The New York City diabetes database, created to track the growth of (type 2) diabetes amongst the city's residents, has raised the ire of some who claim it violates their right to privacy. A reporter for the Staten Island Advance quotes resident Melissa: "Every time I go to have my blood sugar checked, my test results are being wired to the (city) Health Department. The idea of your privacy being taken away from you goes across all bounds." Melissa also says she doesn't think the city has justification to track patient records for something like diabetes, which is not contagious like, for example, tuberculosis.

My first instinct on reading this: cry me a river, Melissa. Residents should be aware their blood sugar levels are being sent to the health department, and they should be aware of why it is being done. But, really, isn't it a tad paranoid to worry too much about privacy? I mean, why should anyone care about your blood sugar levels out of all the thousands of others out there? If this is a way to gauge how type 2 diabetes is spreading in the NYC area, and if this data can help (as the city claims) determine how best to spend public money on containing the problem, I say go for it.

On the other hand, protecting peoples' privacy should be a factor for consideration, says Dr. Peter Sheehan, of the Mount Sinai School of Medicine and board member of the American Diabetes Association. "We applaud this kind of work," says Dr. Sheehan, but "we're somewhat concerned about the privacy of the individual." This concern is shared by the people entrusted with maintaining the database, says Dr. Diana K. Berger of the Health Department: "We are so careful to protect people's privacy," says Dr. Berger. She adds that only a handful of people have access to the room in which the data is stored, and data is encrypted as it makes its way from laboratories to the city.

All-in-all, it's a slightly unsettling case of weighing priorities: public good versus the right to privacy.

A new report says physical activity is critical for kids with type 1 diabetes because it helps prevent heart trouble later in life. The German and Austrian researchers behind the study reached this conclusion after crunching the numbers for more than 23,000 kids between ages three and eighteen, comparing their health with activity levels. As you would expect, the most active kids had the healthiest hearts and lower levels of cholesterol and triglycerides. By comparison, thirty-six percent of children who were active only once or twice a week had high cholesterol and triglycerides.

For type 1 kids, activity levels relate to HbA1c levels: fit children had lower HbA1c levels. High HbA1c levels in childhood practically guarantee your child will experience heart problems down the road. Says lead researcher Antje Herbst: "Clearly, getting off the couch and out of doors, where they can be more physically active, is good for all kids. But for children with type 1 diabetes, the need to stay physically active is even greater due to the increased risk for heart disease."

Parents: you don't have to sign your little ones up for triathlon training, boot camp or anything like that. Vigorous exercise is not necessary to reap the benefits. Regular periods of normal play are adequate. Even half an hour a day can make a difference, the researchers say. Common sense, however, suggests this is a case where more is definitely better.

The results of this study appear in the latest Diabetes Care (August 2007).

There is still no evidence to declare superiority of rapid-acting insulin analogues in the treatment of type 1 diabetes. These studies compared either insulin aspart (NovoLog) or insulin lispro (Humalog) with human insulin; no such study was available for glulisine (Apidra).

Based on average HbA1c values, patients treated with NovoLog had lower levels. However, statistical comparisons were so small that an effect on patients' health is not to be expected. It was also hypothesized that Humalog may prevent night time lows better than Apidra.

Even though patients have been treated with insulin analogues for 10 years, it is still unclear as to how these types of insulin affect long-term complications of type 1 diabetes. The long-term effects of insulin decisively increase the risk of heart disease and cancer, according to recent studies at Howard Hughs Medical Institute. Would you be surprised to learn that one of the insulin analogue manufacturers chose to withhold some of the results of their studies?

Although the A1c test provides important information about how blood glucose has behaved over the preceding three months, the blood sugar fluctuations after meals have a greater impact on diabetic complications. GlycoMark is a test that monitors mealtime spikes over 2 days to 2 weeks in a single sample.

For diabetics who have good control (A1c less than 7.3%), blood glucose levels immediately following meals account for up to 70% of their total A1c. There is a growing body of evidence suggesting that controlling after-meal glucose levels is critically important in reducing diabetic complications. GlycoMark measures the brief blood glucose elevations (postprandial hyperglycemia) by reading 1,5-anhydroglucitol (1,5-AG). 1,5-AG drops as blood glucose rises above the renal threshold of glucose. The renal threshold of glucose is the blood sugar at which the kidneys start excreting sugar into the urine.1,5-AG decreases rapidly in people with elevated blood sugar.

