Wow. I'm floored. Not every diabetic experiencing hypoglycemia in a pubic place becomes a victim of police brutality. A Texas woman with diabetes was recently discovered in her car on the side of a road by a police deputy. She was incoherent, talking to herself. No, the deputy did not drag her in to the station for DUI. Constable's Deputy Russell Whitton, intelligent guy, realized something was up and used the lady's cell phone to call the most recently missed call. This put him in touch with a relative, and he was able to establish that the lady had been reported missing, is diabetic, and was about to go into shock. The deputy gave her LifeSavers to help raise her blood sugar and called for an ambulance. .

In the course of blogging for TDB I've read I-don't-know-how-many news stories about diabetics being manhandled by police during hypo episodes. The typical scenario is this: person's blood sugar drops. Person sways, loses way, crashes car, acts incoherent or all of the above. Cops are called or happen along. Cops mistakenly assume symptoms are due to drunkenness or a drug-induced high. So they proceed to arrest said innocent citizen, who may resist, sparking actions of police brutality. The most recent high-profile case involved "Mr. Natural Universe," Doug Burns.

And then this story came along. Just when I was becoming super-cynical and irreversibly biased against the police, too. Aww. Thanks, Deputy Whitton!

In a case of stunning ineptitude, staff at an Orange County branch of Bank of America locked in an elderly diabetic woman after closing at the end of the day on Wednesday. The woman, Marian R. Prescher (73), went to the bank late Wednesday to access the contents of a storage box she keeps there. The bank shut up shop at 6 p.m., and employees apparently forgot to check the private room that she was in before leaving.

Around that time - I'm not clear on whether it was before she was locked in or perhaps as a result of being locked in - Prescher's blood sugar dropped into the danger zone. Fortunately, Prescher was discovered around midnight by a cleaning crew, whose members found her in diabetic shock - "unconscious and cold to the touch," according to a spokesman for the OC Sheriff's Department. The woman was treated in hospital for hypoglycemia and later released.

The is pretty serious. If she had not been found when she was, Prescher could have died. A friend told a reporter that Prescher's blood sugar had dropped to 20, which is dangerously low.

A statement came from Bank of America on Friday to say the incident is under investigation. I'm thinking they are justifiably sweating over the bad publicity this has brought the bank.

Isn't it amazing that even toddlers can operate computers and cell phones these days? Alex Merriam lives in Pleasanton, Texas. Alex is only two-years-old, but he helped save his dad's life recently. His father, William Merriam, has had type 1 diabetes since he was only four. Last Friday, William's blood sugar got dangerously low and and he fell unconscious in a chair. Alex was the only one in the house with him at the time.

Alex's mom, D'anna, was worried when she kept trying to call her husband. No one answered. In the end, aware that a hypoglycemic episode could have hit William, she had her father try calling too. Eventually, Alex - all of two-years-old, mind you - got the ringing cell phone out of his dad's bag and answered it. He told his grandpa that his dad was "asleep" and then hung up. Kids do the darndest things! The grandfather called back and, yet again, Alex picked up. This time the boy took the phone over to his father and it was clear that dad was not responding at all. Emergency services were alerted and an ambulance arrived not long after that.

After recovering, dad William said "It's nice he doesn't know what's wrong, but knew enough to tell the right person at the right time." Cute story.

A few days ago, I blogged about Sally, the fabulous hypo-detecting dog from the UK. Here's a similar story from right here in the US, and boy does it show you what big things one little dog can do! Pint-sized Chihuahua, Coyote, lives with human mom Katherine Caldwell in California. The five-year-old, nine-pound pooch alerts Katherine, a diabetic, whenever her blood sugar drops below 70 or rises above 150.

Coyote, a specially trained service dog (Katherine's second), is able to smell the change and alert his owner. "He starts nagging me: pacing, barking, nipping, licking, pushing me," explains Katherine. If she's asleep at the time, she says, Coyote gets quite frantic until she awakens. If her blood sugar gets to 68, Katherine says, "he's going crazy."

Coyote even knows how to use a special bite pager. When he holds the device in his mouth and bites down, a signal goes out to the emergency services and an ambulance is dispatched. Caldwell says Coyote has successfully activated the pager twice so far. Not only that, Coyote has been a busy boy with an important sideline: he has fathered two more certified service dogs that have inherited his superior sense of smell and sensitive demeanor. There are hopes for more soon. Good luck with that, Coyote, but don't neglect Mom.

