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Diabetes Update: Erectile Dysfunction

Number 66; January 1, 2004

By David Mendosa

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

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

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

My most recent contributions are:

  • Erectile Dysfunction
    Before Viagra burst on the scene eight years ago, they called it impotence. Now it is merely erectile dysfunction, since it is a function that can usually be restored. If one drug doesn’t do it, a couple of others probably will.

    Levitra has been available for several months. Cialis came on the market last month. All of these drugs are quite similar in the way they work. The biggest difference is when they work.

    Whether it is impotence or erectile dysfunction, it is one of the biggest complications of diabetes. We haven’t talked about it much — until now. You can read my new article on erectile dysfunction at

  • The Hunt for the Hormone Responsible for Diabetes
    Since 60 percent of all Americans are overweight and just 6 percent have diabetes, it’s clear that obesity doesn’t cause diabetes. Yet there is a close, not well-understood relationship.

    We now understand it better. Scientists at the Eleanor Roosevelt Institute in Denver found that diabetes in obese mice requires the melanocyte-stimulating hormone, which is made by the proopiomelanocortin (POMC) gene that is found in both mice and humans. Mice without the MSH hormone were obese, but did not develop diabetes.

    There’s more. These mice didn’t induce any glucagon. The absence of glucagon looks like hypersensitivity to insulin, leading earlier researchers to think that type 2 diabetes is caused by insulin resistance instead.

    It’s a complicated story that is hard to follow in their printed article. But researcher Miles Brennan explained the research in an interview with me. You can read my article about it at

  • Buyer’s Guide for Pedometers
    If walking is the best exercise for people with diabetes, a pedometer is the best gadget to encourage you to get going and measure your miles. The problem is that there are hundreds of different pedometers on the market, each with different functions and capabilities. The place to start your search for the one that is right for you is my new article in Diabetes Wellness News, which is also available online at


  • Exenatide Trials
    The drug based on gila monster venom is crawling closer to market. The second of three Phase 3 trials of exenatide (synthetic exendin-4) produced dramatic results — lower A1C levels coupled with weight loss. Amylin Pharmaceuticals Inc. and Eli Lilly and Company plan on asking the U.S. Food and Drug Administration for approval in about six months.

    That’s part of the good news. The bad news is that the drug requires two shots per day. Ouch!

    The other good news is Exenatide LAR (Long Acting Release) might allow once-a-week to once-a-month administration. That version of the drug is in Phase 2 trials.

    Amylin’s website has more at

Book Review:

    Dana Carpender’s 15-Minute Low-Carb Recipes

    Dana’s Latest but Not Greatest

  • 15-Minute Low-Carb Recipes
    As a beginning cook, there is nothing I would like more than a cookbook that will tell me how I can prepare a delicious meal with little effort. I call myself a beginning cook, because I now do my share of cooking at home. My inspiration was Dana Carpender’s outstanding 500 Low-Carb Recipes, which I reviewed here two months ago.

    I follow a low-GI rather than a low-carb diet, but certainly have nothing against low-carb recipes. Low-carb is what these two books have in common. The idea of getting in and out of the kitchen quickly makes Dana’s new book especially exciting to me.

    That’s why I was disappointed when the book arrived and I began to study it. The recipes are certainly quick and clearly low-carb. That’s not something that I would fault. They just do not excite me.

    I’m mostly in to cooking vegetable soups and stews these days, and these one-dish meals might seem to be perfect candidates for a cookbook such as this, but there are no stews and only a few thin soups offered here. I guess what I really like is the complex taste of slow-simmering stews, which are impossible in the 15-minute time limit.

    The bigger problem is that since I work at home I can be in and out of the kitchen all day, unlike most people who have to drive miles to get to their office. For those people this book will be a lot more valuable. Indeed, the book’s reviews on are uniformly positive. So if you, unlike me, are busy and committed to eating low-carb, this is another cookbook that you probably should check out.

    Dana Carpender’s 15-Minute Low-Carb Recipes, published in October 2003 by Fair Winds Press in Gloucester, Massachusetts, for $17.95, is a 253-page trade paperback.

Research News:

  • Poorer Control
    Researchers report that only 35.8 percent of U.S. adults with type 2 diabetes have an A1C level below 7.0 percent. Along with the American Diabetes Association, they call that being in control, although a growing number of people would say that the level would have to be below 6.5 percent or even below 6.0 percent.

    The analysis is based on the initial release of the National Health and Nutrition Examination Survey (NHANES) 1999 to 2000. Compared to the earlier NHANES III for 1988 to 1994, our control is getting worse. In the earlier survey 44.5 percent of us were in control by their standard.

    Strangely, this decline parallels more aggressive therapy. People relying on diet alone declined from 27.4 to 20.2 percent. Use of oral medication went up from 45.4 to 52.5 percent, and the number of those of us on both orals and insulin shot up from 3.1 to 11.0 percent. Those on insulin only dropped from 24.2 to 16.4 percent. That means total insulin users were practically unchanged from 27.3 to 27.4 percent.

    The numbers for insulin and oral use are a substantial change from previously available data reported in Chapter 25, “Therapy for Diabetes” by Brian J. Fertig, MD; David A. Simmons, MD; and Donald B. Martin, MD in Diabetes in America, Second Edition, online at They report in Table 25.2, based on the 1989 National Health Interview Survey, that of U.S. adults with NIDDM (now called type 2 diabetes) 18 years and older 39.4 percent used insulin and 52.0 percent used orals.

    The big question is why our control is getting worse. Could it have something to do with the larger portion sizes of the meals we eat? That’s a cultural reality and whether we like it or now, we are a part of that larger culture.

    The research is “Glycemic Control From 1988 to 2000 Among U.S. Adults Diagnosed With Type 2 Diabetes: A preliminary report” by Carol E. Koro et al. in the January 2004 issue of Diabetes Care, pp. 17-20. The abstract is online at


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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

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