Number 57; April 1, 2003

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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:

• Take Your Vitamins and Minerals!
  For most people the greatest effect of taking supplements of vitamins and minerals may be expensive urine. But not for people with diabetes.

  Researchers at two universities in North Carolina studied the effect of these supplements on the rate and severity of infections among the elderly and among people with type 2 diabetes. They were surprised to find no benefit to the elderly. They were even more surprised to find a huge benefit for people with type 2 diabetes. The URL is
  http://www.mendosa.com/vitamin.htm.

• Insulin Index
  Back in December I wrote a brief item in this newsletter, http://www.mendosa.com/diabetes_update_27.htm about the Insulin Index for the first time. Now I have expanded it to include the complete (but still small) list of foods tested for their effect on insulin circulating in our systems. The URL is http://www.mendosa.com/insulin_index.htm.

• My “About the Internet” Columns
  Now that I have stopped writing “About the Internet” for the American Diabetes Association reviewing Web sites, I have moved them to my Web site. Between 1997 and early this year I wrote 123 columns. Nine of them, however, reviewed sites that are no longer on-line. The other 114 columns are linked at http://www.mendosa.com/diabetes.htm#columns.

Updates

• UltraSmart Meter
  For the past week I have been using a new blood glucose meter courtesy of LifeScan. Jeff Christensen, LifeScan’s communication manager in Milpitas, California, came to my home to demonstrate the meter to me. His demonstration and my use of the meter was persuasive. I have permanently retired my previous meter, the Accu-Chek Compact, as good as it is.

  One thing that the Compact isn’t, however, is a meter that facilitates testing on alternative sites. It claims to have that capability, but since it requires a 3 microliter sample, I found that I usually had to puncture my arm three times to get enough blood. Several bruises were the long-term result.

  My endo says that a meter should require 1 microliter or less to be able to use alternative sites. I agree. The UltraSmart requires 1 microliter and returns the result in just five seconds. I was so sold that I switched, even though my insurance doesn’t cover LifeScan test strips.

  The UltraSmart works the same as the Ultra, except that it includes extensive logbook functions. They are so good, in fact, that I don’t see the point of connecting it to the computer to use a software program. Nevertheless, LifeScan has just updated its In Touch program—now renamed One Touch Diabetes Management Software, version 2—to work with the UltraSmart as well as all of LifeScan’s older meters.

  In fact, short of continuous sensing, the UltraSmart is about as far as meters can go. It satisfies the most important point that I have been making to meter manufacturers for years. That is the ability to flag test results with activities that affect blood glucose levels. This includes the ability to enter whether the reading was fasting, after lunch, etc. Previously, the OneTouch Profile was the only meter on the market that used these event markers. The Profile, however, takes a huge drop of blood. My guess is that LifeScan will now retire this venerable meter.

  The other critique I have been making of all meters is that none of them permit connecting to a USB port, which is much handier than the older serial port. Right now you can connect the UltraSmart only to a serial port, but LifeScan customer service says that by June a USB cable will be available too.

  For outstanding and extensive reviews of the new meter and software program please refer to http://www.childrenwithdiabetes.com/d_0i_292.htm and http://www.childrenwithdiabetes.com/d_06_15b.htm respectively.

  I have updated my Blood Glucose Meters page at http://www.mendosa.com/meters.htm accordingly.

Research Notes

• Islet Cells without Immunosuppression
  The holy grail of islet cell transplants is to somehow avoid rejection. Our bodies naturally reject foreign cells, so when islet cells are transplanted from a cadaver whether human or animal our bodies will kill them unless we stop that natural process with large doses of drugs that suppress our immune system. Even the Edmonton Protocol, which I reported at http://www.mendosa.com/diabetes_update_55.htm, has to use immunosuppressive drugs. Their biggest advance was to use less toxic drugs.

  Other approaches based on stem-cell research also require transplant recipients to take these drugs for the rest of their lives. Further, some of this research has been slowed down by ethical considerations. INGAP Peptide, which stimulates the growth of insulin-producing cells in the pancreas, may also require immunosuppressive drugs.

  But what if researchers were able to take your own bone marrow cells and transform them into islet cells? Until last month the idea was laughable. But now scientists at the New York University School of Medicine have done precisely that in mice. I will spare you the technical details, but rest assured that human trials will follow.