It is important to note that GlycoMark values decrease when blood sugar increases. An increase in 1,5-AG would indicate improvement, and decrease would indicate worsening of glycemic control. Upon return of better glycemic control, 1,5-AG increases at a constant rate. This consistent recovery rate in 1,5-AG levels provides a rapid indication of the patient's response to treatment. With the GlycoMark, perhaps now we can really evaluate the affects of certain types of foods and how they affect our ability to control our blood sugar after meals. Fore more details, checkout the full brochure online.

Change appears to be coming for diabetes care. The HbA1c test may not be the safest approach for diabetics to follow in preventing complications. Instead, experts are saying the average blood glucose level per individual will add clarity to diabetic patients looking to manage their disease.

A study supporting the change showed a close correlation between average glucose and HbA1c levels. So the myth, busted is: maintaining an average blood sugar is a safer approach for diabetes management -- NOT CHASING A UNIFORM HbA1c value. The fluctuation in blood sugar is what causes complications in the small vessels of the eyes, kidneys and peripheral nerve endings. For example - sustaining a blood sugar of 200 mg/dL is a lot safer than waking at 240 and ushering a boatload of sugar into your cells to drop your sugar to 80 mg/dL. It is the transfer of glucose into the cell that causes the injury to cell membranes and resulting complications.

Think of it like the movement of the ocean. High tide to low tide happens gradually, over the course of many hours throughout the day. When a storm hits - the waves become turbulent, crashing against the shore causing erosion. Is the human body any different? I'm not a doctor -- but I did stay at a Holiday Inn Express last week.

If you've been around the diabetes online community you've certainly heard of Amy Tenderich. Her award-winning site is touted as one of the most influential diabetes sites out there. If you're looking for a gold mine of straight talk and encouragement -- Diabetes Mine is your destination. And now is your chance to speak to the celebrity herself! Amy will be chatting live on Tuesday, May 22, 9pm EST on Diabetes Talkfest.

Her charm comes through, loud and clear, in her cynically optimistic view of the trials of living with diabetes. Her journalistic flair derives from the heart and covers topics like breaking news and inside looks at diabetes research, as well as daily life with diabetes and uncovering the diabetics' deepest hopes and fears. Her all inclusive panache, along with her comedic nuances, make every moment of reading worth it.

Diabetes Mine has been featured in the Wall St. Journal, the UK Guardian, TechCrunch, NPR's Future Tense, and a number of other publications. The most recent feather in Amy's cap was added when she collaborated with Dr. Richard Jackson, a leading physician from Joslin Diabetes Center, to co-author the book Know Your Numbers, Outlive Your Diabetes. True to form, the book is hailed as the first-ever straightforward guidebook providing a clear strategy for living well with diabetes and avoiding the long-term health damage it can cause. I look forward to the opportunity of chatting with Amy. Hope you all can join us!

Suffering succotash - do you believe the nerve of these scientists professing the antithesis of insulin-dependent diabetes!! Scientist have proven that supplementation of Gymnema sylvestre appears to enhance endogenous insulin production by regeneration of the residual beta cells in insulin-dependent diabetes. Wouldn't this study imply that insulin-dependent diabetes is curable??

GS4, a water-soluble extract of the leaves of Gymnema sylvestre, was given to 27 patients with insulin-dependent diabetes on insulin therapy. They received 400 mg per day. Their insulin requirements came down together, along with their fasting blood glucose, HbA1c and glycosylated plasma protein levels. Patients in the study receiving insulin therapy only (without Gymnema sylvestre supplementation) showed no significant reduction in serum lipids, HbA1c or glycosylated plasma proteins when followed up after 10-12 months.

There you have it, folks. A study published in the Journal of Ethnopharmacologyin October 1990 says - there are possible ways to regenerate beta cells in insulin-dependent diabetics, previously believed to be nonexistent and gone forever. Never say never, right Dr. Faustman?

Diamyd showed promising results in slowing the attack on remaining islets in recently diagnosed type 1 diabetics. Diamyd is a therapy specifically designed to preserve residual beta cells in recently diagnosed type 1-diabetes.

The results from the Diamyd study demonstrated that the group of 35 recently diagnosed type 1-diabetes patients that received Diamyd produced approximately twice as much meal stimulated insulin, as measured by C-peptide levels. These results were present 15 months after the first treatment. Insulin and C-peptide are produced in equal amounts. As C-peptide is easier to measure, meal stimulated C-peptide levels is the most important parameter to follow in a type 1-diabetes study where the aim is to preserve beta cell function. C-peptide levels in both groups experienced a decline but the decline was significantly reduced in the Diamyd group. There were no significant differences in fasting C-peptide levels between the two groups.