On the 18th of July I blogged about a study that aims to explain how dogs are able to detect approaching hypoglycemic episodes in diabetic humans. Well, reader Margaret from Cumbria, in the UK, posted a comment about her dog, Sally, who is one of these amazing hypo-detecting dogs. I asked Margaret to tell us more and she obliged. Here is Sally's story:

Sally is a thirteen and a half-year-old Border Collie mix who lives with human "parents" Margaret and Alan, and canine buddy Poppy, who is a Cocker Spaniel. That's Sally (right) and Poppy (left) in the picture. Margaret and Alan adopted Sally from an animal shelter when she was just a tiny pup. Little did they know that Sally came complete with a special gift: she knows when Margaret, who has type 1 diabetes, is heading dangerously low.

"She has always been a sensitive dog," writes Margaret. "She gets very upset when there is thunder in the air. She shakes uncontrollably - even if we never even hear the thunder, but she knows it is about somewhere." As for detecting oncoming hypos, Margaret says: "my husband, perhaps more than me, notices her reaction. I can be just sitting staring into space, not doing anything, and Alan comes in, sees me and sees Sally acting strangely, by which I mean slinking around, really unhappy and just looking so miserable, trying to hide in a corner and she doesn't do that for any other reason, not even for the thunder."

I asked Margaret if Sally had received any training or if they rewarded or encouraged her reaction in any way. No, replied Margaret. "We certainly don't reward her for this. I really don't want her to be so unhappy about me! But, according to my husband, it is pretty obvious when he sees Sally behaving in this way - even though it is not obvious by my actions - that I am hypo, and this has been proved to be so." She adds, "Sally is very close to me. She is with me all the time and she has done this for as long as we can remember."

Margaret has had type 1 for thirty-five years. She was nearly twenty years-old when diagnosed. She also writes that one of her three sisters was diagnosed with type 1 at age seven, but is still going strong - fifty-seven years later.

Thanks, guys, for sharing your story!

Around a year ago I posted the story of two elderly brothers, both of whom have had type 1 diabetes since childhood. It's amazing to read about these guys for two reasons: first, they've lived with diabetes for a reeeaally long time. Secondly, for most of that time, they did not have the medical knowledge or technology on which today's diabetics depend. (Okay, so when it comes to stuff like Avandia, you could argue that's a good thing!)

Anyway, one of the brothers - Robert "Bob" Cleveland (87) - will be featured in a new book titled 50 Secrets of the Longest Living People with Diabetes by Sheri R. Colberg and Steven V. Edelman. The book is part of the Marlowe Diabetes Library series. It will be published in November and is available for pre-ordering on Amazon.

Linda von Wartburg, writing for Diabetes Health, has posted an excerpt about Cleveland taken from the book, for those who want an advance taste. According to that post, Bob Cleveland has lived with the disease for an amazing eighty-two years. This makes Cleveland second in line for the title of person in the US who's lived with diabetes the longest. He was five years old when diagnosed in 1925. Bob's brother, Gerald, has not had diabetes for quite so long, but he is the oldest living person with diabetes in the US. The brothers are pictured at right, with Bob on the left and Gerald on the right.

Reading Cleveland's account of his early years with diabetes, before insulin became available, is quite harrowing. He describes being on a "starvation diet," hospital stays, and memories of his mother desperately trying to pull him out of hypoglycemic episodes. Incredible reading.

Anyone out there following the case of Mr. Universe's beating and subsequent arrest at the hands of police will be interested in this latest news: a five million dollar lawsuit has been filed by the bodybuilder against Redwood City, California. The suit includes claims for two million dollars in economic damages and three million in non-economic damages.

Read Allie's previous blogs (one and two) on the subject if you want all the details. But here's a quick summary: Mr. Natural Universe, Doug Burns (43), was at the movies in Redwood City, back in April. Burns, a type 1 diabetic, felt a little giddy. Attributing this to low blood sugar, he headed to the lobby for a snack but was intercepted by security who mistook him for a drunk. There followed a struggle with police, during which Burns was allegedly beaten and maced.

Needless to say, this sorry episode is yet another example of how law enforcement see a person swaying, weaving and incoherent and the assumption is always that the person is drunk or high. At least in the case of Doug Burns, the victim has some public clout to help him out. There is an urgent need for education here: police officers must be aware of the signs of hypoglycemia.

For those diabetics injecting insulin and getting frustrating results - this blog's you. I include in this group of frustrating results: hypo unawareness, diabulemia, lethargy, weight gain, erratic blood sugars, and missed periods (for the ladies) - these are all side effects people have experienced once beginning genetically modified human insulin. It so happens it is the only kind available in the United States.

Bev did a terrific blog on the Insulin Dependent Diabetes Trust and the difference a choice has offered me: more controlled blood sugars, lower blood pressure, less hunger and even a little weight loss - high five! But herein lies the problem - the choice is not easy to come by. Most doctors believe Big Pharma pushed genetically modified human synthetic insulins because it was better. However this, like the insulin analogues - was nothing but stellar marketing with lackluster scientific proof.

