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

The New York Times: “Is Sugar Toxic?”

May 21st, 2011 · 1 Comment

In 1961 I started to read The New York Times when I went to work in Washington. But its magazine always disappointed me.

Until Sunday. This week’s issue focuses on “Health and Wellness 2011.” All four of the magazine’s main articles are essential reading for everyone.

The cover story by Gary Taubes, “Is Sugar Toxic?,” makes the case against sugar. This isn’t his first time to tilt at the medical establishment in this magazine. Nine years ago his article, “What if It’s All Been a Big Fat Lie?,” began his crusade to expose the myth that fat was bad and carbohydrates are good.

His 2007 book, Good Calories, Bad Calories, built on that article so well that it convinced me and thousands of others to follow a very low-carb diet. In “Addicted to Carbs” I wrote here three years ago about how that book changed my life. With his book, Why We Get Fat: and What to Do About It, Taubes takes his argument to a wider, non-scientific audience.

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Posted in: Diabetes Diet, Exercise For Diabetes

Why We Check Our Blood

April 18th, 2011 · 2 Comments

With all the emphasis on how we check our blood glucose levels using all the new meters that we can choose from, many of us who have type 2 diabetes forget or never learned why we check our levels. Anyone who has type 1 diabetes has to know why he or she checks as do those type 2s who uses insulin. Those of us who inject insulin check their levels so they can take more if their levels are too high or take a glucose tab or something similar if they are too low.But three-fourths of all type 2s don’t take insulin. Some of them still use the first oral medication, one of the sulfonylureas that can cause hypos, a level below about 70 mg/dl. Then they too will need to take something like a glucose tab to bring their level back to normal.

The overwhelming majority of all people who have diabetes rarely if ever get hypos. So why should they go through the trouble of checking their blood glucose? What can they do with that information?

If our doctors and nurses ever told us why, most of us have forgotten by now. As a result, a lot of people with diabetes don’t bother at all any more with blood glucose checks.

That’s a shame, because even people who don’t use insulin or one of the sulfonylureas, can benefit from checking if they do it at the right time.

The most right time is after eating a big meal, especially one that has a substantial amount of starch in it. Nothing raises our blood glucose level as much and as fast as starch — the stuff in potatoes and grains and grain products, like bread, bagels, pizza, or anything made from wheat flour.

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Posted in: Diabetes Testing

Which Blood for Checking Glucose

April 5th, 2011 · 2 Comments

The blood that we need to use to check our blood glucose levels may seem obvious. After all, it’s a check, not a test to pass or fail. We need to use our own blood, not blood borrowed from a friend or foe.

But until now some basic questions about blood glucose testing haven’t had a tested answer. They do now with the publication of a study in this month’s issue of Diabetes Care, a professional journal of the American Diabetes Association.

The abstract of the study, “Self-Monitoring of Blood Glucose: The Use of the First or the Second Drop of Blood” is free online. My friend Dr. Bill Quick, who also writes about diabetes for HealthCentral, sent me the full text of the study.

The seven Dutch diabetes professionals who researched basic questions about blood glucose testing recruited 123 people with diabetes. They checked the variability of their blood glucose testing results in four different situations:

1. When they did or did not wash their hands

2. After they handled fruit (specifically apples or bananas)

3. After washing their fingers that had touched the fruit

4. And two different amounts of pressure applied to their fingers — squeezing

Their conclusions were simple and straightforward. But now for the first time we have them based on the actual experience of real people who have diabetes:

1. We don’t have to waste a drop of blood to use a second drop — but only if we wash our hands first.

2. But when we aren’t in a position to wash our hands and they aren’t particularly dirty or exposed to something that has sugar in it, testing with a second drop of blood will work.

3. Which finger we use doesn’t matter.

4. When we apply heavy pressure — meaning squeezing a lot — we can get unreliable results.

“The first choice is to wash the hands with soap and water, dry them, and use the first drop of blood,” the authors wrote. “Firm squeezing of the finger should be avoided.” The authors admitted that they had a hard time defining the difference between firm and light squeezing.

Strangely, the study did not look at the old recommendation that we should use alcohol to clean our fingers. Maybe they read my review of the Clever Chek meter, which I wrote here in November 2007. I hope that I disposed of the myth that it’s better not to use alcohol.

“The [Clever Chek] packaging includes a box of ‘Alcohol Prep Pads,’” I wrote then. But, “Any alcohol on the skin may interfere with your test result, so the experts don’t recommend that you use alcohol prep pads routinely. Only where you don’t have warm water is it a good idea to use alcohol to clean the test area. And be sure to air dry it well before testing.”

