Intensive Structured Self-Monitoring of Blood Glucose and Glycemic Control in Noninsulin-Treated Type 2 Diabetes

The PRISMA randomized trial

Abstract

OBJECTIVE We aimed to evaluate the added value of intensive self-monitoring of blood glucose (SMBG), structured in timing and frequency, in noninsulin-treated patients with type 2 diabetes.

RESEARCH DESIGN AND METHODS The 12-month, randomized, clinical trial enrolled 1,024 patients with noninsulin-treated type 2 diabetes (median baseline HbA_1c, 7.3% [IQR, 6.9–7.8%]) at 39 diabetes clinics in Italy. After standardized education, 501 patients were randomized to intensive structured monitoring (ISM) with 4-point glycemic profiles (fasting, preprandial, 2-h postprandial, and postabsorptive measurements) performed 3 days/week; 523 patients were randomized to active control (AC) with 4-point glycemic profiles performed at baseline and at 6 and 12 months. Two primary end points were tested in hierarchical order: HbA_1c change at 12 months and percentage of patients at risk target for low and high blood glucose index.

RESULTS Intent-to-treat analysis showed greater HbA_1c reductions over 12 months in ISM (−0.39%) than in AC patients (−0.27%), with a between-group difference of −0.12% (95% CI, −0.210 to −0.024; P = 0.013). In the per-protocol analysis, the between-group difference was −0.21% (−0.331 to −0.089; P = 0.0007). More ISM than AC patients achieved clinically meaningful reductions in HbA_1c (>0.3, >0.4, or >0.5%) at study end (P < 0.025). The proportion of patients reaching/maintaining the risk target at month 12 was similar in ISM (74.6%) and AC (70.1%) patients (P = 0.131). At visits 2, 3, and 4, diabetes medications were changed more often in ISM than in AC patients (P < 0.001).

CONCLUSIONS Use of structured SMBG improves glycemic control and provides guidance in prescribing diabetes medications in patients with relatively well-controlled noninsulin-treated type 2 diabetes.

http://care.diabetesjournals.org/content/36/10/2887.short?rss=1

Graham

Another Dietitian gets it right !

There are coming to be more and more registered dieticians and registered nutritionists such as myself that are very, very much in line with LCHF diets, especially in reference to diabetics. Before instantly dismissing the advice of a dietician or nutritionist, at least hear them out. You will know pretty darn fast if they are on board with LCHF/Paleo-ish diets or if they are still following the low fat and high carb dogma.

It has been my experience that almost ALL T2DM's will respond very quickly and positively to a LCHF diet (sometimes combined with metformin to increase insulin sensitivity and to prevent the liver over-producing glucose, which is common in folks with metabolic issues).

Personally, in experiences with my clients, the only folks who do not respond amazingly well to diet alone (or diet and Met) are those T2DM's who are considered "late stage", meaning that diabetic complications have already set in in earnest, and those diabetics who are actually both T1 and T2, which occurs when the beta cells in the pancreas become damaged. Then the patient will often exhibit signs of BOTH T1 and T2.

Unfortunately... this is often a result of "being an obedient little patient" and following the conventional high carbs diet that is prescribed to diabetics. To follow this dietary advice is a literal guarantee that a diabetic will experience the myriad of major life threatening diabetic complications (heart disease, blindness, kidney disease, neuropathy leading to amputation) as well as the minor but life affecting ones such as continual infections (especially bladder), slow healing and slow stomach emptying.

Do your own research, and once again... seek the advice of a dietician or nutritionist who has broken free from the indoctrination. Don't expect your conventional doctor to refer you to one either. You will most often have to find her or him on your own by doing some research and pavement pounding.

Shamelessly nicked from here.

Eddie

Nigel posts a stinker !

Link to Nigel's nugget here.

One in 10 adults in deprived parts of Britain have diabetes, new figures show !

People in deprived parts of England are twice as likely to have diabetes as those in wealthier areas, according to new figures Brent in north London has the highest rate in the country, with 10.5 per cent of over-16s having the condition. This is almost double the rate in the City of London (5.5 per cent), which has England’s lowest rate despite being just three miles from Brent, according to analysis by the charity Diabetes UK. The vast majority of cases are of Type 2 diabetes, which is linked to unhealthy lifestyles and obesity.

