Pharmaceutical giant GlaxoSmithKline has announced an initiative designed to improve the health of employees with diabetes. Yes, the company's head honchos decided they would take the bull by the horns: if employees have difficulty taking care of their health, they determined to find out why and correct the problem. Result: an internal analysis of healthcare spending within GSK.

Turns out diabetes was one of the biggest problems for Glaxo employees. Glaxo's number-crunchers found the company spends more on diabetes medications, but less on medical care, than the national average. GSK's report states the company spent a total of $26.2 million on diabetes treatment for employees in 2005. Glaxo has now launched what it describes as a multilateral plan to address the needs of employees with diabetes. Leading the charge: a patient education campaign ("Know Your Numbers") and a physician intervention program.

Says Glaxo's US benefits chief, Michael Killian, "As a nation, we are seeing our healthcare costs soar and patients' health decline due to chronic diseases such as diabetes. GSK faces these same challenges and is prepared to meet them." Translation: prevention, prevention, prevention.

Glaxo figures there is nothing to lose, but lots to gain. Healthcare plans for employees already cost a bundle. By targeting the health issues that are hurting employees the most, the company can give those employees a better life and save a lotta money. In addition to making the results of its internal analysis available to the general public, Glaxo has invited other employers to utilize this same approach.

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."

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.

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!

A study just out links high rates of diabetes to African Americans who lived in substandard housing. Sigh. Doesn't that seem rather obvious? Does it really require a big study to confirm it?? Well, anyway, here's the scoop: researchers collected data on 998 African American men and women born in St. Louis between 1936 and 1950. They looked at all the risk factors for those individuals - factors that could contribute to ill health. Examples of risk factors include access to medical care and quality of neighborhoods (including such things as air quality, condition of yards and sidewalks, and proximity to industrial sites and traffic noise.)

The conclusion? Those whose housing conditions were ranked as only fair or poor were at increased risk for type 2 diabetes. Interestingly, even after adjusting for other social or environmental factors, those in substandard housing had double the risk for diabetes.

Confused as to why? So are the researchers behind the study. Says lead researcher Dr. Mario Schootman of the Washington University School of Medicine, "So far, we can't explain why that is. It could potentially be related to lead. Lead is associated with the development of diabetes, and we know that in some poorer housing conditions, there's likely to be lead exposure. But it also could be related to other, unknown, environmental contaminants."

Just yesterday I shelled out for a quality water filter. My concern is that there could be lead in the plumbing of my old house. Reading this, I'm so glad I did. Who knows what junk is floating around in our air and water these days. Sad, huh?

Results for Dr. Schootman's study have been published in the American Journal of Epidemiology (August, 2007).

UPDATE 8/21: One reader commented in no uncertain terms that this is just a bunch of PC overkill. Read carefully. "After adjusting for other...factors, those in substandard housing had double the risk for diabetes." So you have two obese guys who eat Fritos for dinner and fried chicken for breakfast. They both drink soda at every meal. The one who lives in substandard housing is statistically more likely to develop diabetes than the guy who lives in fair or poor housing.

The current system, rests on a precarious and complex (or should I say, chaotic?) relationship between public and private healthcare providers and the insurance industry. Sadly, reform may not be possible until Americans get much, much angrier about how badly they are being let down by the system that's supposed to serve them. A great place to start your reading is the editorial in today's New York Times. Titled "World's Best Medical Care?," it neatly summarizes not just how the US needs to do better, but also describes how badly the US is doing in relation to the rest of the developed world. The key issues: forty-five million uninsured, many more underinsured, and quality of care that varies wildly depending on the size of the patient's wallet.

What about diabetes? Surprise! The news is not good. According to the Times editorial, the US came in last in an eight-country comparison of lives lost to a number of major diseases, one of which being diabetes.

Type 2 diabetes, mate? By crikey. Australia's diabetes epidemic continues to be a problem. News this week indicates the spread of obesity, and with it associated conditions like Type 2 diabetes, in rural areas is far worse than previously realized. A survey of 806 randomly selected adults (okay, not the biggest sample, admittedly) found that a great many are affected by the disease.

Based on their findings from that survey, researchers calculate that almost three-quarters of Aussie men living in rural areas are overweight. They think women in rural areas may be slightly better-off - around two-thirds may be overweight. This puts rural Australians at a very high risk for T2DM. The conclusion, stated in the Medical Journal of Australia: "urgent population-wide action is required to tackle the problem."

As is the case in the US, a big concern is how to treat all those people as they age and their overall health worses. Specifically, what will become of Australia's public healthcare system? "We might get a whole generation, now in their 40s, 50s and 60s, who will do markedly worse than their parents," predicts lead researcher for the study, Professor Edward Janus of Melbourne's Western Hospital.

