Dr. Bernstein, a world leading authority in diabetes, is hosting a live internet broadcasts to answer your questions on diabetes. Diabetes 911 is setup to stop the complications of diabetes before it's an emergency. Here's a link to the page where you can submit your questions, to be answered on his next broadcast -- September 19, 2007.

Just a heads-up for The Diabetes Blog reading community - AOL has announced they will be retiring The Diabetes Blog on September 14, 2007. So this is a preemptive blog to get your calendar out, send yourself a reminder email titled: OPEN ON SEPTEMBER 19th!!!!

This will not be my last blog shared with you, all mighty readers of the blogosphere. I'm working to get my proverbial welcome mat in place to continue unfolding the mysteries of diabetes on LoveDiabetes.com. More to come...

Nutrigenetics is the study of the interaction of genes and diet. The Diet Channel has published an article explaining what nutrigenetics is and how it will revolutionize the world of diabetes.

Researchers believe elevated blood sugar can be mapped back to a genetic reaction. Drugs are only overriding the cause of elevated blood sugar and forcing the sugar into the cells, causing damage over time. Nutrigenetics is addressing the cause of the elevated blood sugar and may suggest a better diet to control your diabetes. Genes control how you metabolize certain vitamins, minerals, and nutrients. These genes can vary from one individual to the next. See what happens to Buddy the Elf when he consumes way too much coffee? Yes, I know - that's Hollywood. Nevertheless - a comical example of what nutrigenetics explores.

Consumer-friendly tests are available for these gene and diet interactions. The tests are done with a cheek swab. You send your swab off to a specialized lab, which analyzes DNA from the cheek cells. You receive a report identifying your gene variations. A qualified health professional can explain the test results, and make specific diet and supplement recommendations to optimize your health. If this is a test you're interested in taking, Sciona's Mycellf Program will be happy to prepare your profile. Open up and say Ahhhh.

Drug War '07: drug giants Novo Nordisk and Sanofi-Aventis have been sparring recently over their insulin pen designs. Novo alleges Sanofi has stolen its design ideas, basically. Check out Bev's post on this to learn more.

The reason it's such a big deal to them is money. The insulin pen could be super-lucrative for investors. Meanwhile, here's some news that's bound to get big pharma even more excited: a new study reports that insulin pens are cheaper and more effective than insulin shots.

Why so good? Fewer trips to the emergency room and fewer visits to the doctor. Insulin pens boast a pre-measured dosing system, with each dose of insulin contained in a single, disposable cartridge. This eliminates the risk of over- or under-dosing, says senior author of the study, Dr. Rajesh Balkrishnan of Ohio State University in Columbus. The researchers say that study participants who used an insulin pen instead of a regular syringe ended up reducing their annual healthcare costs by nearly $17,000. Wow.

What I'm not clear on here is whether or not they factored in the added expense of upgrading from syringes to insulin pens.

Want to know more? The study has been published in the latest issue of Clinical Therapeutics, but you can click here to read a summary.

Oramed is developing a soft gel insulin capsule for the treatment of diabetes. The company has recently announced it the successful completion of its clinical trial demonstrating the safety and efficacy of the oral insulin gel capsule.

The pills were shown to reduce blood sugar, with no significant adverse effects. The insulin used in the gel caps is a generic brand of human insulin. The duration of the insulin is similar to Regular. But the most beautiful thing about these gel caps is that they reintroduce the liver into glucose metabolism, thereby reducing the likelihood of dangerous lows associated with injected insulin and oral medications. This could blow away the necessity of blood sugar testing because you are regulating glucose metabolism in the liver, like a person without diabetes.

Up until now, the idea of insulin pills or tablets was inconceivable due to the fact that insulin, when swallowed, breaks down in the digestive system. Oramed's patented technology overcame the problem of digestion as well as permeability to the intestine. The company's goal is for the completion of formal Phase 1 studies in the US by mid-2008. Sign me up!