Barbara Young, the charity’s chief executive, said: “It is truly alarming that there is now somewhere in England where more than one in 10 of the people have diabetes and shows that we are heading at frightening speed towards a future where diabetes becomes the norm.”

The Independent today here.

Diabetes UK must be getting desperately short of funds, judging by how often they wheel out Barbara Young these days. Hardly a day goes by without her telling us what we already know. Yes Barbara we know there is an obesity epidemic, yes, we know type two diabetes rates are going through the roof ! When are you going to tell us something we don’t know ?

Of course we do know what is leading to the twin epidemics of obesity and type two diabetes, and I suspect so does Barbara Young. But poor Barbara is stuck between a rock and a hard place. Her charity has pushed an unhealthy diet for so long, it can’t back down. Their pay masters big pharma and junk food would swiftly stop the funding if DUK started to promote a lowcarb diet. As so many low carbing diabetics know, medication is minimal for the low carber and often non diabetic blood glucose numbers can be achieved with nil diabetes medication, for the type two.

So there you have it folks, another day another dollar, another meaningless sound bite from Barbara Young. DUK meetings will continue to serve the cakes, buns and biscuits. The next NHS audits will show zero progress is being made, just like the last five years.  People will be phoning their local funeral director today, to bury their loved one, who checked out ten years early and riddled with diabetic complications. But hey, thems the breaks folks.

Eddie

diabetes.co.uk Ya get what ya pay for !

Check out diabetes.co.uk. Thread locking is still the name of the game today ! Jeez even Kenny boy never got this over zealous with the big thread lock button. The senior mod Anna is about as much use as a fart in a space helmet. But as I say, ya get what ya pay for and diabetes.co.uk pay zilch for mods. What a farce, and to think, this is largest diabetes forum in the UK. Is it any wonder UK diabetics are in a dark place ? Welcome to the gulag that is diabetes.co.uk.

Eddie

Link to the land of nil free speech and thread lock here.

Three quarters of a million page views and rising.

Over five years ago, Graham and myself became type two diabetics. We joined the forum diabetes.co.uk, the first forum we had ever joined. We were very fortunate. A small bunch of lowcarbers talked of their brilliant blood glucose control, weight control and minimal medication. Despite many years of diabetes, none had serious complications. One low carbing long term type one diabetic  Fergus Craig, was over forty years of age and running marathons and competing in 100 mile cycle races. Fergus introduced us to the work of Dr. Richard Bernstein, it transformed our lives. Three months after starting my lowcarb lifestyle I had a full bloods test. So astonished was my Doctor with the results, he asked if I was being treated elsewhere. HbA1c from close to twelve to mid fives, improved lipids and fifty pounds of weight lost. Graham is one of the never been overweight diabetics, he too has controlled his diabetes, by lowcarbing, for over five years. One metformin pill per day his only diabetes medication.

So, good people at diabetes.co.uk had been our, and others salvation. We could have walked away from DCUK, we were sorted, we both had better things to do than hang around on a diabetes forum. But we stayed, we had no choice, for two reasons. One, we wanted to repay the people who had helped us, and two, a small bunch of highly active, highly organised lowcarb antis, were working to rubbish lowcarb at every opportunity. The main anti was a registered dietitian, together, with a soon to be group of forum moderators. We took these people on, as did other lowcarbers, many were banned including me and Graham, other good and highly knowledgeable lowcarb people walked. Our voice was gone, we had been silenced, we had lost, time to move on. Except, Graham and myself are born fighters, we were down, but not out.

As I said earlier, we had never joined a forum before DCUK and never run or commented on a blog. I started a 'wind up' blog called Carbo Soze, named after the notorious villain in the film Usual Suspects Keyser Soze. We went for the ‘usual suspects’ big time, ridiculing them and their crackpot ideas mercilessly. They went ape, I had expected them to ignore us, but no, they were posting links to our blog on forums and other blogs. We were animals, posting vile things about people, we were the lowest form of human life. For me and Graham it was one hell of a laugh, clearly they were going batshit. But one thing became apparent very quickly, the page views were amazing. We realised blogs could be a very powerful tool for spreading our lowcarb message. We wound up the Carbo Soze blog and started this blog. 

