A Watchful Neighbor
A Prairie Dog along the South Boulder Creek Trail

My most recent articles are:

• Pumping in Real Time
  The MiniMed Paradigm REAL-Time Insulin Pump and Continuous Glucose Monitoring System is the first linked insulin pump and continuous glucose monitor. Olympic athlete Chris Jarvis tells me how it works. My article originally appeared in the August 2006 issue of Diabetes Health and is now also online here.

• Me and My Byetta
  Weight loss is only an incidental benefit of taking Byetta. But for me it has been the main event. At the time I wrote this article I had already lost 48 pounds in my first 3 and one-half months on Byetta. My article originally appeared in the August 2006 issue of Diabetes Health and is now also online here.

• My Diabetes Blog
  It’s too hard to keep up with blog content without subscribing to their RSS (Really Simple Syndication) feeds. An RSS feed aggregator makes it easy to keep track of blogs you want to read on a regular basis. I use Bloglines to keep up with the blogs that I like to read.

  My new blog entries for July are:

  • The Gliptins are Coming. The gliptins are a promising new class of drugs that block the DPP-4 enzyme. They include two drugs, vildagliptin (proposed trade name Galvus) from the Swiss pharamaceutical giant Novartis and sitagliptin phosphate (proposed trade name Januvia) from an American company, Merck. The gliptins are theoretically similar to Byetta and its cousins, the GLP-1 analogs. But there are huge differences between the gliptins and the GLP-1 analogs. The big pluses of the gliptins are that they greatly reduce A1C levels, have few side effects, work well with existing diabetes drugs, and especially that you will be able to take them as a once-a-day pill, rather than by the injections that the GLP-1 analogs require. Still, the clinical trials of the gliptins showed one big disappointment. They don’t cause much if any weight loss.

  • Eating to Lose Weight. Now there is proof that you can really lose weight if you eat  —  breakfast. Scientists in Santa Barbara, California, carefully studied 2,701 adolescents from two public high schools there. They compared those who skip breakfast against those who daily eat a complete breakfast. The breakfast skippers were heavier than those who ate breakfast. It didn’t matter whether they had a family history of diabetes or how much their parents weigh.

  • Living the Good Life with Diabetes. To live a good life with diabetes has to mean first that we control our blood glucose. But it also means enjoying the good things in life. I particularly enjoy moderate amounts of Scotch whisky and sometimes immoderate amounts of espresso.

  • Duo Care of Diabetes and Hypertension. GenExel-Sein, headquartered in South Korea, has just introduced the first combined blood glucose and wrist blood pressure monitor. They call it the Duo-Care. The Food and Drug Administration approved it in January, and the first units came off the assembly line a few days ago. I got one of the first Duo-Care units.

  • Walking Faster. We may be walking long enough, but most of us don’t walk fast enough. The latest physical activity guidelines for people with type 2 diabetes recommend 150 minutes of exercise per week. But these guidelines say that our walking needs to be at least “of moderate intensity.” Researchers accept that a walking speed of 4 kilometers per hour  —  2.5 miles per hour  — defines moderately intense physical activity. We don’t walk that fast.

  • Zinc-Fingered Therapy. Sangamo BioSciences calls their zinc-fingered therapy SB-509. It’s a catchy name. Even better, it might some day prevent or even cure diabetic neuropathy.

  • The Fructose Puzzle. Fructose is a strange sugar. It is the sweetest natural sugar, yet it has the lowest glycemic index of any sugar. Still, many people link our increased consumption of fructose to the national obesity epidemic. Generally, these people are concerned about the fructose in high fructose corn syrup. But I herewith dismiss any concern about the fructose in fruit and vegetables as de minimis.

  • Water Everywhere. Everybody agrees that we need plenty of water. How much water we need has, however, been a matter of controversy for years. To me there is nothing better than filtered or sparkling water.

  • A Noble Meter. The new Rightest GM300 blood glucose meter is a noble one in more ways than one. The Righest uses gold electrodes, which is a noble metal. In addition, I like the meter’s accuracy as well as the look and the feel of the meter in my hand.

  • China’s GlucosePilot. The first blood glucose meter made in China for the U.S. has arrived. You can read my evaluation of it here.

