FAT BITCH

What causes the dawn phenomenon? This is something that is always alluded my understanding. I have found that, without a doubt, the number of units of insulin that I took the previous day (especially in the evening) has a major impact. In my experience, the following four reasons have caused the dawn affect:

1. Fat intake the night before, especially when mixed with carbohydrates
2. Protein intake the night before
3. Caffeine intake the day before
4. Amount of exercise the day before

I think that all of these things ultimately cause a delay in carbohydrate absorption. I have found that fat intake usually delays my absorption of carbs, and I often find that high fat meals within a few hours of bed time invariably create a low blood sugar at bed time and a high blood sugar when I awake in the morning (unless I have timed m y square wave bolus well). I also find that large amounts of protein, even when not consumed with carbs, can actually raise my blood sugar. Interestingly, though, I usually awake with a blood sugar within the target range but find that it rises dramatically with my first meal. Has anyone else experienced this? Fortunately, my insulin pump allows me to change my carbohydrate to insulin ratio based on the time of day.

I have found that caffeine, especially in the form of coffee, lowers my blood sugar in the short run but often causes it to go up in the long run. This has led me to believe that coffee does not actually have a positive impact on Type 2 diabetes control but instead just delays the absorption of carbs. For example, if I drink coffee, my blood sugar is usually lower than expected in the short run but will then spike several hours later. I think that the timing and impact of coffee and caffeine in general varies significantly depending on the amount.

I will soon undergo a detailed study of my own eating habits and see how each of these factors impacts blood sugar. I will post both the plan and the results on this site. If anyone else has knowledge on any these things, I’d love to hear about your experiences.

Some researchers and commentators have recently suggested that continuous blood glucose monitoring may not improve control for someone with Type 1 Diabetes. This is quite surprising to me, and the view is short sighted. The continuous blood glucose monitoring devices that have been created by MiniMed, DexCom, and others are the first generation of these products. Without a doubt, they will get better in the future. Even now, I would much prefer to have sometimes inaccurate readings that alert me of a low blood sugar during the night than to have a low blood sugar without realizing it. I would much rather wake up a few times during the night (because of the alarm) than to never wake up despite having a potentially life threatening low blood sugar.

I hope that these sorts of studies do not thwart the efforts to improve the lives of people with Type 1 Diabetes. Indeed, any new invention when first released is not perfect, but it is a base upon which great inventions can be built. Only 30 years ago, most people did not even conceive of the idea of a computer that you could fit inside a room of your house. Today, we have laptops that are far more powerful that only weight 3 pounds.

My hope is that the technology can improve quickly and that doctors will see the benefit for people with Type 1 Diabetes. Within only a few years, we will wonder how we ever lived before continuous blood glucose monitoring. It will save lives, and it is the missing piece in the “artificial pancreas”.

Recently, doctors in Calgary discovered a way to create large amounts of insulin at far lower prices than the insulin that is currently being created synthetically. As reported, the insulin, which comes from genetically modified safflower, has the potential to supply the needs of all people by 2010 with only 16,000 acres of safflower plants.

This is remarkable. In particular, one statistic is staggering: Last year, there were only 10,000 pounds of insulin used, but it is expected that approximately 35,000 pounds of insulin will be needed by 2010. According to this report, the amount of insulin needed for all people with diabetes will more than triple over the next four years.

Clearly, people have been contracting Type 2 Diabetes at epidemic proportions, but it’s hard to believe that the worldwide insulin needs would increase by 3.5 times in just four years. Of course, the projected quantity for 2010 could take into account the vast number of people that currently cannot afford treatment and the large number of people that are undiagnosed. Nevertheless, the numbers are pretty scary.

This is great news. Although I hope to have a cure before too long, it is great to hear another early story of a substantial advance in diabetes treatment. When I was in Africa a few years ago, I remember being told that diabetes was “the rich person’s disease”. With this and other advancements, the hope is that treatment will become more available to everyone, not just the privileged.

Original Story

Are dairy products healthy? Does drinking a glass of milk a day keep our bones strong? Like with studies of coffee, it seems that eachstudy of milk seems to contradict the one that preceded it. For example, Walter Willett, a professor of medicine at Harvard Medical School, has suggested that most Americans get far more calcium than they actually need and that an adult would do well with only one to
two servings of dairy each day. A new study in Diabetes Care suggests something quite different, however. The authors find that higher milk consumption for women with Type 2 Diabetes may have a negative relationship with being overweight and with being insulin resistant. Thus, the women that drank more milk were healthier over the ten years (on average) for the study.

Dr. Willett has suggested that there is an inherent conflict with the USDA creating the food pyramid. The USDA has an interest in supporting the consumption of dairy and agriculture, both of which he feels are overrepresented on the pyramid. He recommends supplementing your diet with one calcium vitamin if you are concerned of a shortage, especially a vitamin that also includes vitamin D.

This new study focused on middle aged and elder women only. Although the study does not suggest that drinking more low-fat milk causes a person to have a lower chance of diabetes, the correlation was present in their findings of women with no history of diabetes in their families. Unlike the USDA, this group of doctors did not have the same incentive to support dairy farmers.

Who is right? Should we consume more or less dairy than we already do? If you are a middle aged or elder woman, the latest study suggests that low fat dairy may do you well. For adults, both sides do recommend that the milk that is consumed be low-fat or skim (because of the high saturated fat content).

Higher obesity levels mean more health problems — HealthandAge 

A study suggests that the health problems of very obese women may have been underestimated. Obesity is defined as having a body mass index (BMI) of at least 30. Three categories of obesity exist - BM1 30 to 34.9 is obesity I, BMI 35 to 39.9 is obesity 2 and over 40 is extreme obesity.