From the start we wanted a magazine type format. Links to diabetes and lowcarb articles. Good food ideas and recipes, some jokes, cartoons, and of course, continuing to shine the spotlight on lowcarb antis. Over the years, we helped to issue exit visas to the worst of the mods. We have watched ex moderators and lowcarb antis forums fail. A blog set up to take on Graham and I and rubbish other lowcarbers, has not put up a comment or post in months. The few lowcarb antis at diabetes.co.uk are now irrelevant. Either seen as idiots, or behind the scenes schemers and trouble makers. For over five years, almost all the success reported has been by way of the lowcarb lifestyle. So many diabetics helped, and so few following the dietary information promoted by the lowcarb antis, as pushed by the NHS and DUK, which we call the diet of slow death. Low GI, portion control, starchy carbs with every meal and chase highly elevated blood glucose numbers with medication. It does not work, the NHS audited statistics prove it, and have done for years. So, what of the future for our team.

Recently we started a new blog for various reasons. For one we want a one place stop off for all diabetics and those interested in a lowcarb lifestyle. A blog with sound information and links to the latest news, trials and studies. A blog where information is much easier to find and can be linked to our lowcarb diabetic website. A place that does not include the well reported aggravation with naysayers and lowcarb antis. As I said earlier, they are now irrelevant. Over the years we have been supported behind the scenes by some well known names in the medical establishment. Two professionals had the courage to openly support us. They are Dr. Jay Wortman and Registered Dietitian Franziska Spritzler. Obviously they would not condone or agree with many of the posts on this blog. But I reckon they know our hearts are in the right place, or they would never have put links on their blogs to this blog. We are very grateful for their support. We are hoping our new grief free zone blog, will attract other professionals, guest posters and commenters. As all, who have read this blog recently, will have noticed three new members have joined our team. Kath, Paul and my wife Jan. They have added new dimensions to this blog and have posted some great posts. Paul and Kath have been working hard on the new blog. It is already looking good and in the near future will be where most of our activity will take place. Other people have promised to guest on the new blog. I believe in time it will become a very useful resource for all it’s readers.

So, a new blog with a new approach, to further the promotion of the lowcarb lifestyle. With new team members, eager to help others to a safer place. To live a happier, healthier life. Who would have thought a couple of old geriatric diabetics, would still be kicking butt years on after being banned from diabetes.co.uk. And in my case banned from other forums. Who would have thought, our posts on forums and blogs would have received over a million reads or page views.

As I often say, welcome to the crazy world of diabetes. A world where fresh home cooked untainted food, food that has been eaten since the emergence of the human race, food that people ate before the epidemics of obesity, type two diabetes, heart attacks and stroke, could be seen as a risky option. We are constantly told to eat the food that is leading to the downfall of the human race, and expensive, often dangerous big pharma drugs should be used as the antidote. This dietary lunacy is not progress. But, progress is being made. Increasingly medical professionals are promoting the lowcarb lifestyle. All over the world, people are telling their good news stories and how a lowcarb lifestyle has transformed their lives. One way or another the truth will always out, and we will continue to fight against dietary stupidity and corporate greed.Thank you to all the people that have contributed over the years.

“This year I slept and woke with pain, I almost wished no more to wake”

Taken from Tennyson’s ‘In Memoriam’ The fate that awaits so many diabetics, this does not have to be.

Good luck and health to you and yours.


Eddie Mitchell Telling it like it is, for over five years.

Our new blog is here.

DUK ‘The Leading Diabetes Charity’ The not so silent assassins !