There was no difference in HbA1c levels between the Diamyd group and the placebo group. This is consistent with type 1-diabetes patients striving to reach normal blood glucose levels through their standard insulin treatments. There was a tendency of increased GAD antibody levels in the Diamyd group, indicating that the drug candidate has an immunomodulating effect. Diamyd treated patients with disease duration of less than 3 months showed improved C-peptide levels at 15 months, whereas placebo treated patients showed a decline.

These results provide strong support that the administration of Diamyd is effective in preserving islet cell function in type 1-diabetes patients. Additionally, maintenance of endogenous insulin production is important as it helps patients to better control their disease and reduce long-term complications. There were no serious adverse events reported that were related to the Diamyd treatment.

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!

In 1996 a 41 year old male (a type 1 diabetic for 18 years) was injected with biocapsules containing pig islets to regulate his blood sugar level. The transplanted cells helped reduce the patient's insulin requirement by 34% for over a year, which provided better control. By 2005 the patient's glycated hemoglobin levels (HbA1c) remained lower than the pre-transplant levels.

Ten years later, the patent contacted Living Cell Technologies to inform them that he believed the transplanted pig islets were still alive and well. After tests were conducted, it was concluded that the pig cells were (as he reported) still functioning. This proved that the LCT patented technology for xenotransplantation was effective. It allows the islets to survive at least ten years in a micro-capsule coating and continue to release insulin into the patient's bloodstream without immune suppression. After tests we conducted on the type of insulin present in the patients blood - it was with 100% certainty that it was pig and not human insulin.

LCT has significantly advanced the encapsulation process since the 1996 clinical trial and there is an even greater understanding and control over the longevity and robustness of the encapsulation process, as well as the porcine islet cells. LCT will be trialing the DiabeCell pig islet cell transplant in patients in a phase I/IIa clinical trial, expected to begin in Quarter 2, 2007. In addition, LCT is awaiting approval to conduct an additional trial in New Zealand this year with a different treatment protocol. Subsequent trials in the US or Europe are intended following initial results from these studies.

If overseas trials are coming through with flying colors - why aren't we doing this yet? C'mon USA - where's your competitive spirit? All these pigs up in Spring Point might be put to good use, after all. Oink Oink.

Central obesity is associated with insulin resistance through factors that are not fully understood. Researchers studied the effects of three different diets on body fat distribution, insulin sensitivity and peripheral adiponectin gene expression.

Adiponectin is secreted from fat tissue into the blood. The presence of adiponectin can result in improved insulin sensitivity and glucose tolerance, and can assist in mobilizing sugar out of the blood The hormone plays a role in the suppression of the metabolic derangements that may result in type 2 diabetes, obesity, atherosclerosis and non-alcoholic fatty liver disease.

The study involved 11 volunteers who were the offspring of obese type 2 diabetic patients with noticeable abdominal fat deposits. The volunteers were considered insulin resistant and they maintained average hemoglobin A1c levels of greater than 6.5% without medication. All subjects underwent three dietary periods of 28 days each in a crossover design: a) diet enriched in saturated fat (SAT), b) diet rich in monounsaturated fat (MUFA; Mediterranean diet) and c) diet rich in carbohydrates (CHO). Weight, body composition and resting energy expenditure remained unchanged during the three dietary periods. However, when patients were fed a CHO-enriched diet their fat mass was redistributed towards their abdominal region and their periphery fat accumulation decreased compared with a diet MUFA-rich and high SAT diets. Changes in fat deposition were associated with decreased levels of adiponectin after meals and lower insulin sensitivity.

The results of this study conclude a diet rich in monounsaturated fat prevents central fat redistribution and a decrease in after meal adiponectin levels. These findings support the belief that a carbohydrate-rich diet in insulin-resistant subjects exacerbates the insulin resistance. The moral of the story is: to enhance insulin sensitivity - look for a diet rich in monounsaturated fats and less dense in carbohydrates. Chances are if you've tinkered around with your food pyramid - you already knew the results of this study.

Here we go round the mulberry bush -- you know the nursery rhyme but did you have any idea how influential the center of attention could be? Well, regardless of Mother Goose, Roman Poets and silkworms staple diet - the mulberry has more to offer than you might think.

