I've had it with FaceBook. I can't control the ads they show people who come to my page, which are invariably for scams that prey on people with diabetes. I'm tired of channeling a steady flow of people with diabetes into the greedy hands of FaceBooks's abusive advertisers.
Even worse, after I had recruited 1700+ people to my FB page, FB stopped showing most of them my updates, telling me I'd have to pay upwards of $100 each time I posted if I wanted the people who had subscribed to my page to see these updates.
FaceBook's belief that they have a right to spam people who like my page with damaging ads while withholding the useful information I was posting from these same subscribers is criminal.
And to add insult to injury, since FB scrolls posts into hiding very fast, much of what I have posted over the past two years has for all practical purposes vanished and is not accessible via search engine, further ensuring that people won't ever see it.
So I will be killing the FaceB ookBlood Sugar 101 page, if that is possible, and posting new material only in places where I control the advertising and where I can be sure that everyone who subscribes will see the feed.
This blog and my web pages are under my control and the blog, unlike FaceBook posts, is fully searchable by Google, which means that hundreds and sometimes even thousands of people get to read the posts I put on the blog, even years after they are made. (Right now the page about Metformin I posted back in 2006 is among the top 3 pages visited on this blog each month, and it still gets a comment or two every week.)
I like having a place to note small bits of Diabetes news that didn't rise to the level of needing a full blog post. That is why I stuck with the FB page even after they started cutting down on who could see the page. So to continue being able to feature news snippets what I've decided to do is this:
Each month I will start a new post here on this blog in which I will post the month's minor news items in the comments section. Visitors are free to comment on these snippets, though I will ask that you keep your comments short and limited to the subject of the latest snippet. Comments that don't follow this guideline will not be made public.
I know this will cut down on the number of people who see my posts, but the comments on my FB page make it very clear that very few people who have liked the page have bothered to check out any of the substantive information available on the Blood Sugar 101 web site.
Since FB's format makes it impossible to conduct ongoing discussions in a way where people can easily follow them, the page failed in its goal, which was to help spread the information available on the main site and help people improve their health.
To ensure you get the monthly post and comments, you can subscribe to the blog (or its comments, separately) via a blog reader like The Old Reader or Feedly.
For those of you who wonder why I have been posting so few substantive blog posts of late, the reason is simple. There is very little news that comes up that hasn't already been discussed in an earlier post here on this blog.
There are currently 552 posts on this blog, which you can search using the search box you will find in the right hand column of this page. They discuss just about every topic that comes up in the news, whether it be the worthlessness of rodent research, the problems with the A1c test, or the value of various drugs and surgeries.
So for most new news items, all that is required on my part is a line or two of comment. The substantive discussions on related topics are already available here and life is too short for me to spend many hours of my day rewriting them for people too lazy to look them up!
--Jenny
March 11, 2013
February 21, 2013
Another Dangerously Misinterpreted Study: Insulin Doesn't Raise Cancer & Heart Disese Risk--High Blood Sugars Do
A huge, long-term UK study appears to show that for people with Type 2 Diabetes injecting insulin raises the risk of both cancer and heart disease.
The study is:
Mortality and Other Important Diabetes-Related Outcomes With Insulin vs Other Antihyperglycemic Therapies in Type 2 Diabetes
Craig J. Currie et al. The Journal of Clinical Endocrinology & Metabolism February 1, 2013 vol. 98 no. 2 668-677
The study examined the records of 84,622 people with Type 2 Diabetes treated with 5 different drug combinations. It concludes: " In people with T2DM, exogenous insulin therapy was associated with an increased risk of diabetes-related complications, cancer, and all-cause mortality."
This conclusion is likely to lead insurance companies and physicians to deny insulin to people with Type 2 diabetes. This is tragic and very ill advised.
That is because what this study shows is a correlation between insulin use and heart disease and cancer, not causation. In fact, these results are easily explained when you understand that insulin use in people with Type 2 Diabetes in UK is a marker for long-term exposure to very high, uncontrolled blood sugars, and conclude that it is the high blood sugars, not the insulin causing the increase in mortality.
Indeed, the way that insulin is prescribed in the UK makes it so that patients aren't given insulin until they have had extremely high blood sugars for many years, and when insulin finally is prescribed it is done so in a way that does not bring blood sugars down to safe, physiologically normal levels.
So it isn't the insulin that is to blame here, it is the high blood sugars, which a great deal of research has shown cause all the classic diabetic complications as well as heart disease and cancer.
Let's look a bit more closely at how Type 2 Diabetes is treated in the UK where this study was conducted. Because the UK has a National Health Service, patients and to some extent doctors are not given choices about what treatment to use for Type 2 Diabetes. Treatment is based on the use of a rigid set of guidelines that links the treatment to long term blood sugar level. The guidelines consider 7.0% a safe and healthy blood sugar level for people with Type 2 diabetes. So no interventions occur when blood sugars are that high, though we know that level is high enough to produce all the classic diabetic complications. (You can read about the research connecting complications to blood sugar levels HERE and HERE.
At diagnosis, with A1c over 7.0%, patients in the UK are told to change their lifestyle--to exercise and eat the low fat/high carb diets that do little to lower blood sugar. Only if their A1cs continue to climb well above 7.5% are they put on oral drugs.
As we know, studies presented in the prescribing information included with diabetic oral drugs show that none of these oral drugs lower A1c more than about .5%. (I.e. from 8.5% to 8.0%.) Patients are left on these drugs, with their A1cs in the 7-9% range for years.
Only when A1cs climb much higher are patients prescribed insulin. Unfortunately, they are not prescribed the basal/bolus insulin regimens that make it possible to get normal, physiological blood sugars. Instead, they are given only enough insulin to lower fasting blood sugars to a level that will produce A1cs in the 7-7.5% range. This basal insulin does nothing to lower the post meal blood sugar spikes that research suggests cause heart disease and promote cancer. (You can learn more about the right way to use insulin for Type 2 diabetes HERE.)