Over at diabetes.co.uk nothing to do with DUK ‘The Leading Diabetes Charity’ an interesting thread has been running for a few days called ‘Diabetes UK tea party’ which can be found here. The original poster said this “Just got my invite to a Diabetes UK regional 'thank you' event. I quote: 'I am also happy to say that this event will include refreshments and afternoon tea featuring finger sandwiches, cakes and scones'. I'm glad he's happy about it.…” I knew immediately this was going to be a heated debate, which over at the forum so often ends in the thread being locked. People had widely different views, and as usual three of the remaining Kens clique lowcarb antis showed up, as expected. From Kens time at the helm, his number one enforcer and bully boy Sid Bonkers, said this, 

“If you are so anti DUK then why go to their events at all? You are clearly a troublemaker whos sole intention is to disrupt an event that is being put on by a charitable organisation who does great work to both help diabetics and raise awareness of diabetes on behalf of all of us. Their event is certainly no place for you to air your personal views and grievances.” 

Another member said today “Is it just me or is everyone missing the point instead of moaning about which catering company they use for functions should we not just all be thankful there r charitys like this working hard for people like us and show our thanks and support no matter what?”
Great work to both help diabetics and raise awareness of diabetes Sid says. What great work ? Where has DUK done great work to help me, and the close to two million like me, namely UK type two diabetics ? Does DUK promote a diet that will help me control my diabetes with minimal or no drugs ? No they do the opposite. They promote a diet that guarantees highly elevated blood glucose numbers, which in turn guarantees dependence on medication. Just what their pay masters want, i.e big pharma and junk food outfits.

Has DUK worked hard and won the right for all diabetics to get test strips, No. Has DUK worked hard to ensure all know about the corruption of big pharma and how big pharma has been find $billions. For lying, falsification of trial data, and killing people with their useless and dangerous drugs, No. Has DUK informed diabetics how ineffective most type two drugs are ? No. Has DUK improved upon the gruesome data and lamentable HbA1c results from type one diabetics, i.e. 93% of UK type one diabetics fail to get to a safe HbA1c as reported in the annual NHS audits ? No !

Kath stated in a comment on this blog the other day, words to the effect DUK is worse than the corrupt big pharma and junk food companies, because DUK come to us as friends. I agree with Kath 100%. Some years ago DUK run a campaign called ‘Diabetes The Silent Assassin’ another awareness campaign, a chance to beat the drum and raise money, as is their latest relationship with Tesco. Another chance for misguided volunteers, to work for free, to continue the abomination that is DUK. Another chance to keep people in a job, another chance to keep the company cars running, another chance to keep Baroness Young in her hundred grand a year job. It is my opinion DUK are the assassins, and they might as well be silent, for all the good they do not do for the average diabetic. In fact if they were silent, most diabetics would be in a safer place. He who pays the piper, names the tune !

Eddie  

Click on the screen shots to see the latest DUK diet recommendations.

DUK The diabetes charity.

Abbott Bayer Boehringer Ingelheim Bristol Myers Squibb Bupa Bunzl Everyclick First Capital Connect Flora pro.activ Kodak Lilly Lloyds Pharmacy Menarini Merck Serono Morphy Richards Merck Sharp & Dohme Limited Novartis Novo Nordisk Nursing Times PAL Technologies Ltd Pfizer Rowlands Pharmacies Sanofi-aventis SplendaTakeda Tesco Diets

HEART UK -The Nation’s Cholesterol Charity

Abbott Healthcare Alpro UK AstraZeneca BHR Pharma Cambridge Weight Plan Cereal Partners UK (Sh Wheat) Food & Drink Federation Fresenius Medical Care (UK) Limited Genzyme Therapeutics Hovis Kellogg’s (Optivita) Kowa Pharmaceutical Europe Co Limited L.IN.C Medical Systems Limited Merck Sharpe & Dhome PlanMyFood Pfizer Premier Foods Progenika Biopharma s.a. Roche Products Limited Unilever (Flora) Welch’s (Purple Grape Juice)

The British Nutrition Foundation

However, the organisation’s 39 members, which contribute to its funding, include – beside the Government, the EU – Cadbury, Kellogg’s, Northern Foods, McDonald’s, PizzaExpress, the main supermarket chains except Tesco, and producer bodies such as the Potato Council. The chairman of its board of trustees, Paul Hebblethwaite, is also chairman of the Biscuit, Cake, Chocolate and Confectionery Trade Association.

