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:
- Medtronic Monitors
Medtronic Diabetes is not only the leading insulin pump company. It was also the first to offer a continuous monitor.
While that monitor left a lot to be desired, the company has been moving steadily ahead on both the monitor and pump fronts. There are so many monitors in development that it gets confusing.
The best of these monitors doesn’t even have a name yet. The company calls it the next generation Guardian Monitor. It should hit the market in a few years, in time for the current generation of blood glucose testers. The URL is Medtronic Monitors.
More and more scammers write or call me so that I will tell you about the stuff they sell. I usually don’t write about them. This month, however, I have a couple of situations that I must bring to your attention.
- The first is for a diabetic neuropathy product that I have a lot of unanswered questions about. So I’m not ready yet to name the company. But the CEO of a reputable company does provide guidelines that you can use to do due diligence in making your buying decisions on this and other products:
- Ask for their clinical data.
- Ask how they arrived at their protocol.
- Ask for a copy of their clearance by the Food and Drug Administration (FDA) or read it on the FDA’s website, http://www.fda.gov.
- Ask for their clinical data.
- The second is a contribution by an endocrinologist, Dr. William C. (Reddy) Biggs, who has a practice in Amarillo, Texas. Dr. Biggs is a frequent contributor to the most active diabetes newsgroups, misc.health.diabetes and alt.support.diabetes. With his permission here is one of his recent trenchant contributions:
Every few weeks a spammer offers one of these discount medical cards in this forum. I can understand the potential appeal since diabetes makes purchasing health insurance difficult, if not impossible.
It has been my experience that my office is often listed as a provider for these cards, even when it isn’t.
An interesting study was posted on the web about these discount cards: http://www.cmwf.org/usr_doc/808_kofman_discountmedicalcards_ib.pdf
It unfortunately confirms my impressions. They are often sold by high pressure salesmen, and may not live up to their claims. For four of five cards studied, the number of doctors accepting the card was a fraction of the number of providers listed.
If you think one of these cards may work for you, be sure to confirm that your doctor’s office actually accepts them before you get pressured into signing up.
My addition: Please see also http://www.healthatoz.com/healthatoz/Atoz/hl/sp/info/alert08242004.jsp
Research Notes: Salacia Oblonga
My correspondents stay up-to-date about new drugs and alternative therapies for diabetes. I wasn’t surprised to be asked about something called Salacia oblonga, also known as Celastraceae and Ponkoranti. This plant grows in India and Sri Lanka.
A short article in the January issue of the Journal of the American Dietetic Association entitled “Effects of a medical food containing an herbal alpha-glucosidase inhibitor on postprandial glycemia and insulinemia in healthy adults” triggered all of the interest. You can read the MEDLINE abstract online.
When you evaluate a proposed new treatment, you need to see what peer-reviewed research has been conducted. For that you need to search MEDLINE, the master index of all research reported in peer-reviewed journals since 1965. A search of “Salacia oblonga” turns up no more than10 studies, but only the one in the Journal of the American Dietetic Association was a study of humans. They previously studied its effects on rats.
Salacia oblonga is potentially an alternative treatment for diabetes. So, in addition, to checking out MEDLINE, when you want to check out alternative medicine, the only reliable source in my view is The Natural Pharmacist. You can find it several places online, including Memorial Hospital Jacksonville. But The Natural Pharmacist, which describes all herbs and supplements from Acetyl-L-Carnitine (ALC) to Zinc Sulfate, doesn’t even mention Salacia oblonga.
This one new study is really not enough to go on. Only 39 people were in the study, not enough to generally be considered as statistically significant. And the results seem strange:
It is unusual and troublesome for a 1000 mg dose to have a big result and a 700 mg dose to have none. You have to consider this as very preliminary research.
