A Deer Animal
With permission of Graham Jeffery

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 contribution is:

• The GlycoMark Option
  Aren’t daily fingersticks and quarterly A1C checks enough? Maybe not.

  Now we can get a GlycoMark test. It has just become available in this country. Developed by two companies in Japan, it has, however, been used there for more than a decade.

  What it does best is to reflect blood glucose spikes after you eat. For people who have their diabetes under pretty good control that can be the key to doing even better.

  I wrote about the GlycoMark test for my “Meter News” column in the June issue of Diabetes Health magazine. My column is also online at http://www.mendosa.com/glycomark.htm.

Research Notes:

• Another Drug Choice Coming
  Soon, we will probably have another class of drugs to help control blood glucose levels. The Food and Drug Administration is reviewing an application by Bristol-Myers Squibb and Merck for a glitazar drug — a dual alpha/gamma PPAR (peroxisome proliferator-activated receptor) activator.

  They call the drug Muraglitazar. In Phase 3 clinicial trials just completed its results were impressive. After just 24 weeks A1C levels typically dropped considerably. Triglyceride levels dropped and HDL (good cholesterol) levels rose. The details are complex, depending on the amount of the drug, the baseline A1C level, and whether the trial was double-blind and placebo-controlled or open label. You can read further details at the BMS press release.

  If and when Muraglitazar becomes available, we will have eight classes of oral drugs to chose from, all of which I list, describe, and link at http://www.mendosa.com/drugs.htm. Before 1955 insulin was our only choice. From 1955 to 1995 the only oral drug choice was a sulfonylurea. Then, in rapid succession came a biguanide (metformin or Glucophage), alpha-glucosidase inhibitors (Precose and Glyset), thiazolidinedione (Avandia and Actos), meglitinide (Prandin), an amino acid D-phenylalanine derivative (Starlix), and quite recently at incretin mimetic (Byetta or exenatide).

  Book Reviews:

  There doesn’t seem to be anything that people like to tell us more than what we should eat. Of course, they all have completely contradictory advice. This month two new books keep that record intact.

  • Beating Diabetes: The First Complete Program Clinically Proven to Dramatically Improve Your Glucose Tolerance
    
    

    Beating Diabetes
    

    The authors of Beating Diabetes have excellent credentials. David M. Nathan, M.D., is the director of the Diabetes Center at Massachusetts General Hospital and a researcher for both the Diabetes Prevention Program and the Diabetes Control and Complications Trial. The co-author (and probably the one who did most of the work on this book) is Linda M. Delahanty, the center’s chief dietitian. For good measure the dustcover makes a point of stating that the book is “from Harvard Medical School” and is “based on groundbreaking scientific studies.”

    Who could resist? In broad terms I can’t fault their advice — only the way they give it. Maybe I’m jaded from reading too many diabetes books, but this one just didn’t excite me or motivate me to make any changes in my imperfect life.

    The recommended lifestyle changes to treat type 2 diabetes, summarized on pages 53-4, shouldn’t be any revelation:

    • Start by losing at least five to 10 pounds
    • Reduce or eliminate sweetened beverages
    • Eat small meals at regular intervals rather than skip meals
    • Eat more fiber
    • Increase activity
    So this book also covers exercise, and is not just another diet book, although what you should eat is its basic focus. The recommended diet is, of course, mainstream, meaning that it is 50 to 60 percent carbohydrate (page 61).

    McGraw-Hill Trade lists this 272-page hardcover for $24.95. The ISBN is 0071438319.

  • The French Diet: The Secrets of Why French Women Don't Get Fat
    
    

    The French Diet
    

    Here comes Michel Montignac again. He was one of the first to popularize the glycemic index and years ago inspired the Sugar Busters diet.

    Unlike Dr. Nathan and his co-author, he has been around the diet scene for years. And unlike them (and me) he doesn’t have the proper credentials. M. Montignac is a businessman who lost 30 pounds and lived to write about it.

    I certainly don’t think that M. Montignac’s lack of academic credentials is important. But academics at least make an attempt to be accurate. M. Montignac doesn’t.