When basal insulin isn't enough, most patients are given the worst form of insulin, the 70/30 mix which combines fast and slow-acting insulin in a way that makes it impossible to cover meals tightly without risking hypos. Patients are forced to eat high carb meals to avoid hypos with this nasty insulin blend and are unlikely to be able to lower A1c below or even to 7.0%.
Insulin under this regimen is dosed by the health professional who issues a simple guideline. As a result patients must eat a lot of carbohydrate to avoid hyping. This way of using insulin is like driving with one foot on the accelerator and one on the brake.
So patients "on insulin" at best end up with A1cs between 7.0 and 8.0%, and this occurs only after years of exposure to the much higher blood sugars that almost certainly explain the depressing rates of heart attack and cancer seen in this study.
The outcomes of patients using insulin who use it properly are much better. But using insulin safely to normalize blood sugars require education and a lot of careful observation and adjustment of doses. It can't be done with one appointment but takes time and training. Most if not all family physicians do not understand the proper dosing of insulin. Many don't even know there is such a thing, as they refer their patients with Type 1 Diabetes to endocrinologists. (And sadly, not all endocrinologists are familiar with how to dose insulin properly, especially not those trained before the mid 1990s.)
Used properly, the right combination of basal insulin to lower fasting blood sugars and fast-acting insulin to cover the carbohydrates in meals can make it possible to get A1cs in the 5% to low 6% range and avoid the classic diabetic complications.
To be fair to the researchers who publishsed this study, they concluded at the end of the report, "Differences in baseline characteristics between treatment groups should be considered when interpreting these results." But because they don't spell out what those differences are--that it means that the people on insulin are those with the very worst blood sugars who have lived with these very bad blood sugars for years and whose insulin did not really reverse them--this statement is very likely to be ignored.
Instead, because most U.S. physicians in general practice--the people who treat most people with Type 2 Diabetes--have almost no familiarity with the research explaining how blood sugar causes complications, this study is likely to result in fewer people with Type 2 Diabetes being given access to insulin when they need it.
Drug company marketers will use this result to pressure doctors to prescribe more of the dangerous, heavily marketed and very expensive DPP-4 inhibitors like Januvia and Onglyza (which also cause cancer) and the GLP-1 analogs like Byetta and Victoza (the latter of which as been linked to Thyroid cancer.) Neither class of drugs lower blood sugar in people whose beta cells aren't able to secrete insulin or have been killed by very high blood sugars. These are the very people who need insulin the most.
So if doctors use this result to deny patients insulin it will, in fact, raise the number of heart attacks and cancers over time. But it will save insurers money to deny people insulin, so expect to see this happening
The study is:
Mortality and Other Important Diabetes-Related Outcomes With Insulin vs Other Antihyperglycemic Therapies in Type 2 Diabetes
Craig J. Currie et al. The Journal of Clinical Endocrinology & Metabolism February 1, 2013 vol. 98 no. 2 668-677
The study examined the records of 84,622 people with Type 2 Diabetes treated with 5 different drug combinations. It concludes: " In people with T2DM, exogenous insulin therapy was associated with an increased risk of diabetes-related complications, cancer, and all-cause mortality."
This conclusion is likely to lead insurance companies and physicians to deny insulin to people with Type 2 diabetes. This is tragic and very ill advised.
That is because what this study shows is a correlation between insulin use and heart disease and cancer, not causation. In fact, these results are easily explained when you understand that insulin use in people with Type 2 Diabetes in UK is a marker for long-term exposure to very high, uncontrolled blood sugars, and conclude that it is the high blood sugars, not the insulin causing the increase in mortality.
Indeed, the way that insulin is prescribed in the UK makes it so that patients aren't given insulin until they have had extremely high blood sugars for many years, and when insulin finally is prescribed it is done so in a way that does not bring blood sugars down to safe, physiologically normal levels.
So it isn't the insulin that is to blame here, it is the high blood sugars, which a great deal of research has shown cause all the classic diabetic complications as well as heart disease and cancer.
Let's look a bit more closely at how Type 2 Diabetes is treated in the UK where this study was conducted. Because the UK has a National Health Service, patients and to some extent doctors are not given choices about what treatment to use for Type 2 Diabetes. Treatment is based on the use of a rigid set of guidelines that links the treatment to long term blood sugar level. The guidelines consider 7.0% a safe and healthy blood sugar level for people with Type 2 diabetes. So no interventions occur when blood sugars are that high, though we know that level is high enough to produce all the classic diabetic complications. (You can read about the research connecting complications to blood sugar levels HERE and HERE.
At diagnosis, with A1c over 7.0%, patients in the UK are told to change their lifestyle--to exercise and eat the low fat/high carb diets that do little to lower blood sugar. Only if their A1cs continue to climb well above 7.5% are they put on oral drugs.
As we know, studies presented in the prescribing information included with diabetic oral drugs show that none of these oral drugs lower A1c more than about .5%. (I.e. from 8.5% to 8.0%.) Patients are left on these drugs, with their A1cs in the 7-9% range for years.
Only when A1cs climb much higher are patients prescribed insulin. Unfortunately, they are not prescribed the basal/bolus insulin regimens that make it possible to get normal, physiological blood sugars. Instead, they are given only enough insulin to lower fasting blood sugars to a level that will produce A1cs in the 7-7.5% range. This basal insulin does nothing to lower the post meal blood sugar spikes that research suggests cause heart disease and promote cancer. (You can learn more about the right way to use insulin for Type 2 diabetes HERE.)
When basal insulin isn't enough, most patients are given the worst form of insulin, the 70/30 mix which combines fast and slow-acting insulin in a way that makes it impossible to cover meals tightly without risking hypos. Patients are forced to eat high carb meals to avoid hypos with this nasty insulin blend and are unlikely to be able to lower A1c below or even to 7.0%.
