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.

Drug companies are very good at making it seem like taking a certain medication or supplement will be a panacea for just about everything that ails you. Even at the end of their commercials, when they're rattling off a whole host of possible unwanted side effects, the person on-screen is still smiling, riding or a horse, swinging on a swing in slow-motion, or something just as cheery. And while there are many amazing drugs out there that do help people a great deal, there are also many out there that are no more than snake oils.

Case in point, I just came across this supposed interview (it looks kind of staged to me) on YouTube, featuring a doctor who claims that type 2 and type 1 diabetes can be miraculously cured by drinking alkaline water. A bunch of B.S.? Honestly, I hope it's not! But, it probably is. So, instead of relying on miracle drugs and supplements, here are two very easy ways to address issues commonly faced by many people living with diabetes:

1 - Weight Loss. Very often, doctors will recommend that their patients with type 2 lose weight, hoping that this may lead to a lower A1C and improved overall health. So, instead of trying out Alli or any other popular weight loss drug on the market, try this little weight loss tip. Whenever you go out to dinner, eat a cup of broth-based soup (i.e. chicken, tomato) as an appetizer. New research into people's restaurant eating habits shows that people who consume a cup of soup as an appetizer tend to eat 20-percent less of their entree. The key is to stay away from cream soups of any kind, and to opt for a cup rather than a bowl. You may also want to add a little chili powder, especially since capsaicin, the compound found in chili pepper, has been shown in lab tests to actually kill fat cells.

2 - Lower Blood Pressure. People with diabetes must stay on top of their blood pressure, as an elevated level is rather common among those with both type 1 and type 2. While there are many trusted medications available to treat high blood pressure, you may also want to consider eating pistachio nuts. Penn State nutritionists discovered that eating one and a half ounces of pistachios daily for one month helped keep test subjects' blood pressure down. What's more, eating three ounces per day also showed signs of arterial relaxation, allowing better blood flow and making the heart's job that much easier.

Menopause means the end of estrogen production in women. One of the changes resulting from that loss is a rise in blood sugar. Other undesirable side-effects include a tendency to overweight and high blood pressure (hypertension). That news comes courtesy of a new study conducted on female rats.

The lead researcher for the study was Dr. Lourdes A. Fortepiani of the University of Texas Health Science Center at San Antonio. According to Dr. Fortepiani, simulating menopause in rats caused a thirty-five percent rise in blood sugar levels. Other changes included significantly higher blood pressure and weight gain at double the normal rate.

Yikes! Is that what we ladies have to look forward to?? This is certainly something to keep in mind if you have diabetes. But wait. There is a silver lining. Estrogen replacement therapy erases all these nasty hormonal and metabolic side effects, says Dr. F. Could this mean that hormone replacement therapy, which has lately fallen really, really out of favor, might be making a comeback?

Gastric bypass or banding surgery has become known as an effective measure for treating type 2 diabetes. What has put it in the news, of late, is the fact that gastric bypass is incredibly successful. Many recipients who've gone under the knife respond not only with extreme weight loss (of course - that's what the surgery is designed to do!), but also a normalization of blood sugar levels. Sometimes the reaction is so positive that patients can stop taking blood sugar controlling meds.

Case in point: Marlene Zytcer (57) and her daughter Aimee (31) of Phoenix, Arizona. Marlene and Aimee recently both had gastric banding surgery at the University of California, San Diego Medical Center. Prior to the surgery, both mom and daughter were doing poorly health-wise. They were both obese and fighting heart disease and type 2 diabetes. They say they both have a genetic predisposition to those conditions.

Seems a dose of Vitamin C (ascorbic acid) is good for more than just fighting off coughs and colds. According to a report from the BBC, a new study has found that - in theory, at least - Vitamin C could reduce diabetes-related health complications. Vitamin C, said the University of Warwick-based researchers, was almost as effective as Telmisartan, a medication used to lower blood pressure.

Vitamin C packs a punch, they said, because it helps to clean up ("scavenge," in the words of lead researcher Antonio Ceriello) free radicals - molecules that cause tissue damage. This is of particular concern for diabetics because diabetics' bodies produce more free radicals than those of non-diabetics. This is why diabetics are especially likely to suffer from heart disease. It is also why diabetics are prone to tissue and nerve damage in the feet and legs - damage that all-too-often necessitates amputation.

The researchers also reported they were able to normalize free radical levels in patients with Type 1 diabetes using a course of insulin therapy followed by long-term treatment with Vitamin C or Telmisartan. And there's the rub: while Telmisartan is considered okay to take long-term, Vitamin C supplementation could in fact be dangerous if continued over time. Actually, the purpose of this study was not to look into treating diabetics with Vitamin C, but rather to investigate the workings of free radicals and methods for controlling free radical production. Sorry, folks. Things are never that easy.

