I don't mind high sugars as much as I loathe lows. Personally I'm not so ruffled by shots either (but my liver begs to differ). However, in a message posted on The Islet Foundation, Pfizer reported that insulin-dependent diabetics declared they most hate taking shots. Was this the warm-up for the Exubera campaign? Here's a fact I support! A close second to this hatred is the hypos. Any diabetic will confess -- hypos are unforgiving. So what if you could catch two birds with one capsule?

I must reiterate the scientific genius behind the Oramed gel caps. The encapsulated insulin bypasses destruction in the stomach cavity. It reaches an entry point in the intestines where it reports for duty to the liver. This allows the liver to resume command of the glucose metabolism, just like Mother Nature intended. Whey you inject insulin - you are overriding the livers ability to monitor blood sugar and putting yourself in the line of fire for the dangerous lows. We all know this state of derangement too well. You won't find my lows picture on a milk carton if I happen to lose it, either.

Frequent episodes of hypoglycemia (even mild ones) force the brain to become accustomed to the low glucose. Unfortunately this also causes suppressed signaling of adrenaline, the livers last resort before dangerous lows. More specifically, the glucose transporters located in the brain cells are damaged from frequent episodes of hypoglycemia. So what was once the hypo threshold for the brain to signal adrenalin release becomes lower. Clinically, the result is hypoglycemic unawareness. Down with the shots, down with the lows and big ups with the future of diabetes control! Now we're getting somewhere.

Imagine taking insulin was as easy as applying skin cream. Guess what - it's not so far fetched an idea, thanks to Phosphagenics and it may be coming soon!

Phosphagenics' has patented a transdermal carrier technology (TPM) that rapidly transports insulin across the skin without disrupting or damaging its surface. The company has recently announced successful results from clinical trials in Australia. This confirmes the TPM technology is safe and effective at delivering insulin into the bloodstream, without adverse events. The trial showed that the insulin safely penetrated through the human skin and delivered insulin into the bloodstream over a sustained period of time. Could this be the next generation of basal insulin? Adios Lantus. Arrivederci Levemir! Almost -- TPM/Insulin, applied topically, delivered insulin through the skin and into the bloodstream for up to 8 hours. So like sunblock -- you'll probably have to reapply.

Weep not, fellow Americans. Although Phosphagenics is based in Australia, they are in the process of applying for Phase 2 clinical trials in the U.S. Big ups to the Muffin Man for keeping me abreast of his leading-edge news from the diabetes-friendly forefront!

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.

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!

The Rule when it comes to managing diabetes is maintaining a blood sugar between 80 and 120 mg/dL by all means necessary. This does not take into consideration that some people might function better with a higher blood sugar. For all intents and purposes this is for safety reasons. Clocking in at no higher than 120 mg/dL is evidenced to delay the onset of long-term diabetic complications.

However, in my blog about Jeff the Trucker, in order for Jeff to be considered safe to drive -- the Federal Standards said that he must maintain blood sugars between 140 and 200. Whereas conventional medicine says the safest range for blood sugars is between 80 and 120. If Federal Standards say that you can function better with a higher sugar - why is it that we are encouraged to keep them lower? I understand this from a clinical perspective this is to delay the onset of complications. But in reality - the complications result from the fluctuations in blood sugar level and not so much the level at which it is sustained.

So herein lies my question for all diabetics out there - do you feel better or worse when your blood sugar is 80 compared to a blood sugar of 130? Compare being high and being low - what are the strengths and weaknesses of each?

I'll start - I prefer my blood sugar to be higher (<120 mg/dL) rather than lower (<80 mg/dL). When I am higher I know I am never on the verge of being disoriented, uncoordinated, or likely to lose my ability to think clearly. Having a higher blood sugar allows me to continue on without worrying if I'm too close to having a reaction. My weakness of being high is the inconvenience of needing water - ice, cold water. Now how do you all feel about your highs and your lows? It's okay. I know it's frustrating as H-E-double hockey sticks to test, treat, and repeat - only to find that your numbers aren't always perfect. Tell me about it. No, really -- please, do!!

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.

For the past 10 years, the city of Asheville, NC has given free diabetes medicines and supplies to municipal workers if they agree to monthly counseling from specially trained pharmacists. The results are significant: almost twice as many patients have their blood sugar levels under control and the city's health care plan has saved more than $2,000 in medical costs per patient each year.

Every dollar spent on medicines or counseling saves the city $4 by preventing emergency room visits, dialysis, amputations or other common complications of diabetes. The program has reduced the number of sick days taken among employees, reduced their chances of catastrophic hospitalization, and saved-money for the federal health care system by encouraging better diabetes management.

Efforts to help people change their lifestyles are complicated by a health care system in which insurers typically do not reimburse doctors for the kinds of counseling and monitoring that might keep patients on track. This experiment has enlisted pharmacists as coaches, clinicians and cheerleaders for the participating patients. It seems the coaches, the players, and the club owners agree -- the teamwork is well worth the payoff!