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Diabetes Developments - A blog on latest developments in diabetes by David Mendosa
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Intensive Control Does Work

May 27th, 2009 · 1 Comment

All over the world people with diabetes are slacking off how well they control their diabetes. Their A1C levels are climbing to 7.0 percent or more, apparently blessed by scientific research.

Researchers designed the Action to Control Cardiovascular Risk in Diabetes trial, universally known as ACCORD, hoped to prove that we would have fewer heart attacks and strokes when we able to bring our A1C levels below 6.0 percent. Instead, they were surprised to discover that 257 patients in the intensive-therapy group died, compared with 203 patients in the standard-therapy group. Consequently, they terminated the intensive therapy regime 17 months before the scheduled end of the study.
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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

Saving our Brains

February 22nd, 2009 · No Comments

Many of us who have diabetes are more in tune with our minds than our bodies. We are “not athletic.” Many of us will frankly acknowledge that we are “into our heads.”

Now its clear that we can’t have a good head on our shoulders without having good shoulders and all. Our diabetic body will give us a diabetic mind — if we let it. And when we control our diabetes, not only our bodies but also our brains work better.

A diabetic body has high blood glucose. When we succeed in bringing our blood glucose level down to normal, our bodies aren’t diabetic any more. When our diabetes is controlled, it may not be cured, but it’s certainly in such remission that no tests would show that it’s diabetic.
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Posted in: Psychosocial

Testing Cholesterol at Home

February 18th, 2009 · No Comments

Just yesterday I got my first home cholesterol and triglyceride test results. It took three weeks for them to get back to me after I mailed them in. That’s acceptable.

But I have been waiting years to be able to check these levels at home. That’s not good.

The new Check Up America test from Home Access Health Corp. in Hoffman Estates, Illinois, is the only way that we can check our cholesterol levels — total, HDL (good), and LDL (bad) — at home. With the same blood sample it also checks our triglyceride levels and A1C.
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Posted in: Testing

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.
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Posted in: Testing

The First Bluetooth Meter

February 8th, 2009 · 8 Comments

Some of us have been waiting a long time for a bluetooth blood glucose meter. Almost all cell phones and computers sold today support Bluetooth technology that lets us connect devices like blood glucose meters without using any wires.

Three different bluetooth standards permit connections between devices separated from about 1 meter to about 100 meters. In the past two and one-half years I’ve been so exciting about the prospect of automatically connecting our meters to cell phones and computers that I’ve written about three companies that promised us bluetooth meters.

Just like cures for diabetes and wonder drug that will let us perfectly control it, many of the announced devices never make it through the U.S. Food and Drug Administration and come to market. As far as I have been able to determine, theGlucoTel device that I wrote about in Diabetes Health magazine in October 2006 didn’t make it here.
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Posted in: Testing

When We Peak

January 28th, 2009 · No Comments

Our blood glucose still tends to peak at about 73 minutes after the first bite of our meal, if we have diabetes. But the peak comes much sooner for other people. And, of course, their peak isn’t nearly as high.

In my article “New Time to Test Glucose Levels” here two and one-half years ago I suggested that on the basis of two studies the peak was generally 72 or 74 minutes after the first bite. So when I saw new reports from a research group headed by Professor Jennie Brand-Miller, I got confused. Dr. Brand-Miller is professor of human nutrition at Australia’s University of Sydney and the world’s leading expert on the glycemic index.
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Posted in: Testing

Good News About Non-Caloric Sweeteners

January 7th, 2009 · 10 Comments

The most comprehensive study ever about those sweeteners that don’t have any calories just appeared as the lead “original research communication” in the January 2009 issue of The American Journal of Clinical Nutrition. It is really good news for anyone with diabetes who is trying to lose weight or maintain weight loss.

This study changed my mind about using non-caloric sweeteners. A little more than a year ago I wrote here that, “The classic 1969 experiment by Stylianos Nicolaïdis showed that merely tasting a sweet substance – whether it is sugar or a non-caloric sweetener – causes rats to secrete insulin.” The problem with that is that more circulating insulin can make us hungry so that we will probably eat more.
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Posted in: Food

New Glycemic Tables

December 19th, 2008 · No Comments

Ever since 1995, when the first international tables of glycemic index appeared in print and on my website, they have been the gold standard for determining the glycemic index of as many foods as researchers had tested at that point.

Now, in the third revision of the international tables you can find the glycemic indexes of many more foods.

The 1995 tables listed the glycemic indexes of 565 foods from 79 studies in the professional literature from around the world. Professor Jennie Brand-Miller, PhD, of the school of microbial biosciences at Australia’s University of Sydney was the lead author of those and subsequent updates of those tables.
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Posted in: Food

A Better A1C Test

November 9th, 2008 · 5 Comments

Even in these difficult times when almost all of us are learning how to become frugal again, money isn’t everything. Especially when it comes to our health.

For those of us who have diabetes the A1C test is the best measure that we have of the state of our health. The A1C is the only commonly available check that we have of our average blood glucose level for the past two or three months.

Those of us who are fortunate enough to have health insurance usually go to the lab at our doctor’s office or local hospital for their A1C. I know that’s what I was doing several times a year ever since my diabetes diagnosis in 1994. My health insurance provides up to two A1C tests annually for a modest $15 co-pay each time for my visit to my primary care physician.

But until now I didn’t take into account how much time getting an A1C test at the lab took out of my busy schedule. And most importantly, I didn’t realize that the lab’s results may not be right.
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Posted in: Testing