  • Exercise for Type 2 Diabetes. Anecdotally, we have known for a long time that we can control our diabetes a lot better with exercise. Now we have the proof that it works. It brings down our blood glucose levels.

  • Size Matters. Can you fool yourself into eating less? A Cornell University professor shows that you can make use of an illusion to take off pounds.

New Edition of My Book
What Makes My Blood Glucose Go Up…and Down?

• The second American edition of my first book came out this month, and I was as excited as anyone to get my copies from the publisher. Unlike my magazine and Web articles, which I know in advance what they will say because none of my current editors have learned the fine art of hacking my work to death, what the book will look like is always a surprise. That’s not because of the editing, but because I am only one of the book’s three authors.

  The book has a very long title. I complained to the publisher about the long title of the first edition. Consequently, the title of the second American edition is even longer, The New Glucose Revolution: What Makes My Blood Glucose Go Up…and Down?

  Jennie Brand-Miller, professor of human nutrition at Australia’s Sydney University; Kaye Foster-Powell, an Australian dietitian; and I each wrote one-third of the book. The first American edition came out in 2003. An edition for Australia came out in 2004, followed by British and Chinese editions last year.

  The first thing that I noticed about the new edition is that it has a prettier cover than any edition except the British one. The second thing is that the publisher printed it on better quality — whiter — paper.

  Other changes are minor. One that I had asked to be make was part of the answer to a question that I had written. The question is “How long does it take for my blood glucose to go up after I eat?” Part of the answer now says that by three to four hours after eating your blood glucose returns to pre-meal levels. This corrects my mistatement in the first edition that it takes just two hours.

  Both edition say that our levels generally reach a peak in 30 to 45 minutes. However, research published after we finished editing the book now indicates that the peak is 72 minutes, as I wrote in my blog entry at http://blogs.healthcentral.com/diabetes/david-mendosa/new-time-to-test-glucose-levels-2006-06-19/print

  This is just one part of 101 frequently asked questions about your blood glucose levels. We divided the book into three main sections:

  1. Your Blood Glucose Levels. Here are 36 general questions and answers.
  2. What Makes my Blood Glucose Levels Go Up? We divided this section into 18 food factors that increase blood glucose levels and six non-food factors that increase them.
  3. What Makes My Blood Glucose Levels Go Down? We divided this section into 32 food factors and 9 non-food factors.

  A big bonus is a complete glycemic index and glycemic load table. It is even more complete that the table on my website at http://www.mendosa.com/gilists.htm, because the table in the book also includes foods that have so little carbohydrate that the GI value can’t be tested.

  Marlowe & Company in New York publishes this 196-page soft cover book for $12.95. The ISBN-13 is 978-1-56924-302-2. The older ISBN-10 is 1-56924-302-6.

Questionnaire:

• A researcher from the University of Nottingham in England named Verbena Braga wrote me. She says that the university is interested in the use of online social support and diabetes. “Although an increasing number of people participate in online forums that provide medical information and help along with social support, a recent article in the British Medical Journal concluded that our understanding of the effects among users is currently very limited,” she writes. “We are trying to assess what kinds of support people seek and benefit from within these online forums.”

  The study, unlike previous research, focuses on the social and psychological benefits of online communities. But in order for this research to succeed, they rely on the willingness of site users to participate. She says that the questionnaire is completely anonymous, complies with BPS ethics guidelines, and has been passed by the university ethics committee. The questionnaire is short and designed to be as non-intrusive as possible. People can stop at any time.

  At the end of the project they will share the key findings with me, and I will share them with you.

  The questionnaire is online at http://www.surveymonkey.com/s.asp?u=36552414850

Announcements:

• This Newsletter
  Diabetes Update 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 at the upper left of all my Web pages.

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

• 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.

• My Guarantee
  This newsletter:
  1. Is and will remain free.
  2. Will never include advertising (except targeted Google ads at the bottom of the web page and not in the email newsletter).
  3. Nor will I ever sell, rent, or trade your e-mail address to anyone.
  4. I will link sources of information.
  5. I will disclose any conflict of interest.
  6. If and when I learn of any errors of fact, I will correct them.

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