Ever wonder how Eli Lilly was able to get away with the Zyprexa scandal? A former member of the Lilly neuroscience team put it simply: statistics are like prisoners -- torture them long enough and they'll tell you what you want to hear. This YouTube video gives 6 jaw-dropping minutes of priceless pharmaceutical rep training on how to overcome sales resistance.

Quite remarkable is the coaching Lilly provided their pharmaceutical reps in dismissing the feedback they were receiving from doctors. Lilly told reps to ask doctors (in no uncertain terms) do you want a thin psychotic patient or a healthy fat patient? I think the operative word here is healthy. Does Lilly believe that excessive weight gain, insatiable hunger and Type 2 diabetes are healthy?

In Type 2 diabetes - the blood sugar rises, and spills into the urine, because the body resists insulin and resists its transfer of glucose out of the blood and into the cells of the body. The most important organ in the body – the brain – is protected by this insulin resistance. This is a protective reaction to prevent too sudden a fall in blood glucose, which can cause the brain to swell up with water! If too much glucose suddenly leaves the bloodstream the other sugars in the brain (sorbitol and fructose which are relatively unaffected by insulin) cause water to flow into the brain to correct the osmotic imbalance -- so the brain runs the risk of sustaining injury = too much sugar + too much insulin causes too much water.

Those of us who know what it's like to correct a high sugar with insulin know what it's like to feel bloated as our sugar comes down too quickly. The body is designed to protect its brain by only slowly reducing glucose in the blood and for any excess glucose to be flushed out in the urine. This is a temporary fix for a temporary carbohydrate overload. My billion dollar question is this: Have Lilly pharmaceutical reps been trained to dismiss the side effects of GM insulin (genetically modified to overcome insulin resistance) since it was first introduced in 1983? I'm curious how Lilly justifies diabetic complications.

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.

Ever wonder what would happen to a non-diabetic's blood sugar if they loaded up on a pile of concentrated sugar, preservatives and weird science fats? Doctors and the ADA call it prediabetes. This clip takes it to the extreme by sandwiching the center of 16 double stuff Oreos! Sometimes you have to be insanely blunt to make your point.

This is a brilliant example of the diabetes epidemic in action. In today's world -- many people are eating for convenience without realizing the consequences. More convenient equates to less nutritious - more preservatives, more sugar and even more fattening (the wrong fats, too!) The combination increases the amount of time our digestive enzymes need to work on these lab-derived ingredients. This sustains an elevated blood sugar following the time of consumption. Add the ADA definition of pre-diabetes (a blood sugar between 140 to 199 mg/dl 2 hours after a meal) and there you have it -- a potential player on Team Diabetes!

Think what would happen if this guy was in his doctor's office 2 hours after this stunt. I'd like to thank his employer for keeping him busy (whatever he's paid to do) well after the lunch hour - and protecting him from becoming another statistic. Big ups to HR for hiring this guy!! If he's not in marketing already -- you might consider a transfer and give this guy a raise. He's my Oreo hero.

Oh, this is awesome news for anyone touched by the Avandia mess: manufacturer GlaxoSmithKline (GSK) has announced that its shares are up despite its troubles over the diabetes drug Avandia. The scandal arose over revelations that Avandia could cause heart problems. Things only escalated as details came to light, particularly the role of the US Food and Drug Administration and its completely inadequate response to the problem.

Given all this bad publicity, wouldn't you expect GSK's stocks would take a dive? Well, they did during the quarter that Avandia hit the news. However, the company's overall outlook for the year 2007 still looks pretty darn good, apparently. As a result, projections for earnings-per-share remain stable and the company is expanding its share buyback program.

So much for suffering the consequences of your actions... On the other hand, GSK has vigorously defended Avandia against claims of heart damage. They would say: "Why should we suffer? We haven't done anything wrong."

Howard Hughs Medical Experts have discovered the key to a longer life is lower insulin levels. Less insulin helps cells fend off diseases that lead to early death like heart disease, cancer and diabetes. So how does one lower their insulin levels? Caloric restriction by way of eating less carbohydrates.

