Study after study shows that Byetta is not the wonder drug that its manufacturer would like you to believe it is, but that doesn't keep the drug company from spinning the results of their disappointing studies.
Here's the abstract of this new study which was preformed by researchers who were forced to disclose that they were funded by the makers of Byetta:
Exploring the Substitution of Exenatide for Insulin in Patients With Type 2 Diabetes Treated With Insulin in Combination With Oral Antidiabetes Agents
It concludes "it is feasible to sustain glycemic control when substituting exenatide for insulin". But a closer look at the study finds that this is NOT at all what it really found.
First of all, the researchers stacked the deck for Byetta by comparing Byetta with insulin used incorrectly. To quote an editorial published besides the study "the insulin regimen used in this study was often non-physiological and that no attempt was made to optimize insulin therapy before substituting exenatide."
Secondly, even when compared to those using poorly prescribed insulin regimens, the people taking Byetta saw their A1c deteriorate and suffered many more side effects.
This doesn't stop the people who profit from Byetta from touting the idea that their study "proves" that expensive Byetta can be substituted for insulin.
You can bet your bippy drug company reps will be telling your doctor that these exciting new results mean they should move patients on insulin to Byetta.
If your doctor tells you this, call him or her on it and ask why they haven't looked at the actual data. You might also cite the conclusions published in the accompanying editorial by Drs. Julio Rosenstock, of the Dallas Diabetes and Endocrine Center, and Vivian Fonseca, of Tulane University, New Orleans, who were not funded by the makers of Byetta.
They wrote, "The overall effect on glycemic control was rather disappointing. ...this was clearly a negative trial, with a flawed study design and a conclusion that perhaps should have been stronger against substituting exenatide for insulin."
Wednesday, December 5, 2007
Monday, December 3, 2007
Avandia Causes Osteoporosis and Broken Bones--But Actos Does TOO!
This week's medical news is full of reports about a study that explains why Avandia causes osteoporosis.
Here's a report that gives more than the usual amount of detail about this study:
Avandia Researchers Find Reason Behind Bone Fracture, Osteoporosis Side Effects
http://www.newsinferno.com/archives/2123
I have already blogged about Avandia's connection with a doubling of the incidence of fractures this last year HERE.
But what concerns me now is that the way this new story is being reported makes it sound as if the osteoporosis is only a side effect of Avandia, a drug that for all practical purposes is dead after the press discovered the long-known fact that research proved it increases heart attacks.
But as the article I link above makes clear, the reason Avandia causes the bones to thin is because of the way it affects the PPAR-gamma receptor. To quote the report cited above, "the new research found that Avandia also appears to affect a key cellular protein called the peroxisome proliferator-activated receptor (PPAR-gamma). In their study, the California team discovered that activating this receptor in mice also stimulates the production of osteoclasts, cells whose key function is to degrade bone."
Those of you who study diabetes drugs know that it is NOT news that both Avandia and Actos stimulate PPAR-gamma. In fact, this PPAR-gamma stimulation has been the mechanism used to explain how these drugs work ever since the drug companies started selling them over a decade ago. So this finding that Avandia's effect on PPAR-gamma destroys bone suggests strongly that Actos, too, may cause osteoporosis and fractures.
The way the media has spun the Avandia story until now has been that Avandia is bad but Actos, its competitor, is still a good choice. But this new finding should make us think twice about using Actos at all.
The prescribing information for Actos clearly cites that osteoporosis and a doubling of bone fractures has been found by research to be an Actos side effect.
Here is what the FDA-mandated Prescribing Information for ACTOS tells us:
Fractures: In a randomized trial (PROactive) in patients with type 2 diabetes (mean duration of diabetes 9.5 years), an increased incidence of bone fracture was noted in female patients taking pioglitazone. During a mean follow-up of 34.5 months, the incidence of bone fracture in females was 5.1% (44/870) for pioglitazone versus 2.5% (23/905) for placebo. This difference was noted after the first year of treatment and remained during the course of the study. The majority of fractures observed in female patients were nonvertebral fractures including lower limb and distal upper limb. No increase in fracture rates was observed in men treated with pioglitazone 1.7% (30/1735) versus placebo 2.1% (37/1728). The risk of fracture should be considered in the care of patients, especially female patients, treated with pioglitazone and attention should be given to assessing and maintaining bone health according to current standards of care.