If any of those symptoms listed in my first paragraph kept you reading to this point - please ask your doctor to give natural animal insulins a second chance. Do yourself and other diabetics a favor and request information to bring to your doctor by emailing enquiries@iddtinternational.org. The IDDT will send information on natural animal insulins. You may not be interested, but another diabetic may love the fact it will soon be a choice for them. Freedom of choice - isn't the Liberty Bell appropriate here?

A few days ago, Bev posted a football-related blog. Now here's another. This one, though, is decidedly less uplifting. In fact, it's the kind of story you file under 'What Went Wrong?' Takirra La'Fee "TT" Koonce (28), a promising young semi-pro footballer for the New Bern Grizzlies of North Carolina, died suddenly on the playing field in the middle of a game. His death occurred on the Saturday before last (July 14). Teammates and a medic tried unsuccessfully to revive him until an ambulance arrived. It is not known whether or not a blood sugar test was administered to Koonce, who was diabetic, or whether he was given anything to correct hypoglycemia.

Doctors say the cause of Koonce's death probably won't be revealed for four to six months due to a lab backlog. (Outrageous!) However, according to a report in local newspaper, the New Bern Sun Journal, Koonce's dad says his son's diabetes killed him. What's really unusual is that the dad, Cleveland Ballard, is holding the team's managers to blame for the tragedy. Ballard says his son was insulin dependent and was not managing his condition well. "He shouldn't have been running in the heat," said Ballard. "If they did a physical he would not have been there, they would not have let him play."

However, it looks like the Grizzlies are in the clear on this one: an official for the Minor League said Koonce had signed a waiver to play in lieu of taking a physical. Even so, it sure raises an interesting question: if an adult sportsman goes out on the field, does the team management share responsibility if anything happens? Should the managers insist on routine physicals?

One of my family's favorite remedies for hypoglycemia is orange juice. Quickly absorbed, it packs a glucose punch. Get this -- not only do a few ounces of orange wonder bring 'em back to the land of clarity, it also reduces inflammation in the body.

A recent study by endocrinologists at the University of Buffalo reveals orange juice is packed with flavonoids. Not only that, flavonoids suppress destructive oxygen free radicals (aka reactive oxygen species or ROS). ROS can damage cells and contributes to chronic diseases such as diabetes, heart disease and stroke.

Previous research has shown 300 calories of glucose induces ROS and other proinflammatory responses. Now the researchers wanted to see how orange juice, fructose and saccharin-sweetened water impacted ROS compared to glucose. For this study, 32 healthy people between ages 20 to 40 were divided equally into four groups and given 300 calories worth of either o.j., fructose, saccharin water or glucose. Significant increases in ROS were reported in samples from the glucose group, but not the o.j., fructose or water group.

Orange juice has the same concentration of glucose as participants in the glucose group, so the researchers dug further to determine what was suppressing ROS in the juice. Turns out two flavonoids in orange juice inhibited ROS generation.

Dr. Paresh Dandona, senior author of the study, stated it is important people with diabetes are aware of non-inflammatory food choices. Gotta spread the good news to my family! Read more in Medical News Today.

I apologize for covering a topic that may have very well been covered already a few weeks ago, but the way I see it, if the entries on this page change too quickly for the bloggers to keep up, it must be extra tough for the readers. That all being said, I wanted to point out the mixed results of a recent study on inhaled insulin (or the insulin bong, as I like to call it).

For people with type 2 diabetes, taking extra insulin during mealtimes is a necessary step in helping to regulated blood glucose levels. These doses are taken in addition to baseline insulin that is taken throughout the day and night. What researchers at the ECRI Institute have discovered is that inhaled insulin may improve blood sugar control for people with type 2 just as well as short-acting insulin taken by injection.

After a three-month period, the researchers found the inhaled insulin to produce equally as effective results in patients than insulin shots. The tricky part, however, is that the inhaled insulin seemed to be a bit problematic for users who experienced low blood sugar levels -- hypoglycemia.

Despite the mostly positive results, inhaled insulin still gets mixed reviews from researchers. Not only is its problem dealing with hypo a...well, a problem, but speculation also surrounds the long-term effect of inhaled insulin on the lungs.

Bad headline for the week: "Does Diabetes Have a Canine Cure?" This, from the Lincolnshire Echo in the UK. Well, no. Of course dogs can't cure diabetes! However, they can do more than just roll their lovable brown eyes at you. Specifically, dogs can be trained to detect building hypoglycemic episodes caused by perilously low blood sugar levels. Dogs that have received such training will then try and sound the alert in various ways like pawing and whining, or pouring you a glass of orange juice (joke). Heck, I think there was even one dog that was trained to dial 911 for his owner, and saved the guy from going into a coma, might I add.

