Tuesday, November 26, 2013

Coffee Friend or Foe To Type 2 Diabetes

A touchy topic you might want to read only after you have had your morning caffeine intake.

This article on Medscape shines a small amount of light on the subject:

Coffee Break: Studies Don't Tell Whole Story in Diabetes

There is a weak indication that coffee may reduce the incidence of type 2 diabetics, you might have to sign up to read so I will paste some highlights here:
Drinking coffee might help prevent type 2 diabetes, according to a newly updated collection of studies compiled by the Institute for Scientific Information on Coffee (ISIC). But as ever, the devil lies in the details, with 2 experts disagreeing as to the exact conclusions that can be drawn from this work.
"The truth is, they can't show that drinking coffee reduces the risk for developing diabetes; all they can show is that there's a correlation," he told Medscape Medical News.
 One theory is simple calorie replacement: Choosing coffee over sugary drinks leads to reduced calorie consumption, and coffee also speeds up the metabolism.
And there may be ingredients in coffee — apart from caffeine — with beneficial effects. According to the ISIC report, coffee contains components with potential anti-inflammatory, antioxidant, and hormonal properties that could improve insulin sensitivity. Other coffee ingredients could chelate iron, which also may improve insulin sensitivity or cardiovascular health.

Sorry To Be The Bearer Of Bad News for Type 2 Diabetics

Dr. Lane said his findings apply to all sources of caffeine, not just coffee. Caffeine raises levels of epinephrine (adrenaline), which also are known to stimulate the liver to produce glucose in a "fight-or-flight" response.
"We know caffeine has certain effects. It raises epinephrine and blood pressure. It can make you jittery and sweaty. For some people that's bad, for others it's just an annoyance… I would say people who have type 2 diabetes would be better off if they didn't drink coffee."
Dr. Lane's own work has shown a consistent acute worsening of glycemia with caffeine consumption. Most recently, in a small pilot study, he showed that 3 months of total caffeine abstinence improved glycemic parameters among 12 established coffee drinkers with type 2 diabetes (J Caffeine Res. 2012;2: 45-47). "Here, all they did was quit taking in caffeine, and their A1c improved as much as if they were taking in another medication," he told Medscape Medical News.
And in a prior review article, Dr. Lane cites 17 studies finding that caffeine exaggerates the rise in glucose after carbohydrate ingestion even in healthy, nondiabetic adults (J Caffeine Res. 2011;1:23-28 ).
Dr. Lane told Medscape Medical News that he has had difficulty obtaining grants to further his research. "Critics say it's not worth funding because you can't get people to stop drinking coffee, which we actually did in the pilot study... Even scientists reviewing research grants seem to love their coffee so much they don't want to see research against it."
For further information I suggest you read the references given by the link at the top to the original article. Or alternatively that of Dr. Lane's original article.

It might be worth a try to see if reducing your caffeine ingestion will help with your blood sugar.

Personally as a type 1 I am usually successful at keeping my caffeinated beverages to 1 or 2 a day any more and I become more jittery

Also you might find this article "Chocolate consumption and Nobel Prizes: A bizarre juxtaposition if there ever was one" interesting as it illustrates why correlation does not imply causation.

Before you decide that going out and drinking 5 or more cups of coffee a day might prevent you from getting Diabetes you should read this Mayo Clinic Proceedings . It doesn't look good for heavy coffee drinkers, but still doesn't show causation as many heavy coffee drinkers are also heavy smokers.

Monday, November 25, 2013

My Diabetes and My Hobbies - Part 2 Photography In The City

Besides Yoga, Pilates, and maybe Kick boxing I dislike exercising just for the sake of exercising. Preferring to get my exercise through a long ride someplace any place on my bicycle or a walk around town. So when I gave up my race car (see part 1) and moved away from the small city of Burlington Vermont what to do for an hobby became a question.?

Brazil 1979

While at university and after I did a fair amount of traveling for the geophysics industry so I had a decent camera to chronicle my travels. But as the camera marked me as a possible tourist in places where there were no tourists I sold it in Brazil where a good SLR was in demand because of strict trade protectionism. Except for a few vacation trips to the ocean I was without a camera for over 25 years. That was until 2006 when I joined a camera club and brought my first digital camera a Canon Rebel XT. From that day on I was hooked!

I spend hours almost everyday walking the streets of Toronto, taking photographs, talking and interacting with people. Good exercise for both body and the artistic side of my brain. My professional side of life includes a background in medical imaging so the technical side came very easy allowing me to move to the hard parts like composition and human emotions.

Compassion Now
Not only to I get my exercise and improve my people skills. I'm now recognized as a Toronto Photographer and invited to show at local galleries.

Shop closing in Paris

All in all photography has had a very positive impact on my diabetes. I try to put something back into the community by both mentoring and lecturing on photography.