Note that these studies only lasted a few years. Over time it is likely that a higher incidence of broken bones and osteoporosis would be found with this drug. Men have thicker bones than women and it would take longer for bone thinning in males to be diagnosed.
Bottom line: Broken hips are one of the biggest killers of older people whose bones naturally thin with age. Hastening the degeneration of your bones is suicide. Don't take either Avandia or Actos. These drugs do not provide anywhere near enough benefit to outweigh their dangerous side effects.
Here's a report that gives more than the usual amount of detail about this study:
Avandia Researchers Find Reason Behind Bone Fracture, Osteoporosis Side Effects
http://www.newsinferno.com/archives/2123
I have already blogged about Avandia's connection with a doubling of the incidence of fractures this last year HERE.
But what concerns me now is that the way this new story is being reported makes it sound as if the osteoporosis is only a side effect of Avandia, a drug that for all practical purposes is dead after the press discovered the long-known fact that research proved it increases heart attacks.
But as the article I link above makes clear, the reason Avandia causes the bones to thin is because of the way it affects the PPAR-gamma receptor. To quote the report cited above, "the new research found that Avandia also appears to affect a key cellular protein called the peroxisome proliferator-activated receptor (PPAR-gamma). In their study, the California team discovered that activating this receptor in mice also stimulates the production of osteoclasts, cells whose key function is to degrade bone."
Those of you who study diabetes drugs know that it is NOT news that both Avandia and Actos stimulate PPAR-gamma. In fact, this PPAR-gamma stimulation has been the mechanism used to explain how these drugs work ever since the drug companies started selling them over a decade ago. So this finding that Avandia's effect on PPAR-gamma destroys bone suggests strongly that Actos, too, may cause osteoporosis and fractures.
The way the media has spun the Avandia story until now has been that Avandia is bad but Actos, its competitor, is still a good choice. But this new finding should make us think twice about using Actos at all.
The prescribing information for Actos clearly cites that osteoporosis and a doubling of bone fractures has been found by research to be an Actos side effect.
Here is what the FDA-mandated Prescribing Information for ACTOS tells us:
Fractures: In a randomized trial (PROactive) in patients with type 2 diabetes (mean duration of diabetes 9.5 years), an increased incidence of bone fracture was noted in female patients taking pioglitazone. During a mean follow-up of 34.5 months, the incidence of bone fracture in females was 5.1% (44/870) for pioglitazone versus 2.5% (23/905) for placebo. This difference was noted after the first year of treatment and remained during the course of the study. The majority of fractures observed in female patients were nonvertebral fractures including lower limb and distal upper limb. No increase in fracture rates was observed in men treated with pioglitazone 1.7% (30/1735) versus placebo 2.1% (37/1728). The risk of fracture should be considered in the care of patients, especially female patients, treated with pioglitazone and attention should be given to assessing and maintaining bone health according to current standards of care.
Note that these studies only lasted a few years. Over time it is likely that a higher incidence of broken bones and osteoporosis would be found with this drug. Men have thicker bones than women and it would take longer for bone thinning in males to be diagnosed.
Bottom line: Broken hips are one of the biggest killers of older people whose bones naturally thin with age. Hastening the degeneration of your bones is suicide. Don't take either Avandia or Actos. These drugs do not provide anywhere near enough benefit to outweigh their dangerous side effects.
Special strains of acidophilus fight yeast and adjust pH
I'm really happy to note that last week the New York Times wrote a long article praising Good Germs, Bad Germs: Health and Survival in a Bacterial World
by Jessica Snyder Sachs, which I reviewed here enthusiastically a few weeks ago.
In the discussion of how we can harness other microorganisms to fight the harmful ones in our bodies, Sachs's book contained what the medical newsletters call a "pearl for practice", one which I tested out myself with excellent results.
