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Diabetes Update: Is INGAP a Cure?

Number 37; May 15, 2002

By David Mendosa


This newsletter keeps you up-to-date with new articles, columns, and Web pages that I have written. I list and link most of these on my Diabetes Directory at www.mendosa.com/diabetes.htm

From time to time Diabetes Update may also include links to other Web pages of special interest.

My most recent contribution is:

on May 15, 2002

  • INGAP Peptide
    When a company better known for its soap than its pharmaceutical products invests in a promising cure for diabetes, it's big news. Particularly when the company is Procter & Gamble, famous for Tide, Pampers, and about 300 brands of household products. Less well known is its drug division, Procter & Gamble Pharmaceuticals. Its best known products are Prilosec and Plendil for which it has co-marketing agreements. It doesn't have any diabetes drugs on the market, but its investment in INGAP Peptide could be the biggest blockbuster ever. Think cure for both type 1 and type 2 diabetes. That's the hope. The URL is
    http://www.diabetes.org/main/community/info_news/web/default.jsp

Update:

    on May 8, 2002
  • JAMA Supports the G.I.
    The G.I. in question is no soldier. It's the glycemic index, and a "Special Communication" from Dr. David Ludwig of the Boston Children's Hospital gives it a big boost in the May 8 issue of the Journal of the American Medical Association, perhaps the country's most prestigious medical journal. This support should help resolve some of the controversies over the glycemic index that still linger here. "The habitual consumption of high-glycemic index foods may increase risk for obesity, type 2 diabetes, and heart disease," Dr. Ludwig writes. "Despite areas of continuing controversy, clinical use of glycemic index as a qualitative guide to food selection would seem to be prudent in view of the preponderance of evidence suggesting benefit and absence of adverse effects." Dr. Ludwig was kind enough to write me that his article had been published. When I replied that I would love to see it, but JAMA charges $9 to view each article on-line, he sent me a copy, which I could forward to you on request. You can read the abstract online at http://jama.ama-assn.org/issues/current/abs/jsc10297.html.

Book Reviews:

Today Diabetes Update kicks off a new section where I will review relevant books, most of them new.

    The G.I. Diet The G.I. Diet
  • A brand new offering from Canada is a weight-loss diet book based on the glycemic index. The G.I. Diet: The Easy, Healthy Way to Permanent Weight Loss by Rick Gallop is a 178-page paperback that Random House Canada just published for Canadian $24.95.

    Gallop comes to the glycemic index by way of Barry Sears's The Zone. He recalls:

    To my amazement and delight [on the Zone diet] I lost the twenty pounds that had been plaguing me for so long. I invited some of my friends and associates to try it as well. By the end of twelve months, however, 95 percent had dropped out. They cited two principal reason for their inability to stick to the diet: 1) it was too complex for everyday life, requiring them to count grams and calculate formulas and ratios; and 2) they were always feeling hungry, which is the death knell for any diet.

    Gallop claims that his diet is most simple and won't leave you feeling hungry. While eating low glycemic in general does that, I can't claim to have lost weight on it (although many people have written me that they have). I haven't tried Gallop's specific diet. I do hope it works. The book is further described on the Web at http://www.randomhouse.ca/catalog/display_can.pperl?isbn=0679310568 and http://www.gidiet.com/

    One point that is perhaps of less consequence to most, but not to me, is coffee. Don't get me started about brewing Kenya coffee from Peet's and filtered water in a French press and drinking it in a fine China cup! There's no better way to start the day, in my judgment. Unfortunately, Gallop doesn't agree. The caffeine in coffee, he says, "does lead to increased insulin production, which reduces your blood sugar levels and makes you feel hungry."

    I don't agree with him there, and neither does Jennie Brand-Miller, the lead author of the top two glycemic index books, The Glucose Revolution and The Glucose Revolution Life Plan. The later book is, in fact, an outstanding diet book directly based on her glycemic index research.

    A few years ago Jennie responded to my question about coffee this way:

    We did some unpublished studies looking at effect on one cup of coffee or tea and found no effect whatsoever.

    I asked Gallop the source of his statement. His reply was:

    It came out of discussions with David Jenkins, though when I talked to him today he felt this was a grey area, though he leans towards it having some impact. I also came across it elsewhere but I'm damned if I can find the reference in my notes. I may add a qualifier on my web site as I've had a lot of wailing about this from readers.

    Guide to Healthy Restaurant Eating Food Charts

  • A updated book is Guide to Healthy Restaurant Eating, second edition by Hope S. Warshaw. The American Diabetes Association just published this 620-page paperback for $17.95. About 600 of these pages are charts.

    Focusing on the top 55 fast-food chains where unfortunately most people eat, Hope lists the nutrition content for more than 3,500 items on their menus. Well, she does show some of the nutrition content, but neither trans fats nor fiber.