Insulin under this regimen is dosed by the health professional who issues a simple guideline. As a result patients must eat a lot of carbohydrate to avoid hyping. This way of using insulin is like driving with one foot on the accelerator and one on the brake.
So patients "on insulin" at best end up with A1cs between 7.0 and 8.0%, and this occurs only after years of exposure to the much higher blood sugars that almost certainly explain the depressing rates of heart attack and cancer seen in this study.
The outcomes of patients using insulin who use it properly are much better. But using insulin safely to normalize blood sugars require education and a lot of careful observation and adjustment of doses. It can't be done with one appointment but takes time and training. Most if not all family physicians do not understand the proper dosing of insulin. Many don't even know there is such a thing, as they refer their patients with Type 1 Diabetes to endocrinologists. (And sadly, not all endocrinologists are familiar with how to dose insulin properly, especially not those trained before the mid 1990s.)
Used properly, the right combination of basal insulin to lower fasting blood sugars and fast-acting insulin to cover the carbohydrates in meals can make it possible to get A1cs in the 5% to low 6% range and avoid the classic diabetic complications.
To be fair to the researchers who publishsed this study, they concluded at the end of the report, "Differences in baseline characteristics between treatment groups should be considered when interpreting these results." But because they don't spell out what those differences are--that it means that the people on insulin are those with the very worst blood sugars who have lived with these very bad blood sugars for years and whose insulin did not really reverse them--this statement is very likely to be ignored.
Instead, because most U.S. physicians in general practice--the people who treat most people with Type 2 Diabetes--have almost no familiarity with the research explaining how blood sugar causes complications, this study is likely to result in fewer people with Type 2 Diabetes being given access to insulin when they need it.
Drug company marketers will use this result to pressure doctors to prescribe more of the dangerous, heavily marketed and very expensive DPP-4 inhibitors like Januvia and Onglyza (which also cause cancer) and the GLP-1 analogs like Byetta and Victoza (the latter of which as been linked to Thyroid cancer.) Neither class of drugs lower blood sugar in people whose beta cells aren't able to secrete insulin or have been killed by very high blood sugars. These are the very people who need insulin the most.
So if doctors use this result to deny patients insulin it will, in fact, raise the number of heart attacks and cancers over time. But it will save insurers money to deny people insulin, so expect to see this happening
December 10, 2012
Research Posted on The BS101 FB Page Since September
It's time to collect and post all the substantive, research-related posts that have been posted on the Blood Sugar 101 Facebook Page.
As you can see there is the usual mix of disturbing findings about environmental pollutants, bad diet advice, dangerous prescription drugs, mistaken medical policy, and the benefits of lowering blood sugar by cutting back on carbohydrates.
I have put red arrows (==>) next to a few studies that have immediate, serious health implications for people with diabetes.
I continue to be less than thrilled with FB, but since so many people use it I've concluded it is a pretty good way to reach people who would otherwise never find this blog.
====
Study: After weight loss, Roux-en-Y causes dramatic post-meal blood sugar spikes. Banding makes no difference in blood sugar. Stats argue against either being a "cure" for diabetes, doesn't it.
See this chart:
http://www.jci.org/articles/view/64895/figure/4
From this article http://www.jci.org/articles/view/64895
=====
Ketones may why calorie restriction leads to life extension. So don't starve yourself, cut back on carbs.
http://www.sciencedaily.com/releases/2012/12/121206142025.htm
=====
Apparently, free speech extends to drug reps lying about prescription drugs. We're all screwed.
http://www.reuters.com/article/2012/12/04/us-offlabel-conviction-idUSBRE8B21DC20121204
=====
"Countries that use high fructose corn syrup in their food supply have a 20% greater prevalence of type 2 diabetes compared with countries that do not" Study says.
http://americannewsreport.com/high-fructose-corn-syrup-blamed-for-worldwide-diabetes-epidemic-8816853
=====
Dangerous concentrations of PCBs are found in many women's blood. They are known to promote diabetes.
http://www.sciencedaily.com/releases/2012/11/121128143944.htm
=====
You'll find lots of low carb holiday treats including cookies and other desserts here that you can indulge in without spiking your blood sugar.
http://www.tudiabetes.org/group/lowcarbrecipeswap/forum/topics/holiday-foods?commentId=583967%3AComment%3A2487538
=====
Flame retardants are hormone disrupters that promote obesity. You can't avoid them if you own upholstered furniture.
http://www.sfgate.com/health/article/Chemicals-in-furniture-hard-to-avoid-4072857.php
=====
What a shocker: The Wash Post notices that drug companies have polluted high impact medical research studies.
http://www.thedailybeast.com/cheats/2012/11/25/bias-may-taint-big-pharma-research.html
=====
A mouse study finds the specific cancer gene that is silenced when dietary carbs are restricted.
http://www.sciencedaily.com/releases/2012/11/121115133152.htm
=====
PCBs which concentrate in body fat (and therefore in the fat of the meat we eat) not only cause diabetes, they lead to infertility. This is a serious issue for people eating low carb diets, alas. Organic meat may be better, but the pervasiveness of these toxins in our environment makes them difficult to avoid with husbandry practices, as the animals still have to breath polluted air and drink polluted water.
http://www.sciencedaily.com/releases/2012/11/121114084027.htm
=====
A UK study concludes that screening for diabetes doesn't prevent bad outcomes. No one draws the obvious conclusion--UK treatment for diabetes sucks. Which it does.