Sachs discussed a product, Fem-Dophilus, that contains strains of acidophilus which are those that naturally colonize healthy female reproductive and urinary tracts. After killing off our own friendly acidophilus by using antibiotics, many of us have attempted to introduce acidophilus using yogurt, but it turns out that the kind of acidophilus found in yogurt is a different strain that does not flourish in our bodies for any period of time.
The benefits of having the right strains colonizing your body are that they outcompete yeasts and the bacteria that cause bacterial vaginosis by giving you the correct pH and secreting high levels of hydrogen peroxide that kill other microorganisms.
As those of you who read my blog know, I'm not a big fan of supplements, but I read enough user praise for Fem-Dophilus online to think it was worth a try. I bought it mail order. Buying it that way costs half of what you'll pay in local health food stores even with postage. I have been using it for three weeks.
It really works! Many, if not most, of us older ladies whose hormone levels have dropped have problems maintaining normal vaginal pH. If we have high blood sugars, we may be very susceptible to yeasts or other hostile microorganisms. Even if we have normalized our blood sugars if we had frequent urinary tract infections before diagnosis, we may have fatally screwed up the natural flora in our guts and vaginas.
I've gone through a lot of antibiotics in the past, because my high blood sugars gave me unrelenting urinary tract infections which resulted in some scarring that makes new infections even more likely to occur. After three weeks of introducing these friendly bacteria into my system, I am experiencing improvements in both digestion and in pH-related issues that are quite encouraging.
So if you are a woman who has been battling urinary tract infections or vaginal dryness investing in a bottle or two of this stuff might be well worth a try.
To update my report on another helpful supplement: Vitamin D.
After a brief period I stopped seeing any blood sugar effects from Vitamin D, but I did noticed that I seemed to be more cheerful than usual and when I stopped taking it I found that the mood effects wore off. They came back when I started it again. I think that the initial burst of cheerfulness many of us experience when going out on a sunny day may be connected with our body's pumping out some Vitamin D in response to the sun exposure. (If you are like me and have very pale skin, that cheerfulness turns to dismay as you almost immediately afterwards redden up and everything starts to burn!)
Vitamin D seems like it might be a very good supplement for people with diabetes to take, as it might be related to the depression that has been observed to accompany diabetes--along with the lowered Vitamin D levels.
One caution though: I read that if you don't take calcium WITH your Vitamin D, it may actually promote the storage of other metals in your bones--the ones you are getting in polluted air, Chinese supplements, and foods. So don't take Vitamin D without calcium. Cheese and other food sources are best. I use the kind of supplements that are mostly ground up limestone.
by Jessica Snyder Sachs, which I reviewed here enthusiastically a few weeks ago. In the discussion of how we can harness other microorganisms to fight the harmful ones in our bodies, Sachs's book contained what the medical newsletters call a "pearl for practice", one which I tested out myself with excellent results.
Sachs discussed a product, Fem-Dophilus, that contains strains of acidophilus which are those that naturally colonize healthy female reproductive and urinary tracts. After killing off our own friendly acidophilus by using antibiotics, many of us have attempted to introduce acidophilus using yogurt, but it turns out that the kind of acidophilus found in yogurt is a different strain that does not flourish in our bodies for any period of time.
The benefits of having the right strains colonizing your body are that they outcompete yeasts and the bacteria that cause bacterial vaginosis by giving you the correct pH and secreting high levels of hydrogen peroxide that kill other microorganisms.
As those of you who read my blog know, I'm not a big fan of supplements, but I read enough user praise for Fem-Dophilus online to think it was worth a try. I bought it mail order. Buying it that way costs half of what you'll pay in local health food stores even with postage. I have been using it for three weeks.
It really works! Many, if not most, of us older ladies whose hormone levels have dropped have problems maintaining normal vaginal pH. If we have high blood sugars, we may be very susceptible to yeasts or other hostile microorganisms. Even if we have normalized our blood sugars if we had frequent urinary tract infections before diagnosis, we may have fatally screwed up the natural flora in our guts and vaginas.