I really don't get this, but here goes: according to a report summarized on the website DiabetesHealth, weight gain reduces the severity of heart disease in type 1 diabetics. Huh? How can that be possible, I'm wondering? After all, we live in a world where weight gain is considered a great evil, a threat to individual health, a drain on our healthcare resources etc. etc. And now this!?

The findings come from the Pittsburgh Epidemiology of Diabetes Complications Study, which was conducted over a period of sixteen years and involved the participation of 225 type 1 diabetes patients. The Pittsburgh people agree more fat on the bones adds up to one heck of a big risk factor for heart disease. However, they also say that if you're type 1 and do get heart disease, carrying extra weight makes the heart disease less severe. They also report that this effect is especially true for women. So, the big question: why? The researchers think it's because heavier people may have better insulin control. But don't run for the local Burger Barn; weight gain is not desirable as it does more harm than good in the long run.

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."

For athletes with type 1 diabetes, technological advances have opened up a whole new world. Tell your doctor you want to run a marathon? In past decades, the announcement might have been met with words of caution, even dismay. Exercise wasn't even part of the equation when it came to diabetes management. Being diagnosed with diabetes was a death knell for the careers of budding young athletes. Today, however, docs (well-informed ones, at least) are more likely to say, 'okay, let's come up with a plan.'

Diabetes-related technology is a big reason for this shift in attitudes. An article just out in The New York Times. looks at the extent to which technology has made life easier for type 1 diabetics. Devices like digital meters and automated pumps are not cheap. But they are increasingly efficient, safe, and sleekly high-tech. Above all, they give athletes the tools they need to control blood sugar levels with absolute precision - the kind of precision that was impossible in the days of the urine-glucose test. The down-side, I guess you could say, is the mixed blessing of all that control: "We are essentially the CEOs of our own bodies," observes type 1 diabetic and long-distance cyclist Paul Southerland, "and we don't get a break from them."

Two elderly women died and one remains in a coma after the three apparently received massive insulin overdoses during stays at the University of Chicago Hospitals (UCH). One of the women who died, Ruthie Holloway (82), was diabetic. She was in the hospital in May due to a possible urinary tract infection. When she showed signs of low blood sugar, a test was conducted which showed extremely high insulin levels in her blood - hundreds of times higher than normal. By then it was too late: she quickly became catatonic, suffering brain damage, and she died at a nursing home in June. Particularly disturbing is the fact that there was no record of her being given insulin by a staff member.

The incidents, which occurred between May and June of this year, are under investigation by the Chicago police and by officials at UCH. All three women were in the same hospital wing when the overdoses were given. The question is: were those overdoses the result of staff incompetence or where they given intentionally and, if so, why?

It now looks likely that UCH will have malpractice lawsuits coming its way from the womens' families. According to a report in the Chicago Tribune, attorneys acting on behalf of the families have requested copies of the womens' patient files. They have also requested copies of employee files.

Even though the person responsible has not yet been (publicly?) identified, UCH has made some major changes in its procedures regarding the storage and handling of insulin. In particular, each dose of the drug must go through a procedure of checking and witnessing, with a paper trail backing up all staff actions.

Visit the Trib's website or CBS2 Chicago online to read more about this sad case.

You may have heard that diabetics face a greater risk of complications during hospital stays. Well, now there's evidence that diabetics with trauma injuries are particularly at risk. That info comes courtesy of a large Pennsylvania study that looked at records for around 25,000 trauma patients, half with diabetes, the other half without. The study tracked the patients' progress over the course of almost twenty years. Impressive.

What did they find? Twenty-three percent of the diabetic trauma patients experienced complications. That compares with only fourteen percent of non-diabetics. The diabetics also spent slightly more time in intensive care and were more likely to need ventilator support. The overall risk of infections was higher too - eleven percent versus six percent.

Good news: despite all this, the data did not suggest people with diabetes are more likely to die after a trauma injury. Nor did it suggest diabetics stay in hospital longer than non-diabetics. The team that conducted the study states that the next step would be to examine whether or not improved blood sugar control in diabetic trauma patients would impact these figures.

Read more about these findings by visiting MedPageToday or, for a brief summary, the Atlanta Journal-Constitution. Or check out the full report, published in Archives of Surgery (July, 2007).