The Internet has some great resources to help you evaluate medical treatments:
- One that I have used, but never mentioned before is ConsumerLab. This thoroughly independent provider of products relating to health, wellness, and nutrition has some free research online and other results that you need to pay for. The URL is http://www.consumerlab.com
- A complementary site is the Natural Pharmacist. In fact, you can read it on ConsumerLab.com, if you subscribe. However, I have often mentioned that you can also use it free online at Memorial Hospital Jacksonville
- Another site will definitely cost you, but I use it all the time and can highly recommend it. iHerb.com is the best place I know of anywhere to buy vitamins, minerals, and supplements. It has the best prices, the largest selection, and the fastest shipping. The URL is http://www.iherb.com/
- Another indispensable site is PubMed. This is a service of the U.S. National Library of Medicine and includes more than 15 million citations for biomedical articles back to the 1950’s. These citations are from MEDLINE and additional life science journals. PubMed includes links to many sites providing full text articles and other related resources. The URL is http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?
- The U.S. government also has an authoritative site about food. The USDA National Nutrient Database must answer at least one question a week for me. The URL is http://www.nal.usda.gov/fnic/foodcomp/search/
- If you are looking for a doctor, the best place to start is AMA Physician Select. This site, managed by the American Medical Association, provides basic professional information on virtually every licensed physician in the United States and its possessions, including more than 690,000 doctors of medicine (MD) and doctors of osteopathy or osteopathic medicine (DO). The URL is http://dbapps.ama-assn.org/aps/amahg.htm
- Part of the American Diabetes Association’s huge website is “for health professionals and scientists.” That label doesn’t stop me, so I don’t see why it should stop you. The best part is the Clinical Practice Recommendations that appear in Diabetes Care every January. The URL is http://care.diabetesjournals.org/content/vol28/suppl_1/
I have never been able to write about diabetes television before, because it didn’t exist until last month. The new show is called dLifeTV, and you can see this half-hour program weekly on the CNBC cable channel in your area on Sunday evenings.
I missed the premiere, because I had taped the wrong time. Some day I will master my VCR! [Just four days after sending out this newsletter a subscriber, William Beckerman, kindly sent me the DVD he had made for himself of the first episode. I don”t know how he did it, but the DVD was perfect, doing justice to an important program.] I saw all of the second program and was impressed by the frank coverage of a sensitive topic.
There are good people behind this program. Howard Steinberg, who has lived with type 1 diabetes for more than 36 years, started it. Even more familiar to most of us is Managing Editor Paula Ford-Martin, who for several years was the About.com diabetes guide.
Even the ads are worth watching. Most of them are about diabetes products.
- Johns Hopkins White Papers: Diabetes
This is a surprisingly good little book. Written by two professors of medicine at Johns Hopkins University School of Medicine in Baltimore, this “white paper” on diabetes clearly and authoritatively tells it like the current state of diabetes treatment is.
It’s good (I mean the book is good, not necessarily the treatment of diabetes), but I am not saying to buy it. Most people with diabetes would be better advised to buy Gretchen Becker’s The First Year — Type 2 Diabetes or Dr. Alan L. Rubin’s Diabetes for Dummies. But this “white paper” is an excellent summary of the state of the endocrinological art.
I was most impressed with this book’s review of recent journal articles that suggest that many more people with type 2 diabetes would be well advised to start using insulin earlier than they do. So many people have unwarranted concerns about insulin!
The other part of this book that I was especially happy to see was a list of the top 10 hospitals for endocrinology. It is reprinted from an article in U.S. News & World Report on July 12, 2004, which I haven’t seen. The rankings are admittedly somewhat subjective, and are probably included because Johns Hopkins Hospital ranks so high.
First is no surprise, the Mayo Clinic. Second, is Massachusetts General Hospital, which did surprise me. Then, came Johns Hopkins Hospital, which I know from my own experience back in 1976. I was in attendance to witness an abortion there in a previous life as a family planning officer for the U.S. Agency for International Development. Fourth, is the University of California, San Francisco, Medical Center, which probably was responsible for saving my wife’s life when she was there for a month in May 1998 for a complication of diabetes, blood clots. The other six are all around the country, but unfortunately there aren’t any in the top 10 near our new home in Colorado.
