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.

Scientists from all over the world will meet up in Seattle October 22-23 to attend the Warren G. Magnuson Congress for a Global Diabetes Alliance. The initiative is intended to help fight the rapid rise of type 2 diabetes worldwide. International Diabetes Federation past president Pierre Lefebvre, who will be a speaker at the conference, says the need for such an alliance to fight the T2 global epidemic "could not be more urgent."

More than one hundred diabetes experts hailing from over twenty countries will attend the congress. There's one main goal: the discussion of how to help under-served populations, such as indigenous peoples. However, the more general problems - prevention, treatment and the possibility of a cure - will also be on the table. It is also hoped that the alliance can help change public perception of type 2 diabetes as a disease associated with affluence, when in fact it is spreading faster in poor, developing countries where people frequently lack access to medical care.

Organizers say this is the first global alliance on diabetes. Speaking of organizers: who's behind this anyway? Well, it's being convened by the Pacific Northwest Research Institute (PNRI). Incoming president of the American Diabetes Association, Dr. Paul Robertson, is president and scientific director of the PNRI. Warren G. Magnuson, for whom the conference is named, was a US senator and supporter of the sciences who died from diabetes complications in 1989.

The ADA and PNRI's Dr. Robertson is optimistic the organization can effect change: "The response from top experts from around the world to develop a global, multidisciplinary, collaborative endeavor focused on clinical research on diabetes has been overwhelming."

The American Association of Clinical Endocrinologists (AACE) has released its new medical guidelines for diabetes. Needless to say, the 66-page guidelines are intended for your doc, not for you. Unless you are having trouble getting to sleep at night...

But they're important for you to know about. Very. The guidelines are the first reference point for physicians determining the best course of care for diabetes patients. Blood sugar, blood pressure, type 1, type 2, pregnancy, metabolism, prevention etc etc. It's all in there.

So what's new? According to AACE president Dr. Richard Hellman, the focus is, for the first time, on patient safety - specifically, reducing the incidence of medical errors involving diabetes patients. "These guidelines are the first that specifically point to how best to protect the patient with diabetes against mistakes and misjudgments by all those who directly or indirectly impact their diabetes care, including themselves," said Dr. Hellman. "Patient safety is not a given."

The guidelines are being published as a supplement to the latest issue of Endocrine Practice (May/June 2007), the journal of the AACE. They can also be accessed online. Click here to view the pdf.

The Chicago-Sun Times just ran a piece about area dentists who are doing their bit for type 2 diabetes prevention. These docs are screening all patients with gum disease for high blood sugar. They hope this will help with early detection, since gum disease is a risk factor for diabetes. (In fact, gum disease is a risk factor for tons of health issues, running the gamut from minor to life-threatening.)

The paper profiles, among others, dentist Dr. Ronald Schefdore. Whenever Schefdore gets patients coming in with gum disease, he automatically gives them blood tests that measure cholesterol and blood sugar levels, as well as inflammation. Schefdore describes a success story involving one patient who, thanks to the tests, got an early diagnosis of pre-diabetic symptoms and now, with the help of his PCP, has his blood sugar back under control.

Schfdore has also trained about five hundred other dentists (wow) how to collect blood samples using the finger-prick method. "If every dentist practiced this way," he comments, "we could improve the health of the world overnight."

This is preventive care in action. People like this are raising the bar for everyone. Cheers!

It's often said that grass-roots level initiatives are what will turn the tide on the spread of type 2 diabetes. Here's an example of a grass-roots success story: Catholic News reports that Australian Aborigines from the Mowanjum community of Western Australia are benefiting from the introduction of a type 2 prevention and management program.

Titled "Indigenous communities beat diabetes," (that could be a bit of an overstatement), the article describes the impact of the program in Mowanjum community in Western Australia. Successes include the introduction of a comprehensive diabetes education program aimed at young people with diabetes. The program, which is organized by Aboriginal development group Unity of First Peoples Australia, also reported improved quality of care for diabetics. Next task on the list is trying to get all adolescents in the community to achieve normal or near-normal blood sugar levels.