Driving trucks for a living has never been considered the healthiest of lifestyles. There's the risk of traffic accidents, which already puts truck driving high up on the list of most dangerous jobs in the country. In fact, the profession accounts for nearly fifteen percent of work-related deaths in the US. Then consider all the other lifestyle-related dangers associated with trucking. The greasy food offerings at truck stops? Not so healthy! (I remember one time driving cross-country in a moving truck we stopped at one of those places. The only food item I trusted not to give me food poisoning was an ice cream sandwich. Mmm. Nutritious. But I digress...)

According to a new survey of truckers, that lifestyle of long hours sitting on your tushie is catching up with the nation's big rig drivers. Obesity is rampant and so are obesity-related health problems like heart disease and Type 2 diabetes. Oh, then there's sleep apnea, smoking, and the fact that many drivers admit they don't bother with seatbelts.

The up-side of all this: reading about it makes me feel like a health-nut in comparison! Seriously though, it seems change could be forced onto unhealthy truck drivers: there's talk that the Federal Motor Carrier Safety Administration might introduce stricter health regulations for professional drivers, and any such regulations would likely include diabetes-related guidelines. Trucking companies are also concerned, says a spokeswoman for the American Trucking Association, due to soaring healthcare and worker compensation costs. Click here to read more, including some of the voluntary measures already introduced by employers. Bottled green tea, anyone?

Say what you will about Michael Moore, there's little debate that the guy knows how to make a documentary. Being a filmmaker myself (though I have only worked with narrative projects, not documentaries), I can only imagine the amount of pre-production effort he must go through to eventually pull-off his theater of involuntary candor. Talk around his soon-to-be-released new documentary Sicko, which focuses on the ills of the health care system in the U.S., has already turned, well, Michael Moore-ish; to the point where threats from the U.S. Government have been made for violations of the trade embargo with Cuba.

Um....What? My response was just that after taking a cursory look at an article on Yahoo. But, upon further examination, I found that Moore flew 10 workers, all of whom had worked in the post-9/11 cleanup effort, to Cuba to receive medical treatment. Evidently, the point of doing so was to demonstrate the benefits of a socialized health care system, and how these workers have been neglected by HMO systems here in the U.S. The new documentary, Sicko, was born out of Moore's earlier presentation of a mock funeral he staged in front of a health maintenance organization for his TV show "Awful Truth." In this mock funeral, he took the HMO to task for declining to perform a pancreas transplantation for a man with diabetes.

Moore has been assailed by critics from both sides of the political spectrum, mostly for his alleged penchant for distorting facts in favor of entertainment and shock value. Whether or not this will be the case with Sicko remains to be seen. Be that all is it may, though, I am a firm believer that where there is smoke there is fire,; and in the case of the health care system, there's a blazing inferno -- something that Michael Moore couldn't have possibly started or exacerbated by himself, despite what his critics might claim.

For thousands of years, Ayurveda has used meshashringi as a treatment for adult-onset diabetes, a condition once described as "honey urine". Meshashringi is a climbing plant that grows in the tropical forests of India and could be just the thing to combat high blood sugar.

Thousands of years ago, type 2 diabetes was treated with meshashringi. The plant's sugar-destroying property was released when a person chewed on one or two leaves. Meshashringi was said to "paralyse" a person's tongue to sweet and bitter tastes. This taste-blocking reaction lasted for several hours. Meshashringi blocked sugar in the digestive system, resulting in a decrease in blood sugar. This is known as a hypoglycemic effect. This action has been studied since the late 1930s.

Recent studies have shown that meshashringi helped control blood sugar levels by stimulating insulin release from the beta cells. Meshashringi enhanced natural insulin production, which was evidenced by an increase in levels of C-peptide. C-peptide is the connecting peptide that is found along the amino acid chains in natural insulin (insulin produced in the islets). When insulin is cleaved apart, the connecting peptide disengages and floats off to preserve and protect the body's cells from microvascular damage resulting in diabetic complications like blindness, kidney disease, and neuropathy.

Another study found that 400 mg a day of meshashringi produced similar results for non insulin-dependent diabetics. Fasting blood glucose, A1c and glycosylated plasma protein were significantly reduced compared to baseline values after 18-20 months of treatment. By the end of the treatment period, cholesterol, triglycerides, phospholipids and free fatty acid levels were also significantly reduced. It is possible that the blood sugar lowering effects of meshashringi are mediated through their cortisol inhibiting potency. Clinical trials have recorded the benefits of meshashringi in diabetic patients where 400 mg a day reduced insulini requirements by about 50% in insulin-dependent diabetics.

Hello? Did that study say I might be able to cut my daily insulin requirements in HALF? Where on Earth (besides the Saharan terrain of Africa and the jungles of India) can I find this green Goddess? Somebody clear the fog in my head - does India even have jungles? I'm not a Globe-trotter (not yet, anyway). Irrational fear of turbulance.