This book is a part of the Johns Hopkins Health After 50 series. It’s 61 numbered pages (and a few unnumbered ones) published this year by Medletter Associates for $24.95. ISBN: 1-933087-05-6. The linked website is http://hopkinsafter50.com/html/silos/diabetes/index.php.
I can, you can, we know how.
Blood drops, one and two and three.
Why won’t this meter beep for me?
Numbers now. Number’s high!
182 - my, oh my!
Out with the insulin, out with the needle.
Out with the afternoon snack-n-feedle.
Up, up, up and down the stairs —
Now I’m taking stairs in pairs.
Down with the glucose readings!
Down, down, down!
I’ll have the best numbers in any town.
Funny, now I cannot think —
Think what I thunk and my heart begins to sink.
Oops! Up with the sugar level — up, up, up!
Glucose tablets, Gummi Drops, and sweetened juice in a big, BIG cup.
High again, that’s where I am.
Above 150, gosh darn damn.
And on it goes throughout the day.
Look, what fun! Come on and play.
But like it? No, no, no, I say!
I do not like the vials, the rules,
the thinking, worrying all day…
I do not like it one little bit.
Still, I'm glad to LIVE with it.
By Amy Tenderich and reprinted with permission. Amy writes an unusual Web log about diabetes at www.diabetesmine.com. She says that she is a newish type 1 based in San Francisco, California, who gets good control with a Novolog pen and Lantus injections at night. She’s a part-time freelance writer for the technology industry and a full-time mom.
- HTML Format
I send out Diabetes Update e-mail in HTML format, which all Web browsers and most modern e-mail programs can display. HTML has live links to all the sites named in the text so that with a simple click of a mouse you can connect to the site you have just been reading about.
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- I will link sources of information.
- I will disclose any conflict of interest.
- If and when I learn of any errors of fact, I will correct them.
I now send out Diabetes Update once a month. Previous issues are online:
- Diabetes Update Number 1: Diabetes Genes of December 10, 2000
- Diabetes Update Number 2: DiabetesWATCH of December 18, 2000
- Diabetes Update Number 3: Starlix of January 3, 2001
- Diabetes Update Number 4: Native Seeds/SEARCH, Tepary Beans of January 17, 2001
- Diabetes Update Number 5: Insulin Makes You Fat of January 31, 2001
- Diabetes Update Number 6: Available and Unavailable Carbohydrates of February 15, 2001
- Diabetes Update Number 7: Dates of March 1, 2001
- Diabetes Update Number 8: Quackwatch of March 15, 2001
- Diabetes Update Number 9: The Cost of Insulin of March 30, 2001
- Diabetes Update Number 10: Sof-Tact Meter of April 2, 2001
- Diabetes Update Number 11: iControlDiabetes of April 16, 2001
- Diabetes Update Number 12: Cinnamon, Tagatose of May 2, 2001
- Diabetes Update Number 13: Glycemic Index of May 15, 2001
- Diabetes Update Number 14: Eat Your Carrots! of May 31, 2001
- Diabetes Update Number 15: Glycemic Load of June 21, 2001
- Diabetes Update Number 16: Homocysteine of July 2, 2001
- Diabetes Update Number 17: Chana Dal Tips of July 15, 2001
- Diabetes Update Number 18: Lag Time in AlternativeLand of August 2, 2001
- Diabetes Update Number 19: Fiber of August 15, 2001
- Diabetes Update Number 20: How Diabetes Works of August 30, 2001
- Diabetes Update Number 21: Insulin Resistance of September 14, 2001
- Diabetes Update Number 22: Trans Fats, Honey, CU of October 1, 2001
- Diabetes Update Number 23: Pedometer Power of October 15, 2001
