January 25, 2012

All the Links Posted on the Blood Sugar 101 FaceBook Page Since Inception

One of the things I don't like about FaceBook--besides the fact that I have no control over the spammy ads they show visitors--is that FB can make anything I post disappear at its whim.

Since I started the FaceBook page in August, I've been posting more and more links to small but significant bits of diabetes and medical research news that, while they don't deserve an entire blog post here, do deserve your attention.

So for those of you who don't get FB updates, and for those of you who don't like how hard FB makes it to find old posts, here are all the posts that reference news that have appeared on the FB page until today.

You'll find the FB page at http://www.facebook.com/pages/Blood-Sugar-101/194439440617073?sk=wall

High Fructose Diets: "An analysis of 559 adolescents...correlated high-fructose diets with higher blood pressure, fasting glucose, insulin resistance and inflammatory factors." HFCS has far more fructose than regular sugar. The food companies are not honest about the percentage. High levels of fructose consumption by adolescents may put them at cardiovascular risk, evidence suggests.


Contrast media used in CT scans and cardiac cath can permanently damage thyroid. Use of iodinated contrast media in imaging procedures appears to affect thyroid function.

Severe side effects of a new, expensive drug Rasilez emerge 4 years after approval. Very bad drug for people with diabetes as it can harm kidneys.

Is pork safe? High levels of MRSA bacteria in U.S. retail meat products, study suggests
Retail pork products in the U.S. have a higher prevalence of methicillin-resistant Staphylococcus aureus bacteria (MRSA) than previously identified, according to new research.

Insulin therapy may help repair atherosclerotic lesions in diabetic patients
New research reveals that insulin applied in therapeutic doses selectively stimulates the formation of new elastic fibers in cultures of human aortic smooth muscle cells. These results advance the understanding of the molecular and cellular mechanisms of diabetic vascular disease.

Solving the mystery of an old diabetes drug that may reduce cancer risk
Researchers now report on how the diabetes drug metformin potentially reduces cancer risk.

It lowers blood sugar, yes, a bit--but it also seems to cause cancer. FDA Rejects Dapagliflozin for Type 2 Diabetes www.medpagetoday.com WASHINGTON -- The FDA said it would not approve the novel diabetes drug dapagliflozin until drugmakers Bristol-Myers Squibb and AstraZeneca supply more data on the drug's benefits and risks.

This child's science project should make all of us realize how permeated with organic toxins our supermarket food is. My Potato Project; The Importance of "Organic" www.youtube.com A child's experiment turns into a lesson on the toxins in our food supply.

Toss that red wine. 145 studies of resveratrol and red wine used fake data. Red wine researcher Dr. Dipak K. Das published fake data: UConn - HealthPop - CBS News www.cbsnews.com UConn cut off lab's funding after discovering director of cardiovascular research falsified data on more than 100 occasions Read more by Ryan Jaslow on CBS News' HealthPop.

Omega-3 fatty acids could prevent and treat nerve damage, research suggests Note: Farm-raised fish may not provide Omega-3s if they are fed feeds high in corn oils as many are.
Omega-3 fatty acids, which are found in fish oil, have the potential to protect nerves from injury and help them to regenerate, new research suggests.

Cosmetic chemical hinders brain development in tadpoles This chemical is also found in the paper used to wrap foods. It is one of tens of thousands of chemicals that are approved for use without a full understanding of their toxicity. These toxic industrial chemicals pervade our environment, and go a long way to explaining health changes industry would like you to blame on your behavior. Damage the brain and you damage metabolic control feeback loops.Cosmetic chemical hinders brain development in tadpoles.
A new study finds that low concentrations of the chemical methylisothiazolinone has subtle but measurable negative effects on the neural development of tadpoles. The chemical is found in some cosmetics, although the study does not provide any evidence that cosmetics are unsafe for humans.

