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.

Medtronic, one of the largest manufacturers of insulin pumps and continuous glucose monitors, issued a call to action request for insurance companies. The need for greater coverage on continuous glucose monitors is as important (and as necessary) as the rising demand for insulin pumps.

The president of Medtronic's diabetes division, Chris O'Connell, urged the insurance companies to consider the vast growth of the company - which was measured as considerably faster than the industry average, with sales climbing 24% in the last quarter. The device was approved for adult patients last year and U.S. regulators approved an expanded edition for use in children. The continuous glucose monitor alerts diabetics to dangerous spikes or dips in their blood sugar levels via wire-like sensors inserted under the skin that measure glucose levels and transmit the data wirelessly to a pager-size receiver.

The company plans to conduct clinical studies to demonstrate the cost effectiveness of the technology. Presumably, after two to three years of clinical trials, the evidence will be conclusive enough for insurance companies to consent to providing greater coverage for this continuous glucose monitoring.

Researchers found that offering seniors with diabetes the opportunity to participate in a subsidized community-based exercise program may help lower health care costs.

The researchers analyzed 163 seniors with diabetes who participated in a community-based fitness program that was fully subsidized by the HMO. For comparison, the study also included 364 seniors who did not participate in the fitness program. After 12 months, the researchers found that total health care costs did not differ among the two groups of seniors. However, among those in the HMO subsidized exercise group, those who attended more exercises classes per week than the rest of the group had health care costs roughly 41% less than the average of the group.

The study found that health care costs can be greatly reduced among a previously sedentary older adult who engages in moderate physical activity three days a week or more. One in five Medicare recipients has diabetes. That's a pretty significant number. Diabetes-related health care costs account for about a third of total Medicare expenses. Exercise can reduce health care costs and increase physical functioning. Any amount of physical activity is beneficial for everyone and it is even more so for people with diabetes, regardless of the effects on health care costs. What's the going rate for well-being these days, anyway?

In 2005, insulin cost state Medicaid programs $500 million. The diabetes epidemic is causing the government to question one of the big-ticket items on the shopping list - insulin. Insulin was developed over 20 years ago and many of these original forms are now off patent. This is a screaming opportunity for generic drug makers to prosper and government programs to save.

Two of the largest insulin makers, Novo Nordisk and Eli Lily, say they are opposed to any F.D.A. action that would approve generic insulin without clinical studies. Why the concern? The combined sales in the United States for Humulin and Novolin is about $1 billion. No wonder.

A drug maker needs to prove the generic version contains the same active ingredients, purity and quality, and provides equivalent delivery over time as the brand-name version. However the makers of generic drugs agree that the approval process for generic biologics, like insulin, would be more complex than the current shortened process for other generic drugs. Anybody have a guess as to what the hold up is for this much needed and overdue generic insulin explosion?