Learning to Jump

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

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

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

My recent contributions are:

• The Noninvasive Dream
  This article originally appeared in the January 2005 issue of Diabetes Health and is now also online at The Noninvasive Dream.

  It has long been our dream to have some sort of beam that would test blood glucose without breaking the skin to take a drop of blood. It’s coming.

  Among the hundreds if not thousands of inventors who think they can crack the noninvasive meter conundrum, at least 30 think they are far enough advanced to publicize at least their existence on the Web, as linked in my Blood Glucose Meters page. At least 28 of these sites explicitly use the term noninvasive, and this is implied in a couple of other cases.

  Of the 30 companies listed, I am confident on the basis of what I know that at least 14 of these companies don’t appear to be currently in the race to bring their device successfully to market. This still leaves about 16 companies that have a good chance of winning the noninvasive race. What are those companies? Read The Noninvasive Dream.

• Navigating Lows and Highs
  This article originally appeared in the February 2005 issue of Diabetes Health and is now also online at Navigating Lows and Highs. Continuous sensing meters have suffered two false starts. The most disappointing has been the Cygnus GlucoWatch. The Medtronic Diabetes CGMS System Gold isn’t really a home unit at all, since it requires a trip to your doctor’s office every three days to read your readings.

  But that sad situation is now poised to change. We are on the cusp of a new era with the forthcoming FreeStyle Navigator meter. Designed to help detect lows even during sleep, it will also warn us of dangerous high levels. The trends that it will show are just as important.

Update:

• Tenth Anniversary
  This month is the tenth anniversary of my website. It was on February 12, 1995, that my first page about diabetes went up. That page described and linked all the diabetes resources. There were two other websites about diabetes at that time — and soon after that one of them disappeared. That makes my site the second oldest about diabetes (after the NIDDK site).

  This newsletter is not nearly as old. The first issue didn’t appear until the end of 2000. But since I archive this newsletter online, I count it as the tenth anniversary issue.

• Satiety and the Fullness Factor
  NutritionData.com has just published on that site a diet, the “Fullness Factor,” at http://www.nutritiondata.com/fullness-factor.html. It’s based of the Satiety Index developed by Dr. Susanna Holt at the University of Sydney and explained on my site at What Really Satisfies. Well worth considering.

• Vinegar
  I keep updating my article on acidic foods. This month sees my third one. It is one of the most interesting updates.

  Dr. Carol Johnston and two of her associates in the department of nutrition at Arizona State University in Mesa, Arizona, have just published research showing that a little vinegar can help us control blood glucose. Actually, anyone who read my article on acidic foods would already know that.

  But she also tells me that her ongoing unpublished research is showing that vinegar can also help us to lose weight. During the four-week trials participants lost an average of 2 pounds each. Please read my entire article at Acidic Foods.

Research Notes:

• Dietary Guidelines for Americans 2005
  Few of you have probably missed hearing about the government’s new dietary guidelines. They now include exercise, and if you are proud (as I am) to exercise half an hour every day, these guidelines may make you realize that pride and hubris are closely related. That’s because they recommend doubling (for maintenance) or tripling (for weight-loss) that amount.

  The press makes a big thing over the government’s increasing the recommended servings of fruits and vegetables to nine per day. Actually, these nine servings are more specifically 2 cups of fruit and 2.5 cups of vegetables for the standard 2000-calorie diet, which they adjust up or down for different calorie levels from a total of 2.5 cups to 6.5 cups of fruit and vegetables.

  The best analysis in the press that I have read is an article by William Grimes detailing his personal experience in The New York Times. Mr. Grimes, the newspaper’s former food critic, found it essentially impossible to stay on what The Times calls “the Uncle Sam Diet.“

  “The new guidelines are not just health policy, they're cultural policy, too,” Mr. Grimes concludes. “To comply fully, Americans will have to rethink their inherited notions of what makes a meal, and what makes a meal satisfying.”

  I have to agree with him. I am afraid that many people will just give up because the bar is now set so high. Don’t. Just do what you can and gradually increase your level of exercise and fruit and vegetable servings.

  The big question I had about the new guidelines is what they count as vegetables. Specifically, I wondered if they include the starchy vegetables when counting the nine servings per day. They do:

  1. Dark green vegetables: 3 cups/week
  2. Orange vegetables: 2 cups/week
  3. Legumes (dry beans): 3 cups/week
  4. Starchy vegetables: 3 cups/week
  5. Other vegetables: 6.5 cups/week

  So, clearly starchy vegetables count for this diet. But what are these “Other vegetables” that we are supposed to eat so much of? They don’t seem to say, and not many come to mind.

