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Diabetes Update 97: Pumping in Real Time

August 1, 2006

By David Mendosa


Prairie Dog

A Watchful Neighbor
A Prairie Dog along the South Boulder Creek Trail

My most recent articles are:

  • Pumping in Real Time
    The MiniMed Paradigm REAL-Time Insulin Pump and Continuous Glucose Monitoring System is the first linked insulin pump and continuous glucose monitor. Olympic athlete Chris Jarvis tells me how it works. My article originally appeared in the August 2006 issue of Diabetes Health and is now also online here.

  • Me and My Byetta
    Weight loss is only an incidental benefit of taking Byetta. But for me it has been the main event. At the time I wrote this article I had already lost 48 pounds in my first 3 and one-half months on Byetta. My article originally appeared in the August 2006 issue of Diabetes Health and is now also online here.

  • My Diabetes Blog
    It’s too hard to keep up with blog content without subscribing to their RSS (Really Simple Syndication) feeds. An RSS feed aggregator makes it easy to keep track of blogs you want to read on a regular basis. I use Bloglines to keep up with the blogs that I like to read.

    My new blog entries for July are:

    • The Gliptins are Coming. The gliptins are a promising new class of drugs that block the DPP-4 enzyme. They include two drugs, vildagliptin (proposed trade name Galvus) from the Swiss pharamaceutical giant Novartis and sitagliptin phosphate (proposed trade name Januvia) from an American company, Merck. The gliptins are theoretically similar to Byetta and its cousins, the GLP-1 analogs. But there are huge differences between the gliptins and the GLP-1 analogs. The big pluses of the gliptins are that they greatly reduce A1C levels, have few side effects, work well with existing diabetes drugs, and especially that you will be able to take them as a once-a-day pill, rather than by the injections that the GLP-1 analogs require. Still, the clinical trials of the gliptins showed one big disappointment. They don’t cause much if any weight loss.

    • Eating to Lose Weight. Now there is proof that you can really lose weight if you eat  —  breakfast. Scientists in Santa Barbara, California, carefully studied 2,701 adolescents from two public high schools there. They compared those who skip breakfast against those who daily eat a complete breakfast. The breakfast skippers were heavier than those who ate breakfast. It didn’t matter whether they had a family history of diabetes or how much their parents weigh.

    • Living the Good Life with Diabetes. To live a good life with diabetes has to mean first that we control our blood glucose. But it also means enjoying the good things in life. I particularly enjoy moderate amounts of Scotch whisky and sometimes immoderate amounts of espresso.

    • Duo Care of Diabetes and Hypertension. GenExel-Sein, headquartered in South Korea, has just introduced the first combined blood glucose and wrist blood pressure monitor. They call it the Duo-Care. The Food and Drug Administration approved it in January, and the first units came off the assembly line a few days ago. I got one of the first Duo-Care units.

    • Walking Faster. We may be walking long enough, but most of us don’t walk fast enough. The latest physical activity guidelines for people with type 2 diabetes recommend 150 minutes of exercise per week. But these guidelines say that our walking needs to be at least “of moderate intensity.” Researchers accept that a walking speed of 4 kilometers per hour  —  2.5 miles per hour  — defines moderately intense physical activity. We don’t walk that fast.

    • Zinc-Fingered Therapy. Sangamo BioSciences calls their zinc-fingered therapy SB-509. It’s a catchy name. Even better, it might some day prevent or even cure diabetic neuropathy.

    • The Fructose Puzzle. Fructose is a strange sugar. It is the sweetest natural sugar, yet it has the lowest glycemic index of any sugar. Still, many people link our increased consumption of fructose to the national obesity epidemic. Generally, these people are concerned about the fructose in high fructose corn syrup. But I herewith dismiss any concern about the fructose in fruit and vegetables as de minimis.

    • Water Everywhere. Everybody agrees that we need plenty of water. How much water we need has, however, been a matter of controversy for years. To me there is nothing better than filtered or sparkling water.

    • A Noble Meter. The new Rightest GM300 blood glucose meter is a noble one in more ways than one. The Righest uses gold electrodes, which is a noble metal. In addition, I like the meter’s accuracy as well as the look and the feel of the meter in my hand.

    • China’s GlucosePilot. The first blood glucose meter made in China for the U.S. has arrived. You can read my evaluation of it here.

    • Exercise for Type 2 Diabetes. Anecdotally, we have known for a long time that we can control our diabetes a lot better with exercise. Now we have the proof that it works. It brings down our blood glucose levels.

    • Size Matters. Can you fool yourself into eating less? A Cornell University professor shows that you can make use of an illusion to take off pounds.

organizer

New Edition of My Book
What Makes My Blood Glucose Go Up…and Down?

New Books:

  • The second American edition of my first book came out this month, and I was as excited as anyone to get my copies from the publisher. Unlike my magazine and Web articles, which I know in advance what they will say because none of my current editors have learned the fine art of hacking my work to death, what the book will look like is always a surprise. That’s not because of the editing, but because I am only one of the book’s three authors.