Now, let’s all go and test our blood glucose with confidence that we know what we are doing.

This is a mirror of one of my articles that was originally published on Health Central.

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Posted in: Diabetes Testing

Testing Both Blood Glucose and Blood Pressure at Home

March 20th, 2011 · 10 Comments

Since three-fourths of those of us who have diabetes also have high blood pressure, a combined blood glucose and blood pressure monitoring device makes a lot of sense. Years ago I reviewed basic devices here, but now we have the
chance to use something that seems to approach the sophistication of the devices that nurses regularly use in doctors’ offices. And is probably even better.

The Fora D20 has a regular arm cuff attached to the device that measures either our BG or our BP. This gives me more confidence than the basic devices that previously were all that we had for monitoring our blood pressure at home.

I don’t automatically assume that doctors and their nurses can take better care of our medical needs than we can ourselves. Clearly, we have a greater interest in our own health.

But with blood pressure testing even more considerations come into play. We can do it better at home.

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Posted in: Diabetes Testing

Integrated Testing

February 12th, 2011 · 2 Comments

The experts on the blood glucose meters that we rely on tell me not to hold my breath while waiting for painless, or non-invasive, devices. The GlucoWatch, sold as the first and only non-invasive meter, came and went several years ago. Nothing similar is coming in the foreseeable future.But new and better meters appear all the time. And a whole new concept is on the immediate horizon.

This concept is a completely integrated testing device. That means the device contains not only the blood glucose meter but also test strips and a lancet.

I think that this big step forward to easier and more discreet testing is right around the corner. In fact, if you live in Europe, you can get it right now.

Mendor is a small Finnish company headquartered in Helsinki. It calls its integrated system the Mendor Discreet. It has CE status for sale in the EU, but U.S. approval is awaiting FDA action on the company’s 501(k) clearance request.

Meanwhile, Mendor CEO and co-founder Kristian Ranta was kind enough to send me a Mendor Discreet in advance of its release here. I have one in my hands as I write — which isn’t easy since I generally type with all 10 of my fingers.

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Posted in: Diabetes Testing

Meters for Christmas

January 26th, 2011 · No Comments

If Santa gave you a new blood glucose meter for Christmas, my guess is that you didn’t get what you wanted. But I’m sure that you got what you needed.

In all the history of diabetes only two developments stand out for giving us control. The first was the discovery of insulin in the early 1920s, and the second was the invention of the blood glucose meter in the late 1960s.

An endocrinologist once told me that we need to get a new blood glucose meter every year. His thinking was that they can wear out or get damaged out of alignment when they fall on the floor. Perhaps an even better argument is that every year new and better meters come our way.

A case is point is the Fora V12 blood glucose monitoring system. Made by Fora Care Inc. of Newbury Park, California, and sold by MedPoint Advantage in Birmingham, Alabama, this reasonably priced little meter has the latest bells and whistles.

Requiring no coding — not having to match a number on a vial of test strips to a number on the meter — the Fora V12 makes testing easy. And easier yet is that you don’t even have to look at the meter because it will talk to you in either English or Spanish, at your choice. It also gives you a quick result in seven seconds and takes a tiny blood sample of only 0.7 microliters.

One thoughtful little touch that I appreciate is that the Fora V12 takes two AAA batteries rather than the usual lithium ones. While bigger, AAA batteries are easier to find in our stores when you need replacements.

MedPoint Advantage is the exclusive national distributor for the Fora V12, says Chief Operating Officer Lee Stallings. Their phone number in Birmingham is (866) 563-3764.

The Fora V12 sells for $29.99. A box of 50 blood glucose test strips sells for $28.99. Or you can save by getting a box of 100 for $53.98, a box of 150 for $80.97, or a box of 200 for $107.96.

We all need to think about getting a new meter each year. Christmas is a good time for such presents. Now, tell me please, did you get a new blood glucose meter from a loved one? I hope that you had such good luck.

This is a mirror of one of my articles that was originally published on Health Central.

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Posted in: Diabetes Testing

Comparing Meter Accuracy

January 14th, 2011 · 24 Comments

Anyone who has been trying to control his or her diabetes for more than a few days often gets disappointed with checking blood glucose levels. Our disappointment is sometimes not how high those levels go but how erratic our meters and test strips seem to be behaving.