  In addition to all these types of vegetables (plus fruit), they want you to eat “whole grains,” and they define these too and give examples. In order of the amount Americans consume they are:

  1. Whole wheat
  2. Whole oats/oatmeal
  3. Whole-grain corn
  4. Popcorn
  5. Brown rice
  6. Whole rye
  7. Whole-grain barley
  8. Wild rice
  9. Buckwheat
  10. Triticale
  11. Bulgur (cracked wheat)
  12. Millet
  13. Quinoa
  14. Sorghum
  First, I am surprised that whole wheat leads the list. I had thought that whole wheat meant wheat kernels. And what makes “Bulgur (cracked wheat)” whole again? They do answer these questions. Whole grain “must retain nearly the same relative proportions of bran, germ, and endosperm as the original grain in order to be called whole grain.”

  It’s nice to see popcorn on the list. I won’t feel guilty any more when I pop a quarter cup when I watch an hour of television in the evening. I had already given up the convenient bags of popcorn because of the level of transfat they have.

  Another question is how “whole-grain barley” can rank seventh in popularity. Almost all the barley Americans eat is pearled, i.e. stripped of its bran and germ. Hull-less barley is the true whole-grain barley.

  The experts generally think that the new dietary guidelines are a step forward. These guidelines are readily available online at http://www.health.gov/dietaryguidelines/dga2005/document/.

• Diabetic Neuropathy
  Neuropathy is probably the most common — and often the most painful — complication of diabetes. But now there is more hope than ever. That’s why one of my On-line Diabetes Resources pages focuses entirely on this condition and links the promising treatments.

  This month researchers announced two promising treatments to relieve the pain of diabetic neuropathy:

  1. Acetyl-L-Carnitine, a common dietary supplement, significantly reduced pain in two randomized placebo-controlled trials on more than 1,200 patients. The American Diabetes Association’s peer-reviewed journal, Diabetes Care, reports the studies in its January issue in the article “Acetyl-L-Carnitine Improves Pain, Nerve Regeneration, and Vibratory Perception in Patients With Chronic Diabetic Neuropathy”.

  2. The Food and Drug Administration approved Pfizer’s Lyrica pill to treat the pain of diabetic neuropathy. Lyrica will compete with Lilly’s Cymbalta, which the FDA cleared in September and has just come on the market.

  There’s more about these drugs — and many others — at On-line Diabetes Resources, Part 15: Diabetic Neuropathy.

  But the treatment described there that excites me the most is Anodyne Therapy. This treatment not only reduces or eliminates the pain but even reverses the neuropathy.

  The treatment itself uses monochromatic infrared photo energy to stimulate circulation. It is non-invasive, drug-free, and does not interact with any drugs you may be taking. It is painless, and the only sensation when the pads are applied is a little warmth. The FDA has approved it, and Medicare and most other insurers pay for it.

  You can read about some of the studies of Anodyne Therapy at On-line Diabetes Resources, Part 15: Diabetic Neuropathy.

• Two New Obesity Studies
  
  1. Maybe the young and the restless know something that most of us with diabetes don’t. I don’t mean the long-running soap opera of that name, but rather that it’s the key to weight loss.

     And it isn’t the 30 to 90 minutes of exercise the government prescribes that is the key to losing weight, according to a new research study from the Mayo Clinic in Rochester, Minnesota. They say it is whether you fidget or not.

     I always thought that fidgeting and tapping your foot and restlessness and pacing was a bad thing — a waste of effort. It seems that it’s not.

     “People with obesity are tremendously efficient,” Dr. James Levine, a Mayo Clinic endocrinologist and nutritionist, told The New York Times. “Any opportunity not to waste energy, they take. If you think about it that way, it all makes sense. As soon as they have an opportunity to sit down and not waste those calories, they do.”

     That was me in spades. Before reading this I prided myself on not wasting effort. I am now going to try to be physically inefficient.

     The article by Dr. Levine and his associates, “Interindividual Variation in Posture Allocation: Possible Role in Human Obesity,” appears in the January 28 issue of Science magazine.

  2. Those researchers who are pointing to inflammation as an underlying source of many of our problems seem to be on to something. Now, researchers at the Joslin Clinic in Boston say their studies show that excess weight leads to low-grade inflammation, which in turn hampers our ability to use insulin. That means insulin resistance.

     Furthermore, weight gain activates the “master switch” of this inflammation in the liver. And they showed that we can turn it off by using salicylates, a class of drugs that includes aspirin. As soon as I read this I took two aspirins (in addition to the one I take every morning to thin my blood) and went to bed. But then I got right up again, remembering that I gotta keep moving.

     Steven E. Shoelson, M.D., Ph.D., and his associates will publish their article, “Local and Systemic Insulin Resistance due to Hepatic Activation of IKKβ and NF-κB,” in the February issue of Nature Medicine.

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