The European Food Information Council

Current EUFIC members are: AB Sugar, Ajinomoto Sweeteners Europe, Bunge, Cargill, Cereal Partners, Coca-Cola, Danone, DSM Nutritional Products Europe Ltd., Ferrero, Kraft Foods, Mars, McDonald’s, Nestlé, PepsiCo, Pfizer Animal Health, Südzucker, and Unilever.

The British Heart Foundation

Unilever Flora margarine.

Paul Weller - You Do Something To Me

Graham

Saturday night is music night on this blog !

Some regular readers may have noticed Graham has been writing less over the last few weeks. I can now tell you the reason, he has joined a band and going for the big-time. I hope stardom doesn’t go to his head and when he gets rich doesn’t forget who is mates are. Well, you now how he likes to say to the anti posters “look here sunshine” Eddie

DUK to market diabetic doll.

At a press conference today at the Hilton Hotel  DUK sales and marketing guru Sli Spiv was on top form when he announced that DUK were going into the child’s toy business. “This is our first product” gushed Sli “the diabetic doll. We feel this product will increase diabetes awareness and is timed to dovetail into our massive promotion with Tesco” The doll comes with dark glasses and a white stick. Minus a left leg and the right foot resembling four pound of condemned corn beef, the doll is highly authentic. “Kids will love this doll and next month we will launching a great range of accessories including a kidney dialysis machine, insulin pump and wheelchair” When a member of the audience questioned the DUK dietary advice, and stated it was the reason so many diabetics end up looking like the doll, he was swiftly removed from the conference room by two heavies.

OK I know what you are thinking, he has gone completely batshit, am I right, or am I right. But check out the lunacy that Tesco and Asda have been involved in this week regarding kids toys. From offending people who are mentally ill, to winding up gay people. You couldn’t make it up, and these are two of the largest retailers on earth.

Eddie

BTW Talking of batshit I see the bonkers one is going for the thread lock at diabetes.co.uk here. Sid never fails to entertain, but it is getting sad. He reminds me of a once pro boxer who has become punch drunk, and finishing his days as a fair ground brawler. Or a once faithful dray horse destined for the knackers yard and the glue pot. It ain't gonna end well.

The Independent
 

The supermarket giant Tesco has apologised for advertising an inflatable “gay best friend” doll on its website. The figure was described as being “ready to give you fashion advice, tell you if your bum looks big and b**ch about everyone who doesn’t wear Jimmy Choos”.

The figure, which was described as an “amusing gift” and “suitable for three- to four-year-olds”, appeared with the description: “If SEX in the City and Will & Grace taught us anything, it’s that g*y best friends are in this season. We’ve had the manbag, we’ve had leg warmers and iPhone fever, now it’s time for the new craze.”

The UK’s biggest retailer said it had removed the “offensive item” and that the product had not been sold. But it comes days after it was forced to remove a Halloween costume labelled “psycho ward” from its shelves. The bright orange costume had the word “committed” written on the back.

Asda also apologised earlier this week after it advertised a “mental patient” costume which showed someone covered in blood and holding a machete. Critics said both costumes stigmatised people with mental health issues. Twitter users reacted angrily yesterday to the inflatable doll, as well as to the supermarket’s decision to use an asterisk in the middle of the word “gay.” Activist Peter Tatchell tweeted: “Can @Tesco explain its G*y Best Friend doll? Why is the word gay censored? Why does the doll pander to stereotypes?”

The Sugar You Eat as a Cause of Heart Disease, Diabetes and Other Killers !

John Yudkin was a man decades ahead of his time. He was one of the first scientists to warn of the dangers of sugar and highly refined carbohydrates. He became internationally famous with his book Pure, White and Deadly (published in English in 1972, with new editions in 1986 and 2012). I first heard of Yudkin when reading a Gary Taubes book an extract below re Yudkin.

“The George McGovern’s Senate Select Committee on Nutrition and Human Needs 1973.