Mulberry leaves are reported to lower blood sugar, blood pressure, reduce fever and exhibit anti-inflammatory effects. A study showed the fasting blood sugar of diabetic rats eating a diet with mulberry leaf was reduced by 50% when compared to the diabetic control. The mulberry leaf rats also showed a drop of 30% in their HbA1c. Studies have shown that prolonged intake of mulberry leaves may further reduce HbA1c levels and probably help in achieving better glycemic control. Mulberry leaves also helped control the intracellular balance and reduced the activity of glucogenesis, both telltale signs of uncontrolled diabetes. Glucogenesis is when the body breaks down proteins and fats for glucose.

The mulberry bush should be celebrated. What if drinking a cup of white mulberry tea before a meal could reduce the total sugars absorbed? Researchers in Japan found white mulberry leaves have certain nitrogen-containing sugars (1-deoxynojirimycin) that strongly inhibit the intestinal metabolism of sugars from entering the circulation. Bottom's up for lower post meal numbers.

I just read that the US Food and Drug Administration (FDA) has announced that it is re-classifying the drug NovoLog to allow its use by women with Type 1 diabetes who are pregnant. NovoLog is manufactured by drug-producing giant Novo Nordisk. The change came after a trial which found that pregnant women with T1 diabetes who took NovoLog had HbA1c levels and rates of maternal hypoglycemia comparable to women on regular insulin. The study did not, however, evaluate whether babies whose moms take the drug while pregnant have a greater risk of congenital malformations. On the other hand, women taking NovoLog benefited from a lower risk of diabetes-related pregnancy dangers such as preterm delivery.

Pregnancy and drugs. It's a complicated issue. What's safe? What's not? If only it were so simple as dividing all drugs into one category or the other - the Good or the Bad. Unfortunately, many common medications are in a third category - the Ugly? These drugs, known as category B drugs, constitute a sort of pharmaceutical no-man's land. You see, these meds have not been proven to cause harm to unborn children, like category C drugs. Yet they have not been proven safe, either, like category A drugs. This means, as I discovered when I was pregnant in 2006, if you're sick and could benefit from some specific No-Man's-Land drug, odds are your doc will offer to write you a prescription for it. He or she will warn you that it's possible the drug causes harm and leave the decision of whether or not to take it up to you. Now, I don't want to go back to the Bad Old Days when doctors told patients "do this" or "do that," "take this" or "take that," and, by golly, you did it and didn't ask questions. But wouldn't it be nice to just know what to do? Or to know that your doc knows all the answers? What's a gal to do??

I've mentioned the possibility of oral insulin a few times before, and I'd like to reiterate some exciting news. A recent study confirms that Generex Oral-lyn is as effective as injections in controlling after meal blood sugar rises. The study compared the effects of two forms of mealtime insulin treatments in patients with Type-1 diabetes. The patients were all on 2 daily injections of NPH insulin for long-acting blood sugar control. The study measured the efficacy in treatment of after meal blood sugar spikes.

To treat after meal blood sugar rises, 11 subjects in the control group received three pre-meal injections of regular insulin. The 14 subjects in the treatment group received three split-dose applications of Generex Oral-lyn (i.e. RapidMist puffs of Generex Oral-lyn) before and after meals. The fructosamine and glycated hemoglobin (HbA1c) were checked approximately every 2 weeks to determine the efficacy of treatment. The study demonstrated that both Generex Oral-lyn and mealtime injections of regular insulin achieved near normalization of blood glucose. This measurement was made based on the continuous improvement in fructosamine and HbA1c levels. However, a straightforward comparison of HbA1c levels showed a superior effect for Generex Oral-lyn.

By providing a simple and effective alternative to mealtime insulin injections, Generex Oral-lyn is designed to improve patient compliance which is likely to improve diabetes control, thus reducing the risk of long-term complications. This study prepares Generex for a pivotal late-stage, long-term trial of Generex Oral-lyn which will begin early in 2007. This is sounding more promising with every press release. Thanks to the tenacious women behind the genius of Generex - we won't have to hold our breath too long before we see oral insulin. Way to go, ladies!!

The website Diabetes Self-Management is running a feature about a diabetes mentoring program that has just been launched. The idea behind the initiative is simple: people do better at managing their diabetes when they have the support of other diabetics who can give moral support and helpful tips.

The program is called A1c Champions. Sponsored by insulin manufacturer Sanofi-Aventis, A1c Champions signs up people with diabetes and arranges for them to give presentations to diabetes support groups. The program supplies everything you need for the presentations, including materials and information. It also provides training.

If you're interested, first find out if you qualify. You must have Type 2 diabetes and use insulin. You must also have an HbA1c level of less than seven percent. To apply, call 1-866-741-7047.