Caloric restriction postpones the onset of life-threatening conditions like cancer, diabetes, and heart disease. It may still happen, but at a later age. Scientists manipulated genes in mice to produce 50% less insulin and saw the mice live 18% longer. While lowering insulin throughout the body can lead to a diabetic state, scientists found that allowing insulin levels to be high throughout most of the body, and lowering the insulin signaling only in the brain through genetic manipulation, extended the life of mice.

Although the mice were overweight, they lived longer and seemed active and youthful. Scientists believe that this research explains why some people who live past 100 may have a natural genetic tendency for lower insulin signaling in the brain. They eat a normal amount of calories and may even be a bit overweight, but still enjoy the benefit of life extension. This begs the question: if all diabetes oral meds multiply the effect of insulin -- doesn't this increase the chances of heart disease and cancer? New Rule: Black box warning on ALL prescription diabetes drugs!!

In light of Novo's Meet the Face of Change campaign, I figured I'd address an idea worthy of mention coming out of the Novo product pipeline. This treatment is for Type 2 diabetics but it is not insulin - it's called liraglutide. Liraglutide is a once-daily human analog of the natural hormone Glucagon-Like Peptide-1 (GLP-1). It causes neither excessive hypoglycemia nor weight gain.

Liraglutide works by stimulating the release of insulin only when glucose levels become too high. Unlike many other diabetes drugs - liraglutide also leads to weight loss instead of weight gain. Now we're getting somewhere, Novo!! Patients with Type 2 diabetes treated with liraglutide had a greater reduction in average blood sugar than those patients treated with placebo or insulin glargine (Lantus). As expected, the combination of a GLP-1 analog with a sulfonylurea caused some of the patients to experience hypoglycemia. Okay, point taken. So why impose a glucose lowering drug while mitigating the problem causing elevated sugar in the first place? One drug at a time, folks.

So this is a step in the right direction and I like where it is going. Treating Type 2 diabetes with insulin is counter-intuitive. Looking at another hormone that might interfere with the use of insulin might be the culprit. So here lies a very good idea and I like it. Gold star, Novo! Now when can we meet the face of liraglutide?

House Calls, a popular newsletter written by the prestigious Dr. Inglis, highlights a very important question in light of the Avandia mishap: how many other potential whistle-blowers are out there who have been silenced into submission before the Big Pharma vultures?

A medical expert testified that he agreed to sign a statement that was meant to appease the company's investors. This is not the type of behavior anyone should expect or dismiss of a doctor, entrusted with a patient's life. In his defense, he did forward a letter with his concerns to the FDA, which means they also were aware of the same threat. This same doctor is the President-elect for none other than the American Diabetes Association. Isn't that special? The ADA -- my friend, my confidant, my utter supporter of the C-peptide crusade ... sense the sarcasm? So much for advocacy, when the president-elect of this organization so willingly swept those safety concerns under the table, when he should have been throwing a tantrum on top of it! And all over the threat of litigation from a drug company more concerned about its investors than patients.

The closing comments in Dr. Inglis' newsletter say it all: There are so many vultures out there waiting to pick the bones of the American public, it disgusts me. This example goes to show why I always recommend to you -- and to all of my patients -- that you always question everything when it comes to your health. I don't care if it's your doctor you've had for 50 years or one of these nonprofit organizations -- give them all hell.

Looks like 'shrooms might become a swanky and healthy thing to do! The fungi is affectionately called the Maitake mushroom, and literally means "dancing mushroom. Research has found it lowers blood pressure, abdominal obesity, and lipids in the blood.

Maitake Products plans to target the maitake (grifola frondosa) mushroom to treat metabolic syndrome. Metabolic syndrome is a common precondition for both coronary disease and type 2 diabetes. The condition is characterized by a group of metabolic risk factors including: abdominal obesity, atherogenic dyslipidemia, high blood pressure and insulin resistance. With the growing number of people affected by these conditions, Maitake claims there is significant market potential for its drug, SX-Fraction.

