You will have to excuse me while I get my skepticism under control. I admit that high fiber foods are a good thing and for those of us with diabetes, higher fiber consumption can be a good idea. When someone says that engineered high-fiber foods are becoming tastier and more appealing to consumers, I have to be skeptical.
When high fructose corn syrup (now corn sugar) was introduced it was hailed as a break through sweetener being cheaper than sugar. In the long-term it has caused more health problems. Those of us with diabetes can attest to this.
Fiber is not a food that is easily digested and very little is digested. Chemically created fiber needs closer scrutiny. How will the body react to the fiber? No tests on humans have been reported and from the article it is not known if the FDA or the USDA will become involved in approving the new dietary fibers.
Much of the problems with celiac disease has developed from the genetic modification of wheat. Because of the genetic engineering of wheat and rice being planned to increase fiber, we should be careful of creating more diseases that may even more difficult to treat.
The world is better off today because of some of the genetic changes to our food supply, but this change has also created health problems for a small percentage of the population. No one is testing all the genetic modifications and what it is doing to overall health of the population in general. One has to wonder if some of the disease increase is a result. There is little proof of this, but until some studies are specifically directed at this, how are we to know?
This is the reason for my questioning engineered fiber and whether the health benefits will in the long-term be justified. While the short article is encouraging, please be careful. Read the article here.
11 December 2010
10 December 2010
Seniors Encouraged to be Screened for Diabetes
When I first read the headlines on this, I thought where is this headed when this needs to be done at all ages. Then in the first sentence, I could see that Medicare is putting up the money so naturally it would be about seniors. And for $50,000 what do they expect? For this amount of money to twenty community-based organizations (at $2500 to each) they should not expect to get much bang for the buck.
There is a growing problem in this country and through out the world of people being undiagnosed with diabetes, but for this limited effort what can we expect. Even the American Diabetes Association and the American Association of Diabetes Educators are not putting out much effort to date in getting doctors to diagnose people sooner. And the screening efforts for undiagnosed people with diabetes is all but non-existent from these associations.
Until the American Medical Association and the American Association of Clinical Endocrinologists decide to cooperate and work on screening programs, the sad state of diabetes is going to continue, especially in this country.
While I had a glimmer of hope when I wrote this, in talking to a few doctors, and endocrinologists, no action has yet been advocated at least in materials they have read.
But I have gotten away from the article that started this. Apparently beginning in 2005. the Centers for Medicare and Medicaid Services (CMS) began offering coverage under Medicare for screening for diabetes and pre-diabetes. I am having to wonder if there have been successes for them to start this program as a replacement to get screening accomplished.
Either way, I do not see much that is in line for success. I do think that their intentions are in the wrong place with the cuts in payments they are making. This is not going to encourage screening of seniors when many doctors are refusing to take on new Medicare patients and some are actually turning them away.
Read the article here. If I sound a lot cynical, I am. When a government agency wastes money by allowing so much fraud, and then cuts payments to doctors and hospitals, I have to wonder what miracles they are looking for with an expense of $50,000.
There is a growing problem in this country and through out the world of people being undiagnosed with diabetes, but for this limited effort what can we expect. Even the American Diabetes Association and the American Association of Diabetes Educators are not putting out much effort to date in getting doctors to diagnose people sooner. And the screening efforts for undiagnosed people with diabetes is all but non-existent from these associations.
Until the American Medical Association and the American Association of Clinical Endocrinologists decide to cooperate and work on screening programs, the sad state of diabetes is going to continue, especially in this country.
While I had a glimmer of hope when I wrote this, in talking to a few doctors, and endocrinologists, no action has yet been advocated at least in materials they have read.
But I have gotten away from the article that started this. Apparently beginning in 2005. the Centers for Medicare and Medicaid Services (CMS) began offering coverage under Medicare for screening for diabetes and pre-diabetes. I am having to wonder if there have been successes for them to start this program as a replacement to get screening accomplished.
Either way, I do not see much that is in line for success. I do think that their intentions are in the wrong place with the cuts in payments they are making. This is not going to encourage screening of seniors when many doctors are refusing to take on new Medicare patients and some are actually turning them away.
