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Diabetes Update: Chromium

Number 60; July 1, 2003

By David Mendosa


Good Friends

Arthur and Gus—Good Friends

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:

  • Chromium: Perhaps Good, Perhaps Harmful.
    Honestly, now, how many of you have ever bitten the hand that feeds you? You haven’t? It’s not a civilized thing to do and only wild animals do that.

    Exactly. I don’t mean to imply that researchers who are paid by the companies whose products they test feel any conflict of interest, but if they were negative about those products, it would certainly be biting the hand that had fed them.

    That’s why I don’t buy the clean bill of health that “leading worldwide experts” gave to chromium picolinate in the recent so-called “chromium summit” in Boston sponsored by The Council for the Advancement of Diabetes Research and Education (CADRE). It is indeed a “non-profit organization,” according to Diabetes In Control.Com.

    Nevertheless, that’s hardly the complete picture. One source of CADRE’s funds is a Purchase, New York, company called Nutrition 21. This certainly sounds benign. However, “The Company markets Chromax chromium picolinate, the leading brand of chromium, and holds 35 patents for nutrition products, 22 for chromium compounds and their uses,” Nutrition 21 says in a recent press release.

    Furthermore, several of the researchers at the chromium summit are also in Nutrition 21’s pay. The Diabetes In Control article cited above identifies one of the presenters at the chromium summit, Gary Evans, as a consultant for Nutrition 21. John Hathcock from the Council for Responsible Nutrition presented data on the safety of chromium and chromium picolinate. This organization also sounds benign, but it is a “trade association representing ingredient suppliers and manufacturers in the dietary supplement industry.” Of course, Nutrition 21 is one of the organization’s member companies.

    For my article on chromium I studied the professional articles written by John Vincent, MD, of the University of Alabama and interviewed him via email. He is probably the world’s leading expert on chromium, and certainly has written the most.

    Dr. Vincent wrote me that “If you interview Dr. Cefalu, be sure to ask him about his connections to Nutrition 21, the company that produces chromium picolinate. Just so you know, I have no connections to any company producing or marketing dietary supplements.” William T. Cefalu, MD, of the University of Vermont, was the summit’s co-chair.

    One subscriber to Diabetes Update, Steve Adam, notes that, “While it [the Diabetes In Control article] quotes some of the same doctors you do, the conclusions and mention of dangers of chromium are much different than yours.” He’s right. I don’t know about Diabetes In Control, but I do know that Deep Throat’s admonition to “follow the money” worked for Watergate investigative reporters Bob Woodward and Carl Bernstein as it generally does in politics and business.

Updates:

  • Glycemic Values of Common American Foods
    Thanks to correspondent Jon Landenburger, I have improved the table showing the glycemic index and glycemic load values of the most common American foods that have been tested. I had a complicated one-dimension table with nine divisions for low, medium, and high GI and GL. Jon had the bright idea of turning it into a 3x3 two-dimension table. It’s online now.

Offer:

  • If you are troubled by hands that seem to be always cold and are one of the first three people to reply, a friend of mine has a free Smitten for you. Some people say the Smitten reminds them of a “muff,” a hand-warming article of clothing from back in the good old days. The Smitten is made of plush polar fleece. There’s a Smitten Web site at http://www.smitten.com.

Research News:

  • Can PKC-Beta Inhibitors Fight Complications?
    Nowadays I am spending more time reading about diabetes in many different magazines and seem to be finding less and less that hasn’t already been said better. There are a raft of journals and magazines for people with diabetes and several more for health professionals. My friends Dr. Bill Quick and his wife Stephanie Schwartz have the best directory of these magazines online at Journals and Magazines about diabetes.