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)61422-6/abstract
=====
BPA slows thyroid in pregnant animals and their offspring.
http://www.sciencedaily.com/releases/2012/11/121114083226.htm
=====
==> The EU has approved dapagliflozin which will be sold as Forxiga. This drug blocks absorption of glucose in the kidney, so you lower blood sugar by peeing away glucose. The FDA did NOT approve it because of possible liver damage and signals of breast and bladder cancer. Do NOT take this new drug until it has been on the market for at least 5 years and we know a bit more about what it really does.
http://medcitynews.com/2012/11/eu-approves-bristol-astra-diabetes-drug-forxiga-after-fda-rejection-due-to-cancer-risk/
=====
Arsenic, DDE, dioxin and pesticides all are strongly associated with both diabetes and obesity. It's NOT personal choices damaging our children.
http://www.sciencedaily.com/releases/2012/11/121113134928.htm
=====
==> FDA committee approved very long lasting basal insulin. But it isn't better than Lantus/Levemir and the 70/30 mix makes it impossible to cover post-meal spikes safely.
http://www.healio.com/endocrinology/diabetes/news/online/%7B61213728-C9A3-46E8-AD49-0010CE03911E%7D/Insulin-degludec-degludecaspart-receive-FDA-committee-approval-in-8-4-vote
=====
More evidence that sulfonylureas are worse for the heart than metformin. There is a well-understood reason why this should be true. They are discussed HERE
http://www.sciencedaily.com/releases/2012/11/121107122453.htm
=====
Doctors really are biased against fat people. If you thought your doctor was dissing you, it wasn't paranoia.
http://www.sciencedaily.com/releases/2012/11/121107200036.htm
====
==> Low vitamin D levels correlate to longevity in this new study. Perhaps because high levels often result in calcium in arteries.
http://www.sciencedaily.com/releases/2012/11/121105130355.htm
=====
==> If you have heart disease and diabetes don't let a cardiologist rush you into stenting, the way this NEJM editorial explains they will. A major long-term study found coronary artery bypass produces much better results in people with diabetes than stenting.
http://www.nejm.org/doi/full/10.1056/NEJMe1212278
=====
Another study proves that soy is useless against menopausal symptoms. Since it also promotes autoimmune attack by promoting leaky gut, wise women avoid soy.
http://www.sciencedaily.com/releases/2012/11/121101110633.htm
=====
The radical weight loss surgeries can lead to significant bone loss.
http://www.sciencedaily.com/releases/2012/11/121102115342.htm
=====
==> If you have any signs of early diabetic kidney disease Pradaxa could be very dangerous. The FDA is being defensive since it approved it. Doctors are rarely aware of the fine print about who should NOT get a new, heavily marketed drug.
http://www.nytimes.com/2012/11/03/business/a-rising-anti-stroke-drug-is-tied-to-risk-of-bleeding-deaths.html
=====
Cochrane Review: Cranberry juice for Urinary Tract Infections is a myth promoted by people funded by the cranberry industry. It's extremely high in sugar and terrible for blood sugar. High blood sugar promotes UTIs.
http://summaries.cochrane.org/CD001321/cranberries-for-preventing-urinary-tract-infections
=====
Losing weight using a low fat/high carb diet that raises blood sugar won't reduce heart disease. Duh. It isn't the weight. Note the supposed experts never ask, "What diet?" But just assume "diet" doesn't work. The "experts" cited are drawing huge sums as they are on the payroll of drug companies as "consultants" and other weaselly terms meant to hide the fact that they are drug pitchmen.
http://www.washingtonpost.com/national/health-science/moderate-weight-loss-alone-doesnt-lower-heart-disease-risk-in-diabetics-study-shows/2012/10/19/89cee7cc-1a22-11e2-aa6f-3b636fecb829_story.html
=====
Ex- top insurance exec (at a company I used to write software for) reveals how insurers deceitfully manipulate data to make it look like people are uninsured by choice.
http://www.publicintegrity.org/2012/10/15/11413/opinion-myths-healthy-uninsured
=====
The Sweetarts sold at drug store and convenience store counters have shrunk. The new nutritional info shows they are no longer 2 grams each. Now they are 1.6 grams. Important to know if you use them to correct lows.
=====
Doctors finally admit that lowering post-meal blood sugars is ALL you need to do to avoid heart attack. But they also want to link it to DPP-4 inhibitors, ignoring the cancer and immune system risks. If you can lower your post-meal blood sugar without these dangerous drugs, do it.
http://www.healio.com/endocrinology/diabetes/news/print/endocrine-today/{3d16eba1-1568-4b2d-8e92-b516391831f7}/dpp-iv-inhibitors-appear-to-reduce-cv-risk-in-type-2-diabetes-
====
It took 6.5 years to "decades" before the benefits of tight control became obvious in the landmark diabetes studies. Lowering A1c DOES help. If you wait another decade until ignorant doctors finally admit lowering your A1c 5% range using SAFE technique WILL significantly lower the rates of all complications, it may be too late for you as the higher blood sugars associated with 7% A1cs will have damaged and destroyed your organs.
http://www.nejm.org/doi/full/10.1056/NEJMp1208169
=====
BD is announcing a new Ultra-Fine needle that is supposedly even thinner than their previous ones. My experience with the short ultra-fines is that they are painless. The new ones should be even better. Note, however, that contrary to what you may be told, many of us find we can get several days worth of injections from one pen needle before it starts to blunt.
http://www.bd.com/us/diabetes/page.aspx?cat=7002&id=7409
====
Almost all rice contains the inorganic form of arsenic that’s known to cause bladder, lung and skin cancers. And to destroy pancreas' ability to secrete insulin, too.
http://www.washingtonpost.com/business/economy/fda-working-on-plan-to-limit-arsenic-levels-in-rice/2012/09/18/3238a578-0133-11e2-b257-e1c2b3548a4a_story.html
As you can see there is the usual mix of disturbing findings about environmental pollutants, bad diet advice, dangerous prescription drugs, mistaken medical policy, and the benefits of lowering blood sugar by cutting back on carbohydrates.
I have put red arrows (==>) next to a few studies that have immediate, serious health implications for people with diabetes.