- Diabetes Update Number 24: Is Glycerin a Carbohydrate? of October 31, 2001
- Diabetes Update Number 25: Kill the Meter to Save It of November 15, 2001
- Diabetes Update Number 26: Protein, Fat, and the GI of December 1, 2001
- Diabetes Update Number 27: Insulin Index of December 14, 2001
- Diabetes Update Number 28: Fructose of January 4, 2002
- Diabetes Update Number 29: Aspirin of January 14, 2002
- Diabetes Update Number 30: Stevia of January 31, 2002
- Diabetes Update Number 31: Gretchen Becker’s Book of February 19, 2002
- Diabetes Update Number 32: The UKPDS of March 4, 2002
- Diabetes Update Number 33: Financial Aid of March 18, 2002
- Diabetes Update Number 34: Pre-Diabetes of April 1, 2002
- Diabetes Update Number 35: More Glycemic Indexes of April 15, 2002
- Diabetes Update Number 36: Gila Monsters of April 30, 2002
- Diabetes Update Number 37: Is INGAP a Cure? of May 15, 2002
- Diabetes Update Number 38: Native American Diabetes of June 3, 2002
- Diabetes Update Number 39: FDA Diabetes of June 19, 2002
- Diabetes Update Number 40: Diabetes Support Groups of July 1, 2002
- Diabetes Update Number 41: New GI and GL Table of July 15, 2002
- Diabetes Update Number 42: Diabetes Sight of August 1, 2002
- Diabetes Update Number 43: DrugDigest of August 18, 2002
- Diabetes Update Number 44: Hanuman Garden of September 3, 2002
- Diabetes Update Number 45: Guidelines of September 16, 2002
- Diabetes Update Number 46: Trans Fat of October 4, 2002
- Diabetes Update Number 47: Nutrition.Gov of October 16, 2002
- Diabetes Update Number 48: Our Hearts of October 31, 2002
- Diabetes Update Number 49: Our Kidneys of November 15, 2002
- Diabetes Update Number 50: A1C<7 of December 2, 2002
- Diabetes Update Number 51: Diabetes Searches with Google of December 16, 2002
- Diabetes Update Number 52: e-Patients of January 2, 2003
- Diabetes Update Number 53: Email News of January 16, 2003
- Diabetes Update Number 54: Third Generation Meters of January 31, 2003
- Diabetes Update Number 55: Hypoglycemic Supplies of February 14, 2003
- Diabetes Update Number 56: Food Police of March 1, 2003
- Diabetes Update Number 57: Vitamins of April 1, 2003
- Diabetes Update Number 58: Lancets of May 1, 2003
- Diabetes Update Number 59: Accurate Meters of June 1, 2003
- Diabetes Update Number 60: Chromium of July 1, 2003
- Diabetes Update Number 61: Traveling of August 1, 2003
- Diabetes Update Number 62: My Book of September 1, 2003
- Diabetes Update Number 63: Hot Tubs of October 1, 2003
- Diabetes Update Number 64: Home A1C Testing of November 1, 2003
- Diabetes Update Number 65: Detemir of December 1, 2003
- Diabetes Update Number 66: Erectile Dysfunction of January 1, 2004
- Diabetes Update Number 67: Acidic Foods of February 1, 2004
- Diabetes Update Number 68: Net Carbs of March 1, 2004
- Diabetes Update Number 69: Glycemic Index of April 1, 2004
- Diabetes Update Number 70: Dreamfields Pasta of May 1, 2004
- Diabetes Update Number 71: Cholesterol of June 1, 2004
- Diabetes Update Number 72: Meter News of July 1, 2004
- Diabetes Update Number 73: Pill Splitting of August 1, 2004
- Diabetes Update Number 74: GlucoMON of September 1, 2004
- Diabetes Update Number 75: Coding of October 1, 2004
- Diabetes Update Number 76: Sleep Apnea of November 1, 2004
- Diabetes Update Number 77: Keynote Address of December 1, 2004
- Diabetes Update Number 78: Mangosteen of January 1, 2005
- Diabetes Update Number 79: Noninvasive of February 1, 2005
- Diabetes Update Number 80: Pelikan Sun of March 1, 2005