    Invariably, Diabetes Interview is one of the most valuable of these magazines, even if I often disagree with what they have to say. However, the current issue has one of the most interesting articles about diabetes that I have found in print for quite a while. Written by R. Keith Campbell, associate dean and professor of pharmacy practice, College of Pharmacy, Washington State University, Pullman, and one of his students, C. J. Cahoon, the article explores how too much of an enzyme called protein kinase C-beta (PKC-beta to those who know it well) can cause the microvascular complications of diabetes. The article says that Lilly is working on a PKC-beta inhibitor called LY333531 that might eliminate the negative effect high blood glucose levels have on the eyes and kidneys.

    Dr. Campbell himself has type 1 diabetes and is perhaps the country’s leading expert on diabetes drugs. He has helped me on several of my articles.

    My thanks also go to Scott King, the publisher of Diabetes Interview. He authorized me to reprint the article on my Web site.

  • Statins for Everyone!
    A huge, long-term study of the use of statin drugs is finished. About 10,000 people took one of the statin drugs, simvastatin (Zocor), every day for five years. Another 10,000 took a fake pill.

    About 25 percent of the people who took the fake pills had a heart attack, a stroke, or needed angioplasty or bypass surgery. By comparison, about 20 percent of those given the statins suffered these events.

    In itself, that is a statistically meaningful difference, but some of the people assigned fake pills ended up taking statins otherwise. That diluted the real difference. One of the study’s investigators, Dr. Jane Armitage, says that they estimate the true effect of taking a statin is a one-third reduction in the risk of heart attacks, strokes, or artery operations.

    Only about 30 percent of the people in the study had diabetes. About half of them had no evidence of heart disease and about half had normal or below-average cholesterol levels. But they seemed to benefit as much as the others, Armitage says.

    This led the study’s authors to recommend that just about all adults with diabetes should take one of the statins. The authors are the UK Heart Protection Study, led by epidemiologist Rory Collins of Oxford University and his colleagues.

    The exceptions are some people newly diagnosed in their 20s or 30s when the risk of heart trouble may not be so high. The exceptions do not include people who have low cholesterol levels. The study proved that they also benefit from taking a statin.

    That is a remarkable conclusion given that the medical profession prescribes statins for high cholesterol. When my endocrinologist told me to take a statin for my high cholesterol, I protested, because I had just read Dr. Uffe Ravnskov's book, The Cholesterol Myths: Exposing the Fallacy that Saturated Fat and Cholesterol Cause Heart Disease (NewTrends Publishing, 2002).

    When I protested, my doctor cut to the core issue—even if cholesterol is not the problem, statins have been shown to reduce heart disease. The current study amply validates his recommendation to me.

    In fact, statins are so valuable that some people have gone so far as to recommend that our water supply should be laced with them, the same way we fluoridate our water. That would be overkill, however, because you and your doctors still have to watch for rare but potentially serious side effects.

    After registering (free), you can read the abstract of the study online. The study appeared in the June 14, 2003, issue of The Lancet, Britain’s premier medical journal. Peter Jaret has an excellent article on the statins in the June 23 issue of the Los Angeles Times, online at http://www.latimes.com/features/health/la-he-statin23jun23.story.

  • Is it Smart or Hype?
    If you believe the reviews, those whiz kids at the Massachusetts Institute of Technology (MIT) and Harvard Business School are cooking up a form of insulin that would make Sir Frederick Banting bug-eyed with astonishment. Already they have won the grand prize for the MIT entrepreneurship competition and the $30,000 that goes with the first place finish. The MIT press office says they “delivered a business plan for a once-a-day, self-regulating insulin delivery system for diabetics. The technology uses a new kind of biodegradable polymer to produce stimuli-responsive nanoparticles for controlled drug delivery.”

    The honchos at MIT are impressed. Likewise, Wired News, The (Syracuse) Post- Standard, and even the Diabetes in Control Web site. The latter source says:

    SmartInsulin contains nanoparticles that release insulin in proportion to blood-glucose levels. These particles will start to slowly break down and release insulin into the bloodstream, regulating (the) blood-sugar level. Once the blood sugar is at normal levels, the particles close back up, resolidify, and then stop releasing insulin.