I continue to be less than thrilled with FB, but since so many people use it I've concluded it is a pretty good way to reach people who would otherwise never find this blog.
====
Study: After weight loss, Roux-en-Y causes dramatic post-meal blood sugar spikes. Banding makes no difference in blood sugar. Stats argue against either being a "cure" for diabetes, doesn't it.
See this chart:
http://www.jci.org/articles/view/64895/figure/4
From this article http://www.jci.org/articles/view/64895
=====
Ketones may why calorie restriction leads to life extension. So don't starve yourself, cut back on carbs.
http://www.sciencedaily.com/releases/2012/12/121206142025.htm
=====
Apparently, free speech extends to drug reps lying about prescription drugs. We're all screwed.
http://www.reuters.com/article/2012/12/04/us-offlabel-conviction-idUSBRE8B21DC20121204
=====
"Countries that use high fructose corn syrup in their food supply have a 20% greater prevalence of type 2 diabetes compared with countries that do not" Study says.
http://americannewsreport.com/high-fructose-corn-syrup-blamed-for-worldwide-diabetes-epidemic-8816853
=====
Dangerous concentrations of PCBs are found in many women's blood. They are known to promote diabetes.
http://www.sciencedaily.com/releases/2012/11/121128143944.htm
=====
You'll find lots of low carb holiday treats including cookies and other desserts here that you can indulge in without spiking your blood sugar.
http://www.tudiabetes.org/group/lowcarbrecipeswap/forum/topics/holiday-foods?commentId=583967%3AComment%3A2487538
=====
Flame retardants are hormone disrupters that promote obesity. You can't avoid them if you own upholstered furniture.
http://www.sfgate.com/health/article/Chemicals-in-furniture-hard-to-avoid-4072857.php
=====
What a shocker: The Wash Post notices that drug companies have polluted high impact medical research studies.
http://www.thedailybeast.com/cheats/2012/11/25/bias-may-taint-big-pharma-research.html
=====
A mouse study finds the specific cancer gene that is silenced when dietary carbs are restricted.
http://www.sciencedaily.com/releases/2012/11/121115133152.htm
=====
PCBs which concentrate in body fat (and therefore in the fat of the meat we eat) not only cause diabetes, they lead to infertility. This is a serious issue for people eating low carb diets, alas. Organic meat may be better, but the pervasiveness of these toxins in our environment makes them difficult to avoid with husbandry practices, as the animals still have to breath polluted air and drink polluted water.
http://www.sciencedaily.com/releases/2012/11/121114084027.htm
=====
A UK study concludes that screening for diabetes doesn't prevent bad outcomes. No one draws the obvious conclusion--UK treatment for diabetes sucks. Which it does.
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)61422-6/abstract
=====
BPA slows thyroid in pregnant animals and their offspring.
http://www.sciencedaily.com/releases/2012/11/121114083226.htm
=====
==> The EU has approved dapagliflozin which will be sold as Forxiga. This drug blocks absorption of glucose in the kidney, so you lower blood sugar by peeing away glucose. The FDA did NOT approve it because of possible liver damage and signals of breast and bladder cancer. Do NOT take this new drug until it has been on the market for at least 5 years and we know a bit more about what it really does.
http://medcitynews.com/2012/11/eu-approves-bristol-astra-diabetes-drug-forxiga-after-fda-rejection-due-to-cancer-risk/
=====
Arsenic, DDE, dioxin and pesticides all are strongly associated with both diabetes and obesity. It's NOT personal choices damaging our children.
http://www.sciencedaily.com/releases/2012/11/121113134928.htm
=====
==> FDA committee approved very long lasting basal insulin. But it isn't better than Lantus/Levemir and the 70/30 mix makes it impossible to cover post-meal spikes safely.
http://www.healio.com/endocrinology/diabetes/news/online/%7B61213728-C9A3-46E8-AD49-0010CE03911E%7D/Insulin-degludec-degludecaspart-receive-FDA-committee-approval-in-8-4-vote
=====
More evidence that sulfonylureas are worse for the heart than metformin. There is a well-understood reason why this should be true. They are discussed HERE
http://www.sciencedaily.com/releases/2012/11/121107122453.htm
=====
Doctors really are biased against fat people. If you thought your doctor was dissing you, it wasn't paranoia.
http://www.sciencedaily.com/releases/2012/11/121107200036.htm
====
==> Low vitamin D levels correlate to longevity in this new study. Perhaps because high levels often result in calcium in arteries.
http://www.sciencedaily.com/releases/2012/11/121105130355.htm
=====
==> If you have heart disease and diabetes don't let a cardiologist rush you into stenting, the way this NEJM editorial explains they will. A major long-term study found coronary artery bypass produces much better results in people with diabetes than stenting.
http://www.nejm.org/doi/full/10.1056/NEJMe1212278
=====
Another study proves that soy is useless against menopausal symptoms. Since it also promotes autoimmune attack by promoting leaky gut, wise women avoid soy.
http://www.sciencedaily.com/releases/2012/11/121101110633.htm
=====
The radical weight loss surgeries can lead to significant bone loss.
http://www.sciencedaily.com/releases/2012/11/121102115342.htm
=====
==> If you have any signs of early diabetic kidney disease Pradaxa could be very dangerous. The FDA is being defensive since it approved it. Doctors are rarely aware of the fine print about who should NOT get a new, heavily marketed drug.
http://www.nytimes.com/2012/11/03/business/a-rising-anti-stroke-drug-is-tied-to-risk-of-bleeding-deaths.html
=====
Cochrane Review: Cranberry juice for Urinary Tract Infections is a myth promoted by people funded by the cranberry industry. It's extremely high in sugar and terrible for blood sugar. High blood sugar promotes UTIs.