Low protein maternal diets increase child diabetes. Known fact, but here's more evidence. How poor maternal diet can increase risk of diabetes: New mechanism discovered
Researchers have shown one way in which poor nutrition in the womb can put a person at greater risk of developing type 2 diabetes and other age-related diseases in later life. This finding could lead to new ways of identifying people who are at a higher risk of developing these diseases

This new protein sounds like it would affect Type 2, also, since beta cell death and glucagon dysregulation is also a feature of Type 2. Protein that may represent new target for treating type 1 diabetes identified
Researchers have discovered a new protein that may play a critical role in how the human body regulates blood sugar levels. The research team says the protein may represent a new target for treating type 1 diabetes.

WLS lowers CVD risk--with only 17% average weight loss. Could it be the enforced low carbing at work here? Since insulin levels are key, yes. Weight-loss surgery may lower heart attack, stroke risk - CNN.com www.cnn.com Obese people who decide to undergo stomach surgery to speed weight loss may lower their risk of having a heart attack or stroke.

Hypomethylation of genes associated with Type 2 diabetes strongly predictive of Type 2 long before onset. (This is an epigenetic change not necessarily passed by inheritance.) Click the link to the reference for the specifics if you are scientifically inclined. Scientists map susceptibility to type 2 diabetes
New research has provided the first proof of molecular risk factors leading to type 2 diabetes, providing an “early warning” sign that could lead to new approaches to treating this and other human disease conditions.

"A recent University of Michigan survey found that less than 50% of patients were able to answer basic questions about their condition, let alone its treatment. A 2004 Institute of Medicine report summarizes the finding of over 300 studies demonstrating that most people do not understand health information that is intended for them. An analysis conducted by the Department of Health and Human Serv... See MoreWhy health care competition won't work - CNN.com www.cnn.com Candidates, legislators say competition is key to controlling health costs, but Amitai Etzioni says the evidence doesn't support the idea

A bit of insight into how our natural glucocorticoid hormones regulate blood sugar which points to another reason for abnormally high sugars--disrupted glucocorticoid regulators. No practical application for now, but interesting. Discovery may lead to safer treatments for asthma, allergies and arthritis
Scientists have discovered a missing link between the body's biological clock and sugar metabolism system, a finding that may help avoid the serious side effects of drugs used for treating asthma, allergies and arthritis.

Without Autopsies, Hospitals Bury Their Mistakes - ProPublica www.propublica.org Hospital autopsies have become a rarity. As a result, experts say, diagnostic errors are missed, opportunities to improve medical treatment are lost, and health-care statistics are skewed.

Yet another reason to avoid supplementing with herbs and cinnamon used in greater than typical food level quantities. Some plant-based food supplements contain high levels of cancer causing agents, study suggests
While many consumers equal ‘natural’ with ‘safe’, botanicals and botanical preparations such as plant-based food supplements may contain compounds, like the so called alkenylbenzenes, that are of concern for human health. A new study reveals there are plant-based food supplem...

High triglycerides don't CAUSE nerve damage. They come from the high carb intake which turns into the high blood sugars that do. Triglycerides implicated in diabetes nerve loss | University of Michigan Health System www.uofmhealth.org A common blood test for triglycerides -- a well-known cardiovascular disease risk factor -- may also for the first time allow doctors to predict which patients with diabetes are more likely to develop the serious, common complication of neuropathy. Results from a new study suggest that diabetes pati...

The calorie-restricted intermittant low carb diet made the greatest change in IR though non-restricted LC caused the same weight loss. Both beat meditteranean low cal. Intermittent, low-carbohydrate diets more successful than standard dieting, study finds
An intermittent, low-carbohydrate diet was superior to a standard, daily calorie-restricted diet for reducing weight and lowering blood levels of insulin, a cancer-promoting hormone, according to recent findings.

