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Diabetes Update: Hanuman Garden

Number 44; September 3, 2002

By David Mendosa

Rick

This newsletter keeps you up-to-date with new articles, columns, and Web pages that I have written. I list and link most of these on my Diabetes Directory at www.mendosa.com/diabetes.htm

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

My most recent contribution is:

    on September 3, 2002
  • Hanuman Garden
    At the end of 1999 I got a call from Paul Del Bene, who works for Scott R. King, the president of Islet Sheet Medical. Paul and Scott wanted me to write a regular column for one of their Web sites about current issues in diabetes. At their invitation I drove the 80 miles or so to their office in San Francisco and met with them. The prospect of my own column on diabetes—being able to write about whatever interested me—was attractive. So I told them that I would love to have that opportunity if my contract with DiabetesWebSite.com allowed it.

    I was in at the beginning of DiabetesWebSite.com. I signed on in June 1999 to write what turned out to be dozens of articles. The pay was good and potentially even better was the 3,500 shares subject to option in my equity incentive plan. So I wasn’t about to do anything to jeopardize my relationship with the people at DiabetesWebSite. I was working directly for General Manager Michael Reynolds, one of the best bosses I have ever had. Michael gently but firmly reminded me that aside from certain prior commitments that I had, they had the exclusive rights to my services.

    Reluctanly, I told Paul and Scott that I would not be able to write the column for them. But just six months later, as the dot-com implosion was raging, DiabetesWebSite closed down and bought out my contract. Needless to say, my stock options were valueless.

    By then it was too late to take up Paul’s and Scott’s offer, because they were buffeted by the same waves. But Scott didn’t take down his Web sites, even though they stopped keeping them up to date. Their sites, particularly Paul’s creation Hanuman Garden, was always in my mind. It is a beautiful site with a relevant story. In my current column on the ADA Web site I tell that story at http://www.diabetes.org/main/community/info_news/web/default.jsp.

Updates

    on August 21, 2002
  • In Charge, Duet, AtLast Meters Discontinued
    LifeScan recently purchased LXN Corporation, which made the In Charge and Duet meters. They were the only meters that tested fructosamine, which is similar to A1c in that both indicate the average of continuous blood glucose changes over a period of time. But the fructosamine test measures a shorter window of two to three weeks, allowing you to more quickly discover if your glycemic control is slipping and lets you and your doctor respond with diet, exercise, or medication as appropriate.

    LifeScan has now discontinued all LXN products and recalled the GlucoProtein test strips that measured fructosamine. The In Charge Web site says that they recently determined that these test strips “may produce false high results when they have been stored below 86°F (30°C), even though storage at these temperatures is in accordance with the test strip vial labeling.” I couldn’t believe that they meant below 86°F, so I called customer service. They confirmed that it was no mistake—but the strips sure were!

    Meanwhile, Roche Diagnostics purchased Amira Medical, which made the AtLast meter. This was the first alternative site meter allowing painless testing on the arm. Roche has ceased selling this meter and its supplies.

    Personally, I am sorry to see these small companies be swallowed up by the meter giants. I wrote three articles about their meters at http://www.mendosa.com/dws.in.charge.htm, http://www.mendosa.com/2meters.htm, and http://www.mendosa.com/duet.htm. I subsequently did some consulting for each of them, including seven issue of LXN's “e-Charged” newsletter, now on my site and linked at http://www.mendosa.com/diabetes.htm, and, for Amira, David Mendosa’s Top Ten Internet Resources. A few years ago these were exciting meters.

    on August 20, 2002

  • Insulin Tutorial
    An interactive educational diabetes/insulin tutorial is available on my site now, thanks to Dr. Eldon Lehmann of the Imperial College of Science, Technology and Medicine and of Royal Brompton Hospital in London, England, who kindly lets me host these 179 files that he prepared. This Web-based tutorial aims to teach a little bit about balancing insulin and diet in diabetes, as well as offering some information about different insulin-dosage adjustment regimens. The tutorial is linked through my Insulin Resources page.

    on August 8, 2002

  • Satiety
    We’ve known for a long time that some foods will satisfy our hunger better than others. That’s the basis of the “Satiety Index” that I wrote about at http://www.mendosa.com/satiety.htm.

    Now, it seems, there is also a satiety hormone. British, American, and Australian scientists working together have discovered that a hormone in the body curbs appetite and limits the amount of food we eat. Cells in the small intestine make the hormone, called Peptide YY3-36 or just PYY, in response to food, then circulate it to the brain, where it can switch off the urge to eat. While scientists have known about the hormone for two decades, they just discovered its ability to suppress appetite.

    The hope is that the hormone itself, a drug based on it, or a diet that stimulates our bodies to make more of the hormone will help us to lose weight. This research, while in its earliest stages, offers great promise to overweight people, many of whom have diabetes. The journal Nature reported the research “Gut hormone PYY(3-36) physiologically inhibits food intake” by R.L. Batterham et al. in its August 8, 2002, issue, volume 418, pp. 650-654. Nature does not have the full text of the article free on-line, but PubMed’s abstract is at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12167864&dopt=Abstract.

    on August 22, 2002

  • Log Sheets
    When I was in Montreal a couple of weeks ago, one of the doctors I met with was a very impressive endocrinologist named Jean-François Yale. Dr. Yale is an associate professor of medicine at McGill University in Montreal. He also heads the Metabolic Day Centre there. He showed me a log sheet that he gives his patients. I recognized right away that it was the best log sheet I’d ever seen and asked for one for personal use. When he gave me a copy, I asked if he would object if I made it available on my Web site as well. “I would be honored,” he replied.

    He subsequently emailed it to me, and I have uploaded it with a link to it on my Software Resources page. Dr. Yale’s log sheet lets you enter blood glucose readings, insulin dosages, food (grams of carbohydrate), and exercise on a scale of 1 to 5 for any hour of the day. The two pages of the log sheet cover the seven days of the week. You can download the zip file containing two Microsoft Word 2000 documents at http://www.mendosa.com/logsheet.zip.

    on August 30, 2002

  • GlucoWatch
    The odds are that you have already called or written me about the GlucoWatch. I may exaggerate a bit, but there isn’t anything else that more people want to buy from me. A few days ago I got a desparate letter from Italy on behalf of the writer’s niece and in the same day’s email at least two requests to sell it to China. Unfortunately, since the manufacturer won’t give me any free samples, I can’t accommodate. Consequently, I have revised my article about the GlucoWatch to emphasize that they need to contact the manufacturer and not call or write me.

    At the same time the Food and Drug Administration finally approved its use by children ages 7 to 17. Initially the FDA had approved it for adults only. The revised article is on-line at
    http://www.mendosa.com/glucowatch.htm

    on September 1, 2002

  • Drugs for Neuropathy
    When I wrote about neuropathy drugs on the horizon for Diabetes Wellness Letter in January 1999 the emphasis seemed to be changing from the alleviation of pain to drugs that would stop or even reverse the most common complication of diabetes. Now, most of these drugs have failed in further clinical trials. While Lilly just started a trial of an aldose reductase inhibitor called lidorestat (see the “Clinical Trials” section of http://www.mendosa.com/neurdrug.htm), all the other ARIs and practically every other drug that once offered hope of curing neuropathy did not make it through the clinical trials. The most recent disappointment is nerve growth factor, which also doesn’t seem to work. I have accordingly updated my article “Drugs for Diabetic Neuropathy” at http://www.mendosa.com/neurdrug.htm.

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