks are serious business, but we can prevent them. People with diabetes especially need to prevent them.
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Posted in: Complications

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.
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Posted in: Medication

Keeping Our Legs

April 1st, 2009 · No Comments

When you consider how many of us have problems with our feet, you might expect to find lots of resources full of good advice. Then, when you reflect that peripheral neuropathy is one of the most serious complication of diabetes, you could hope to find a book that could help you to keep the legs you stand on.

Until now I have looked in vain for such a book. But I just read it.

Dr. Mark Hinkes, a podiatrist and amputation prevention specialist, wrote Keep the Legs You Stand On and sent me a copy. This big book — 537 pages — is the definitive guide for those of us with diabetes who want to keep both of our legs.
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Posted in: Complications

Glucose Trumps Fructose

March 4th, 2009 · 4 Comments

When my friend Joe Anderson told me a couple of years ago that he prefers glucose to fructose, I thought he was nuts. After all, glucose has a glycemic index of 103, while that of fructose is only 15.

I had never seen a scientific study showing that using fructose was worse for us than using glucose. I have now.

A study team led by Karen Teff, Ph.D., of the Monell Chemical Senses Center in Philadelphia reported its findings a few days ago in the Journal of Clinical Endocrinology and Metabolism. The Monell Center sent me a copy of the full text of the study, “Endocrine and metabolic effects of consuming fructose- and glucose-sweetened beverages with meals in obese men and women: influence of insulin resistance on plasma triglyceride responses.” The abstract is free online.
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Posted in: Food

Breaking the Diabetes-Alzheimer’s Connection

January 5th, 2009 · 3 Comments

Researchers finally know why people with diabetes are more likely to get Alzheimer’s disease. That alone would be big news. The huge news is that we now know what we have to do to break the link.

Did you miss the growing number of reports in the past few years about how those of us who have diabetes are more likely to get Alzheimer’s as we age? I can understand, because until last year I ignored the evidence myself. We have enough on our plate already without worrying about a possible complication many years down the road that until now nobody knew how to prevent anyway.
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Posted in: Complications

Mouth Control

July 31st, 2008 · No Comments

Our mouths are key to diabetes control. And not just what we put in them.

How would you like to reduce your A1C level by 0.67 percent — like from 6.67 to 6.0 — without putting less in your mouth or even increasing your exercise? This third type of A1C control may be the easiest ever.

Research presented at last month’s Scientific Sessions of the American Diabetes Association that I attended in San Francisco made this point. Dr. George Taylor, associate professor of dentistry at the University of Michigan, reported there on recent studies demonstrating the association between periodontal problems and the complications of diabetes. He spoke in the first symposium ever by dentists to ADA meetings.

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Posted in: Diabetes Developments

Fitness and Fatness

March 2nd, 2008 · No Comments

We all know that diabetes is a risk factor for heart disease, and we do our best not to collect any more of these factors. Of course, it’s better not to take any other risks with our hearts. But what’s worse, to be fat or to be unfit?
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Posted in: Complications