Peter Cleave testified to his belief that the problem extended to all refined carbohydrates. “I don’t hold the cholesterol view for a moment,” Cleave said, noting that mankind had been eating saturated fats for hundreds of thousands of years. “For a modern disease to be related to an old fashioned food is one of the most ludicrous things I have ever heard in my life,” Cleave said. “if anybody tells me that eating fat was the cause of coronary disease, I should look at them in amazement. But, when it comes to the dreadful sweet things that are served up … that is a very different proposition.” Yudkin blamed heart disease exclusively on sugar, and he was equally adamant that neither saturated fat nor cholesterol played a role. He explained how carbohydrates and specifically sugar in the diet could induce both diabetes and heart disease, through their effect on insulin secretion and the blood fats known as triglycerides. McGovern now struggled with the difficulty of getting some consensus on these matters.

“Are you saying that you don’t think a high fat intake produces the high cholesterol count?” McGovern asked Yudkin. “Or are you even saying that a person with high cholesterol count is not in great danger?”
“Well, I would like to exclude those rare people who have probably a genetic condition in which there is an extremely high cholesterol,” Yudkin responded. “If we are talking about the general population, I believe both those things that you say. I believe that decreasing the fat in the diet is not the best way of combating a high blood cholesterol …. I believe that the high blood cholesterol in itself has nothing whatever to do with heart disease.” “That is exactly opposite what my doctor told me,” said McGovern.

Extract taken from the brilliant book ‘The Diet Delusion’ by Gary Taubes page 123 a must read for anyone with an interest in weight loss and controlling diabetes.

The John Yudkin book Pure, White and Deadly is available to read for free here. If only action had been taken regarding Yudkin’s work, would we be facing the twin epidemics of obesity and it’s often linked type two diabetes ?

Eddie

Rose tells her story about Raymond, the love of her life.

When I was first diagnosed, like many others, I was confused and traumatised. Medical advice only made things worse. My only real support during this time came from over four thousand miles away, my dear friend Rose, a wonderful lady a native and resident of New Orleans took care of her husband Raymond for many years when he suffered from multiple conditions, including diabetes, and was able to empathise and bear with my problems in accepting the diagnosis and coping with the problems arising from my questionable treatment. In fact it was from Rose that I first heard the piece of advice which proved to be the only one of any real use. She told me that when her husband was first diagnosed the Doctor had advised her to "use her common sense and CUT THE CARBS as far as possible“.

Unfortunately for me, I did not appreciate the value of this information for some time. Mainly I suppose because I was advised to the contrary by my own GP and because I thought my carb intake was negligible. Raymond passed away almost two years ago, Rose is now in her 84th year and despite living in what is arguably, the gourmet capital of the world is not only slim but looks at least twenty years younger than her actual age, as does her beautiful daughter Rochelle. I thought others might like to read her story of how she tried to cope with her husband's diabetes along with his other problems. I am sure it will strike a chord with anyone who may have been in this situation themselves.

Kath

Rose tells her story about Raymond, the love of her life.

When Raymond was diagnosed with type 2 diabetes…. Our physician of over 20 years simply told him in that calm, comforting way of his…”.You can do this, I will help you as much as I can”…As his primary care physician and friend he was already managing his other health problems. With his COPD, emphysema and degenerative spinal arthritis …most physical exercise is all but impossible. He had already gained too much weight because of his limited mobility…how was he to manage another complication? Well, he handled it better than I did….I cried to think he would have to deal with yet another problem.

When we got this news…my husband said…”don’t worry, I’ll handle this just like I’m handling everything else”…..and handle it he did, in that wonderful way he had of making lemonade of the lemons life handed him.

From my point of view, as the wife of a diabetic, I can tell you that living with my diabetic husband was an exercise in ‘tough love’….
My husband was never what is commonly called a ‘foodie.” He loved to eat, but he didn’t live to eat. That was a good thing However, he was used to eating what he wanted, when he wanted it. This would be a major adjustment for him.

Raymond loved soups…I found a recipe for “Good Greens Soup”… one that I made with Chicken, tomatoes and fennel that he enjoyed. He also loved split pea or lentil soups. I made a lot of soups, all of them from scratch, using homemade stocks and fresh vegetables and some adapted by leaving out or adding appropriately.

