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Diabetes Update: Lancets

Number 58; May 1, 2003

By David Mendosa


Kitten

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 and in the site’s menu.

  • From time to time Diabetes Update may also include links to other Web pages of special interest.
My most recent contributions are:
  • Advances in Lancets.
    Lancets have been the undervalued step-child of the blood glucose meter business. Not any more. In this article I offer my sincere appreciation for the brand new BD Ultra-Fine 33 Lancets and the forthcoming electronic lancet cartridge from Pelikan Technologies.

  • The Glycemic Index of Common American Foods.
    Visitors to my Web site have requested something like this file more than anything else. Until now, I have begged off, referring them to lists that I made years ago when only some 300 foods had been tested for their glycemic indexes. Those lists are seriously out-of-date now that 750 foods have been tested. If you can use this list, thank the editor of my forthcoming book, What Makes My Blood Glucose Go Up...And Down? And 101 Other Frequently Asked Questions About Your Blood Glucose Levels, because he insisted that we include it in the book.

  • Glycemic load values.
    This month saw my second publication in a peer-reviewed journal. It was almost 30 years ago, when the Liberian Studies Journal published my first peer-reviewed article under the byline of Richard A. Mendosa, “Review of The Cultural Context of Learning and Thinking: An Exploration in Experimental Anthropology, by Michael Cole et al.” That had been a term paper written for an anthropology class when I was the officer-in-charge of the Liberian Desk for the U.S. Agency for International Development in Washington.

    The new publication is a bit different. It came in the April 2003 issue of the esteemed journal, American Journal of Clinical Nutrition. The publication is just a short letter, but it served a purpose. Jennie Brand-Miller asked me to write it and replied to it in the same issue.

    The letter asked Jennie two questions that she had not addressed in her landmark publication of the “International table of glycemic index and glycemic load values: 2002” in the journal’s July 2002 issue. First, I asked her if the amount of carbohydrate in a food or its glycemic index was the more important part of its glycemic load. That is because the glycemic load of a food is determined by multiplying its glycemic index by its available carbohydrate content per serving.

    “At Mendosa’s suggestion, we used the data published in the revised tables to explore the statistical relations between GI, GL, and carbohydrate content,” Jennie replied. After explaining the statistics, she concluded that the carbohydrate content is the greater determinant of GL. But the GI value accounts for quite a bit of it too.

    “Mendosa’s second question relates to appropriate cutoffs for high, medium, and low GLs,” Jennie added. “As a starting point, we suggest that the preliminary cutoffs be ±10 for a low GL and ±20 for a high GL. Hence, a GL between 11 and 19 represents a medium GL.”

Book Review: Type 2 Book Cover

  • Type 2
    This attractively presented little book, Type 2: A Book of Support for Type 2 Diabetics comes with considerable promise. The author, Miryan Ehrlich Williamson, published the valuable Blood Sugar Blues: Overcoming the Hidden Dangers of Insulin Resistance just two years ago.

    The key to this upbeat book is the little word “support” in the subtitle. It is support, after all, that in my opinion we need more than information in new books about diabetes.

    Yet it is hardly supportive to call us “diabetics,” as the subtitle also does. That word applied to people has been rightly banned by the American Diabetes Association in favor of the less concise but also less labeling “people with diabetes.”

    Ms. Williamson’s new book is essentially the personal stories—both inspiring and heart-rendering— of more than one hundred of us. She goes on to recommend the different ways that we can get support, both in real life and on the Internet. She covers all these bases well.

    Walker & Company in New York published Type 2 this month. This 236 page paperback lists for $12.

Research Update:

  • Alpha Lipoic Acid
    A collaborative study between Mayo Clinic in Rochester, Minnesota, and a Russian medical center in Moscow has found that alpha lipoic acid significantly and rapidly reduces the frequency and severity of symptoms of diabetic neuropathy. The study included 120 people with type 1 or 2 diabetes and the symptoms of diabetic sensorimotor polyneuropathy. The patients were randomized to receive either a daily dose of 600 mg alpha lipoic acid intravenously or a placebo, following one week in which all participants received placebo. The study was double-blinded so neither patients nor investigators knew which patients received each substance.

    Those who took alpha lipoic acid saw a 5.7-point total symptom score improvement from the start of the trial, while those who took a placebo only improved 1.8 points. There were no unfavorable side effects to the alpha lipoic acid.

    However, the Food and Drug Administration has not yet approved the drug for this purpose. The March 2003 issue of Diabetes Care reported the study in “The Sensory Symptoms of Diabetic Polyneuropathy Are Improved With a-Lipoic Acid.” I have updated On-line Diabetes Resources, Part 15: Diabetic Neuropathy accordingly.

Announcement:

  • Web Site Triage
    Three years ago I started a column about Jeff Hitchcock’s Children with Diabetes site by asking the rhetorical question, “If your Web site is so successful that you're going broke, what do you do?”

    I was reminded of Jeff's predicament this month when I faced the same challenge. My Web site is becoming so successful that last month my Internet Service Provider raised my monthly fee from $77 to $462, because downloads from my site took 117 gigabytes of bandwidth in March.

    That compelled me to again zip several of the most popular large files, all of which are related to the glycemic index. They have been taking huge amounts of bandwidth—up to 3.8 billion bytes a week for 72,000 downloads for just one of these files and 3.0 billion bytes for 101,000 downloads of another. Because of this, my site used up to 27 billion bytes per week. That's more than four times that of the huge Children with Diabetes site.

