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Diabetes Update: Keynote Address

December 1, 2004

By David Mendosa


Maroon Bells

A Colorado Lake

This newsletter keeps you up-to-date with new articles, Web pages, and books that I have written about diabetes.

  • I list and link most of these on my at Diabetes Directory and in the site’s menu.

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

My recent contributions are:

  • Keynote Address
    The day after the election I had the pleasure of delivering the keynote address to Institute for the Future’s Health Horizons Program in Menlo Park, California. I attended the entire conference and got a lot out of it, not least the inspiration to buy (and actually use!) a treadmill and weights. You can read my article on my site at Keynote Address.

  • Incorrect Diabetes Terms
    While the conference that I spoke at last month was great, some speakers threw around incorrect diabetes terms, like calling us “diabetics.” Nobody referred to any of us as “noncompliant,” another terms that many of us take exception to. For my directory of what I see as these incorrect terms, please read Incorrect Diabetes Terms. I am sure that you can think of even more such terms than I list. If so, please write me at mendosa@mendosa.com.

  • Precision Comes Before Accuracy
    It doesn’t do much good if your meter is accurate but not precise. Precision is the ability of a measurement to be consistently reproduced. If you can’t consistently reproduce your blood glucose tests, your meter can’t possibly be correct, except once in a while. Random acts of accuracy are worse than useless. This article originally appeared in the November 2004 issue of Diabetes Health and is now also online at Precision Comes Before Accuracy.

Update:

  • Drug Interactions
    At the conference I went to last month that I mentioned above several speakers stressed the importance of knowing about potential drug interactions. So I thought it would be appropriate to review the articles I wrote years ago on this subject.

    Several sites have good interaction tools. Probably the best free Web tools are at Drugstore.com and Drugs.com. The URL of the “Drug Interaction Checker” at Drugs.com is http://www.drugs.com/drug_interactions.html. Drugstore.com also calls its tool a “Drug Interaction Checker.” It is hard-to-find with a difficult URL, Link.

    There are several new sites that I haven’t used myself. The Express Scripts “Check Interactions” site is http://www.drugdigest.org/DD/Interaction/ChooseDrugs/1,4109,,00.html.

    Another one is Discovery Health’s “Drug Interaction Checker.” The URL of this tool is http://health.discovery.com/encyclopedias/checker/checker.jsp.

    If several readers try and compare some of these sites, I may include a further update in a subsequent issue. I would appreciate your comments on the ease-of-use and completeness of these site, if you care to write me at mendosa@mendosa.com.

Research Notes:

  • Preprandial Versus Postprandial Testing
    Just within the past few years we have had a much greater emphasis on blood glucose testing after meals. I emphasized the importance of this “postprandial” testing in a September 2000 article on Starlix in Diabetes Wellness Letter and more fully in a more recent article on testing guidelines on the American Diabetes Association’s website.

    Most experts recommend that you do your postprandial testing two hours after the first bite of the meal. Some, however, would like us to test after one hour. I previously recommended testing after two hours, as I explained in my testing guidelines article referred to above. But a recent study, “The postprandial glucose profile in the diabetic pregnancy” in the August 2004 issue of the American Journal of Obstetrics and Gynecology by doctors in the department of obstetrics and gynecology at the Rabin Medical Center of Tel Aviv University shows that at least for pregnant women who have diabetes, “the time interval for postprandial glucose peak in diabetic pregnancies is approximately 90 minutes after meals throughout the day and is not affected by the level of glycemic control.” This could be a good reason for all of us to change to testing an hour and one-half instead of two hours after the beginning of a meal. That is what I have done.

    But what is a good level? The experts disagree. The ADA says your goal should be below 180 mg/dl. The American College of Endocrinology says that it should be no more than 140 mg/dl. And some endocrinologists set the goal at 120 mg/dl.

    Of course, many people routinely do a fasting blood test every morning. In addition, we have the opportunity to test before and after each meal, before and after exercise, and when going to bed. Which of these are the most important times to test?

    Dr. Richard J. Schrot addresses this question in the October 2004 issue of Clinical Diabetes. His research on “Targeting Plasma Glucose: Preprandial Versus Postprandial” concludes that targeting fasting plasma glucose is more beneficial when your A1C level is very high, like about 10, while targeting postprandial glucose is more effective when you have a lower A1C, say about 7. Personally, I am now testing 90 minutes after each meal.

    You can read the entire article online at http://clinical.diabetesjournals.org/cgi/content/full/22/4/169

Announcements:

  • HTML Format
    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.

  • My Guarantee
    This newsletter is free and will never include advertising. Nor will I ever sell, rent, or trade your e-mail address to anyone.

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
  60. Diabetes Update Number 60: Chromium of July 1, 2003
  61. Diabetes Update Number 61: Traveling of August 1, 2003
  62. Diabetes Update Number 62: My Book of September 1, 2003
  63. Diabetes Update Number 63: Hot Tubs of October 1, 2003
  64. Diabetes Update Number 64: Home A1C Testing of November 1, 2003
  65. Diabetes Update Number 65: Detemir of December 1, 2003
  66. Diabetes Update Number 66: Erectile Dysfunction of January 1, 2004
  67. Diabetes Update Number 67: Acidic Foods of February 1, 2004
  68. Diabetes Update Number 68: Net Carbs of March 1, 2004
  69. Diabetes Update Number 69: Glycemic Index of April 1, 2004
  70. Diabetes Update Number 70: Dreamfields Pasta of May 1, 2004
  71. Diabetes Update Number 71: Cholesterol of June 1, 2004
  72. Diabetes Update Number 72: Meter News of July 1, 2004
  73. Diabetes Update Number 73: Pill Splitting of August 1, 2004
  74. Diabetes Update Number 74: GlucoMON of September 1, 2004
  75. Diabetes Update Number 75: Coding of October 1, 2004
  76. Diabetes Update Number 76: Sleep Apnea of November 1, 2004
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