A large epidemiological study of Zocor over 11 years finds a 23% decrease in cardiovascular events and no increase in cancer or other kinds of death. Effects on 11-year mortality and morbidity of lowering LDL cholesterol with simvastatin for about 5. www.thelancet.com Effects on 11-year mortality and morbidity of lowering LDL cholesterol with simvastatin for about 5 years in 20536 high-risk individuals: a randomised controlled trial. By - Heart Protection Study... http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)61125-2/abstract?rss=yes

Another "sounds like it makes sense" theory turns out to be wrong. Other research has shown that blocking oxidation removes the benefits of exercise and that people taking antioxidants are more likely to die than those who don't.
Oxidative stress: Less harmful than suspected?
Oxidative stress is considered to be involved in a multitude of pathogenic processes and is also implicated in the process of aging. For the first time, scientists have been able to directly observe oxidative changes in a living organism. Their findings in fruit flies raise doubts about the validity...

An interesting rundown on some real-world stem cell cures that are in the pipeline. Note NONE involve diabetes. The "stem cell" cures you see advertised online for diabetes are all expensive scams.Stem cell therapy poised to shake-up medicine as dozens of clinical trials show early success www.dailymail.co.uk Dozens of adult stem cell treatments are moving through clinical trials and showing early success, raising hopes that some could reach the market within five years.

Note the list of self-serving reasons why doctors fight letting patients see the test results THEY paid for. Every patient should get a copy of every lab test they take and keep it, as doctors rarely transfer these to another doctor when you move, so the new doctor won't see important results that the first doctor missed. I learned this the hard way when my new doctor only received a one page summary sheet covering 7 years of complex medical problems.Should Patients Get Direct Access to Their Laboratory Test Results? - — JAMA jama.ama-assn.org (FULL TEXT NO LONGER AVAILABLE FREE)

Study identifies Rice as a source of Arsenic. 

This should speed the development of the CGMS/Pump combo marketed as an "artificial pancreas." Type 2s with no insulin production will find them useful too. New FDA Guidelines for Testing Artificial Pancreas diabetes.webmd.com The FDA has released new guidelines for the development and testing of artificial pancreas devices for the treatment of type 1 diabetes.

It really IS poison! (And BTW the "diseases" that arsenic causes includes Diabetes.) See link in comment below. High levels of arsenic found in fruit juice today.msnbc.msn.com The apple and grape juice your kids are drinking may have arsenic at levels high enough to increase their risk of cancer and other chronic diseases, according to a new study by Consumer Reports.

No need to starve yourself. This low cal diet achieves its results because it is also a LOW CARB diet. Mainstream medicine still can't bring itself to let people eat fat, so a "balanced" diet with Very Low Carb levels will be 500 calories. Study: Low-cal diet cuts fat around heart in obese people yourlife.usatoday.com Heart function improved in obese people with type 2 diabetes who ate a very low-calorie diet, a small new study says.

More good news: Metformin has strong effect in combating estrogen's effect turning breast cells cancerous. Diabetes drug shows promise in reducing risk of cancer, study suggests
An inexpensive drug that treats Type 2 diabetes has been shown to prevent a number of natural and human-made chemicals from stimulating the growth of breast cancer cells, according to a new study.

Fatty Liver Disease (NAFLD) makes NO difference in how long you live. One less thing to worry about? Researchers surprised to find fatty liver disease poses no excess risk for death
Non-alcoholic fatty liver disease is a common condition associated with obesity and heart disease long thought to undermine health and longevity. But a new study suggests the condition does not affect survival.

High protein dairy rich diet improves fat loss and bone density for pre-menopausal overweight women. (Are you surprised?)High dairy protein intake may aid bone formation during diet and exercise in overweight women www.endocrinetoday.com Overweight and obese premenopausal women who increased dairy food and protein intake during weight loss regimens developed improved markers for bone formation
http://www.endocrinetoday.com/view.aspx?rid=89688 refers to

This is one of several studies I've seen lately that suggest that for people using meds to control blood pressure, keeping it in the high normal range rather than aggressively lowering it might be healthier. My guess is that this is because when BP goes too low counterregulation kicks in and releases great bursts of stress hormones which might raise the risk of cardiovascular events. I've had that happen and it's NOT fun. Study evaluates 'normal range' systolic blood pressure levels after ischemic stroke and risk of recu...
Among patients who experienced an ischemic stroke, systolic blood pressure levels of less than 120 mm Hg, or higher than 140 mm Hg, were associated with an increased risk of subsequent stroke, according to a new study.

