We could all benefit from added fiber in our diets. However, it seems the type of fiber consumed is important too. A new study concludes that vegetable fiber is a good defence against type 2 diabetes. The study comes courtesy of researchers at the University of Sydney, Australia, who found that adults eating five grams of vegetable fiber daily were 24 percent less likely than other adults to develop the disease. People over the age of seventy enjoyed a thirty-one percent risk reduction.

The study tracked the eating habits of more than two thousand people over a ten year period. Wow. The researchers also reported that those whose diets contained fiber from mainly cereal or fruit sources did not fare so well - they had a higher risk for type 2 diabetes than those getting lots of fiber from veggie sources. The reason could be that foods high in vegetable fiber produce smaller fluctuations in blood glucose and insulin levels than would cereal or fruits. Lead researcher, Alan Barclay, says legumes are the best fiber source of all.

The results have been published in the latest Diabetes Care.

Ever heard of MedCo Health Solutions? It's not a household name like the big pharmaceutical companies Novo, Glaxo etc. However, MedCo, which happens to be in the prescription benefit management business, is a large and powerful company. Now it's about to become even larger: the company is poised to pay $1.5 billion for PolyMedica Corporation, the nation's biggest supplier of diabetes-related products.

According to a Forbes report on the deal, PolyMedica has nearly one million patients using its products. Its product line includes Liberty Healthcare brand, blood glucose test kits and meters, lancet kits, insulin and the like. The Forbes article says the move is basically a smart one on the part of MedCo: it can cash in on the growing demand(14.5 % growth, annually!) for diabetes supplies. MedCo's chief exec, David Snow, told Forbes he anticipates the purchase could make his company (indirectly) the supplier of diabetes treatment products to half of all insured Americans with diabetes.

Factoid: ads for PolyMedica star "Cocoon" and "Seinfeld" actor Wilford Brimley.

Medical gadget manufacturer Medtronic has teamed up with LifeScan, maker of blood glucose meters. The powers-that-be at those companies say they want to introduce a fab new blood glucose meter to the US market. The meters will be developed by LifeScan for Medtronic and should be reasonably high-tech, with wireless transmission of test results to Medtronic's MiniMed Paradigm pumps or the Guardian REAL-Time continuous monitoring system. Tying it all together: Medtronic's CareLink diabetes management software. The plan is to get the meters on the market by early 2008.

The press release announcing the deal made me laugh. It stresses that, in addition to their alliance, Medtronic and LifeScan "will also educate people about the importance of insulin pump therapy and proactive diabetes management." Oh, ha ha. Translation: "buy our stuff. Please!" It's okay Medtronic and LifeScan. Just be yourselves. You exist to make money. We understand that. Just be honest about it and spare us the whole "education" angle.

Yes, I'm back on the topic of diabetes and car crash liabiity. Here's a case from Montana that's become particularly ugly. Eleven-year-old Cady Tucker was killed in a head-on collision five years ago. The driver of the car that caused the crash has diabetes. Now, usually in these situations the diabetic (sorry, BetterCell!) driver was experiencing low blood sugar. But in this case, the driver had extremely high blood sugar.

Ever since the crash, the girl's mom, Pat Tucker, has been trying to press criminal charges against the woman. Tucker likens the crash to a DUI. The driver, she says, was "drunk on sugar." The Tuckers have even founded an organization devoted to changing the law: People Against Impaired Drivers.

Now Tucker is very upset because she was not able to get to court before last week, when the statute of limitations ran out on the case. "I couldn't believe a crime wasn't committed when a child's life was taken," says Tucker.

There's a ton of sympathy out there for grieving mom, Tucker. But no one's going to bat for her. Attorney General Mike McGrath has said that while he's sorry for Tucker, the accident was just that: an accident, and not a case of negligent homicide. "We don't put people in prison for high blood sugar," says McGrath.

Shhh. Big Pharma scientists hard at work. On what, you ask? Why, on Novo's new "baby" - a drug designed to treat type 2 diabetes. Liraglutide, a hormone analogue, is supposed to improve blood sugar control. It's also supposed to get you that coveted magic bullet (a la Byetta): weight loss. Ooh, baby. Now that's medication!

Novo Nordisk has been working on Liraglutide for a while now. Here's the latest: Novo announced Monday that two Phase III studies were successful in demonstrating the aforementioned blood sugar control and weight reduction. Novo is riding high on the news: its shares rose six percent on the announcement. According to a pharmaceutical industry analyst quoted by Reuters, the shares surged so healthily because the positive news was expected.