A preliminary clinical study was conducted among 19 patients with type 2 diabetes. Patients taking 9 tablets of SX-Fraction (per day) for 2 months found that it significantly reduced fasting blood glucose, triglycerides, and body weight. The possibility of maitake mushroom as a safe, natural agent for treatment of type 2 diabetes, Syndrome X and insulin resistance has been examined for the past several years and will soon prove to be a therapeutic dancing mushroom in days to come. Yeah man.

A Medco Health Solutions report found that spending on diabetes drugs could rise 70% by 2009, and was second only to cholesterol medications in 2006. Yet, myths about this condition abound. Life@work tells you what causes diabetes, and offers tips to help reduce the complications of the disease.

The following risk factors increase your chances of developing Type 2 diabetes: age, obesity, physical inactivity, and a high fat diet. Rarer causes of diabetes (including type 1 diabetes), include: certain medicines, as well as any illness that damages the pancreas and affects its ability to produce insulin. Eating sweets does not cause diabetes. However, it may cause obesity and this is associated with people developing Type 2 diabetes. Stress does not cause diabetes, although it may be a trigger for the body turning on itself as in the case of Type 1 diabetes. It does, however, make the symptoms worse for those who already have diabetes.

Diabetics can reduce heart disease by consuming ½ c. soy nuts. Half a cup of soy nuts (dry-roasted soybeans) every day, may work as well as anti-hypertension medication to lower blood pressure, a new study conducted on women at Beth Israel Deaconess Medical Center in Boston found. A technique used in yoga to reduce stress and lower blood pressure is the Bhramari or Humming Bee. To perform this pose: Sit comfortably, eyes shut. Inhale and exhale deeply a few times. Inhale. While exhaling, hum gently, making an "mmm" sound. Lips must remain shut. You can also insert index fingers into each ear to feel the sound vibrating at your facial sinuses. This is one round. Do up to nine rounds. This exercise is used to create a meditative mind-set, for healing or controlling various ailments, from diabetes to digestive disorders. Pause for a moment today and enjoy some soy nuts and a humming bee pose.

You will soon have role playing cards available for your doctor's visits. The conversation is scripted with four questions and the answers as to whether or not you should be on a statin. Two can play, but millions will have a chance of their very own!

The pocket cards are intended to empower patients to determine whether they should or should not take a statin. Statins are cholesterol lowering drugs that supposedly reduce the risk of heart attack. Diabetics are typically at a higher risk for heart attack. The card includes answers to four questions: (1) What is your risk of having a heart attack in 10 years? (2) What are the benefits of taking statins as compared to not taking statins? (3) What side effects can you expect from statins? (4) What do you want to do now?

If the risk of having a heart attack is very small, a pill that reduces that risk may not be worth it, but if the risk is really high, lifestyle changes (or a pill) might sound compelling. Once a patient has a sense of the potential dangers and benefits they can make an informed choice. I hope the cards come equipped with the source of the funding for this study: Mayo Clinic and the American Diabetes Association. I wonder if that's the underhanded way to say this study was funded by Merck, Pfizer, and GSK?

Last time I checked -drugs weren't cool, but according to a recent study, within the last 3 years, the number of teens using type 2 diabetes drugs has soared.

Medco, the largest US drug benefits manager, found the number of children taking medicine for type 2 diabetes more than doubled between 2001 and 2005. An analysis of prescription data found a 146% increase over four years in young people aged 10-19 taking type 2 diabetes drugs, and 115 % increase in all children in the survey. Children on diabetes medicines also faced other serious problems. About 17% of the boys and 13% of the girls were on drugs for high blood pressure; 5% of both were taking cholesterol-reducing drugs; and nearly 20% were taking narcotic pain relievers, drugs for respiratory conditions and antidepressants. Medco reviewed over 500,000 children each year. Of those aged 10-19, about 1.47 per 1,000 were taking type 2 diabetes drugs with a clear rising trend.

I'm so glad I'm not a teenager any more. These days it's not about abstaining from drugs. It's about the type of drugs you use. Just because your doctor is the one prescribing it doesn't mean you have to succumb to the peer pressure of drug use. I found an appropriate Chinese proverb for this blog: it is easy to get a thousand prescriptions but hard to get one single remedy. Put that in your pipe and smoke it.