An upside? People with a 'sweet tooth' have sweeter dispositions
If you're dealing with a crabby co-worker or sour-faced friend, perhaps some new research can help. It sheds light on the question: Can eating sweets make you--well--sweet? A new study suggests people with a "sweet tooth" have sweeter dispositions.

Eating canned soups raises BPA blood levels dramatically. "A 2008 study of 1,455 people showed that higher urinary BPA levels were linked with higher risks of developing cardiovascular disease and diabetes, and abnormal concentrations of certain liver enzymes, even after factors such as age, body mass index and smoking were taken into account." Vitals - BPA levels soar after lunching on canned soup vitals.msnbc.msn.com By Karen RowanMyHealthNewsDaily Eating canned food every day may raise the levels of the compound bisphenol A (BPA) in a person's urine more than previously suspected, a new study suggests. People who ate a serving of canned soup every day for five days had BPA levels of 20.8 mi …

American Diabetes Association's preferred testing method fails to identify kids with diabetes, study. It's also true of adults. Note that the random glucose or 1 hour GTT result is the most accurate test. You can do this at home with your meter for free.
In 2009, the American Diabetes Association (ADA) recommended that Hemoglobin A1c be exclusively used for the diagnosis of diabetes in children. The simple test measures longer-term blood sugar levels -- without requiring patients to fast overnight. However, a new study has shown that these tests are...

Surgery Outcomes Better With Some Fat on the Bones  Some good news --read the whole article, though, and note the list of surgeries where risk is higher. Many involves opening the abdomen and the study finds you will do better if you hunt out a highly skilled surgeon (One who does a lot of that surgery, ideally at a high profile, teaching hospital, not the local suburban community hospital.) Surgery Outcomes Better With Some Fat on the Bones www.medpagetoday.com Surgical patients with a body mass index at the lower end of the normal range were more likely to die within 30 days of the procedure than those in the moderately overweight range, researchers found.

Charity Navigator gives American Diabetes Association a poor rating because 24 cents of every dollar raised goes to fundraising and more than $1 Million goes to pay only two of the executives who run the org. What a ripoff. Charity Navigator - Your Search Results www.charitynavigator.org Charity Navigator, America's largest independent charity evaluator, provides free financial evaluations of America's charities. We are the individual donor's first source for unbiased news and information on philanthropy, nonprofit organizations, wise giving, donating money, charitable donations, an...

"Yet all statins are associated with adverse events, especially at higher doses. Muscle-related adverse events, cognitive and memory problems, and elevation of liver enzymes have all been described. Such events reportedly occur with a frequency of less than 5% among patients in randomized clinical trials but in as many as 20% of patients in clinical practice"

After 2 years on two different statins, subjects' carotid plaque was shown to be reduced by about 1%. This is a tiny amount and there is no evidence anywhere that making such a reduction has any effect on health outcomes. Yet another surrogate marker. Why don't they get honest and track the outcomes? Effect of Two Intensive Statin Regimens on Progression of Coronary Disease — NEJM www.nejm.org Original Article from The New England Journal of Medicine — Effect of Two Intensive Statin Regimens on Progression of Coronary Disease

Studies presented at the American Heart Association dog and pony show. Read the detailed summary of the AIM-HIGH study which showed that lowering LDL and raising HDL with drugs made no difference in the incidence of heart attacks, stroke, etc. SATURN and AIM-HIGH: Back down to planet Earth endocrinetoday.com AHA Scientific Sessions 2011Again this year, clinical trials evaluating lipoprotein-modifying therapies are in the spotlight at the American Heart ...

Women with abnormal blood sugar should start insulin BEFORE pregnancy, so that they can learn how to dose it correctly. This helps them avoid having children with birth defects. Tell your friends with diabetes who may be thinking of having children. Pre-pregnancy counseling may reduce risk for congenital anomalies www.endocrinetoday.com Annual Meeting of the CDA/CSEM TORONTO ? To reduce the risk for congenital anomalies in diabetes, clinicians should offer pre-pregnan...