    The French Diet is a low-glycemic diet — one that is certain to give the glycemic index a bad name. What irritates me most about this book — and to a certain extent his previous books — is how he plays fast and lose with glycemic index values. His list on pages 32-35 is simply wrong about the GI values of many foods (including barley and maple syrup) and lists values for many food that have never been scientifically tested (like quinoa, figs, onions, and tomatoes).

    The purported “breakthrough” of this book, according to the publisher’s press release, “is in examining the net GI values of combined foods eaten as a meal.” M. Montignac calls the the “glycemic outcome.” He doesn’t even do the calculations correctly, just averaging the GI values of the foods in a meal (page 93).

    In fact, this is less precise than calculating the glycemic index of a mixed meal. We’ve had this concept for years. I describe it at http://www.mendosa.com/gi.htm.

    “I don’t know what he means by net GI values of foods eaten as a meal unless he’s worked out the GI of the mixed meal based on weighted GI values,” Professor Jennie Brand-Miller tells me. She is the leading glycemic index researcher. “We don’t need to do that.”

    DK Publishing lists this 192-page hardcover (one-half of which is recipes) for $20. The ISBN is 075661578X.

  Announcements:

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    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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    5. If and when I learn of any errors of fact, I will correct them.

  Archives:

  I now send out Diabetes Update once a month. Previous issues are online:

  1. Diabetes Update Number 1: Diabetes Genes of December 10, 2000
     
  2. Diabetes Update Number 2: DiabetesWATCH of December 18, 2000
     
  3. Diabetes Update Number 3: Starlix of January 3, 2001
     
  4. Diabetes Update Number 4: Native Seeds/SEARCH, Tepary Beans of January 17, 2001
     
  5. Diabetes Update Number 5: Insulin Makes You Fat of January 31, 2001
     
  6. Diabetes Update Number 6: Available and Unavailable Carbohydrates of February 15, 2001
     
  7. Diabetes Update Number 7: Dates of March 1, 2001
     
  8. Diabetes Update Number 8: Quackwatch of March 15, 2001
     
  9. Diabetes Update Number 9: The Cost of Insulin of March 30, 2001
     
  10. Diabetes Update Number 10: Sof-Tact Meter of April 2, 2001
      
  11. Diabetes Update Number 11: iControlDiabetes of April 16, 2001
      
  12. Diabetes Update Number 12: Cinnamon, Tagatose of May 2, 2001
      
  13. Diabetes Update Number 13: Glycemic Index of May 15, 2001
      
  14. Diabetes Update Number 14: Eat Your Carrots! of May 31, 2001
      
  15. Diabetes Update Number 15: Glycemic Load of June 21, 2001
      
  16. Diabetes Update Number 16: Homocysteine of July 2, 2001
      
  17. Diabetes Update Number 17: Chana Dal Tips of July 15, 2001
      
  18. Diabetes Update Number 18: Lag Time in AlternativeLand of August 2, 2001
      
  19. Diabetes Update Number 19: Fiber of August 15, 2001
      
  20. Diabetes Update Number 20: How Diabetes Works of August 30, 2001
      
  21. Diabetes Update Number 21: Insulin Resistance of September 14, 2001
      
  22. Diabetes Update Number 22: Trans Fats, Honey, CU of October 1, 2001
      
  23. Diabetes Update Number 23: Pedometer Power of October 15, 2001
      
  24. Diabetes Update Number 24: Is Glycerin a Carbohydrate? of October 31, 2001
      
  25. Diabetes Update Number 25: Kill the Meter to Save It of November 15, 2001
      
  26. Diabetes Update Number 26: Protein, Fat, and the GI of December 1, 2001
      
  27. Diabetes Update Number 27: Insulin Index of December 14, 2001
      
  28. Diabetes Update Number 28: Fructose of January 4, 2002
      
  29. Diabetes Update Number 29: Aspirin of January 14, 2002
      
  30. Diabetes Update Number 30: Stevia of January 31, 2002
      
  31. Diabetes Update Number 31: Gretchen Becker’s Book of February 19, 2002
      
  32. Diabetes Update Number 32: The UKPDS of March 4, 2002
      
  33. Diabetes Update Number 33: Financial Aid of March 18, 2002
      
  34. Diabetes Update Number 34: Pre-Diabetes of April 1, 2002
      
  35. Diabetes Update Number 35: More Glycemic Indexes of April 15, 2002
      
  36. Diabetes Update Number 36: Gila Monsters of April 30, 2002
      
  37. Diabetes Update Number 37: Is INGAP a Cure? of May 15, 2002
      
  38. Diabetes Update Number 38: Native American Diabetes of June 3, 2002
      
  39. Diabetes Update Number 39: FDA Diabetes of June 19, 2002
      
  40. Diabetes Update Number 40: Diabetes Support Groups of July 1, 2002
      
  41. Diabetes Update Number 41: New GI and GL Table of July 15, 2002
      
  42. Diabetes Update Number 42: Diabetes Sight of August 1, 2002
      
  43. Diabetes Update Number 43: DrugDigest of August 18, 2002
      
  44. Diabetes Update Number 44: Hanuman Garden of September 3, 2002
      
  45. Diabetes Update Number 45: Guidelines of September 16, 2002
      
  46. Diabetes Update Number 46: Trans Fat of October 4, 2002
      
  47. Diabetes Update Number 47: Nutrition.Gov of October 16, 2002
      
  48. Diabetes Update Number 48: Our Hearts of October 31, 2002
      
  49. Diabetes Update Number 49: Our Kidneys of November 15, 2002
      
  50. Diabetes Update Number 50: A1C<7 of December 2, 2002
      
  51. Diabetes Update Number 51: Diabetes Searches with Google of December 16, 2002
      
  52. Diabetes Update Number 52: e-Patients of January 2, 2003
      
  53. Diabetes Update Number 53: Email News of January 16, 2003
      
  54. Diabetes Update Number 54: Third Generation Meters of January 31, 2003
      
  55. Diabetes Update Number 55: Hypoglycemic Supplies of February 14, 2003
      
  56. Diabetes Update Number 56: Food Police of March 1, 2003
      
  57. Diabetes Update Number 57: Vitamins of April 1, 2003
      
  58. Diabetes Update Number 58: Lancets of May 1, 2003
      
  59. Diabetes Update Number 59: Accurate Meters of June 1, 2003
      
  60. Diabetes Update Number 60: Chromium of July 1, 2003
      
  61. Diabetes Update Number 61: Traveling of August 1, 2003
      
  62. Diabetes Update Number 62: My Book of September 1, 2003
      
  63. Diabetes Update Number 63: Hot Tubs of October 1, 2003
      
  64. Diabetes Update Number 64: Home A1C Testing of November 1, 2003
      
  65. Diabetes Update Number 65: Detemir of December 1, 2003
      
  66. Diabetes Update Number 66: Erectile Dysfunction of January 1, 2004
      
  67. Diabetes Update Number 67: Acidic Foods of February 1, 2004
      
  68. Diabetes Update Number 68: Net Carbs of March 1, 2004
      
  69. Diabetes Update Number 69: Glycemic Index of April 1, 2004
      
  70. Diabetes Update Number 70: Dreamfields Pasta of May 1, 2004
      
  71. Diabetes Update Number 71: Cholesterol of June 1, 2004
      
  72. Diabetes Update Number 72: Meter News of July 1, 2004
      
  73. Diabetes Update Number 73: Pill Splitting of August 1, 2004
      
  74. Diabetes Update Number 74: GlucoMON of September 1, 2004
      
  75. Diabetes Update Number 75: Coding of October 1, 2004
      
  76. Diabetes Update Number 76: Sleep Apnea of November 1, 2004
      
  77. Diabetes Update Number 77: Keynote Address of December 1, 2004
      
  78. Diabetes Update Number 78: Mangosteen of January 1, 2005
      
  79. Diabetes Update Number 79: Noninvasive Dream of February 1, 2005
      
      
  80. Diabetes Update Number 80: Pelikan Sun of March 1, 2005
      
  81. Diabetes Update Number 81: Medtronic Monitors of April 1, 2005
      
  82. Diabetes Update Number 82: ExtendBars of May 1, 2005

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