The powers-that-be at the drug giant say they hope Liraglutide can be submitted for regulatory approval by mid-2008. They hope it will become another blockbuster, with estimated annual sales topping one billion. Stay tuned.

Wow. I'm floored. Not every diabetic experiencing hypoglycemia in a pubic place becomes a victim of police brutality. A Texas woman with diabetes was recently discovered in her car on the side of a road by a police deputy. She was incoherent, talking to herself. No, the deputy did not drag her in to the station for DUI. Constable's Deputy Russell Whitton, intelligent guy, realized something was up and used the lady's cell phone to call the most recently missed call. This put him in touch with a relative, and he was able to establish that the lady had been reported missing, is diabetic, and was about to go into shock. The deputy gave her LifeSavers to help raise her blood sugar and called for an ambulance. .

In the course of blogging for TDB I've read I-don't-know-how-many news stories about diabetics being manhandled by police during hypo episodes. The typical scenario is this: person's blood sugar drops. Person sways, loses way, crashes car, acts incoherent or all of the above. Cops are called or happen along. Cops mistakenly assume symptoms are due to drunkenness or a drug-induced high. So they proceed to arrest said innocent citizen, who may resist, sparking actions of police brutality. The most recent high-profile case involved "Mr. Natural Universe," Doug Burns.

And then this story came along. Just when I was becoming super-cynical and irreversibly biased against the police, too. Aww. Thanks, Deputy Whitton!

In a case of stunning ineptitude, staff at an Orange County branch of Bank of America locked in an elderly diabetic woman after closing at the end of the day on Wednesday. The woman, Marian R. Prescher (73), went to the bank late Wednesday to access the contents of a storage box she keeps there. The bank shut up shop at 6 p.m., and employees apparently forgot to check the private room that she was in before leaving.

Around that time - I'm not clear on whether it was before she was locked in or perhaps as a result of being locked in - Prescher's blood sugar dropped into the danger zone. Fortunately, Prescher was discovered around midnight by a cleaning crew, whose members found her in diabetic shock - "unconscious and cold to the touch," according to a spokesman for the OC Sheriff's Department. The woman was treated in hospital for hypoglycemia and later released.

The is pretty serious. If she had not been found when she was, Prescher could have died. A friend told a reporter that Prescher's blood sugar had dropped to 20, which is dangerously low.

A statement came from Bank of America on Friday to say the incident is under investigation. I'm thinking they are justifiably sweating over the bad publicity this has brought the bank.

Isn't it amazing that even toddlers can operate computers and cell phones these days? Alex Merriam lives in Pleasanton, Texas. Alex is only two-years-old, but he helped save his dad's life recently. His father, William Merriam, has had type 1 diabetes since he was only four. Last Friday, William's blood sugar got dangerously low and and he fell unconscious in a chair. Alex was the only one in the house with him at the time.

Alex's mom, D'anna, was worried when she kept trying to call her husband. No one answered. In the end, aware that a hypoglycemic episode could have hit William, she had her father try calling too. Eventually, Alex - all of two-years-old, mind you - got the ringing cell phone out of his dad's bag and answered it. He told his grandpa that his dad was "asleep" and then hung up. Kids do the darndest things! The grandfather called back and, yet again, Alex picked up. This time the boy took the phone over to his father and it was clear that dad was not responding at all. Emergency services were alerted and an ambulance arrived not long after that.

After recovering, dad William said "It's nice he doesn't know what's wrong, but knew enough to tell the right person at the right time." Cute story.

Kingman, Arizona, resident Joseph Zarate made it into his local newspaper recently. Zarate was in the US Marines for four and a half years back in the day. He now depends on the US Veterans Administration for his health care services. Right now he believes he's being shortchanged.

Zarate has type 2 diabetes. The VA gives him Metformin and testing strips to do blood sugar tests. However, he says he thinks it's a double standard that he only gets fifty testing strips per ninety day period. He says he needs 180 per month so that he can test himself three times daily. He says his VA doc told him he should be testing himself that often. That's why he's upset. In the meantime, he's been buying extra testing strips from a local pharmacy at his own expense. Meanwhile, a VA spokeswoman says it's VA policy: type 1 patients get 200 testing strips per ninety day period, while type 2s get only fifty per ninety day period.

