I Did Not Attend The Roche Media Summit

I wish I had been able to attend, but some things just weren't meant to happen. Did I lose out? Maybe. I was fortunate to have a visit from an army friend of many years ago. We had reconnected about 12 months ago now and we spent two afternoons enjoying each others company. He is nearing retirement now as an endocrinologist and has been following my blogs the entire time.

We talked about our past and then about diabetes – I think we spent too much time on diabetes and blogging, but he was most interested in my research since I am not medically trained. We have a lot in common on many of the topics I write about and I think he was very kind about my understanding of some medical topics. I do draw on his knowledge about some topics and he has asked me to research some topics for him.

He supplies me with a few topics (URLs) and answers questions I may have. It was my blog on non-diabetic hypoglycemia that reconnected us after about 35 years. I am just happy that he found my research useful and the blog got us back together.

Now to the reports to-date from the Roche summit. I enjoyed David Mendosa's and Gretchen Becker's reports on Dr. Polonsky's speech to the group. This is one where I would have liked to have been in attendance. I have followed the Behavioral Diabetes Institute newletters for well over a year now and wish they had branches in one or two Midwestern cities as this could be very helpful for many with diabetes and depression.

I just hope that the International Diabetes Federation (IDF) will not look too unfavorably on the actions of a few who felt it necessary to “ambush” their representative, Isabella Platon. The IDF is doing a lot of good, and after all folks, this organization speaks for the majority of the world's population with diabetes. Yes, the IDF needs to be more active in the USA as it just might be able to do more for the PWD than the ADA which is governed by its advertising and doctor members and does not have the best interest in the patients.

At least there were some in the DOC that spoke with interest about the mission of the IDF and what they are working so hard to accomplish in the underdeveloped countries of the our world. At least they could remember the names, including the IDF President, Jean Claude Mbanya which one blogger chose to dismiss in an offhand manner.

I can see the support for JDRF as that is the organization dear to the majority of those in attendance, so it is right to be supportive of that organization. I would not expect anything less.

An Example of Poor Research

This article started it all as people were asking Jenny Ruhl about it. Her response is here.

Then to make matters worse, many people were posting about this on many diabetes forums and some were actually thinking this might be an answer. It now appears some clearer heads have prevailed on several diabetes forums.

This also fits Gretchen Becker's blog about press spin as this is a ploy to find funding for what I agree is a very dangerous attempt to give people hope.

Here are two more articles - one from BBC Health. Another one is by WebMD from the presentation at ADA so we know this is not peer reviewed and is just a hope of a very few people. Even CBS News dot com had to use the information.

I agree with Jenny that this is not good science and badly flawed. On Monday, I expect to see more articles on this.  Only one more article and not all that jazzed up about this.

As of this time, people may have become smarter and realized how poor this is and not published anything after WebMD gave it a big splash. Refer to my blog here as to some of the reasons behind our determining this is such poor research in addition to what Jenny writes.

FDA Warns About Risks With Victoza

On Monday, June 13, the US Food and Drug Administration (FDA) issued a warning to all healthcare professionals to closely monitor all diabetes patients receiving laraglutide (Victoza) injections for thyroid C-cell tumors and acute pancreatitis.

This also is supported by Novo Nordisk in their letter stating that a recent assessment has showed that some primary care providers are not fully aware of the serious risks involved with the use of Victoza.

Even though the the evidence is from animal studies that prompted this alert, it is considered serious enough to warrant extra attention by healthcare professionals. The FDA recommends that patients with thyroid nodules noted by physical examination or imaging for other reasons be referred to an endocrinologist for additional evaluation.

The FDA urges physicians to observe patients carefully after initiation of Victoza therapy or dose increases for signs of pancreatitis. This includes ongoing severe abdominal pain that can sometimes radiate to the back, and which may or may not be accompanied by vomiting.

Read this important warning about Victoza (laraglutide) here. And if you have read my blog about Victoza here, also heed the warning.
 
I thought this was important enough to post this on both blogs.

Sorry for the absence

I have been in a fog lately.  Too many tasks to do, things to accomplish, and nothing as far as studies that I have had real interest in.  Most were poor to very bad studies and some were almost laughable when they try to factualize information that is not there.

So for the time being, until I either find something that is very interesting I will be away from this blog and putting what I have that still requires more research on my blog here.

Hope everyone has a happy Easter and I will be back, but only ocassionally for present.

Thank you!

How Much Fiber Is Enough? Part 1

I do have to wonder when the different medical groups are going to become unified in their recommendations for daily dietary fiber intake. I see different ranges quite often. One groups orders 31 grams of fiber for everyone, another claims that women only need 25 grams, and men need 38 grams of daily dietary fiber. Most seem to recommend within this range, but I have seen more precise suggestions based on age, weight, and other factors.