Says a member of the review panel responsible for assessing the program, it's success "is testament to the fact that Indigenous communities have the capabilities and are able to implement life changing programs in a manner that is sustainable and community owned."

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!!

This headline on the website Diabetes Health got my attention: "The Federal Government Hugely Out-of-Pocket for Diabetes Care." Here are the key numbers: In 2005, the federal government spent almost eighty billion dollars on diabetes care, writes Linda von Wartburg, reporting on a study commissioned by drug giant Novo Nordisk as part of its "Changing Diabetes" campaign. In fact, one in every eight healthcare dollars - or twelve percent of the budget - was spent on diabetes. Need some more perspective? Well, according to the Novo study, this amounts to more than the entire budget of the Department of Education. Phew.

Yes, diabetes care is costing a lot of money. But the ballooning cost of diabetes treatment is only part of the problem. Of equal concern is the amount spent on care versus the amount allocated for prevention and education. Paltry, is the word you might use. Of the 79.7 billion spent, only 3.9 billion went to prevention or education. Considering Type 2 diabetes cases are ballooning in the US - some say it constitutes an epidemic - the feds might want to consider tweaking the budget a bit, don't you agree? That's what the study's authors are recommending. They say more money is desperately needed for prevention and public education. Click here to read more on Novo's Federal Spending Report.

Who would've thought the juicy nectar of a mango could aid in diabetes control? A study is analyzing how individual components of the mango can affect human cells. Early results suggest these components could be isolated to form alternative treatments for metabolic disorders like diabetes and high cholesterol.

This study aims to find unique ingredients in mangoes and other tropical fruit like paw paws. Sounds adorable, doesn't it? Typically studies involve vegetables and fruits like broccoli and grapes. The nutritional values of tropical fruits have been historically discounted. Recent interests in the fruits are opening new doors to further scientific discoveries. Early results suggest some compounds in mangoes work by activating or inhibiting groups of receptors known as peroxisome proliferator-activated receptors, or PPARs. PPARs play a role in cellular metabolism. The findings of this study could present positive nutritional health benefits for diabetes and high cholesterol. Furthermore, preliminary findings also suggest that mango skin, often a component of mango juice, is particularly rich in these compounds.

Okay, as an aside-I would like to point out that the skin of the mango can inflict a reaction similar to that of poison ivy. I know this because I've had the misfortune of this happening to me. If you are predisposed to reacting to poison ivy, and you come in contact with the sap on the skin of a mango- it could possibly result in a terribly uncomfortable reaction for you, too. Take my word for it. Don't say I didn't warn you.

A new study has found evidence that a regimen of preventive medications is effective in reducing diabetes risk. But here's a little secret: you have to stick with the program long-term. Yes, one of the problems that health care providers face, apparently, is the fact that many people prescribed these meds don't continue to take them regularly.

The medication that is often prescribed to at-risk patients is metformin. The Diabetes Prevention Program carried out a large study (involving 2,155 subjects) that evaluated the effectiveness of lifestyle changes - in the form of healthy diet and increased exercise - compared with metformin prescriptions. The idea was simple: to show which tactic is most helpful in delaying or preventing the onset of Type 2 diabetes in patients identified as high-risk. Turns out metformin works quite well, actually. The patients taking it showed a 38.2 percent reduced risk for diabetes compared with others in the group who were put on a placebo. As mentioned above, though, a problem is getting people to take the drug routinely. The researchers say around twenty-two percent of patients reported forgetting to take their pills. Others blamed adverse effects and "disruption of routine."

American Indians and health professionals congregated in Oklahoma City last week to attend a four-day conference on diabetes prevention. As you may know, American Indians suffer from Type 2 diabetes at astronomical rates, and this is a cause of great concern for tribal leaders and for government and medical experts on the nation's health.

