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!!

I love the Geico commercial with the Caveman-- the one where he's in the therapist's office and his phone rings . He says, "My mother's calling. I'll put it on speaker." According to a recent study published in the medical journal Diabetes Care, researchers have found that family communication and problem-solving skills are important for helping young people with type 1 diabetes to manage the condition. Specially tailored family therapy can help teens with type 1 diabetes keep their blood sugar levels under control.

A family-based behavioral therapy program was specifically tailored to address diabetes-related family issues. The program consisted of 12 sessions offered over six months, and included training in "behavioral contracting" techniques for family members and a 1-week parental simulation of living with type 1 diabetes. For their study, the researchers randomly assigned 104 families of teens with poorly controlled type 1 diabetes to the behavioral family therapy program, standard care, or a multifamily support group that included educational elements. While levels of A1C, a measurement of long-term blood glucose control, fell in all three groups over the first six months, A1C levels climbed again in the standard-care and support-group kids, but remained low for the behavioral family therapy group up to 18 months after the program began.

Researchers concluded that the efficacy of a family-based behavioral therapy approach is more effective in improving diabetes control. There is power in numbers especially when it comes to any family affair. See mom and dad - told you so!

According to research conducted by Ohio State University, conjugated linoleic acid (CLA) may help reduce body fat, but it also increases your risk for nonalcoholic fatty liver disease.

In 2003, a study showed that a 2 month supplementation of CLA lowered body mass and blood sugars in diabetics. The recent studies conducted on mice fed a CLA supplemented diet lost weight very fast, but also accumulated excessive amounts of fat in their livers - a side effect of rapid weight loss. In addition, excessive accumulation of fat in the liver is associated with insulin resistance, a factor exacerbating type 2 diabetes.

Although the recent findings were conducted on mice, CLA may or may not have a similar effect on humans. CLA has been a hot selling item in supplement stores for years. I wonder what the results would be if people who have taken CLA (the t10c12 variety) for years were to discontinue use for 4 weeks. I would be curious to see the baseline and follow-up tests for body mass, insulin sensitivity and fat accumulation in the liver. Any med students out there interested in setting-up a lab profiling hepatic function in CLA poppers?

USA TODAY ran a feature story that covered an American Diabetes Association, ADA, briefing over the weekend in which Robert Rizza, president of the ADA, stated that 7.2 million diabetic disabilities and deaths could be avoided by a simple daily pill that combined low-dose aspirin with drugs that lower cholesterol, blood pressure and blood sugar. A polypill is what Rizza called it.

Rizza went on to say that this treatment would cost approximately $100 dollars a year per person. According to the ADA, 21 million Americans have diabetes with an additional 41 million Americans at risk of developing diabetes. When I read this, it struck me that this is either a groundbreaking statement that has profoundly promising implications in the future treatment for diabetes -- or this is common knowledge in the diabetes community and then -- why is no one acting on this knowledge and developing the pill Rizza is referring to? Then again, is creating a mega-pill combining so many different medications in one pill -- prudent?

I am going with groundbreaking news, as the information shared in this weekend briefing was based on a mathematical model produced by Archimedes that predicts various outcomes based on variables in treatments. Now that they have this information, what will they do with it?