    However, you won’t find me riding on this bandwagon. In the first place, the quote above implies that SmartInsulin exists. It doesn’t. If it will ever exist, it is years away from the market.

    I wondered where the top expert on insulin, John Walsh, came down on this question. John is the author of Using Insulin. I read a draft of the new edition last month and will review here when it is published in a month or two.

    “Their original idea in 2001 appeared to be trying to modify DNA to create a sensor/releasor for BG control,” John wrote me. “But in 2002 they were using ‘nanotechnology,’ which is usually applied to MEMS [Micro Electro-Mechanical Systems]. It is not clear what their concept really involves, but it will require major steps and a few million dineros to go from idea to product. Beta cell transplants are probably a lot closer to reality.”

    Sad, but true. Still, if you believed the hype, it would be even sadder.

Book Reviews:

    Cooking Up Fun for Kids with Diabetes

    Truly, a fun book—and not just for kids.

  • Cooking for Kids with Diabetes
    Finally, the American Diabetes Association has a cookbook worth reviewing! Two top Certified Diabetes Educators, Patti Geil and Tami Ross, have put together Cooking Up Fun for Kids with Diabetes, a 194-page paperback due to be published next month at $14.95.

    The emphasis here is just what I am always looking for: simple, fast, and a bit different. The recipes tend to be savory rather than sweet. While it is for children, also showing all the materials they need, any inexperienced cook will appreciate the detailed directions. Someone who cooks regularly wouldn’t need to have all of this, but it can’t hurt.

    Not for low carb or low glycemic purists, this cookbook is nevertheless more carb moderate than the usual run of the ADA mill. It’s not surprising, because the lead author, Patti Geil, is a vigorous supporter of the glycemic index. In fact, Patti asked me to make her article, “From Jelly Beans to Kidney Beans: What Diabetes Educators Should Know about the Glycemic Index” available on my Web site. Reprinted from the July/August 2001 issue of The Diabetes Educator, the official publication of the American Association of Diabetes Educators, you can read it on my Web site.

    Amazon.com has this book at $10.47. The ADA also has it listed.

    The South Beach Diet

    Not Just another Diet Book—This One is Based on the Glycemic Index

  • South Beach Diet
    I’m delighted to see a new diet book based on the glycemic index make The New York Times bestseller list. Called The South Beach Diet, it is nothing more or less than a good-carb, good-fat diet.

    That is a lot.

    The good carbs are well known to readers of this newsletter. They are, of course, low glycemic.

    The good fats are mono- and polyunsaturated ones. The bad fats are, of course, saturated and transfat.

    Nothing new here. Yet Dr. Arthur Agatston, a highly respected cardiologist practicing in Miami Beach, has taught hundreds if not thousands of Floridians that they can lose weight by following these simple ideas.

    Phase 1 of his diet has you choosing only low glycemic foods. You don’t count carbs or limit portion size. If anything, this diet is simple.

    In Phase 2, you slowly add in high GI foods. No wonder this diet is so popular.

    In fact, there is no essential difference between The South Beach Diet and the diet advice in The New Glucose Revolution, Dr. Jennie Brand-Miller’s compilation of knowledge about the glycemic index. However, unlike Dr. Agatston, she isn’t selling her book as a diet.

    I’m not complaining. This diet just can’t be beat. Moreover, I have nothing but respect for a cardiologist who challenges the orthodoxy of the American Heart Association that only a low-fat diet is good for you.

    Please note that the glycemic index that Dr. Agatston uses is based on white bread = 100, while nowadays most of us use glucose = 100. That can be a bit confusing, because each food has a different number that you will find on my Web site and in Dr. Brand-Miller’s book.

    Published in April 2003 by Rodale, this trade hardcover book lists for $24.95. It’s 310 pages of explanation, testimonials, and recipes.

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  • My Guarantee
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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
    58. Diabetes Update Number 58: Lancets of May 1, 2003
    59. Diabetes Update Number 59: Accurate Meters of June 1, 2003


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