    Eventually, I found a site, http://members.lycos.co.uk/ramendosa/, that allows unlimited bandwidth at no cost. The only disadvantage is advertising—a small ad at the top of each file and a pop-under ad after you leave the site. So I then unzipped the files that I had just zipped up and moved them to the new site. Right now, anything to do with the glycemic index is on this Lycos U.K. site.

    Still, near the end of April it became apparent that these efforts were not enough to avoid large bandwidth charges once again. Consequently, I temporarily removed several large and popular files. It’s a new month today, and I have restored them. Like the Vietnamese village of Ben Tre in 1968, I had to (partially) destroy my site in order to save it.

Boilerplate:

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Archives:

I now send out Diabetes Update once a month. Previous issues are online:

  1. Diabetes Update Number 1: Diabetes Genes of December 10, 2000
  2. Diabetes Update Number 2: DiabetesWATCH of December 18, 2000
  3. Diabetes Update Number 3: Starlix of January 3, 2001
  4. Diabetes Update Number 4: Native Seeds/SEARCH, Tepary Beans of January 17, 2001
  5. Diabetes Update Number 5: Insulin Makes You Fat of January 31, 2001
  6. Diabetes Update Number 6: Available and Unavailable Carbohydrates of February 15, 2001
  7. Diabetes Update Number 7: Dates of March 1, 2001
  8. Diabetes Update Number 8: Quackwatch of March 15, 2001
  9. Diabetes Update Number 9: The Cost of Insulin of March 30, 2001
  10. Diabetes Update Number 10: Sof-Tact Meter of April 2, 2001
  11. Diabetes Update Number 11: iControlDiabetes of April 16, 2001
  12. Diabetes Update Number 12: Cinnamon, Tagatose of May 2, 2001
  13. Diabetes Update Number 13: Glycemic Index of May 15, 2001
  14. Diabetes Update Number 14: Eat Your Carrots! of May 31, 2001
  15. Diabetes Update Number 15: Glycemic Load of June 21, 2001
  16. Diabetes Update Number 16: Homocysteine of July 2, 2001
  17. Diabetes Update Number 17: Chana Dal Tips of July 15, 2001
  18. Diabetes Update Number 18: Lag Time in AlternativeLand of August 2, 2001
  19. Diabetes Update Number 19: Fiber of August 15, 2001
  20. Diabetes Update Number 20: How Diabetes Works of August 30, 2001
  21. Diabetes Update Number 21: Insulin Resistance of September 14, 2001
  22. Diabetes Update Number 22: Trans Fats, Honey, CU of October 1, 2001
  23. Diabetes Update Number 23: Pedometer Power of October 15, 2001
  24. Diabetes Update Number 24: Is Glycerin a Carbohydrate? of October 31, 2001
  25. Diabetes Update Number 25: Kill the Meter to Save It of November 15, 2001
  26. Diabetes Update Number 26: Protein, Fat, and the GI of December 1, 2001
  27. Diabetes Update Number 27: Insulin Index of December 14, 2001
  28. Diabetes Update Number 28: Fructose of January 4, 2002
  29. Diabetes Update Number 29: Aspirin of January 14, 2002
  30. Diabetes Update Number 30: Stevia of January 31, 2002
  31. Diabetes Update Number 31: Gretchen Becker’s Book of February 19, 2002
  32. Diabetes Update Number 32: The UKPDS of March 4, 2002
  33. Diabetes Update Number 33: Financial Aid of March 18, 2002
  34. Diabetes Update Number 34: Pre-Diabetes of April 1, 2002
  35. Diabetes Update Number 35: More Glycemic Indexes of April 15, 2002
  36. Diabetes Update Number 36: Gila Monsters of April 30, 2002
  37. Diabetes Update Number 37: Is INGAP a Cure? of May 15, 2002
  38. Diabetes Update Number 38: Native American Diabetes of June 3, 2002
  39. Diabetes Update Number 39: FDA Diabetes of June 19, 2002
  40. Diabetes Update Number 40: Diabetes Support Groups of July 1, 2002
  41. Diabetes Update Number 41: New GI and GL Table of July 15, 2002
  42. Diabetes Update Number 42: Diabetes Sight of August 1, 2002
  43. Diabetes Update Number 43: DrugDigest of August 18, 2002
  44. Diabetes Update Number 44: Hanuman Garden of September 3, 2002
  45. Diabetes Update Number 45: Guidelines of September 16, 2002
  46. Diabetes Update Number 46: Trans Fat of October 4, 2002
  47. Diabetes Update Number 47: Nutrition.Gov of October 16, 2002
  48. Diabetes Update Number 48: Our Hearts of October 31, 2002
  49. Diabetes Update Number 49: Our Kidneys of November 15, 2002
  50. Diabetes Update Number 50: A1C<7 of December 2, 2002
  51. Diabetes Update Number 51: Diabetes Searches with Google of December 16, 2002
  52. Diabetes Update Number 52: e-Patients of January 2, 2003
  53. Diabetes Update Number 53: Email News of January 16, 2003
  54. Diabetes Update Number 54: Third Generation Meters of January 31, 2003
  55. Diabetes Update Number 55: Hypoglycemic Supplies of February 14, 2003
  56. Diabetes Update Number 56: Food Police of March 1, 2003
  57. Diabetes Update Number 57: Vitamins of April 1, 2003


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