The American Diabetes Association's (ADA) 67th Scientific Sessions conference will draw to a close tomorrow. Among the latest presentations was a report on quality of life for people suffering from diabetic retinopathy. A recent Eli Lilly-funded study involving 684 patients concluded that diabetics with nonproliferative diabetic retinopathy who lose at least ten letters in visual acuity - the measurement used by eye specialists - suffer a notable decline in quality of life. Significance? Vision loss used to be defined as beginning at a loss of at least fifteen letters, but this study says even mild to moderate visual impairment impacts physical functioning. More details of the findings are reported on the website DocGuide.

An example of the insidiousness of diabetes-related health complications, diabetic retinopathy causes damage to blood vessels in the eye's retina. The disease harms vision, and can even lead to blindness. Basically what happens is this: as the disease progresses, blood vessels form on the retina that are particularly susceptible to breaking and bleeding into the eye. This is known as proliferative retinopathy. It obscures the vision and can also lead to the formation of scar tissue that can eventually lead to retinal detachment.

Health Tip: Sadly, you can't cure retinopathy once you have it. However, you can slow its progress by keeping blood sugar and blood pressure levels under control. Diabetics who have not been diagnosed should also know one important fact: diagnosis usually comes after damage has already occurred. It's therefore imperative that you get screened for the disease by an ophthalmologist or optometrist annually. View the ADA's full recommendations by clicking here.

There's good news to be had in the world of diabetes, says researcher Dr. Deborah Burnet from the University of Chicago: fewer diabetic men are dying of heart disease than was the case three decades ago. The bad news is that the disease is killing more and more female diabetics. Specifically? Women with diabetes are four times more likely to suffer fatal heart attacks than are non-diabetics. This can be contrasted with diabetic men, who have double the risk.

Check out a new report published in today's Chicago Tribune for details on this disturbing trend. According to the Trib, there are multiple causes at work here, including the fact that women are getting heavier and more sedentary, making them more prone to both Type 2 diabetes and heart disease, while at the same time older women are making up a greater percentage of the overall population. Dr. Larry Deeb, president of the American Diabetes Association, says that the persistent perception of heart disease as a condition that affects men also continues to be harmful. For one thing, the perception may make women slower to seek treatment for heart problems. Once diagnosed with heart disease, says Dr. Deeb, women may also receive less intensive treatment than their male counterparts.

Worth repeating here are Dr. Deeb's awesome words of advice for women with diabetes: the onus is on you. "Don't accept that your blood sugar is 10 or 15 percent too high. Don't accept that your blood pressure is almost controlled. Don't accept that your cholesterol is almost low enough. You want your numbers to be as good as they can get." Wise words, doctor. And yet...women afflicted with the double whammy of diabetes and heart disease can't do it all alone. Social services, public education and attentive medical care are going to be critically important if we're going to reduce these horrible mortality rates.

The best part of blogging for The Diabetes Blog is the steep learning curve you embark upon as you research media outlets with an eye on diabetes. I've grown up as a sister and daughter of two brothers and a mom and dad with type 1 diabetes, but the challenges type 2 diabetics face are entirely foreign.

Alarmingly, recent surveys reveal about 60% of type 2 diabetics are not reaching glycemic goals. A new book, Know Your Numbers, Outlive Your Diabetes: Five Essential Health Factors You Can Master to Enjoy a Long and Healthy Life, offers type 2 diabetics tools to better manage their health. Authors Richard A. Jackson, MD, Assistant Professor, Harvard Medical School and Amy L. Tenderich, MA, diabetes blogger, journalist and author, hope the book can guide the type 2 diabetic -- who often realizes little face-to-face time with their physician -- get a handle on these five test results for better diabetes control.

The book moves beyond the vague notion many type 2 diabetics have that "they need to eat better and exercise more." Rather, the book teaches the importance and optimal ranges of five tests ... A1C, blood pressure, lipids, microalbumin and eye examinations.

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?

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!

In a landmark study on the effects of cinnamon pre-diabetic subjects, researchers from The Ohio Research Group discovered that regularly using this spice (it is a spice, right? I mean, I keep it with my spices. I have no idea, I'm a guy) significantly reduced fasting blood sugar and systolic blood pressure.

Specifically, the researchers found a cinnamon extract known as Cinnulin-PF to be the most effective in doses of 500mg per day. Perhaps the most impressive part of the study (also the part that makes it different from other diabetes related studie on cinnamon), which was published in the Journal of the International Society of Sports Nutrition (JISSN), was that the positive effects Cinnulin had on blood sugar, blood pressure and overall body composition occurred without changes in diet or exercise.

So, the next time you order your drink or choice, or even want to add some flavor to a whole grain cereal, be sure to reach for this blood sugar and heart healthy additive.