I've gone through a lot of antibiotics in the past, because my high blood sugars gave me unrelenting urinary tract infections which resulted in some scarring that makes new infections even more likely to occur. After three weeks of introducing these friendly bacteria into my system, I am experiencing improvements in both digestion and in pH-related issues that are quite encouraging.
So if you are a woman who has been battling urinary tract infections or vaginal dryness investing in a bottle or two of this stuff might be well worth a try.
To update my report on another helpful supplement: Vitamin D.
After a brief period I stopped seeing any blood sugar effects from Vitamin D, but I did noticed that I seemed to be more cheerful than usual and when I stopped taking it I found that the mood effects wore off. They came back when I started it again. I think that the initial burst of cheerfulness many of us experience when going out on a sunny day may be connected with our body's pumping out some Vitamin D in response to the sun exposure. (If you are like me and have very pale skin, that cheerfulness turns to dismay as you almost immediately afterwards redden up and everything starts to burn!)
Vitamin D seems like it might be a very good supplement for people with diabetes to take, as it might be related to the depression that has been observed to accompany diabetes--along with the lowered Vitamin D levels.
One caution though: I read that if you don't take calcium WITH your Vitamin D, it may actually promote the storage of other metals in your bones--the ones you are getting in polluted air, Chinese supplements, and foods. So don't take Vitamin D without calcium. Cheese and other food sources are best. I use the kind of supplements that are mostly ground up limestone.
Thursday, November 29, 2007
Lessons for the Diabetes Community from the Cancer World
I just read a very disturbing book, The Secret History of the War on Cancer by Devra Davis. Suffice it to say that if you are easily scared, you should not read this book.
Dr. Davis is a distinguished epidemiologist. Her subject in this book is how the companies that profit from selling cancer causing products coopted the very organizations and government organs set up to "fight cancer." She describes how the American Cancer Society was taken over by people from the tobacco industry who used the mantra, "This needs further study" to keep the organization from letting the public know that as early as the 1930s scientists had proved very conclusively that cigarettes caused cancer, and that the more a person smoked the more likely they were to develop cancer.
The tobacco industry provided a great deal of funding for the American Cancer Society and one way it kept the public from learning how dangerous their products were was to fund research into other obscure causes of cancer, which was done to downplay the role their product was playing in the huge rise in lung cancer that followed the addiction of millions of soldiers to cigarettes in World War I.
An even more disturbing finding that Davis documents is the way that industries that produce cancerous chemicals have for decades paid researchers to research the cancer causing properties of their products and the chemicals used to make their products, but kept their results hidden from the wider scientific community. Companies have known for decades that workers in their plants were dying horrible deaths from exposure to chemicals used in their workplace, but kept this secret. In some industries, chemicals were used that caused 100% of all workers to get cancer after 25 years on the job. Nevertheless though scientists working for these companies knew this, the information was kept completely secret, because revealing it would reduce corporate profits. That people died because of the secrets they kept was just too bad.
What does this have to do with diabetes?
Well, the ADA has had the same role in the diabetes world that the ACS had in the cancer world. Funded largely by companies that make the high carb products that worsen blood sugar and the drug companies that profit mightily when people eat those products, the ADA has fought for decades against letting the public know that it is carbohydrates that raise blood sugar and that people with diabetes can control their diabetes by lowering their carbohydrate intake substantially.
Any time research proves that cutting out most carbohydrates from your diet--especially those supposedly "healthy whole grains"--improves the health of people with diabetes, the ADA says, "More studies are needed." Meanwhile they put their stamp of approval on high carb junk foods made by companies like Campbells "One gram of salt per serving" Soup.
The ADA has put millions of dollars into convincing people with diabetes that sugar is good for them. Not so coincidentally a top ADA sponsor is Cadbury Schweppes, the candy and soda maker. Check out the annotated list of ADA sponsors as of August 2006 . The company has removed the list of sponsors from the page linked on that entry, probably because it was so damning. But their sponsors continue to be companies that sell you food that makes you more diabetic or expensive drugs you will need if you eat that kind of food.
