You need to help me a lot with this one.

All of you who read my articles here are motivated to control your diabetes. Almost all of you have a positive motivation. I doubt if many of you have a primarily negative motivation based on fear of the consequences of uncontrolled diabetes. Negative motivations just don’t keep us doing what we need to do for long.

What are your positive motivations? What do you tell people you know who have diabetes to encourage them to tame it?
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Those of us who have diabetes pay a physical cost for it that we know all too well. But many of us aren’t aware of the social cost that we pay for being overweight, which usually accompanies our diabetes.

Fat prejudice is even more subtle than our society’s racial and gender biases and those against and gays and lesbians. Our most recent prejudice, of course, is that against those of the Muslim faith from the Middle East, and that prejudice is anything but subtle. Now, however, social scientists know how to measure fat prejudice.
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Vitamin D testing has been in the news lately. But the mainstream press covered only the bad news. You would have to read the medical press to learn about better choices.

The country’s largest medical laboratory, Quest Diagnostics, just sent out thousands of letter to doctors who ordered Vitamin D tests for their patients. The letters say that results of their Vitamin D tests during the past two years are “questionable.” Quest’s screw up could mean that thousands of people aren’t taking vitamin D supplements when they should.

Testing our levels of vitamin D has surged recently because of studies suggesting that too little can raise the risk of all sorts of complications. More and more recent studies link a vitamin D deficiency to diabetes. Other studies link it to bone weakness, cancer, heart attacks, and other illnesses.
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A study in the January issue of The American Journal of Clinical Nutrition is the first one ever to examine how walking by itself can help us keep the weight off for the long term. Since almost all of us with type 2 diabetes struggle with our weight, this is a key part of controlling it.

Walking may or may not be more beneficial for us that other forms of physical activity. That’s not what the study was about. Rather, for most people walking is the least expensive and most readily available way to get the exercise that we all need.

The study monitored almost 5,000 men and women for 15 years. Walking works.
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At this time of year the thoughts of most people turn to making resolutions to change. For people with diabetes these resolutions are often that we will lose weight in the year ahead. Almost all of us — myself included — put on a few pounds during the holiday season.

And now for our reading pleasure comes along The New Yorker in its January 5, 2009, issue. The issue’s best article is one by Amy Ozols who writes for the TV show “Late Night with Jimmy Fallon.” We couldn’t do worse than to follow her nine-step program for “Looking Your Best.”
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Nobody ever compared whether a low-carb or a low-glycemic diet works better to control our blood glucose levels. Until now.

Both diets improved A1C levels and helped participants in a 24-week study to lose weight. But the low-carb group did a lot better.

Five doctors at the Duke University Medical Center in Durham, North Carolina, just reported their results in the journal Nutrition & Metabolism. Led by Eric Westman, M.D., the study, “Effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus,” appeared on December 19.
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Dr. Richard K. Bernstein knows how to cure diabetes, and researchers are ready to start the research. All they need is money. Does anyone have enough money and care enough about curing diabetes to fund this research? Do you?

Even if you have type 1 diabetes, you almost certainly still have some of your beta cells. If your body stops killing them, they will replicate and produce insulin — and then you will possibly have a cure.

When I talked with Dr. Bernstein a few days ago, he told me that he knows how kill the specific killer T cells. Most famous as the leading proponent of a very low-carb diet, Dr. Bernstein is a diabetologist with a practice near New York City. He was also an engineer before he got in M.D. degree in his 40s.
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Maybe it won’t cure diabetes. But a compound slated to begin a new Phase 2b clinical trial early next year stands a good chance of knocking diabetes back into remission.

Almost never do I write about new drugs unless they are at least in in the final stage of development, a Phase 3 trial. The odds are against them.

Of 100 drugs for which developers submit investigational new drug applications to the Food and Drug Administration for approval, about 70 will successfully complete Phase 1 trials and go on to Phase 2. About 33 of the original 100 will complete Phase 2 and go to Phase 3. And 25 to 30 of the original 100 will clear Phase 3.
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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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If you have both diabetes and depression, you probably don’t care which came first. In fact, the latest research indicates that the two conditions are a two-way street. Sometimes we get depressed first; something we get diabetes first. Does it matter?

Diabetes and depression go together. Research research found that 19 percent of people with type 2 diabetes probably suffer from major depression and an additional two-thirds of us have at least some depressive symptoms. People with diabetes are twice as likely to be depressed as other people.

This reminds me of the futile argument whether being overweight causes diabetes. I an convinced that being overweight doesn’t cause diabetes or vise versa, and in my second book, Losing Weight with Your Diabetes Medication, I devote the entire first chapter to exploring that concept.
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