Read the article here. If I sound a lot cynical, I am. When a government agency wastes money by allowing so much fraud, and then cuts payments to doctors and hospitals, I have to wonder what miracles they are looking for with an expense of $50,000.
09 December 2010
Combining Byetta and Lantus Best?
This study may be true, but I wonder. The side effects can be horrendous and do affect people differently so be sure that you are aware of all of them before taking. This study promotes it a 'Best Result Ever' when used with Lantus for Type 2 diabetes.
One of the more serious side effects is that it overworks an already in trouble pancreas and can cause pancreatitis (inflammation of the pancreas). This is just one of the side effects and people have not had any problems with this. Then you add nausea, vomiting, and diarrhea and the side effects can be very unpleasant.
The other benefit is exenatide (Byetta) does promote weight loss and for some people this is a good thing. When used with Lantus, there appears to be some good benefits in that hypoglycemia is generally not a problem. Yes, it can happen if you are careless and overdose with either.
With this being an interesting study, I question why it was only 30 weeks and only used 261 participants in five countries. This has been published in the Annals of Internal Medicine on December 7, 2010. You may read it here.
The study was funded and sponsored by an alliance of Eli Lilly and Company and Amylin Pharmaceuticals, who are collaborating to market Byetta, and they have the most to gain from this study. This is another reason I question the value of the study.
One of the more serious side effects is that it overworks an already in trouble pancreas and can cause pancreatitis (inflammation of the pancreas). This is just one of the side effects and people have not had any problems with this. Then you add nausea, vomiting, and diarrhea and the side effects can be very unpleasant.
The other benefit is exenatide (Byetta) does promote weight loss and for some people this is a good thing. When used with Lantus, there appears to be some good benefits in that hypoglycemia is generally not a problem. Yes, it can happen if you are careless and overdose with either.
With this being an interesting study, I question why it was only 30 weeks and only used 261 participants in five countries. This has been published in the Annals of Internal Medicine on December 7, 2010. You may read it here.
The study was funded and sponsored by an alliance of Eli Lilly and Company and Amylin Pharmaceuticals, who are collaborating to market Byetta, and they have the most to gain from this study. This is another reason I question the value of the study.
08 December 2010
When Do You Take Your Blood Pressure Pills?
This sounds reasonable and right. I have been taking mine at night since shortly after I started, and have had excellent results from day one. Yes, originally I was to have taken mine in the AM, but because I was forgetting them, I changed to night without asking the doctor. That was just over seven years ago.
New research shows that we should be taking blood pressure pills at night. The research has found that those taking their blood pressure medications before going to bed have at least one-third less cardiovascular episodes of those taking medications in the morning. This is significant by anyone's measure.
There is no information to relate this to those of us with diabetes, but even then I would have to estimate that the results would be statistically the same if not slightly better.
The five year study is very interesting and should be read by everyone. This is the link to the report of the study.
New research shows that we should be taking blood pressure pills at night. The research has found that those taking their blood pressure medications before going to bed have at least one-third less cardiovascular episodes of those taking medications in the morning. This is significant by anyone's measure.
There is no information to relate this to those of us with diabetes, but even then I would have to estimate that the results would be statistically the same if not slightly better.
The five year study is very interesting and should be read by everyone. This is the link to the report of the study.
07 December 2010
Random and Divergent Thoughts
Sometimes a thought will come to you and at other times you are left thinking. This time the thought is there, but how to present it is wanting. This has to be easier, but I have not found it.
On a few of the diabetes forums that I participate, quite a few people are asking good and sensible questions. When they receive advice from people's experiences, they seem to ignore it and move on to other topics. Others join several forums as the same time and ask the same question then select the forum that gives what is desired to continue the discussion on. I have seen this so often that you can almost tell what they are looking for.
When they don't get the answers they are looking for, they head off to other diabetes forums or discussion groups to test their question. The last one that came across this way was a question about the necessity of exercise. Three of the diabetes forums were very pro-exercise and very emphatic about it. The fourth was pro-exercise, but only with two answers.