Like the American Cancer Society, the ADA raises huge amounts of money from the victim of the disease their policies have made more widespread. These donors do not realize that just as the ACS's leadership was full of chemical industry and cigarette company lobbyists, the ADA's leadership is not made up of people with diabetes or of doctors, but of laymen whose corporate connections are not made public, but who probably have long histories of connections with the drug and junk food companies.
Just as the ACS kept the public from knowing for 20 years that cigarettes caused cancer, the ADA has fought to keep you from knowing that it is carbohydrates that raise blood sugar and that a "healthy diet" for a person with diabetes is one that does not raise the blood sugar over normal limits.
Recently a news release went out to say that the ADA has decided to soften its long held hostile stance against recommending low carbohydrate diets for people with diabetes. Well, don't get your hopes up. The outcry against their dangerous and outdated dietary advice has gotten so loud they have to do some kind of spin control. But a "diabetes" organization that in 2007 still defines "tight control" as a blood sugar that drops to 180 mg/dl (10 mmol/L) at 2 hours after eating, and does not mention the word "carbohydrate" once on their Tight Diabetes Control web page is not about to tell anyone to stop eating the diet that is killing them. Not when the funds that pay the salaries of the mystery people who run the organization are paid by huge corporate junk food and drug makers.
The venality documented in Davis' book is terrifying. I had naively thought that the mess that is diabetes treatment was the result of our having a non-glamorous disease people think is caused by our own bad habits. Davis' book makes it clear that callous disregard for the public, deceptive advertising, and cooking the research to hide results that might cost some company money are standard operating procedure throughout the health establishment.
The end-of-life repentances of the cigarette and chemical executives who spent their lives misleading people about the safety of their products do not begin to atone for the hundreds of thousands of people they killed. Will the ADA executives and their self-serving sponsors who fund the organization to ensure that their products continue to find a market, ever come to grips with the way they have caused generations of Americans to go blind, lose their feet, and go on dialysis?
Probably not. After all, unlike those cigarette industry folks who eventually got cancer from their own product, the ADA denizens don't have diabetes, they only profit from it.
by Devra Davis. Suffice it to say that if you are easily scared, you should not read this book.Dr. Davis is a distinguished epidemiologist. Her subject in this book is how the companies that profit from selling cancer causing products coopted the very organizations and government organs set up to "fight cancer." She describes how the American Cancer Society was taken over by people from the tobacco industry who used the mantra, "This needs further study" to keep the organization from letting the public know that as early as the 1930s scientists had proved very conclusively that cigarettes caused cancer, and that the more a person smoked the more likely they were to develop cancer.
The tobacco industry provided a great deal of funding for the American Cancer Society and one way it kept the public from learning how dangerous their products were was to fund research into other obscure causes of cancer, which was done to downplay the role their product was playing in the huge rise in lung cancer that followed the addiction of millions of soldiers to cigarettes in World War I.
An even more disturbing finding that Davis documents is the way that industries that produce cancerous chemicals have for decades paid researchers to research the cancer causing properties of their products and the chemicals used to make their products, but kept their results hidden from the wider scientific community. Companies have known for decades that workers in their plants were dying horrible deaths from exposure to chemicals used in their workplace, but kept this secret. In some industries, chemicals were used that caused 100% of all workers to get cancer after 25 years on the job. Nevertheless though scientists working for these companies knew this, the information was kept completely secret, because revealing it would reduce corporate profits. That people died because of the secrets they kept was just too bad.
What does this have to do with diabetes?
Well, the ADA has had the same role in the diabetes world that the ACS had in the cancer world. Funded largely by companies that make the high carb products that worsen blood sugar and the drug companies that profit mightily when people eat those products, the ADA has fought for decades against letting the public know that it is carbohydrates that raise blood sugar and that people with diabetes can control their diabetes by lowering their carbohydrate intake substantially.