Tight control reduced the process leading to kidney failure by 50% in Type 1s who had been in the "Tight control" arm of DCCT (achieving A1cs near 7%). It took ten years for this to become apparent. Imagine how much better Type 2s will do if they get down to the 5% range (which is easier for them to do than it is for Type 1s.)Intensive Diabetes Therapy and Glomerular Filtration Rate in Type 1 Diabetes — NEJM www.nejm.org Original Article from The New England Journal of Medicine — Intensive Diabetes Therapy and Glomerular Filtration Rate in Type 1 Diabetes

Hold the SSRIs, a handful of nuts a day might have the same effect . . . Benefits of nut consumption for people with abdominal obesity, high blood sugar, high blood pressure
For the first time, scientists report a link between eating nuts and higher levels of serotonin in the bodies of patients with metabolic syndrome. Serotonin helps transmit nerve signals and decreases feelings of hunger, makes people feel happier and improves heart health. It took only one ounce of m...

Surgery to clear out the carotid arteries does NOT reduce the risk of stroke. Surgical procedure does not appear to reduce risk of subsequent stroke for patients who have had 'mi
Patients with thickening and blockage of the internal carotid artery (supplies blood to the brain) and hemodynamic cerebral ischemia (insufficient blood flow to the brain, sub-type of stroke) who had a surgical procedure performed to improve blood flow in the artery did not have a reduced rate of ...

Don't fall for "stem cell" scams. This article does a great job of summarizing why stem cell research isn't an option for diabetes yet. (And note, all the research is for Type 1 diabetes.) Diabetes and the stem cell promise www.latimes.com Ever since scientists started talking about the medical potential of embryonic stem cells, curing Type 1 diabetes has been one of the dearest dreams.

A drug company funded study suggests Byetta reduces C-Reactive Protein short term (on average, of course. It's not clear if this, like Byetta's blood sugar reducing effect only occurs in 1/3 of those who take it.) The story is being reported as if this reduction in C-RP means a reduction in inflammation, but that isn't proven. C-RP may be a surrogate marker. Until we see evidence that people taking Byetta for several years have fewer heart attacks or fewer autoimmune symptoms it's hard to know if this is meaningful. Exenatide (Byetta) has rapid, powerful anti-inflammatory effect, study shows
Exenatide, a drug commonly prescribed to help patients with Type 2 diabetes improve blood sugar control, also has a powerful and rapid anti-inflammatory effect, a new study has shown.

Don't dose yourself with animal hormones whose dosage you don't know and whose effect can be dramatic and toxic. Use of over-the-counter thyroid support pills is risky, researcher finds
People who use over-the-counter "thyroid support'' supplements may be putting their health at risk, according to a new study. The supplements contain varying amounts of two different kinds of thyroid hormones apparently derived in large part from chopped up animal thyroid glands, says an endocrinolo...

Bottom line: Don't scan that frozen shoulder or sore tendon unless you got it after an accident.M.R.I.’s, Often Overused, Often Mislead, Doctors Warn www.nytimes.com Some sports medicine specialists are taking a stand against overreliance on M.R.I.’s, saying they are easily misinterpreted and can result in misdiagnoses and unnecessary, even harmful, treatment.

Another reason to take ACE inhibitors and ARBs besides the fact they protect your kidneys! Could hypertension drugs help people with Alzheimer's?
A new study has looked at whether certain types of drugs used to treat high blood pressure, also called hypertension, might have beneficial effects in reducing the number of new cases of Alzheimer's disease each year.

Lung cancer patients survive much better if they have it.  Correlation is not causation, but here's some inexplicable "good" news about diabetes: (Probably due to metformin.) Lung cancer patients with diabetes show prolonged survival
Lung cancer patients with diabetes tend to live longer than patients without diabetes, according to a Norwegian study.

Activating this youthful pathway that shuts down in adults may cause beta cells to proliferate. New molecular target for diabetes treatment discovered
Researchers have identified a key molecular pathway responsible for the natural decrease in the proliferation of insulin-producing cells that occurs as a person ages. Artificially activating this pathway, which is normally not functional in adults, may be a new way to combat diabetes.