Here you can find more on my not so secret life as a Photographer

Some links on the value of walking:

Walking could save 37,000 lives a year: 20 minutes' exercise a day would ward off disease

Walking 'is better than the gym': Long periods of gentle exercise are more beneficial than a high-intensity workout

Sunday, November 24, 2013

My Diabetes And My Hobbies - Part One My Brief Racing Career

A few years before I was misdiagnosed with type II diabetes I decided to check off one of the items on my bucket list and actively pursue my hobby of motorsports by buying a car and fixing it up to be a racecar. I then trained for and received my SCCA/CASC license. My rookie year was fairly successful netting the rookie of the year from the British Automobile Racing Club.
My Car and Me At Watkins Glen
After I was diagnosed with type 2 I continued to race at road courses in Canada and the States. Later when I was correctly diagnosed with type 1 I had to take an extensive physical to renew my race license, fortunately I passed with flying colours.

During a race weekend I was testing my blood sugar before and after a race. The reading always went up due I think to the amount of adrenaline in my system. Besides the sugar levels, I had to make sure I was well hydrated and keep my core temperature from overheating while wearing a racing fire suit out on a hot track. Fortunately the races were short never much over an hour. The sugar level were much less difficult to control than when I was on prednisone for a very bad case of poison ivy!

When I moved back to Toronto I sold my race car and retired from the racing scene and took up a new hobby more in keeping with downtown city life.

Control during sports can be especially difficult. You might find this interesting http://fit4d.com/blog/diabetes­technology­friend­or­foe/

Stay Tuned For Part II - My Hobby In The City

Saturday, November 23, 2013

Is Low-Dose Aspirin Right For You?

First off I'm not qualified to answer the question. FYI I take 150mg 2 to 3 times a week usually at night really more for it's anti-inflammatory and painkiller properties rather than for my heart. But as I diabetic I am compelled to ask myself the question. So I will quote from the experts at Harvard Men's Health Watch.
For every 10,000 people who already have cardiovascular disease who take low-dose aspirin 40 are harmed by bleeding and 250 are helped.
For every 10,000 people at risk of cardiovascular disease who take low-dose aspirin 4 are harmed and 7 are helped

What should you do?

For the time being, the science remains uncertain and experts don't agree on who should take aspirin to prevent a first heart attack or stroke. In Europe, for example, guidelines for cardiology do not recommend aspirin for primary prevention, citing an unfavorable ratio of risk to benefit. In the United States, the FDA has not approved any labeling for aspirin bottles regarding its use in preventing cardiovascular disease.
That may change in a few years, as results from new and better primary prevention trials are released. In the meantime, make sure you know where you stand on the scale of risk and benefit. 
And if you have prescribed yourself low-dose aspirin because of what you've read in the health press—seriously consider a chat with your doctor.
From Harvard Men's Health Watch 

More details on aspirin  from the same source: Aspirin and your heart Many questions, some answers including the age old question of what should I tell my wife?

What should I tell my wife when she asks about taking aspirin?

Aspirin is every bit as effective and important for women with heart disease as it is for men. But for healthy women, it's another story; aspirin does not appear to reduce the risk of heart attack, but it does offer protection against strokes caused by blood clots (ischemic strokes). The USPSTF recommends that women between 55 and 79 consider aspirin when their risk of stroke exceeds their risk of gastrointestinal bleeding.
It shouldn't be a surprise anyone that it turns out that women are different than men. Once again our friends at Harvard Medical offer some sage advice to women.
Is aspirin right for you?
Many factors influence whether aspirin will probably help you, harm you, or have little effect. Your age is one of the most important. Other factors that enter into the calculation include your risk for heart disease and stroke, prior gastrointestinal bleeding, and other lifestyle and clinical factors. 
“This is an individual decision that must be made by sitting with your doctor or health care provider and weighing the chances of having a stroke or heart attack against the risks of taking aspirin on a regular basis,” cautions Dr. Buring.
Please read the whole article at: Aspirin and women age matters
The jury is out on how effective aspirin is on the prevention of cancer
Taking an aspirin every other day may help healthy women ward off colon cancer according to a new long-term study published in the Annals of Internal Medicine.
However, the researchers, led by Nancy Cook, Associate Biostatistician at Brigham and Women's Hospital and Professor of Medicine at Harvard Medical School in Boston, found it took years for this benefit to emerge, and this should be weighed against the raised risk of gastrointestinal bleeding from long-term use of aspirin and the fact the treatment made no difference to cancer deaths. http://www.medicalnewstoday.com/articles/263407.php
 Also you might want to read these:

Statement from Dr. Nabel, Director of the NHLBI of the NIH, on the  Findings of the Women's Health Study

Women's Health Study (WHS): A Randomized Trial of Low-dose Aspirin and Vitamin E in the Primary Prevention of Cardiovascular Disease and Cancer

A nonsystematic review of articles published on PubMed® that examines the role of aspirin in Women. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3140811/

Each one of us is different so what works for one person may be deadly for another. A new study haa shown a weakly defined benefit for taking your aspirin at bedtime. http://www.eurekalert.org/pub_releases/2013-11/aha-bam111413.php

But I digress so before I close I repeat this sage advice from the experts:
If you have prescribed yourself low-dose aspirin because of what you've read in the health press—seriously consider a chat with your doctor.