Any time research proves that cutting out most carbohydrates from your diet--especially those supposedly "healthy whole grains"--improves the health of people with diabetes, the ADA says, "More studies are needed." Meanwhile they put their stamp of approval on high carb junk foods made by companies like Campbells "One gram of salt per serving" Soup.
The ADA has put millions of dollars into convincing people with diabetes that sugar is good for them. Not so coincidentally a top ADA sponsor is Cadbury Schweppes, the candy and soda maker. Check out the annotated list of ADA sponsors as of August 2006 . The company has removed the list of sponsors from the page linked on that entry, probably because it was so damning. But their sponsors continue to be companies that sell you food that makes you more diabetic or expensive drugs you will need if you eat that kind of food.
Like the American Cancer Society, the ADA raises huge amounts of money from the victim of the disease their policies have made more widespread. These donors do not realize that just as the ACS's leadership was full of chemical industry and cigarette company lobbyists, the ADA's leadership is not made up of people with diabetes or of doctors, but of laymen whose corporate connections are not made public, but who probably have long histories of connections with the drug and junk food companies.
Just as the ACS kept the public from knowing for 20 years that cigarettes caused cancer, the ADA has fought to keep you from knowing that it is carbohydrates that raise blood sugar and that a "healthy diet" for a person with diabetes is one that does not raise the blood sugar over normal limits.
Recently a news release went out to say that the ADA has decided to soften its long held hostile stance against recommending low carbohydrate diets for people with diabetes. Well, don't get your hopes up. The outcry against their dangerous and outdated dietary advice has gotten so loud they have to do some kind of spin control. But a "diabetes" organization that in 2007 still defines "tight control" as a blood sugar that drops to 180 mg/dl (10 mmol/L) at 2 hours after eating, and does not mention the word "carbohydrate" once on their Tight Diabetes Control web page is not about to tell anyone to stop eating the diet that is killing them. Not when the funds that pay the salaries of the mystery people who run the organization are paid by huge corporate junk food and drug makers.
The venality documented in Davis' book is terrifying. I had naively thought that the mess that is diabetes treatment was the result of our having a non-glamorous disease people think is caused by our own bad habits. Davis' book makes it clear that callous disregard for the public, deceptive advertising, and cooking the research to hide results that might cost some company money are standard operating procedure throughout the health establishment.
The end-of-life repentances of the cigarette and chemical executives who spent their lives misleading people about the safety of their products do not begin to atone for the hundreds of thousands of people they killed. Will the ADA executives and their self-serving sponsors who fund the organization to ensure that their products continue to find a market, ever come to grips with the way they have caused generations of Americans to go blind, lose their feet, and go on dialysis?
Probably not. After all, unlike those cigarette industry folks who eventually got cancer from their own product, the ADA denizens don't have diabetes, they only profit from it.
Tuesday, November 20, 2007
Tagged
Khürt Williams from Honey Sweet tagged me with the meme going around with these rules:
1. Link to the person’s blog who tagged you.
2. Post these rules on your blog.
3. List seven random and/or weird facts about yourself.
4. Tag seven random people at the end of your post and include links to their blogs.
5. Let each person know that they have been tagged by posting a comment on their blog.
===========================================================
Seven Random and or Weird facts about myself:
1. My great-grandfather was born in the 1820s.
2. My daughter has appeared in music videos by Green Day and Kelly Clarkson.
3. I lived for three years on a farm that had no indoor plumbing.
4. I have written two completed novels set in the early 19th century.
5. I was a professional musician in Nashville in the late 1970s.
6. I sent and received my first email in November of 1980.
7. I've been involved in online discussion groups since 1987.
======================================================
The folks I know online are pretty much tagged, so I'm going to risk whatever it is that happens if you don't pass on a meme and not pass this one on.