Check out the mean comments from readers responding to this article. Some readers criticize the VA, others Zarate, and one guy even takes the time to criticize the journalist who did the story. Why all this anger, people? I'm mystified. In the end, it looks like a simple case of institutional ineptitude. Does Zarate, a type 2 diabetes, really need to test his blood sugar three times daily? Probably not. And if not, why did his doctor tell him to do that? Or maybe he misunderstood his doctor's instructions. In any case, the VA has a responsibility to communicate better with patients about what their medical needs are. This guy was obviously trying to take care of his health, but was having a hard time getting answers. I felt sorry for him.

As Bev observed in a post yesterday, California schools will now be required to ensure that diabetic kids get their medical needs met during school hours. Parents are relieved by the settlement, which was reached between the California Department of Education and two school districts (on one side) and four families with diabetic children, working in conjunction with the American Diabetes Association (ADA).

It's a thorny issue. If you require by law that kids be in school during specified hours, you'd better make darn sure you can meet their needs while they're there. As Michelle Ferry, mom of a seven-year-old boy with diabetes, observed "If I had a child in a wheelchair, they wouldn't expect me to come in and take them out of a wheelchair" as necessary throughout the school day. Michelle, you see, was required to drop everything and come running to the school when her son needed a shot because there was no one at the school willing/qualified/permitted to administer it.

While she has a point, you could also argue that helping a (developmentally normal) child in and out of a wheelchair doesn't require special training. Helping a child monitor and adjust his or her blood sugar level most certainly does. Understandably, school administrators were, and remain, concerned about legal liability. Teachers also have a right to be concerned.

Seriously, you'd have to have a heart of pure stone not to be moved by this YouTube video called "Hope is in a Cure." To a fairly sappy soundtrack (okay, okay I'm not a Mariah Carey fan), we see a photo slideshow unfold, telling the story of one little girl's daily experiences with type 1 diabetes. The power of this piece is in its simplicity: a series of one family's snapshots illustrates perfectly what these brave kids go through and the sacrifices the whole family must make when type 1 enters a child's life. Not to mention the agony the moms and dads go through. That is something I can only imagine - and hope I never have to experience myself.

There's a heartbreaker of a shot in here of the little girl asleep, hands tucked daintily and securely under her pillow, asleep and in one sense relaxed, yet on guard against the next skin prick she knows will eventually come.

"Hope is in a Cure" was posted by Lisa of Londonderry, New Hampshire. I don't know who made it. Check it out today. Better yet, send the link to a few people you know. Too few people understand what "type 1 families" live with day-to-day. Let people know that diabetes never takes a vacation and never sleeps. And let them know the Juvenile Diabetes Research Foundation needs our support - you can start by supporting the upcoming Walk to Cure Diabetes.

The police came knocking at the home of Parlier, California, resident Terry Hillblom (59) in April 2006. They were there to deal with a dispute between Hollblom's daughter and her son, but Hillblom got involved and ended up scuffling with a sheriff's deputy, and getting arrested. Hillblom, who has diabetes and wears an insulin pump, says his pump's needle was torn out during the incident. Worse still, he claims the deputy involved would not let him reinsert it before taking him into custody. He says when he told the deputy he needed to fix the pump, the officer said "I don't care." Hillblom was later allowed to reattach the pump but says by then his blood sugar was more than twice its normal level.

Hillblom's not taking this lying down though - last week he filed a lawsuit over the incident. The deputy, Hillblom says, not only damaged his pump connection, but also entered the home without permission or a warrant, and Hillblom wants damages. The Fresno Bee reports that Hillblom is a prominent local resident, former attorney, and vice president of a medical-related non-profit.

As for the deputy involved, he maintains Hillblom caused his own injuries by resisting arrest. Says Hillblom's lawyer, however, "What I know from prior cases is that officers sometimes lose their temper and feel civilians fail the attitude test and they sometimes misuse their power."

What is most disturbing about this case? It's not the fact that the needle was torn out, but the fact that Hillblom was not allowed to fix it immediately. Like the incident involving Doug "Mr. Universe" Burns, this seems like yet another example of police ignorance causing harm to diabetics. Police must be better informed about diabetes, particularly the seriousness of disconnecting person from pump!

Today I compose an ode in remembrance for our islets of Langerhan. Their job is far more complex than balancing blood sugar. They balance everything in our metabolism, starting with the hormones that tell us to eat or stop eating. The islets of Langerhan house 4 critical cell groups: beta cells, alpha cells, delta cells, and gamma cells - also referred to as the PP cells and D1 cells.