Diabetes Bigwigs  have significant conflicts of interest due to their Industry ties. Big surprise. Industry conflicts of interest are pervasive among medical guideline panel members, experts say
Researchers have found that conflicts of interest are prevalent and potentially under-reported among individuals participating in the development of clinical practice guidelines, which inform standards of patient care. The findings provide further evidence of the potential influence of industry on m...

A list of herbs and supplements that can cause problems if you have surgery. Not all surgeons warn you about these problems. Herbal supplements may cause dangerous drug interactions in orthopaedic surgery patients, study sugg
Complementary and alternative medical treatments such as herbal supplements have become increasingly popular in the United States, especially among older patients and those with chronic pain. However, many of these products can have serious and potentially harmful side effects when combined with med...

This is at least the 3rd study that finds a higher risk of death in people who take vitamin supplements. Get your vitamins from food. That's what your body is adapted to. The pills have toxic inclusions and too much vitamin often does something harmful--like antioxidants keeping you from burning glucose. Vitamins Tied to Higher Death Rates in Older Women in Study - Businessweek www.businessweek.com Multivitamins and some dietary supplements, used regularly by an estimated 234 million U.S. adults, may do more harm than good, according to a study that tied their use to higher death rates among older women.

Tamoxifen may raise risk of diabetes, possibly by lowering estrogen. Estrogen definitely lowers my blood sugar. How about you? Breast cancer drug tied to diabetes in older women www.reuters.com NEW YORK (Reuters Health) - Older women taking the breast cancer drug tamoxifen may have an increased risk of developing diabetes, a new study suggests.The findings, reported in the journal Cancer, do

High doses of glucosamine kill beta cells. And it turns out not to help joints either.

Key protein causing excess liver production of glucose in diabetes.Researchers have identified a powerful molecular pathway that regulates the liver's management of insulin and new glucose production, which could...

Researchers looking at how GLP-1 affects the beta cell find that it involves two genes heavily involved in cancer. That's not what the press release emphasizes, but if you read down into the article that's what you learn. Discovery of insulin switches in pancreas could lead to new diabetes drugs
Researchers have discovered how a hormone turns on a series of molecular switches inside the pancreas that increases production of insulin.

You have been getting BPA for years from cans. Besides these terrible impacts on fetuses, earlier research has found it increases obesity in offspring too. A MAJOR cause of the "obesity epidemic" and a contributing cause to diabetes in those with the underlying genetic profile. Shame on industry for resisting attempts to remove it from our environment. BPA alters development of in vitro ova and could increase risk of Down syndrome, study suggests
Researchers in Spain analysed the effects of bisphenol A (BPA), a polymer widely used to manufacture plastics, in an in vitro culture of ovaries. The research demonstrated that exposure to this substance gravely altered the development of oocytes and future ova, possibly diminishing the fertility of...

Another much-hyped supplement bites the dust. Sirtuin doesn't extend animal life in well-conducted research. I wouldn't invest heavily in resveratrol either, if I were you. Anti-aging creams: Is the 'longevity gene' nearing the end of its life?
Sirtuins, proteins believed to significantly increase lifespan in a number of organisms -- and the claimed target of some anti-aging creams -- do not, in fact, affect animal longevity, according to new research.

Bad news for Januvia, Byetta, Onglyza and Victoza. From ET: analysis "... revealed a sixfold increase in the odds ratio for reported cases of pancreatitis associated with GLP-1 therapy, when compared with four other diabetes therapies used as controls. In addition, patients receiving the two drugs were more likely to develop cancer compared with those treated with the other therapies."GLP-1 therapy, cancer connection scrutinized www.endocrinetoday.com EASD 47th Annual Meeting LISBON — The relationship between the glucagon-like peptide 1 agonists sitagliptin and exenatide and risks for cancer

January 4, 2012

New Jimmy Moore Podcast on La Vida Low Carb Show

Listen to it here:


Questions and comments are welcome, just click on the "comment" link below.