Damage to the retina that sometimes comes with diabetes is associated with an increased risk of having a stroke.

A study involving 1,617 middle-aged people with diabetes led researchers to this conclusion, linking retinopathy and stroke risk. At the start of the study, 197 participants had moderate retinopathy and 44 had severe retinopathy. During an average follow-up of almost 8 years, 75 strokes occurred in the group as a whole. Considering all exacerbating factors -- such as blood pressure, insulin treatment and cholesterol levels -- having diabetic retinopathy more than doubled the likelihood of having a stroke.

Dr. Tien Y. Wong advised Reuters Health, "Diabetes can exert its effects on multiple organs in the body, and damage in the blood vessels seen in the eye -- retinopathy -- is a marker of probably unseen damage occurring elsewhere." Detecting blood vessel damage in the eye is linked to blood vessel damage in the brain, which could result in a stroke. He advises all eye care professionals to perform a more comprehensive assessment of stroke risk if they detect retinopathy in a patient.

Remember the A-Game suggestions I dangled for Eli Lilly to tap for performance enhancement? Well here it comes. I called Eli Lilly headquarters to speak with the Chairman and CEO, Mr. Sidney Taurel but I was directed to their idea submission form (which consequently didn't work). Oh boy, Sid. I'm a little disappointed. So here goes - my idea is going free for all when you could've had it, first. Let's call this new and improved product Beta Juice. It delivers the essential functions of a fully operational beta cell. It produces: insulin, amylin and c-peptide. Here's why insulin should always come equipped with the other two...

Insulin brings sugar to the cells to keep our energy levels sufficient for life, homeostasis and (if we're lucky) some energy for the gym. Amylin is a controlling agent for appetite, gastric emptying and tells the liver to dispatch glucose. It is also shown to have an impact on lipolysis --- the metabolism of stored fat. Until recently C-peptide was nothing more than a number used to decipher if you were a type 1 or a type 2 diabetic. However, recent scientific studies have shown C-peptide protects small vessels from the complications associated with diabetes. The Reuters Health article is titled C-Peptide Replacement Improves Early Diabetic Neuropathy.

The American Diabetes Association promotes the ABC's of Diabetes Care in an effort to educate diabetics on controlling their disease. The ABC's of diabetes care refer to a patient's Hemoglobin A1c, blood pressure, and cholesterol. A diabetic must maintain a hemoglobin A1c less than 7%, their blood pressure must remain below 130/80 and their good and bad cholesterol must be kept in range. The ABCs of Diabetes Care were established in order to reduces the chances of developing diabetic complications like neuropathy (nerve damage), nephropathy (kidney damage) and retinopathy (eye damage).

Here comes the perfect Insulin (code name Beta Juice) -a laboratory engineered balance of insulin, amylin, and C-peptide. Insulin to balance the blood sugar level, amylin to regulate fat and cholesterol levels and C-peptide to control the damage inflicted upon the micro vessels throughout the body. This is a GREAT IDEA!! Not just because it is MY idea, but because this is a huge opportunity to mitigate the complications that insulin by itself can impose, without the checks and balances of the other beta cell hormones. What do you say, Eli Lilly? You're halfway there!! You've already partnered with Amylin Pharmaceuticals. They have one third of this patent pie. Now hop on the horn and join forces with the C-peptide patent holder and ride your stock price to the moon. The diabetic girl has spoken. I know you care, Eli Lilly. Now put your money where your mouth is and make this new and improved insulin a light at the end of the diabetes tunnel.

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.

British researchers have found that tight glucose control during hospitalization for a stroke may not improve survival.

The study involved 933 patients enrolled within 24 hours of a stroke who had glucose in the range of 6.0 to 17 mmol/l. Participants received saline solution or continuous glucose, potassium, insulin infusions to reduce their blood glucose. Patients were monitored every two hours with glucose adjusted if needed every eight hours. The researchers found that both treatment and placebo groups had improvement in glucose levels. The treatment group had an overall mean 0.57 mmol/l reduction in glucose over 24 hours while glucose levels also fell spontaneously with simple saline hydration. There was also no difference in the secondary outcome of disability. There was a significant reduction in systolic blood pressure in the treatment group. A researcher noted, "In the majority of patients, treatment with a simple saline infusion will correct mild to moderate hyperglycemia."

The saline and glucose relationship is similar to the way the noninvasive glucose monitors measure blood sugar (aka Glucowatch)., This relationship between sodium and glucose in the blood moves inverse. When your sugar levels are elevated, your sodium is down. When you force sodium into your blood, your sugar is suppressed. Doctors must proceed with caution in light of this study. When it comes to aggressively lowering glucose, especially after a trauma, it could be more harmful than helpful.