This is what this Echo article is really all about. Professors and students at the University of Lincoln have set out to examine the use of dogs to predict hypos. The study is being run in conjunction with Queen's University in Belfast, and has received funding from Diabetes UK. Says research team member Dr. Niro Siriwardena, "We are not yet sure whether dogs detect this [hypos] by smell or because they are much more adept than humans in detecting change. That is something we are looking into."

Stay tuned for details when this study is complete. "Dog people" like myself will be excited to hear what they discover. Wouldn't you like to know what enables dogs to be so super-sensitive? And doesn't it make you wonder: if dogs can detect something like low blood sugar, what else are they noticing about us as we go (obliviously) about our daily lives?

Hypoglycemia, an attack of low blood sugar, doesn't just happen. It takes a complex chemical reaction involving the brain and hormones - the brain's chemical messenger pigeons. We can now understand this incredible process and the body's response to it thanks to the work of a research team led by neuroscientist Arshad Khan, of the University of Southern California, and colleagues. Part of the study was also carried out in conjunction with the University of California at Riverside.

A feature on the LiveScience website handily explains what Khan et al found and why it's important. Basically, the hormone norepinephrine plays a critical role in hypoglycemia, effectively sending messages to the brain that the body is experiencing dangerously low blood sugar. When the body tells the brain that low glucose levels are afoot, norepinephrine shoots out of the hindbrain and into another area of the brain called the paraventricular hypothalamus. Its presence triggers the release of stored energy to make up for the shortfall. This step in the process involves the release of more hormones, this time from the pituitary gland. Khan describes norepinephrine as the "emissary" in this sophisticated chain of events, informing the brain about what is going on.

Why does this matter? Simple: understanding how hypoglycemia unfolds is a window into understanding how the brain senses glucose in the blood and, in particular, how it senses changing glucose levels. This, after all, is at the very heart of the physical changes associated with diabetes.

The results of this study were published in The Journal of Neuroscience (July 4, 2007).

Eli Lilly has an award they give to people who have been diabetic for 25, 50 and 75 years. They call it the Lilly for Life Award. The award recognizes people who have been enslaved to the exorbitant expenses of diabetes management, in addition to the other schedules of daily life. Endearing isn't it? The award is a significant token of Lilly's appreciation for all you have endured and sacrificed.

Lilly awards people who have used insulin for 25 years with the monetary equivalent of what your diabetes management has cost. All your copays for each bottle of insulin, each box of syringes, each blood sugar testing strip, and your ability to adapt to the ever-changing technology of diabetes care (I swear, it says that in block letters) - Lilly awards you $42,500!! I told you I lived in the land of milk and honey. ACTUALLY - it's a medal and a consent form to have your face exploited in Big Pharma marketing. You should've bought the stock! The shareholders of LLY paid approximately $1.75 per share 25 years ago, when you were diagnosed. Today that share is worth approximately $56. Anybody know the math on that return? It's probably around 3,000%.

Let's go back to that statement ever-changing technology of diabetes care. Why must it be ever-changing? Doesn't that sound a lot like never-ending? We need not spend too much time on identifying how to treat this disease when we've got that down. What we need to do is spend more time and energy on preventing the disease from happening in the first place. That is what I consider achievement. Achieve that, Lilly! And by the way - I'll take 3,000% of my $42,500 while you're at it. Thanks.

In light of Novo's Meet the Face of Change campaign, I figured I'd address an idea worthy of mention coming out of the Novo product pipeline. This treatment is for Type 2 diabetics but it is not insulin - it's called liraglutide. Liraglutide is a once-daily human analog of the natural hormone Glucagon-Like Peptide-1 (GLP-1). It causes neither excessive hypoglycemia nor weight gain.

Liraglutide works by stimulating the release of insulin only when glucose levels become too high. Unlike many other diabetes drugs - liraglutide also leads to weight loss instead of weight gain. Now we're getting somewhere, Novo!! Patients with Type 2 diabetes treated with liraglutide had a greater reduction in average blood sugar than those patients treated with placebo or insulin glargine (Lantus). As expected, the combination of a GLP-1 analog with a sulfonylurea caused some of the patients to experience hypoglycemia. Okay, point taken. So why impose a glucose lowering drug while mitigating the problem causing elevated sugar in the first place? One drug at a time, folks.

So this is a step in the right direction and I like where it is going. Treating Type 2 diabetes with insulin is counter-intuitive. Looking at another hormone that might interfere with the use of insulin might be the culprit. So here lies a very good idea and I like it. Gold star, Novo! Now when can we meet the face of liraglutide?