http://summaries.cochrane.org/CD001321/cranberries-for-preventing-urinary-tract-infections
=====
Losing weight using a low fat/high carb diet that raises blood sugar won't reduce heart disease. Duh. It isn't the weight. Note the supposed experts never ask, "What diet?" But just assume "diet" doesn't work. The "experts" cited are drawing huge sums as they are on the payroll of drug companies as "consultants" and other weaselly terms meant to hide the fact that they are drug pitchmen.
http://www.washingtonpost.com/national/health-science/moderate-weight-loss-alone-doesnt-lower-heart-disease-risk-in-diabetics-study-shows/2012/10/19/89cee7cc-1a22-11e2-aa6f-3b636fecb829_story.html
=====
Ex- top insurance exec (at a company I used to write software for) reveals how insurers deceitfully manipulate data to make it look like people are uninsured by choice.
http://www.publicintegrity.org/2012/10/15/11413/opinion-myths-healthy-uninsured
=====
The Sweetarts sold at drug store and convenience store counters have shrunk. The new nutritional info shows they are no longer 2 grams each. Now they are 1.6 grams. Important to know if you use them to correct lows.
=====
Doctors finally admit that lowering post-meal blood sugars is ALL you need to do to avoid heart attack. But they also want to link it to DPP-4 inhibitors, ignoring the cancer and immune system risks. If you can lower your post-meal blood sugar without these dangerous drugs, do it.
http://www.healio.com/endocrinology/diabetes/news/print/endocrine-today/{3d16eba1-1568-4b2d-8e92-b516391831f7}/dpp-iv-inhibitors-appear-to-reduce-cv-risk-in-type-2-diabetes-
====
It took 6.5 years to "decades" before the benefits of tight control became obvious in the landmark diabetes studies. Lowering A1c DOES help. If you wait another decade until ignorant doctors finally admit lowering your A1c 5% range using SAFE technique WILL significantly lower the rates of all complications, it may be too late for you as the higher blood sugars associated with 7% A1cs will have damaged and destroyed your organs.
http://www.nejm.org/doi/full/10.1056/NEJMp1208169
=====
BD is announcing a new Ultra-Fine needle that is supposedly even thinner than their previous ones. My experience with the short ultra-fines is that they are painless. The new ones should be even better. Note, however, that contrary to what you may be told, many of us find we can get several days worth of injections from one pen needle before it starts to blunt.
http://www.bd.com/us/diabetes/page.aspx?cat=7002&id=7409
====
Almost all rice contains the inorganic form of arsenic that’s known to cause bladder, lung and skin cancers. And to destroy pancreas' ability to secrete insulin, too.
http://www.washingtonpost.com/business/economy/fda-working-on-plan-to-limit-arsenic-levels-in-rice/2012/09/18/3238a578-0133-11e2-b257-e1c2b3548a4a_story.html
November 26, 2012
Food Self-Defense for the Holidays
We people with diabetes have just entered the six week period during which managing what we eat can morph from a daily challenge to an ongoing nightmare, culminating, all too often, in diet disaster.
As anyone who has read my books or web site knows, I'm not a fan of rigid regimentation or obsessive self-denial. I believe very strongly that the key to crafting an effective diabetes diet that you can stick to for decades, not months, is to respect yourself and your emotional needs, build in safety valves, and provide enough variety to avoid burn-out.
But over the past decades the holidays have morphed into a celebration of gluttony, not just of food, but of every kind of consumer good. And those of us who don't believe that the best way to show our love for the people around us is to shower them with gifts and stuff them with sugary, fatty food are labeled "Scrooges" or accused of promoting economic slowdown that will rob our neighbors of jobs.
Unless you are an independently wealthy, only child orphan who lives in a cave in the wilds of Montana, the chances are you will find yourselves continually assaulted by the messages: Buy More! Spend More! Eat more!
So the weeks ahead are a minefield. Because food isn't just food. Food is memories. Food is love. Food is what keeps us safe when things get scary. Food is what keeps us alive and when we are feeling threats to our survival, real or symbolic, food is the easiest way to fight them off. It's legal. It's cheap. It's everywhere.
If we didn't have a medical condition where eating certain foods raised our blood sugar in ways that will, over time, clog up our arteries, damage our kidneys, shut down our retinas, and destroy our nerves, the food we are faced with during holidays might leave us a few pounds heavier, but all in all the holiday eating would really be no big deal.
But for people with diabetes the case is very different. Because if we get out of control with our food for a month or longer, we kick off physiological changes that can make us ravenously hungry and lead to months and even years of eating the foods that will ruin our organs.
So while a day here and there of unrestrained eating won't kill us, people with diabetes cannot let those days turn into weeks. And to do this they must NOT rely on the dieter's worst friend, that questionable facility known as,"Will power," but on the known and tested strategies that help us get through weeks of food temptations without having to rely on it.
So without further ado, I list below the techniques you can adopt to keep yourself from going off the rails at this most dangerous time of the year.
1. If It Isn't There, You Can't Eat It. We're talking about the food you bring home. If there is something you are really craving, eat a portion at a restaurant or a friend's house--watching portion size, but don't bring a big box or bag of it home. If the food isn't in the house no matter how much it calls out to you, you can't eat it. It's as simple as that. Meanwhile, stock up on delicious foods that you can eat.
If you have to bring something dangerous home because you have to serve it to others, keep it out of sight. I have learned the hard way that anything left out on the counter will beg me to eat it every time I enter the kitchen. Put things you don't want to have tempt you in the closet or in the back of the fridge where you can't see them.
2. Ask Friends or Loved Ones For Help With Food. If you have a good relationship with people likely to give you food gifts or invite you to dinner and/or parties, explain--briefly--that foods filled with carbohydrates raise your blood sugar and suggest some alternatives that would be a treat for you at the holidays so that, for example, they can show their fondness for you by offering your a delicious platter of low carb imported cheeses, or sausages, or nuts, that will not raise your blood sugar instead of a brandied cake or sugar cookies that will put you into a hyperglycemic fog.