1. Link to the person’s blog who tagged you.
2. Post these rules on your blog.
3. List seven random and/or weird facts about yourself.
4. Tag seven random people at the end of your post and include links to their blogs.
5. Let each person know that they have been tagged by posting a comment on their blog.
===========================================================
Seven Random and or Weird facts about myself:
1. My great-grandfather was born in the 1820s.
2. My daughter has appeared in music videos by Green Day and Kelly Clarkson.
3. I lived for three years on a farm that had no indoor plumbing.
4. I have written two completed novels set in the early 19th century.
5. I was a professional musician in Nashville in the late 1970s.
6. I sent and received my first email in November of 1980.
7. I've been involved in online discussion groups since 1987.
======================================================
The folks I know online are pretty much tagged, so I'm going to risk whatever it is that happens if you don't pass on a meme and not pass this one on.
Saturday, November 17, 2007
Great Diabetes Gift!
I just got the diabetes bag I ordered only two days ago from Rickina at Stick Me Designs.
It is even nicer than I expected it to be. I can stuff every possible diabetes supply I can think of into this bag and still get it shut.
Here's a photo:
Needles, pen, pen needles, insulin vial, meter, lancet, strips, even my handy dandy needle snipper, all fit in. And with all this stuff in the bag, it still closed:
Rickina, who recently went through a diabetic pregnancy which made her realize the need for this kind of bag, makes these herself. I also sew, and I can tell you, her work is beautiful.
You could also put your glucose in one of the zippered compartments, or your house keys wallet and money, for that matter. It would also be perfect for putting in a larger handbag or for when you travel and want to be sure you have all your stuff with you as carry on.
Most of all what I love is how jaunty it is.
Way to go Rickina!
It is even nicer than I expected it to be. I can stuff every possible diabetes supply I can think of into this bag and still get it shut.
Here's a photo:
Needles, pen, pen needles, insulin vial, meter, lancet, strips, even my handy dandy needle snipper, all fit in. And with all this stuff in the bag, it still closed:
Rickina, who recently went through a diabetic pregnancy which made her realize the need for this kind of bag, makes these herself. I also sew, and I can tell you, her work is beautiful.
You could also put your glucose in one of the zippered compartments, or your house keys wallet and money, for that matter. It would also be perfect for putting in a larger handbag or for when you travel and want to be sure you have all your stuff with you as carry on.
Most of all what I love is how jaunty it is.
Way to go Rickina!
Friday, November 16, 2007
When to Test Blood Sugar in Type 2
One of the topics that comes up a lot in the email I get from visitors to my What They Don't Tell You About Diabetes web site is the question of when is the best time to test your blood sugar.
A lot of doctors still tell people with Type 2 to test first thing in the morning and before meals. That was what I was told at diagnosis in 1998. People who test using this schedule may tell you their blood sugar is usually 120 mg/dl, which sounds pretty good, except that since this is a fasting number it usually hides the information that the person's blood sugar maybe going to 250 mg/dl or higher after every meal.
Research has shown that for people with Type 2 diabetes--especially those who have been diagnosed recently and still retain some beta cell function--it is the high spikes after meals that contribute most heavily to raising the A1c and causing complications. If you only test your fasting blood sugar, you will not know anything about how high your blood sugar is spiking after meals, so you won't know which foods are toxic to you because they cause dangerous spikes.
If you are like most people with Type 2 your access to the very expensive blood sugar testing strips is limited. You may have to pay for strips yourself or your insurance may pay for a single box each month. That means that you need to use each strip as efficiently as possible. Here are some strategies that you can use to get the information out of your blood tests that will let you drop your A1c back into the healthy zone.
A lot of doctors still tell people with Type 2 to test first thing in the morning and before meals. That was what I was told at diagnosis in 1998. People who test using this schedule may tell you their blood sugar is usually 120 mg/dl, which sounds pretty good, except that since this is a fasting number it usually hides the information that the person's blood sugar maybe going to 250 mg/dl or higher after every meal.
Research has shown that for people with Type 2 diabetes--especially those who have been diagnosed recently and still retain some beta cell function--it is the high spikes after meals that contribute most heavily to raising the A1c and causing complications. If you only test your fasting blood sugar, you will not know anything about how high your blood sugar is spiking after meals, so you won't know which foods are toxic to you because they cause dangerous spikes.