January 2, 2012

It's That Time Again . . .

The rows of candy in the Seasonal Aisle will be replaced with Diet Food, mostly toxic. The media will be full of diet advice, mostly wrong. The bookstores (what few are left, but that's another story) will move the newest Miracle Diet books to the front of the store, each one promising to reveal a simple secret that will make the pounds drop off like magic. The gym will be packed.

It only lasts a month. Then the shelf at the grocery store will be full of chips and dips for SuperBowl parties, at least in the USA, you won't have to wait in line for a treadmill at the gym. The Miracle Diet Books will be shelved with all the other, failed, diet books, as it becomes clear that this year's magical secret is no better than last year's.

People with diabetes, of course, don't have the luxury of dieting only for 2 weeks in January. We have to watch what we eat year-round because we can't afford to let high blood sugars ravage our bodies. But as I've explained elsewhere, people with diabetes are also normal human beings, and that means that a certain amount of the time we are going to eat things that aren't good for us, overdo it, and pack on a few pounds over holidays.

The critical thing for us to master is not that we never eat anything that is off plan, but that, when we do, we learn how to get back on track as soon as we realize things are getting out of control.

A few hours over 200 mg/dl (11.1 mmol/L) won't make you go blind, give you a heart attack, or take out your kidneys. Neither will a few weeks. Most people who develop the classic diabetic complications do so after years of exposure to blood sugars way over 140 mg/dl (7.7 mmol/L)--the level that appears to be the upward limit of safety. Details HERE.)

But as many of us have learned the hard way,those harmless hours of high blood sugars have a way of turning into weeks and months, sometimes without our noticing it, and when that happens, those damaging years aren't far behind.

So it's good practice to clean up our act every now, and this January period right after the holidays is a great time to do it.

As always, our primary focus should be first on bringing our blood sugars back to where we know they should be. Most people at this time of year diet for weight loss, but weight loss is not what preserves the health of people with diabetes, no matter how many times you may have heard this said.

What preserves our health is keeping our blood sugars as close to the normal range as possible. That means staying under 140 mg/dl (7.7 mmol/L) and, if possible, ended up under 120 mg/dl a few hours after we finish a meal. Lower is better if we can do it without experiencing hypos (defined, technically, as blood sugars under 70 mg/dl (3.9 mmol/L)).

After you've gotten your sugars into control, you might also decide to drop some weight which may happen on its own if you're new to cutting back on carbs, but which will likely require some calorie restriction if you are an old hand at it.

Modest weight goals work better than ambitious ones. Set a goal you can achieve in a month, which may be anywhere from three to ten pounds depending on your size, and then set a new goal at the end of the month rather than setting a grandiose goal ("I'm going to lose 80 lbs!") which is much harder to attain and much easier to depress you after the first enthusiasm wears off.

If your blood sugar has been running a bit high lately or your occasional snacking has turned into round the clock eating, you will run into some known problems when you cut back. For starters, you're likely to be very hungry. Fortunately, the physiological component of your hunger is entirely due to the change you are making in your blood sugar and should be gone within a day or two once you get back on track. Remind yourself that if you can get through two days of eating the way you want to eat it will become a lot easier.

The other problem you'll run into is temptation. There is something about seeing some food we have decided not to eat that makes us immediately crave it. If that food is always in our field of vision, it can become very hard to withstand the urge to eat it. Diets that rely on willpower can be very short diets. So plan ahead to eliminate as much temptation as possible. Here are some suggestions I've found helpful. Please post your own in the comments section.

1. If it's not there, you can't eat it. Rid your home of any food that you find hard to resist. A common diet disaster pattern is eating perfectly all day, only to come home and blow it all by snacking on junk as the evening progresses. So throw out, or give away the items you end up pigging out on. If they aren't there, you might think about eating them, but you won't be able to eat them. This sounds idiotically simple, but the world is still full of people who try to diet with fridges full of ice cream.