    The book has a very long title. I complained to the publisher about the long title of the first edition. Consequently, the title of the second American edition is even longer, The New Glucose Revolution: What Makes My Blood Glucose Go Up…and Down?

    Jennie Brand-Miller, professor of human nutrition at Australia’s Sydney University; Kaye Foster-Powell, an Australian dietitian; and I each wrote one-third of the book. The first American edition came out in 2003. An edition for Australia came out in 2004, followed by British and Chinese editions last year.

    The first thing that I noticed about the new edition is that it has a prettier cover than any edition except the British one. The second thing is that the publisher printed it on better quality — whiter — paper.

    Other changes are minor. One that I had asked to be make was part of the answer to a question that I had written. The question is “How long does it take for my blood glucose to go up after I eat?” Part of the answer now says that by three to four hours after eating your blood glucose returns to pre-meal levels. This corrects my mistatement in the first edition that it takes just two hours.

    Both edition say that our levels generally reach a peak in 30 to 45 minutes. However, research published after we finished editing the book now indicates that the peak is 72 minutes, as I wrote in my blog entry at http://blogs.healthcentral.com/diabetes/david-mendosa/new-time-to-test-glucose-levels-2006-06-19/print

    This is just one part of 101 frequently asked questions about your blood glucose levels. We divided the book into three main sections:

    1. Your Blood Glucose Levels. Here are 36 general questions and answers.
    2. What Makes my Blood Glucose Levels Go Up? We divided this section into 18 food factors that increase blood glucose levels and six non-food factors that increase them.
    3. What Makes My Blood Glucose Levels Go Down? We divided this section into 32 food factors and 9 non-food factors.

    A big bonus is a complete glycemic index and glycemic load table. It is even more complete that the table on my website at http://www.mendosa.com/gilists.htm, because the table in the book also includes foods that have so little carbohydrate that the GI value can’t be tested.

    Marlowe & Company in New York publishes this 196-page soft cover book for $12.95. The ISBN-13 is 978-1-56924-302-2. The older ISBN-10 is 1-56924-302-6.

Questionnaire:

  • A researcher from the University of Nottingham in England named Verbena Braga wrote me. She says that the university is interested in the use of online social support and diabetes. “Although an increasing number of people participate in online forums that provide medical information and help along with social support, a recent article in the British Medical Journal concluded that our understanding of the effects among users is currently very limited,” she writes. “We are trying to assess what kinds of support people seek and benefit from within these online forums.”

    The study, unlike previous research, focuses on the social and psychological benefits of online communities. But in order for this research to succeed, they rely on the willingness of site users to participate. She says that the questionnaire is completely anonymous, complies with BPS ethics guidelines, and has been passed by the university ethics committee. The questionnaire is short and designed to be as non-intrusive as possible. People can stop at any time.

    At the end of the project they will share the key findings with me, and I will share them with you.

    The questionnaire is online at http://www.surveymonkey.com/s.asp?u=36552414850

Announcements:

  • This Newsletter
    Diabetes Update 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 at the upper left of all my Web pages.

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

  • 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:
    1. Is and will remain free.
    2. Will never include advertising (except targeted Google ads at the bottom of the web page and not in the email newsletter).
    3. Nor will I ever sell, rent, or trade your e-mail address to anyone.
    4. I will link sources of information.
    5. I will disclose any conflict of interest.
    6. If and when I learn of any errors of fact, I will correct them.

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
  77. Diabetes Update Number 77: Keynote Address of December 1, 2004
  78. Diabetes Update Number 78: Mangosteen of January 1, 2005
  79. Diabetes Update Number 79: Noninvasive Dream of February 1, 2005
  80. Diabetes Update Number 80: Pelikan Sun of March 1, 2005
  81. Diabetes Update Number 81: Medtronic Monitors of April 1, 2005
  82. Diabetes Update Number 82: ExtendBars of May 1, 2005
  83. Diabetes Update Number 83: GlycoMark of June 1, 2005
  84. Diabetes Update Number 84: My British Book of July 1, 2005
  85. Diabetes Update Number 85: Disintegrating of August 1, 2005
  86. Diabetes Update Number 86: Meter Research of September 1, 2005
  87. Diabetes Update Number 87: Evaluating Meters of October 1, 2005
  88. Diabetes Update Number 88: When to Test of November 1, 2005
  89. Diabetes Update Number 89: Blogging of December 1, 2005
  90. Diabetes Update Number 90: RSS Feed of January 1, 2006
  91. Diabetes Update Number 91: An Uncommon Doctor of February 1, 2006
  92. Diabetes Update Number 92: More Blog Entries of March 1, 2006
  93. Diabetes Update Number 93: Talking Meters of April 1, 2006
  94. Diabetes Update Number 94: Navigating of May 1, 2006
  95. Diabetes Update Number 95: Measuring Sweat of June 1, 2006
  96. Diabetes Update Number 96: The Future of Pumps of July 1, 2006
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