If you are like most people with Type 2 your access to the very expensive blood sugar testing strips is limited. You may have to pay for strips yourself or your insurance may pay for a single box each month. That means that you need to use each strip as efficiently as possible. Here are some strategies that you can use to get the information out of your blood tests that will let you drop your A1c back into the healthy zone.
- Keep a written log that matches what you eat with the test result you get.
Even though your meter may keep a list of your readings, these readings are meaningless unless you know what food you ate that resulted in each particular reading. If you write down what portion size of which food you ate and match it to the blood sugar you saw after eating it, you will accumulate the information you need to eliminate toxic foods and replace them with those that do not raise your blood sugars. - Determine when your blood sugar reaches its highest point after eating.
Your goal is to bring your blood sugar peaks below the level that we know cause complications. To do this, you need to learn when your blood sugar hits its highest level. Research studies show that the average person sees a blood sugar peak 75 minutes after eating carbohydrate.
But you're not average, you're you. So the first thing you need to do is determine when your own blood sugar peak occurs. Start out by testing at 1 hour, 1.5 hours, 2 hours, and 3 hours. Do this for three meals. You should start seeing at which time the highest reading occurs. That's the time you should plan to test in the future.
Don't test at 30 minutes after eating. Though many people see a high at this point, research has shown that brief peaks at 30 minutes after eating do not correlate with an increased incidence of complications. The one hour reading is the earliest that you should concern yourself about.
If you eat pasta which digests very slowly you may see a peak much later than usual. You should test for peaks from pasta 4 or 5 hours after eating if you don't see them in the first 3 hours. - Eliminate the Foods that Cause Unacceptable Spikes.
You can test all you want, but if you don't use the test result to eliminate the foods that cause blood sugar spikes, you might as well not test at all. Testing is the most powerful tool you have as a person with diabetes to regain your health, but you must act on the information you get from your testing.
If you see an unacceptable high blood sugar reading, the only way to bring it down is to cut back on the amount of carbohydrate in your meal. Carbohydrates are what raise blood sugar, and despite what you may read in books written by people who do not have diabetes, every gram of carbohydrate you eat will raise your blood sugar no matter whether it is supposedly "healthy", "low glycemic" or the label says it is magically treated to keep it from raising blood sugar.
So if your blood sugar is too high after eating a meal, determine where the carbs came from that raised your blood sugar in that meal, and cut back on the carbohydrate food or eliminate it completely. - Nutritional Software Can Help You Discover Where The Carbs Are
I like LifeForm. Others use Fitday. Find a reliable source of nutritional information and look up the foods you eat to see where the carbs are coming from. Read the labels on the prepared foods you buy and be careful to note the portion sizes which are almost always much less than you eat. For example, have you ever gotten "2.5" servings out of a can of Campbell's soup? No. I didn't think so. But that's the portion size given on the label, so if you eat half the can, you're getting 20% more carbs than are listed on the label. - Shoot for Healthy Blood Sugar Targets
These are the targets that will give you an A1c in the 5% range no matter how high your A1c is now. If you don't believe me, check out THIS PAGE of reports from people who have used these targets to dramatically lower their A1cs.
One hour after eating: under 140 mg/dl (7.8 mmol/l)
Two hours after eating: under 120 mg/dl (6.7 mmol/l)
If you can do better than this, go for it. Normal people rarely go over 120 mg/dl ever and are usually under 100 mg/dl at 2 hours after eating. - Use Generic Meters and Strips if Access is Limited
Wal-mart sells the Relion meter for $8.88 and the strips are less than half the price of the name brand strips. They work just as well. The drugstore brand meters made by TrueTrak are also much cheaper than the brand name strips, though the strips may lose their accuracy over time, once the vial is opened. Companies give away "free" meters only to get you using their overpriced strips. Don't pay full price for name brand strips. It isn't necessary. You can sometimes get good deals on strips on eBay but check the expiration date. Don't buy expired strips and don't buy strips by mail when it is hot as the heat can destroy them.
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