Meter accuracy is a pain — an emotional pain that can be more than the physical pain of lancing. Just which meter systems are accuracy?

That’s probably the question that people newly diagnosed with diabetes ask me the most. And now for the first time we have the beginning of an answer.

In my 15 years of following diabetes developments I haven’t seen a single scientific comparison of the blood glucose meters that we have to work with. Until now.
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Posted in: Diabetes Testing

A New Talking Meter

September 14th, 2010 · 6 Comments

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 [Read more →]
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Posted in: Diabetes Testing

Drug Interactions

August 30th, 2010 · 2 Comments

My friends at Diabetes in Control have just updated their valuable list of drugs that can cause us problems. The URL is http://www.diabetesincontrol.com/images/tools/druglistaffectingbloodglucose.pdf

They sent their list to me in their weekly email, but it’s also available on their website as a PDF. The list, which shows both the generic and brand names, includes those drugs that can cause us to have either low blood glucose levels or  high blood glucose levels. It also includes a short list of other drugs that can mask hypos.

This is a good list for all of us to keep handy.


This is a mirror of one of my articles that was originally published on Health Central.

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Posted in: Diabetes Medication

Potato Poison

August 30th, 2010 · 2 Comments

Many people with diabetes have already stopped eating potatoes for several reasons. Now we have one more.

Some varieties of potatoes raise our blood glucose level faster and higher than just about anything. The glycemic index of a baked russet potato is 111 on the scale where glucose equals 100.

A cup of hashed brown potatoes has 46 grams of carbohydrate. That’s more than a whole day’s ration of carbohydrates for people following the best known very low-carb diet for people with diabetes.

About 80 percent of a potato’s carbohydrate comes from starch, a white, tasteless, and odorless powder. But starch is cheap, and adding salt and fat can make it palatable.

Since hashed brown potatoes and french fries count as a vegetable, the potato is America’s most important vegetable crop. More than 30 percent of the vegetables that we eat are potatoes, and we eat 142 pounds of them each year.

Maybe people with diabetes eat fewer potatoes than other Americans. I hope so. But everyone who eats lots of potatoes not only indulges in a very high glycemic and very high carb food but also is at risk of potato poisoning.

Potatoes are a member of the deadly nightshade family. This family includes Jimson weed, mandrake, belladonna, tobacco, as well as potatoes and tomatoes. While potatoes, tomatoes, and other members of the nightshade family are important food sources, they are often rich in alkaloids, which are toxic to humans and animals and can range from being mildly irritating or fatal, depending in part on how much we eat. By affecting the nervous system, this poison causes weakness and confusion. Some people are especially sensitive to foods in the nightshade family and experience allergy-like symptoms from the alkaloids. These alkaloids protect the plant from attacks by microbes and insects by dissolving their cell membranes.

But this poison hasn’t discouraged us from eating lots and lots of potatoes. Cooking them long enough and avoiding the green parts and sprouts reduces their toxicity. But when people eat foods in the
nightshade family, the alkaloids can create pores in the lining of the gut. This increases intestinal permeability, and if enough of the alkaloids gets into our bloodstream, this destroys the cell membranes of our red blood cells.

The large amount of potatoes that we eat is what makes them a concern to Loren Cordain, who has been has been a professor in the Department of Health and Exercise Science at Colorado State University since 1982. His new paper, “Consumption of Nightshade Plants, Human Health and Autoimmune Disease Implications,” interested me so much that I bought a copy for $21.29. It was worth the money.

We eat somewhat less tomato products, and relatively few bell peppers, chili peppers, and eggplants, some of the other food crops in the nightshade family.

“When the gut becomes ‘leaky,’ it is not a good thing,” Dr. Cordain writes, “as the intestinal contents may then have access to the immune system, which in turn becomes activated, thereby causing a chronic low level system inflammation.” The increased intestinal permeability, particularly in people with diseases of chronic inflammation — like type 1 diabetes — and diseases of insulin resistance — like type 2 diabetes — particularly troubles Dr. Cordain.

His conclusion is “to eliminate or drastically reduce potato consumption, and for autoimmune and allergy patients to be cautious with the consumption of tomatoes, chili peppers, and eggplants.”

Until recently, I had a weakness for hashed brown potatoes, as I have written here. Even though I knew that potatoes are both high glycemic and high carb, that wasn’t enough to stop me. But knowing that they are poisonous did.

This is a mirror of one of my articles that was originally published on Health Central.

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Posted in: Diabetes Diet

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