Do we need standardization? It would seem wise as too many medical groups recommend on one number fits all. They do not specify what age range they are talking about or even if there are other factors involved in the determination. I am not sure whose recommendation to use and therefore I go with one I trust more that most which is the Mayo Clinic (see page 2). While their recommendation is from the National Academy of Sciences' Institute of Medicine (IOM), which I hesitate to use, it is reasonable.

This recommendation does not account for children for which I fault the IOM and Mayo Clinic. It does say that age 50 and younger for women the amount of daily dietary fiber should be 25 grams and for women age 51 and older the need drops to 21 grams. For men age 50 and younger the amount of daily dietary fiber should be 38 grams and for men age 51 and older the need decreases to 30 grams.

The best table for dietary fiber is this table by the World Health Organization and you can find it here. You may wish to bookmark it for future reference. It does account for children and the table is about one third down the page. There is other valuable dietary fiber information on the site as well.

Dietary fiber is sometimes referred to as bulk or roughage. Dietary fiber is found in plants, fruits, vegetables, and grains. Dietary fiber is part of a heart-healthy diet. It adds bulk and the full feeling quicker which helps control weight, aids digestion and makes bowel movements easier.

Dietary fiber is of two types – soluble and insoluble Insoluble fiber facilitates easier movement through you digestive system and increases stool bulk. Soluble fiber dissolves in water and forms a gel-like material. This helps lower blood cholesterol and glucose levels. The amount of each type of fiber varies by plant foods. This is why everyone recommends eating a wide variety of high fiber foods.

Benefits of a proper level of fiber in your diet are many and this is the reason for making this known over and over to people. Of course, the correct amount of fiber in your diet makes bowel movement easier and can help with preventing loose stools and for some people it may provide assistance from irritable bowel syndrome. Other benefits of a proper fiber diet is that it may lower your risk of developing hemorrhoids, and possibly other colon diseases.

Next a study and more in fiber – part 2.

I Will Attempt to Have Posts, But I Am Down Right Now

There has been some diabetes news, but most have been shockers trying to get peoples attention to lure more grant monies for research. To me this is not news, but gamesmanship to attract grant funds.

I have seen so many of these lately, that I am jaded in my views and need to get away from some of them. I am not sure that some of them are even legitimate studies or even designed to obtain results other than what the companies want to be shown.

A lot of this started for me when I wrote and posted this blog. To have a government agency develop a 10-year plan and not even encourage finding a cure, but to concentrate on managing diabetes and preventing complications, leaves me wondering whom has paid off whom at the government level.

Yes, this is an undocumented accusation, but it bothers me that our government does not care about finding a cure. Letters to my congressional representatives have not yielded even an acknowledgment of receiving them. I was asking questions that normally should yield answers.

So for the time being, if I am not here with a blog, I may not have found something that deserves attention or I have more research to complete before posting.

Thank you for your patience.

Primary Care to Enter the Dentist's Office?

Can you get past the fear of the dental office to accept dentists doing some primary care? I am not sure I could even though I have no fears of the dental office. I think I would be forced to look elsewhere for my dental work if primary care came to the dental office where I get my dental work done.

I know that the primary care physicians may be in short supply in the near future, but I am having serious problems with the ones trying to fill this vacuum. First the pharmacies, see my blog here, and now the dentists. I guess my initial reaction is one of lets not change the current system.

With what is happening, this may be wishful thinking, but I will do my best to avoid these situations. The doctor interviewed for this article, is very convincing and well-intentioned. He raises some excellent points and knows this will not happen overnight. He is determined that this should be the course of action for dental students of the future. Figuring that this will take three to five years for this to start, another five years for the first ones to graduate, we are eight to ten years before this begins to happen.

Then for other dental schools to actively turn out graduates, would require at least that long and you know that many students will not chose this area so even with all dental schools putting graduates in to the profession some areas will start to have this in ten to 15 years and probably a full 20 to 25 years before this becomes a complete reality.

The one area that could definitely be an advantage for the dental profession is aiding in the detection of diabetes. The doctor did not say diagnosis, but did emphasize screening and referring the patient to their doctor or referring them a doctor knowledgeable about diabetes. Since many primary care doctors have abdicated their responsibility in the area of screening and diagnosis, this is one positive I could see since often there can be signs that the dentist might see earlier like periodontal disease which has a link to diabetes.

So it will be up to the patient whether they will to accept some primary care from the dental profession. How fast this could become a reality remains to be seen, but if limited in nature, there may be a place for some types of primary care.

Read the interview here.