So I continued to watch a couple of discussion boards and my wife watched a Facebook group. Sure enough they showed up on one of the boards and Facebook. The discussion board basically said exercise is necessary if they were medically able.
What was interesting was the Facebook group's answer. Three people jumped right in with promotions for natural remedies and said exercise was not necessary. The person responded that finally he had found a group that felt like he did about exercise. The number of promotions of natural remedies was immediate and almost 15 people had promotions up in less than an hour. The person thanked them and has not been seen since.
This is somewhat typical of some people. They are there for one reason, to find someone that agrees with what they want to hear that will give them justification for their attitudes about diabetes. Many of the regular members and participants in the forums can see right through these masked attempts to find information to let them off the hook. They normally answer with the right advice and will not back down.
The other problem I am having is how to deal with certain Certified Diabetes Educators (CDE's). I have been surprised lately at the number of inflexible CDE's that I have met. I made a comment about the new CDE position paper that I wrote about here, and I was told by a CDE that it would not be enforced in her office. I asked why not and was told that because it went against the American Diabetes Association (ADA) guidelines. I asked guidelines for what year and was told the general guidelines.
I could see that she was so rigid in her beliefs that further discussion was going to be futile. This is totally discouraging for me, but I know that some of the professionals get stuck in their beliefs and are unwilling to change. A lot like many people that get comfortable and resistant to change. This is why I probably get surprised as I have had to learn to change. This is something that diabetes forces on you.
On a few of the diabetes forums that I participate, quite a few people are asking good and sensible questions. When they receive advice from people's experiences, they seem to ignore it and move on to other topics. Others join several forums as the same time and ask the same question then select the forum that gives what is desired to continue the discussion on. I have seen this so often that you can almost tell what they are looking for.
When they don't get the answers they are looking for, they head off to other diabetes forums or discussion groups to test their question. The last one that came across this way was a question about the necessity of exercise. Three of the diabetes forums were very pro-exercise and very emphatic about it. The fourth was pro-exercise, but only with two answers.
So I continued to watch a couple of discussion boards and my wife watched a Facebook group. Sure enough they showed up on one of the boards and Facebook. The discussion board basically said exercise is necessary if they were medically able.
What was interesting was the Facebook group's answer. Three people jumped right in with promotions for natural remedies and said exercise was not necessary. The person responded that finally he had found a group that felt like he did about exercise. The number of promotions of natural remedies was immediate and almost 15 people had promotions up in less than an hour. The person thanked them and has not been seen since.
This is somewhat typical of some people. They are there for one reason, to find someone that agrees with what they want to hear that will give them justification for their attitudes about diabetes. Many of the regular members and participants in the forums can see right through these masked attempts to find information to let them off the hook. They normally answer with the right advice and will not back down.
The other problem I am having is how to deal with certain Certified Diabetes Educators (CDE's). I have been surprised lately at the number of inflexible CDE's that I have met. I made a comment about the new CDE position paper that I wrote about here, and I was told by a CDE that it would not be enforced in her office. I asked why not and was told that because it went against the American Diabetes Association (ADA) guidelines. I asked guidelines for what year and was told the general guidelines.
I could see that she was so rigid in her beliefs that further discussion was going to be futile. This is totally discouraging for me, but I know that some of the professionals get stuck in their beliefs and are unwilling to change. A lot like many people that get comfortable and resistant to change. This is why I probably get surprised as I have had to learn to change. This is something that diabetes forces on you.
06 December 2010
Legal Euthanasia Vs Rationing
This is a discussion that needs attention in the USA. Many refer to this as rationing of our health care, others refer to it as legal euthanasia, and some call it decision by death panels. Call it what you want, but this is becoming more common as our health care costs continue it rocket upwards.
Where will it end? No one is sure. Even some doctors are beginning to wonder. Dr. Rob at medrants dot com is writing about it. Bob Doherty at The ACP Advocate Blog also writes about it. Both are very careful as they need to be, but at least they are making us aware of what is going on in the world when dealing with Medical Insurance, Medicare, and Medicaid.