This may require taking a hard line with family members. Demand their support. If they argue that just because you are on a diet they shouldn't have to be, ask that they keep their junk food somewhere out of your sight. Even just putting snack foods in a cupboard instead of leaving them out on a counter where you see them every time you walk through the kitchen can make a big difference. Just remember, Monkey See, Monkey Eat.

2. Don't Watch TV Commercials. One major cause of diet stress turns out to be the ads on TV. Seeing food makes people hungry, and TV is full of closeups of pizzas and burgers and "endless" shrimp. One strategy that has worked for our family is to use the commercial breaks for mini exercise sessions. During the commercial breaks turn off the sound and do some pushups. Lift hand weights. Run a few laps around the house. I have a nice long, steep driveway which is just the right size for a few laps of brisk walking during my beloved Patriots games. You'll feel a bit silly, but you may be amazed at how much better you feel if you do this. Even better, turn off the TV entirely and read or do things online that don't expose you to food porn.

3. Set modest goals. I don't tell myself I'm going to eat perfectly for the rest of my life. Instead I say, "I'm going to eat perfectly for the next two weeks. Then I'll see where things are at and decide what to do next." What I usually do next is continue to eat reasonably, because two weeks of keeping things clean makes it much easier for me to continue. But for me, it's very important to maintain my feeling that I am in control, not the diabetes.

4. Eat Dull Food. Stephan Guyenet over at The Whole Health Source Blog has posted some interesting research over this past year about how the palatability of food tends to push us towards weight gain. I've found that it is often easier for me to diet when I eat the same predictable dull low carb foods for breakfast and lunch every day for a few weeks. When they become intolerable, replace them with other dull foods. Eggs and meat or cheese for breakfast, Fage yogurt and nuts for lunch, a big green salad with meat for dinner, are good examples. All too often when people start dieting they spend their time reading diet cookbooks and recipe web sites looking for ideas. This dwelling on food is the last thing you need to do. If you need to come up with recipe ideas for a new diet, do it before your diet starts. Then think about other things.

5. Do A Different Diet. If you're trying to lose weight, especially if your previous attempt hasn't worked out as well as you had hoped, rather than just reflexively reach for the newest diet doctor book with its promise of Miracle Weight Loss Secrets, take some time analyze what it was about your last diet that made it fail.

Was it that you didn't like the foods you ended up eating? If so, don't go back to eating those foods, but find other foods that you might like better to diet on. Did the diet make you hungry, even after the first week was over? If so, maybe you are past the point where diet alone can flatten your blood sugars to where you aren't hungry. Maybe it's time for metformin, or perhaps insulin.

If you haven't had your thyroid checked in a while, do, and make sure your doctor does more than a TSH test to determine if you are having thyroid problems. Diet alone is not enough to solve many metabolic problems. Hunger is a SYMPTOM. If cutting back on sugar and starch do not resolve nagging physiological hunger, it may be time to get help from an intelligent doctor.

Your issues with failed diets of the past may be different, so you need to figure out what it was that derailed you. Doing the same thing over and over again expecting a different result is the definition of futility. So figure out what didn't work for you and solve the problem it posed.

6. Hold Yourself Accountable. Post your weight or blood sugar goal and daily progress in the appropriate section of an online diet or diabetes support forum. If that is too exposed, log them into tracking software, like Fitday.com for diet or one of the diet and blood sugar tracking apps available for your smart phone.

Average your results every week and see if the trend is up or down. Weekly averaging of individual values for things like weight and post-meal sugars will give you a much better idea of how you are doing than just looking at the individual values that can be all over the place.

7.Investigate What You're Eating. One of the biggest reasons for diet failure turns out to be eating a lot more than you think you are eating. If you are trying to cut carbs, you need to learn about how much carbohydrate there is in every food you eat. Look it up online. Download diet software. Use an app.

And remember that the nutrition counts you read are always pegged to a specific weight or volume. Weigh and measure your food for a few days to see what you are really eating. If you are like most people you may find that you are eating between two and three times as much carbohydrate each day as you think you are and far more calories, too.

What are your tips? Add them in the comments section.