I was unable to find a website on the conference detailing exactly what happened and what was said. Oklahoma news station KTEN did create a brief report on the event, however, saying that speakers at the conference emphasized the urgent need for lifestyle changes in the form of weight loss, healthy eating and incorporating daily exercise into peoples' lives. The conference was sponsored by the Indian Health Service (a division of the US Department of Health and Human Services) and the Oklahoma Native American EXPORT Center.

UPDATE August 31: Okay, I tried to add a comment, but was unable for some weird computer-related reason. But it's my understanding that while genetics does play a role in who does and who doesn't get certain diseases, Type 2 diabetes is still largely determined by lifestyle. Until they figure out the role of genetics a little better, it's best to focus on lifestyle because at least that's something you can do something about! By the way, I see a new article has just come out in The New York Times on the subject of genetics and aging. Follow this link to read all about it.

We often hear that the US needs a new approach to treating diabetes if the so-called diabetes epidemic is to be brought under control. Specifically, many advocate reorienting medical care to focus on prevention, not just treatment. The Pittsburgh Post-Gazette is currently running a story that highlights one physician's plan for how this might work.

Dr. Swarna Varma (pictured) believes better preventive care would save the US $18 billion annually. Her solution? Pay doctors for time spent training their patients the art of diabetes self-management. The current system, she argues, rewards doctors solely for treating those who fail to keep strict control of their condition. "We get reimbursed for heart attacks, vision problems, strokes, prosthetics, ulcers and dialysis," says Dr. Varma. "Do we get reimbursed to get their ABCs under control? No."

Dr. Varma believes her own practice illustrates how well such a system would work. She says that patients in her practice are three times more likely than the national average to have their diabetes under control. She spends lots of time counseling patients on what they need to do for effective self-management to work, and makes regular follow-up phone calls. She also advocates a team approach, involving the doctor and other staff, as well as the patient's family. "I'm hoping that someday health companies and employers will reimburse us for doing the right thing," says Dr. Varma. "I want to make this doable."

Scientists have identified what they say is an early warning sign of Type 2 diabetes: a protein known as RBP4. Raised RBP4 levels were found in people with insulin resistance. This phenomenon was first identified through studying mice, but further tests have shown the same is true for people.

There are lots of early warning signs of Type 2 diabetes, of course. The difference here is that the RBP4 protein may be present before those other symptoms arise. And early diagnosis that you're at risk for Type 2 is really, really important - it gives you the chance to undertake preventive measures.

The number one preventive measure? Exercise. Yes, good old-fashioned exercise lowers RBP4 levels, but only in those whose insulin sensitivity was also affected by exercise. People with elevated RBP4 who are already lean and fit could be at risk due to a family history of Type 2 diabetes, in which case docs could try them on anti-diabetic meds, say the researchers behind this development.

These days it's not unusual to hear that different city and state governments around the nation are posting all sorts of information online. It's all about giving the public access to information collected by their governments.

I just read that the Missouri Department of Health has created an online resource just for diabetes. The department's web site now includes all the statistics on diabetes that the state has collected. Statistics are presented by county and by state totals. The idea is to make the numbers available to those involved in treatment and prevention of the disease. It will also likely be of use to those engaged in research. According to departmental figures, the incidence of diabetes in Missouri has nearly doubled since 1990. The idea, then, is that anything has to be better than the status quo!

Ask the experts about diabetes and you'll hear one word over and over and over: prevention. The view is that money spent on prevention is always money well spent. Add to the chorus, this view just put forth by researchers from Indiana University: It would be more cost effective for Medicare to allow diabetes prevention coverage beginning at age fifty, rather than age sixty-five, as is now the case. Waiting until people hit sixty-five, they say, makes no sense because by then many individuals have already developed diabetes. Better to start when people are younger and there is a great chance to nip it in the bud, so to speak.

Note, they are not talking just about patient care here. It's not just about touchy-feely subjects such as quality of life, although that is always a concern. No, simply in terms of money this would make sense. Gives you an idea of how much money the country currently spends on diabetes treatment for seniors, huh?