If someone screws up and with the best of intentions gives you something toxic to your diet, like a box of high carb, maltitol-laden "sugar free" cookies, thank them, eat one in their presence to signify that you appreciate their thoughtfulness and throw the rest away when you get home. Later, at some less emotionally-fraught time you can explain to the giver that "sugar free" products are actually full of hidden sugar that raise people's blood sugar. But don't do it when you are presented with the gift unless you want to make the giver feel bad.
If you are given something that was a huge treat before your diagnosis and can't face throwing it out, ask a family member to hide it away and dole out appropriate portions on a schedule you give them in advance. I have been known to ask My Sweetie put certain much-loved candies in his safe (to which I don't have the combination) because I know what will happen if they are too accessible, but still want to eat a small serving now and then throughout the holiday season.
3. Bring Your Own Food to Events Where You Might Not Have Safe Choices. Fortunately many events nowadays are potlucks, so you can bring a rotisserie chicken to the family gathering or a hunk of cheese to the office party if you are eating a strict low carb diet. Salads with nuts, seeds, and mixed greens are another safe option. If you bake low carb cookies or bars, make a plate of them, labeled so people will know what they are--and avoid them if they don't like artificial sweeteners, leaving more for you.
Search online to find low carb options now, so that when you are faced with the need to prepare or bring low carb treats you will have some at your disposal.
If you have to go to a formal event where there are no safe options, it can be harder to bring your own food as doing so might make a poor impression on your hosts or other attendees. Eating at home before you go can be helpful here. There should be something you can eat just about anywhere, and worst case, if you have to eat a token portion of something for politeness sake having eaten earlier will keep you from going overboard.
4. Plan for Indulgences. This is where the safety valve strategy comes in. Decide what is an appropriate level of off-plan eating for the next few weeks and schedule what you will eat in advance, concentrating on things you will really enjoy.
If your diabetes diet is very new, and you haven't learned how to get back on plan after going off plan, you will want to be very conservative. One or two portions may be all you can tolerate this year, but you can limit yourself with the thought that in a year when your new diet has become habitual you can loosen up some.
If you have learned how to get back on track after going off your diet, you can be a bit more relaxed, but make sure that you do go back on your diet when you have planned to.
5. Test, Test, Test! When you go off plan, test your blood sugar 1 and 2 hours after eating, to reinforce your understanding of why you are on your diet in the first place. The point isn't to scare yourself--one day of high blood sugars a week isn't going to make you go blind. But daily exposure to blood sugars that spend many hours over 140 mg/dl will, over time, damage your organs in ways that may be irreversible. Testing after eating keeps a lot of us honest, and I highly recommend it this time of year.
6. Learn How to Get Back On Track. If we have had our blood sugar under control, eating a lot of carbs can catapult us back into a state of rabid hunger, which is the main reason many people believe (erroneously) that they are "addicted" to carbs and that a single bite of high carb food will send them into an unrecoverable tailspin.
I have written about this at length HERE. Read this page BEFORE you contend with holiday treats. Learning how to recover from a high carb, blood sugar spike-fest is the single most useful skill many people with diabetes will ever learn, and the one that will make it possible for them to maintain their blood sugar control for the decades of healthy life they deserve to live after a diabetes diagnosis.
If you've been doing a good job controlling your blood sugar, let us know what you do to to get through the holiday eating extravaganza by posting in the comment section below.
As anyone who has read my books or web site knows, I'm not a fan of rigid regimentation or obsessive self-denial. I believe very strongly that the key to crafting an effective diabetes diet that you can stick to for decades, not months, is to respect yourself and your emotional needs, build in safety valves, and provide enough variety to avoid burn-out.
But over the past decades the holidays have morphed into a celebration of gluttony, not just of food, but of every kind of consumer good. And those of us who don't believe that the best way to show our love for the people around us is to shower them with gifts and stuff them with sugary, fatty food are labeled "Scrooges" or accused of promoting economic slowdown that will rob our neighbors of jobs.
Unless you are an independently wealthy, only child orphan who lives in a cave in the wilds of Montana, the chances are you will find yourselves continually assaulted by the messages: Buy More! Spend More! Eat more!
So the weeks ahead are a minefield. Because food isn't just food. Food is memories. Food is love. Food is what keeps us safe when things get scary. Food is what keeps us alive and when we are feeling threats to our survival, real or symbolic, food is the easiest way to fight them off. It's legal. It's cheap. It's everywhere.
If we didn't have a medical condition where eating certain foods raised our blood sugar in ways that will, over time, clog up our arteries, damage our kidneys, shut down our retinas, and destroy our nerves, the food we are faced with during holidays might leave us a few pounds heavier, but all in all the holiday eating would really be no big deal.
But for people with diabetes the case is very different. Because if we get out of control with our food for a month or longer, we kick off physiological changes that can make us ravenously hungry and lead to months and even years of eating the foods that will ruin our organs.
So while a day here and there of unrestrained eating won't kill us, people with diabetes cannot let those days turn into weeks. And to do this they must NOT rely on the dieter's worst friend, that questionable facility known as,"Will power," but on the known and tested strategies that help us get through weeks of food temptations without having to rely on it.
So without further ado, I list below the techniques you can adopt to keep yourself from going off the rails at this most dangerous time of the year.
1. If It Isn't There, You Can't Eat It. We're talking about the food you bring home. If there is something you are really craving, eat a portion at a restaurant or a friend's house--watching portion size, but don't bring a big box or bag of it home. If the food isn't in the house no matter how much it calls out to you, you can't eat it. It's as simple as that. Meanwhile, stock up on delicious foods that you can eat.
If you have to bring something dangerous home because you have to serve it to others, keep it out of sight. I have learned the hard way that anything left out on the counter will beg me to eat it every time I enter the kitchen. Put things you don't want to have tempt you in the closet or in the back of the fridge where you can't see them.