    The most up-to-date nutritionists agree that trans fats are even worse for you than saturated fats. The Food and Drug Administration has proposed a rule that would require trans fats to be included on the Nutrition Facts label because it increases the risk of coronary heart disease (http://vm.cfsan.fda.gov/~dms/qatrans.html). Walter C. Willett, M.D., of the Harvard School of Public Health in his recent Eat, Drink, and Be Healthy (Simon & Schuster, 2001) recommends that while you should "limit" your intake of saturated fats, you should "avoid trans fats wherever and whenever you can" (page 79).

    Dr. Willett states that now that fast-food restaurants use heavily hydrogenated vegetable fats for deep frying, they are one of our country's largest sources of dietary trans fats. Eating a doughnut for breakfast and a large order of French fries for lunch or dinner will provide just under 5 percent of the total calories in a 2000-calorie diet.

    So I wrote Hope to ask her why she didn't once mention trans fats in her book. I said I realized that trans fat data would be difficult to get from these chains, but that I was disappointed that she hadn't even discussed it in the text. She replied:

    Trans fats - I think we need to pay most attention to sat fat. The relationship between sat fat and CVD is most clear. This info is both available and provided. A big educational push, and I hope I've done this in the book is to encourage reduction in total fat. This way people reduce all fat. Yes, I think trans fats are important, but on average Americans only consume about 2-4% of their cals as trans fats. Unfortunately the info is not available from restaurants. When I do another revision I will include a discussion of trans fats.

    I wrote Hope that while trans fats are what I most want to avoid in my food, fiber is what I most want to increase. I expect that most people have the same need. She mentions fiber in her text, but doesn't show the fiber portion of the carbohydrates in her charts. I thought that information was available. Why didn't she include it?

    She replied:

    Fiber - this is sometimes available from restaurants, but not always. To an extent the decision comes down to what are the critical nutrients to include and what are people most looking for.

Announcements:

  • Diabetes Care Stinks
    It's official. The quality of care that people with diabetes get from the healthcare establishment leaves, shall we say, a lot to be desired.

    Scientists from the U.S. Centers for Disease Control and Prevention writing in the current issue of the Annals of Internal Medicine have prepared "A diabetes report card for the United States: quality of care in the 1990s." The abstract is on-line at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11955024&dopt=Abstract.

    My hope and guess is that the subscribers to this newsletter are doing a lot better than the average, which is:

    Only 28.8 percent of the people in the survey got an A1c test in the past 12 months. (This figure is not mentioned in the abstract, but it is mentioned in the results and table 3 in the article, according to email from Jinan B. Saaddine MD, MPH, the lead author.)

    Of these, 18 percent had a level greater than 9.5 percent.

    Only about 40 percent monitor their blood glucose level at least once a day.

    About one-third have poorly controlled blood pressure.

    About 37 percent did not have an annual eye examination.

    And 45 percent did not have an annual foot examination.

    This is more evidence of the fact that successful diabetes management depends more on the individual than the doctor. But, of course, you already knew that.

  • New Titles Redux
    This week I received more positive feedback for Joe's suggestion that I put a title on each issue of Diabetes Update than I got for my articles. But one diligent reader named Susie wrote me that she wanted to read one of my columns that I mentioned in Diabetes Update, but the American Diabetes Association site couldn't find it. The problem that the ADA no longer has those columns online. Now, my Web site shows them at http://www.mendosa.com/diabetes.htm in the section "My Pages at the American Diabetes Association Site."

    The titles work best to highlight something you didn't know before. But if you know that it was in one of the previous issues of Diabetes Update, a search engine is much more efficient. The search engine that my ISP provides isn't easy to use. But since all the previous issues of Diabetes Update are linked to my site, the best search engine of them all, Google finds them. For example if you want to find my article that carrots actually have a low glycemic index, just search Google for:

    mendosa update carrots

    As usual with Google, the first link returned is the right one.

  • Understanding Your Meter
    Mark your calendars for the next edition of Diabetes Forecast - Live! "Meters & Monitors: What Do My Blood Glucose Levels Mean?" on Tuesday, May 21. Diabetes Forecast - Live! is a monthly webcast brought to you by the American Diabetes Association and the HealthTalk Diabetes Education Network. Hear experts discuss the importance of monitoring, how to control your glucose levels, new meters and monitors, and answer your questions. For more information, please visit http://www.diabetesforecastlive.com.

Boilerplate:

I send out Diabetes Update e-mail in HTML format, which all Web browsers and most modern e-mail programs can display. HTML has live links to all the sites named in the text so that with a simple click of a mouse you can connect to the site you have just been reading about.

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Archives:

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