I few days ago I touched on the subject of NY-area drug store chain, Duane Reade. The company established a free diabetes program a while back, offering advice, education and support groups. Duane Reade says it's expanding the program because of customer demand.

Is this part of a larger trend? Looks like it. According to yesterday's New York Times, more and more people are turning to drug stores for medical services. We're talking non-urgent things like sprains and minor infections...and diabetes care. Some are frustrated by lack of access to their regular physician. Others are having budget issues going the traditional route. It's super-convenient because you can be seen without an appointment, then get your prescription filled right there.

Drug store chains - Duane Reade, Wal-Mart, CVS and Walgreens included - are stepping up to the plate to fill the void. "Urgent Care Lite," is the tag it's been given. According to the Times, the number of these clinics has exploded in the past two years. And many feel that's a big problem because these clinics are not tightly regulated.

When The Diet Channel reviewed Fiber 35, they took the diplomatic approach, citing good and not so good advice. Good advice including: get plenty of soluble and insoluble fiber from fruits, vegetables, and whole grains, eat reasonable portions, and exercise. The problem is that this excellent, evidence-based message is buried in hyperbolic language and some superfluous advice.

Fiber 35 emphasizes the mechanisms by which fiber and fiber-containing foods can help improve disease markers (cholesterol, blood sugar, and immunity), while helping to control weight and appetite. A concept enjoying heavy rotation and loose interpretations nowadays is the subject of toxins. Fiber 35 claims that toxins are relieved by eating fiber -- 35 grams a day or more. Fat is addressed as being relatively inactive from a metabolic standpoint. However there is emerging research (not addressed in Fiber 35) demonstrating that fat is active to the point of a separate hormone targeting the metabolic response. As the diabetic community grows, the day will soon arrive when local CVS and Walgreens pharmacies carry the next endocrine simulating prescription.

Until that day arrives (and I continue to pray that capitalistic affairs of Big Pharma slow down like the alimentary canal without a trace of fiber) - look toward Mother Nature for the most organic answer to our metabolic quagmire. Thanks to Brenda Watson for Fiber 35 and The Diet Channel for their comprehensive review. To read the full article, click here.

While patrolling the PubMed database this weekend, I came across a very interesting study that investigated the effects of new insulins on insulin and C-peptide antibodies, insulin dose, and diabetic control. Please note - this study was published in 1983. After reading -- I invite EVERYONE to let me know if it is possible to get purified pork insulin and whether or not you have been on it-- and if you have seen a difference in your diabetes control. Please?

24 diabetic patients using bovine (beef) insulin and possessing insulin antibodies underwent a study of the immunological and clinical consequences of changes in both purity and species of their insulin. The new insulin regimes tested were one of three: a) purified bovine insulin, b) highly purified porcine insulin, and c) semisythetic human insulin.

The patients underwent 3 consecutive 4-month periods on each insulin regimen. The average insulin antibody levels changed little on purified bovine (beef) insulin; actually increased on semi-synthetic human insulin but fell substantially on highly purified porcine insulin. Okay - so this means, in lay terms that the patient's insulin antibodies (the stuff killing your islets) remained relatively the same on beef insulin but became categorically HIGH on synthetic human insulin. And most importantly - to me-the highly purified porcine insulin actually DROPPED the insulin antibodies. Of course - it would cost big pharmaceutical companies more to manufacture highly purified porcine insulin.

C-peptide antibodies fell significantly and continuously throughout the study. The slower rate of fall in C-peptide antibody levels is likely to be due to the prolonged half-life of circulating exogenous proinsulin in the presence of insulin antibody. Although insulin dose remained constant the incidence of hypoglycaemic episodes did not increase and glycosylated haemoglobin levels rose significantly when patients were on porcine insulin. The deterioration in diabetic control may have been due to greater temporal mismatch between insulin needs and insulin availability with pork or human insulin than with beef insulins, and to reduced insulin antibody levels.

The use of purer insulins which more closely resemble the human form can cause a significant reduction in levels of insulin and C-peptide antibodies. These changes may not necessarily produce better diabetic control. Recent studies have shown that a depletion of C-peptide in the body results in a greater chance of microvascular complications associated with diabetes.

This study was published around the time when all of the synthetic human insulins were sweeping the Nation. I tried calling my local CVS Pharmacy on Saturday morning to see if I could get some purified porcine insulin. No such luck. Go figure. The big guys were successful at convincing the medical community and patients that no other insulin is better. Correction - no other insulin is cheaper to manufacture and that means it is better for them. And the importance of C-peptide was overlooked entirely - or was it? C-peptide prevents the complications associated with injecting insulin - but that sounds like another marketable drug. After all - synthetic human insulin doesn't have C-peptide. REAL HUMAN INSULIN does (the way it comes out of the beta cells, in natural form, it does)!!! And as long as your body is producing insulin antibodies - you NEED their synthetic insulin (conveniently -- the only kind you can buy). Best business model - customer for life!

Scarborough Research, the leading local market research firm for identifying consumer and retail behaviors in the United States, took the liberty of compiling a list of the top local markets selling diabetic medications in the last 12 months. A dubious distinction it may be, these locations burn like a flame for the moths of diabetes product resellers.

Knoxville, TN, Memphis, TN, and Columbus, OH round out the top 3 local markets for diabetes medication purchasers. The Scarborough analysis also finds that Walgreens is the number one national drug store brand among diabetes medication purchasers. More than 3.1 million, or 18%, of these consumers purchased prescription drugs at Walgreens during the past year. CVS (17%), Wal-Mart (16%), Rite Aid (8%), and Eckerd Drug (4%) complete the top national drug store brands among diabetes medication purchasers.

In Charleston, Wal-Mart is the top store among diabetes medication purchasers, as over one-quarter (27%) of these consumers purchased prescription drugs there during the past year. Rite-Aid (20%), CVS (14%), Fruth Pharmacy (8%), and Kroger (5%) are other leading stores among diabetes medication purchasers.