2. Ask Friends or Loved Ones For Help With Food. If you have a good relationship with people likely to give you food gifts or invite you to dinner and/or parties, explain--briefly--that foods filled with carbohydrates raise your blood sugar and suggest some alternatives that would be a treat for you at the holidays so that, for example, they can show their fondness for you by offering your a delicious platter of low carb imported cheeses, or sausages, or nuts, that will not raise your blood sugar instead of a brandied cake or sugar cookies that will put you into a hyperglycemic fog.
If someone screws up and with the best of intentions gives you something toxic to your diet, like a box of high carb, maltitol-laden "sugar free" cookies, thank them, eat one in their presence to signify that you appreciate their thoughtfulness and throw the rest away when you get home. Later, at some less emotionally-fraught time you can explain to the giver that "sugar free" products are actually full of hidden sugar that raise people's blood sugar. But don't do it when you are presented with the gift unless you want to make the giver feel bad.
If you are given something that was a huge treat before your diagnosis and can't face throwing it out, ask a family member to hide it away and dole out appropriate portions on a schedule you give them in advance. I have been known to ask My Sweetie put certain much-loved candies in his safe (to which I don't have the combination) because I know what will happen if they are too accessible, but still want to eat a small serving now and then throughout the holiday season.
3. Bring Your Own Food to Events Where You Might Not Have Safe Choices. Fortunately many events nowadays are potlucks, so you can bring a rotisserie chicken to the family gathering or a hunk of cheese to the office party if you are eating a strict low carb diet. Salads with nuts, seeds, and mixed greens are another safe option. If you bake low carb cookies or bars, make a plate of them, labeled so people will know what they are--and avoid them if they don't like artificial sweeteners, leaving more for you.
Search online to find low carb options now, so that when you are faced with the need to prepare or bring low carb treats you will have some at your disposal.
If you have to go to a formal event where there are no safe options, it can be harder to bring your own food as doing so might make a poor impression on your hosts or other attendees. Eating at home before you go can be helpful here. There should be something you can eat just about anywhere, and worst case, if you have to eat a token portion of something for politeness sake having eaten earlier will keep you from going overboard.
4. Plan for Indulgences. This is where the safety valve strategy comes in. Decide what is an appropriate level of off-plan eating for the next few weeks and schedule what you will eat in advance, concentrating on things you will really enjoy.
If your diabetes diet is very new, and you haven't learned how to get back on plan after going off plan, you will want to be very conservative. One or two portions may be all you can tolerate this year, but you can limit yourself with the thought that in a year when your new diet has become habitual you can loosen up some.
If you have learned how to get back on track after going off your diet, you can be a bit more relaxed, but make sure that you do go back on your diet when you have planned to.
5. Test, Test, Test! When you go off plan, test your blood sugar 1 and 2 hours after eating, to reinforce your understanding of why you are on your diet in the first place. The point isn't to scare yourself--one day of high blood sugars a week isn't going to make you go blind. But daily exposure to blood sugars that spend many hours over 140 mg/dl will, over time, damage your organs in ways that may be irreversible. Testing after eating keeps a lot of us honest, and I highly recommend it this time of year.
6. Learn How to Get Back On Track. If we have had our blood sugar under control, eating a lot of carbs can catapult us back into a state of rabid hunger, which is the main reason many people believe (erroneously) that they are "addicted" to carbs and that a single bite of high carb food will send them into an unrecoverable tailspin.
I have written about this at length HERE. Read this page BEFORE you contend with holiday treats. Learning how to recover from a high carb, blood sugar spike-fest is the single most useful skill many people with diabetes will ever learn, and the one that will make it possible for them to maintain their blood sugar control for the decades of healthy life they deserve to live after a diabetes diagnosis.
If you've been doing a good job controlling your blood sugar, let us know what you do to to get through the holiday eating extravaganza by posting in the comment section below.
November 4, 2012
Over the Next Weeks I'll Be Updating the Main Blood Sugar 101 Web Site
I haven't been posting much on this blog as I've been very busy with other things over the past few months. Now that I have a bit more time, I am going to be looking over the various pages on the main Blood Sugar 101 web site and bringing them up to date.
I post all significant changes to the main web site on the Changes to Blood Sugar 101 blog, which makes it easy to keep up with them.
If you have any ideas about how to improve the main web site, or any topics you feel should get more coverage, please mention them in a comment on this post. However, keep in mind that there are already over 100,000 words posted on this site and its blog so the challenge with this web site is to keep it from becoming so overwhelming that the people who come to it for the first time don't miss the important information I'd like them to take away from it.
The focus needs to remain on explaining to people what blood sugar levels are normal, what levels cause diabetic complications, and what strategies safely lower blood sugar and prevent complications.
My web stats show me what pages on the site people actually visit, and for now, it is the pages that stick to that core mission that receive the heaviest traffic. The rest of the site, as fascinating as it might be, rarely gets visited. So the only changes I'm really interested in making are those that will make the pages that convey this vital information even more useful.
I post all significant changes to the main web site on the Changes to Blood Sugar 101 blog, which makes it easy to keep up with them.
If you have any ideas about how to improve the main web site, or any topics you feel should get more coverage, please mention them in a comment on this post. However, keep in mind that there are already over 100,000 words posted on this site and its blog so the challenge with this web site is to keep it from becoming so overwhelming that the people who come to it for the first time don't miss the important information I'd like them to take away from it.
The focus needs to remain on explaining to people what blood sugar levels are normal, what levels cause diabetic complications, and what strategies safely lower blood sugar and prevent complications.
My web stats show me what pages on the site people actually visit, and for now, it is the pages that stick to that core mission that receive the heaviest traffic. The rest of the site, as fascinating as it might be, rarely gets visited. So the only changes I'm really interested in making are those that will make the pages that convey this vital information even more useful.
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