Beta cells are activated by a rise in glucose which results in secreting insulin. As this insulin lowers the blood glucose, amylin is also released. Amylin supports the stability of blood glucose levels by slowing the rate that digested glucose enters the bloodstream. The alpha cells are the opposite - they are responsible for preventing hypoglycemia by secreting glucagon. Glucagon helps maintain the level of glucose by causing the liver to release stored glucose. Delta cells secrete somatostatin, which is like the hold button of the alpha-beta cell connection, restraining the release of insulin and glucagon. The last of our Langerhan lineup, and seemingly the least understood, is the gamma cells, PP and D1. These cells affect appetite through the secretion of ghrelin or leptin. Ghrelin is a stimulant for appetite and feeding. Leptin is a hormone that suppresses appetite and speeds up metabolism.

To recap Team Langerhan: beta cells respond to rising blood glucose with insulin, alpha cells respond to falling blood glucose with glucagon. Delta cells respond to perfect balance in blood glucose by suppressing insulin and glucagon, and the gamma cells keep an appetite on an even keel with ghrelin and leptin. If the initial blood glucose lowering medicine prescribed affects any one of these hormones (as you can see it does) - it is definitely causing an imbalance in metabolism. As we memorialize the islets of Langerhan- let us consider all they have done for us. Pay tribute to your islets of Langerhan by doing all that is naturally possible to restore metabolic balance in the future. I have a few ideas - but your job today is complete. You are enlightened. Please have a happy and safe Memorial Day!

A few years back, Dr. Atkins invaded our small towns and villages like a diet-touting Godzilla, crushing bakeries with his bare hands and replacing them with strip malls full of steak houses and vats of butter. The carb craze was on, thanks in large part to the late Dr. Atkins, and it has taken until just recently for carbs to creep back out from their respective hiding places.

Long known by people with diabetes -- but not as well known by the general public -- is that certain carb sources result in different degrees of fluctuation in blood glucose levels. While a whole thing of Laffy Taffy may send your blood sugar soaring, a small serving of whole wheat pasta is much more manageable. This is the whole Good Carb vs. Bad Carb point we have all reached. It's still a bit of a craze, but it's a much healthier and more sound approach to carb regulation than the carb starve movement.

Anyway, now for what I really wanted to mention in this post (and hence the ridiculous title): Lupin-Kernel Flour. Australian researchers found that men who at breakfasts and lunches that included bread baked from this particular type of flour consumed about 360 fewer total calories than men who ate these meals with whole wheat bread.

The reason behind this is the lupin itself; a cousin of soy, this high-protein, high-fiber food has a lesser effect on blood glucose levels, provides more protein per serving, and creates a greater feeling of fullness than whole wheat flour. Unfortunately, it's not yet available in the United States. It may very well be available online on an Australian website somewhere, but I am yet to find it if it is.

I'm sure it will make its way over here soon. If you happen to see it on the shelves of your local Whole Foods or Trader Joe's, please be sure to let us know!!

Caffeine intake makes insulin more resistant to changes in blood sugar levels, Canadian researchers report.

The researchers evaluated sugar metabolism in 23 men before and after a three-month exercise program. Before and during the exercise program, the men were given caffeine or a placebo. The subjects included 8 sedentary lean men, 7 obese men with type 2 diabetes, and 8 obese men without diabetes. Before the exercise program, caffeine reduced insulin sensitivity by 33% in the lean and obese men and 37% in the obese men with diabetes compared to placebo. After the exercise program, insulin sensitivity fell 23% after caffeine intake in the lean men, 26% in the obese men, and 36% in the obese diabetic men. Comparison of the two study phases showed that exercise did not improve insulin resistance related to caffeine intake. It seems that caffeine weakens or offsets any of the beneficial effects of exercise or weight loss on insulin resistance. While the clinical implications remain unclear, the findings are a "red flag" for doctors and are particularly important for obese patients and those with diabetes.

Don't go throwing-away your Starbucks gift card - although the effects of caffeine on insulin were duly noted, the fact remains that coffee may cut the risk of diabetes. Although the findings seem to contradict recent reports that coffee intake may cut the risk of diabetes, coffee contains several other substances that may affect sugar metabolism, such as antioxidants, potassium and magnesium. Caffeine without all of the other substances that are found in coffee produces a different result. Like peanut butter and chocolate - peanut butter by itself is a high-fat protein. When you combine it with chocolate you have a melodic mix disdainfully referred to as candy but happily celebrated in the form of a REESE'S Peanut Butter Cups. It's all in the delivery, folks.