  The Journal of Clinical Investigation reports the research in its March 14 issue (111:843-50). The article by Andreea Ianus et al. is also online at In vivo derivation of glucose-competent pancreatic endocrine cells from bone marrow without evidence of cell fusion .

  A commentary by Vivian M. Lee and Markus Stoffel from the laboratory of metabolic diseases at The Rockefeller University in New York reported in the same issue describes the study as “elegant.”

  Islet cell transplants that require lifelong immunosuppression can’t be regarded as a cure for diabetes. This research, preliminary as it is, could be the harbinger of the first real cure.

• Can You Drink Your Oats?
  Both soluble and insoluble fiber are important in our diet, but nothing can compare with soluble fiber for making us feel full. It forms a gel when mixed with liquid, helping us to eat less and better control our blood glucose. Soluble fiber has also been scientifically proven to reduce blood cholesterol levels.

  One of the most important sources of soluble fiber in our diet are the beta-glucans that occur in the bran of grasses such as oats, barley, and wheat. Oatmeal—called porridge in much of the rest of the world—is probably our most important source.

  But it has never been as popular as it warrants. The lexicographer Samuel Johnson in the first comprehensive English dictionary defined oats as a grain which in England is generally given to horses, but in Scotland supports the people. To some degree that same prejudice remains, if not in England but certainly in America.

  Now, some European scientists are working to increase the acceptability of beta-glucans by taking them out of the oats and other grasses and putting them into new foods that they are designing. The European Commission funded a three-year project that began in 2001. The project, "Design of Foods with Improved Functionality and Superior Health Effects Using Cereal Beta-Glucans," already has succeeded in making new foods high in beta-glucan, including a beverage.

  They fed mice with some of the new foods. It lowered the lipid (cholesterol and triglyceride) levels of those lucky mice. Now, they are going to see how well people like their creations and how well they work for us.

  Thanks to Dr. Mark Varner, professor and extension dairy scientist at the University of Maryland (and a subscriber to this newsletter) for bringing an article about this research at http://www.bionutr.kc.lu.se/EUbeta-glucan_project.htm to my attention.

Announcements

• Woman's World Boost
  The glycemic index has finally made it all the way into American popular culture. The March 18 issue of Woman's World magazine wrote extensively—and with only a little hype and surprising accuracy—about the glycemic index in its cover story, “Turn off your fat-making hormone! Lose 15 lbs in 30 days.”

  I had never heard of this publication before, but supermarkets sell it along with the like of National Enquirer. It is, in fact, one of the top circulation magazines, according to Media Distribution Services. That source says the magazine’s circulation is 1,666,721 copies.

  I found a copy for me at the local Safeway. The article ends with a link to http://www.mendosa.com/gi.htm for more information. A surprising number of readers followed that link. I started getting email about the article on March 8, and the number of hits on that Web page exploded in the weekly report that my Internet Service Provider sent me on March 17. For the first time more than 100,000 people accessed one of my articles in one week. That’s up from 32,000 hits on that file a week earlier, and 14,000 hits the week before that.

• Unzipping GILists
  I keep getting wonderful help from my computer-savvy readers. Because of Greg Johnston, I am now again able to include the complete list of 750 foods tested for their glycemic index values in regular html rather than zip format. It was just in time for the readers of Woman's World, who went on from my introduction to the glycemic index at http://www.mendosa.com/gi.htm to the list at http://www.mendosa.com/gilists.htm. The interest of readers of that magazine boosted the number of hits on that page to more than 75,000 in the March 17 report. That’s up from 27,000 the previous week. The numbers began to head back to normal in the March 24 and March 31 report.

  Greg, whom I had never heard of before, wrote me that he was bored and “Wanted to work on my JavaScript to extract data from a table. I figured you might like the results and I expanded my knowledge of coding at the same time.” He dramatically reduced the size of the file, which I had converted from an Excel spreadsheet, from about 750,000 bytes to 251,108 bytes.

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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© Copyright 2003 David Mendosa. All Rights Reserved.

David Mendosa:
A Writer on the Web: www.mendosa.com
E-mail: mendosa@mendosa.com

Office: 993 E. Moorhead Circle Suite 2F, Boulder, CO 80305