Friday, November 22, 2013

Canadian Disability Tax Credit For Insulin Users

The Canadian government has made a tax credit available to Insulin dependent Diabetics but there is a catch:

The Disability Tax Credit is a credit offered by Revenue Canada to those of who have a severe mental or physical impairment which markedly restricts the basic activities of daily living and/or need and dedicate time for Life Sustaining Therapy (Therapy that must occur at least 3 times per week for more than 14 hours per week).  

But what is an Intensive Insulin Management System?

This means that you are taking more than 1 or 2 injections of insulin per day,  you are monitoring your blood glucose levels 6 or more times per day, you are monitoring your carbohydrate income to match your insulin needs, and you are keeping detailed data on trends and patterns for your diabetes care.  http://www.diabetesadvocacy.com/DTC.htm

You would have to be a statistician or a mathematician to extract anything more than simple information from these complex disjoint sets of real life data. 

14 hours a week and still no clue what that results will be of eating that extra piece of deep dip pizza? Yet how do you continually comply over the years if you really have no idea of what it all means?

Compliance easy to say but even with the grave consequences extremely difficult to achieve for all but a short period of time!

Wake Up Calls Some Are Very Sad

Thursday, November 21, 2013

I Heart Nuts

The New England Journal Of Medicine just published a paper with the snappy title of Association of Nut Consumption with Total and Cause-Specific Mortality

As compared with participants who did not eat nuts, those who consumed nuts seven or more times per week had a 20% lower death rate. Inverse associations were observed for most major causes of death, including heart disease, cancer, and respiratory diseases.

 The risk of dying of heart disease dropped an astounding 29%!

Nuts if you are not allergic might be a superior medicine when compared to the effectiveness of the profitable family of drugs called Statins. Being a Diabetic this news makes me very happy because I eat a lot of nuts, and I can't tolerate Statins as they severally and painfully inflame the joints in my hand! 

This study would indicate that Statins also don't really do much for the knees: Associations between statin use and changes in pain, function and structural progression: a longitudinal study of persons with knee osteoarthritis.

Wednesday, November 20, 2013

My Diabetes Story

By Ryan Raz

It was a hot summer in 1999 with the office air conditioning not working, I was working long hours on a project and drinking plenty of non diet pop to quench my thirst. My weight was going down so I thought nothing about the sugar and the heat masked the other symptoms until my urine showed symptoms of Ketosis plus I was very tired so I visited the doctor. When I was first diagnosed with diabetes I was misdiagnosed with type II, such was the hurried state of the Ontario medical system that they didn't do the simple test that would have determined if I had late onset type I rather than the much more common type II. So at first it looked like diet and exercise kept it well under control. At the beginning I was on the drug metformin but of course it didn’t do anything so they took me off it. Both types are chronic diseases that start out with a honeymoon period where they seem to be easily controlled. It wasn't until almost 2 years later my blood sugars had gotten out of control and I was showing some damage so I went to a specialist in Vermont. He suggested that the first diagnosis was incorrect and that the type II medicines wouldn't work. He confirmed after some simple blood testing that I was actually late onset Type 1 or LADA. (See the link on the right)

At first diagnosis even with good advice from the medical support group I was in denial, felt alone out in the cold. Why me I was only a few pounds over optimal weight, no signs of diabetes in my family history.

I was told not to eat these foods and to eat these other foods. Shown all the terrible long term consequences of disobeying. Even though at first I was religious about changing my diet. exercise and lifestyle I really couldn't see any cause and effect of eating the occasional heap of french fries or giving into the craving for that sweet chocolate bar. Logically I knew I should be doing this and that but I was emotionally unprepared. It took me years to get rid of my sweet tooth. Still hard to keep my salt levels down as we are told we have to protect the heart and vascular system. I’m still addicted to fresh breads even though I know they are the worst of fast carbs.

Now I once a day I inject 30 units of long lasting insulin and a daily total of from 28 to 34 units (depending on the meal) of rapid acting insulin injected. I test my sugar levels from 1 to 6 times a day depending on how stable the level are which depend on a large variety of factors, easily thrown off my current health. I still can’t figure out why sometimes I get lows late at night even when my bedtime levels look good. Even on a good day the timing of my after meal peak is impossible to predict.