Dr. Rob at medrants dot com quotes from the LA Times dot com about what our senators are talking about – rationing. Every time reduction of health care is mentioned at least they admit that this means health care rationing.
The article in the LA Times states quite accurately (quote) “Both Republicans and Democrats are in denial on this point (about rationing). Republicans pretend that our current system doesn't stop anyone from getting all the care they need. Democrats pretend that efforts to control costs won't limit medical choices and treatment. But most real-world consumers know better: There is no free lunch.” (end quote)
The article makes some other good statements and deserves to be read by all. At lease they lay the problem out and point out where the rationing is coming from – the top down. When congress cuts costs, Medicare and Medicaid, with the insurance industry following suit, decide what they will not cover.
Although I cannot read it, in the November 24 issue of JAMA there is a statement by Drs. Meltzer and Detsky which says (quoting from Bob Doherty), “rationing already takes place in the United States in many ways in health care. Managed care is exactly a form of rationing in which a private insurer determines whether patients should or should not receive services. In addition, private sector rationing injects profit motives into the calculations... It is critical that Americans learn that rationing currently exists and is inevitable and focus their thinking on how its vagaries are best minimized, rather than use the word to instill fear.” (End of quote).
I will agree that using words like “death panels” and “death by budget cuts” creates fear. However, these words are going to appear in the media and must be recognized for what they are. We cannot put our heads in the sand and hope that they will go away. And as more people are denied medical care, these words will be used.
Over the next months as we see how the Affordable Care Act is carried forward, funded or unfunded, we will see a lot more of fear words and probably a larger number of severe rationing decisions. A lot of people are not going to be pleased about this.
This follows when we consider what potentially may happen to our testing supplies if Medicare is not stopped in their proposal to cut our testing supplies for diabetes. This should be considered preventative supplies and should not be limited like Medicare is planning. This is form of rationing we cannot afford.
Where will it end? No one is sure. Even some doctors are beginning to wonder. Dr. Rob at medrants dot com is writing about it. Bob Doherty at The ACP Advocate Blog also writes about it. Both are very careful as they need to be, but at least they are making us aware of what is going on in the world when dealing with Medical Insurance, Medicare, and Medicaid.
Dr. Rob at medrants dot com quotes from the LA Times dot com about what our senators are talking about – rationing. Every time reduction of health care is mentioned at least they admit that this means health care rationing.
The article in the LA Times states quite accurately (quote) “Both Republicans and Democrats are in denial on this point (about rationing). Republicans pretend that our current system doesn't stop anyone from getting all the care they need. Democrats pretend that efforts to control costs won't limit medical choices and treatment. But most real-world consumers know better: There is no free lunch.” (end quote)
The article makes some other good statements and deserves to be read by all. At lease they lay the problem out and point out where the rationing is coming from – the top down. When congress cuts costs, Medicare and Medicaid, with the insurance industry following suit, decide what they will not cover.
Although I cannot read it, in the November 24 issue of JAMA there is a statement by Drs. Meltzer and Detsky which says (quoting from Bob Doherty), “rationing already takes place in the United States in many ways in health care. Managed care is exactly a form of rationing in which a private insurer determines whether patients should or should not receive services. In addition, private sector rationing injects profit motives into the calculations... It is critical that Americans learn that rationing currently exists and is inevitable and focus their thinking on how its vagaries are best minimized, rather than use the word to instill fear.” (End of quote).
I will agree that using words like “death panels” and “death by budget cuts” creates fear. However, these words are going to appear in the media and must be recognized for what they are. We cannot put our heads in the sand and hope that they will go away. And as more people are denied medical care, these words will be used.
Over the next months as we see how the Affordable Care Act is carried forward, funded or unfunded, we will see a lot more of fear words and probably a larger number of severe rationing decisions. A lot of people are not going to be pleased about this.
This follows when we consider what potentially may happen to our testing supplies if Medicare is not stopped in their proposal to cut our testing supplies for diabetes. This should be considered preventative supplies and should not be limited like Medicare is planning. This is form of rationing we cannot afford.
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