Some of these things are good carbs…like beans…you know New Orleans is famous for its red beans. “Land of red beans and slot machines”….and I forgot to add the most important thing….controlled portions!!!!...Its not always what you eat its HOW MUCH….. Had to watch that, because as I stated earlier…he hardly got any exercise. He walked up and down and around the porch and around the house and I bought a little contraption to set in front of his chair…with foot pedals on it…to simulate riding a bike. He didn’t even have to get out of his chair!

The hard part for me was telling my diabetic “NO!”…..when he wanted a bowl of his favourite peach ice cream, or a taste of that luscious lemon meringue pie that I had been making for him ever since the first year we were married….many years ago. Now I would have to be creative and still find ways to ‘celebrate life’s precious moments’ with food…but in a more healthy way. I told myself that it would be good for me and everyone else so…… ‘get movin’ girl!’

I studied and learned all I could about how to alter the recipes that would not exclude him when all the ‘goodies’ were passed around. It required some work, and it was sometimes demanding.

Raymond’s snacks of choice were potato chips and chee whees. He loved salty things, especially when he was watching a Saints football game….he could really ‘overdose’ on peanuts and chips. Sometimes I wanted to scold him for sneaking a few, after I had laboured over an especially nice gourmet dinner for him…..but in the end, I couldn’t help smiling, because he’d shoot me that sheepish look of a little boy who just got caught with his hand in the cookie jar….and I didn’t have the heart to chastise him.

During the last two months of his life, when he was on oxygen and dying of severe pulmonary disease, besides the diabetes …I told myself…maybe its time to forget about tough love….I must confess I just couldn’t bring myself to refuse a few of those simple pleasures that he had been denied. Those were the difficult days….should I or shouldn’t I? Sometimes, even now….I wonder if I did the right thing, but we both knew that his time was running out.

He was my hero, my Rock. For a lifetime, I tried my best to take care of him. ...60 years. It was a job that I relished, he was the love of my life. What else did I have to do?

Rose

DCUK quote of the day !

A member writes.

"Just got my invite to a Diabetes UK regional 'thank you' event.
I quote:

"I am also happy to say that this event will include refreshments and afternoon tea featuring finger sandwiches, cakes and scones".

I'm glad he's happy about it...."

Ya couldn't make it up, bring on the meds.

Eddie

Sulfonylurea Use Increases All-Cause Mortality Risk

BARCELONA, Spain — First-line therapy with sulfonylureas significantly increases the risk for death in patients with type 2 diabetes when compared with treatment with metformin, a new study shows. Additional research showed that the combination of metformin and a sulfonylurea was also associated with a significantly increased risk for death when compared with combination therapy with metformin and a dipeptidyl peptidase-4 (DPP-4) inhibitor (or "gliptin").

Presenting the results of both studies to the media during theEuropean Association for the Study of Diabetes (EASD) 2013 Meeting, Craig Currie, PhD, from the University of Cardiff, United Kingdom, said the findings should be a wake-up call to physicians and authors of clinical guidelines about the hazards of prescribing sulfonylureas to diabetic patients.

"I am bewildered it's still being used," Dr. Currie told Medscape Medical News. "People should avoid using a drug where the balance of evidence, at the moment, demonstrates that it kills people."

To Medscape Medical News, Andreas Pfeiffer, MD, from Charité Universitätsmedizin, Berlin, Germany, who moderated the EASD press conference, said sulfonylureas are used as first-line therapy in approximately 15% of patients, although use varies from country to country. Second-line treatment in Europe and North America typically includes sulfonylureas, however, because they are a very cheap and established treatment course and so are widely used as combination therapy with metformin.

"There has been a long discussion about this," said Dr. Pfeiffer. "The first study to highlight the risk wasUKPDS in 1996, in which there was increased mortality in the combination group of metformin plus sulfonylureas. Since then, there have been about 25 papers saying why [the UKPDS] finding is not relevant, but now more signals are starting to emerge from other trials."

Data From the CPRD

In the first analysis, the researchers retrospectively analyzed the UK Clinical Practice Research Datalink (CPRD), a data set of more than 10 million patients that has been validated as representative of the UK population. In their assessment of the safety of sulfonylureas as a first-line therapy, they identified 15,687 type 2 diabetes patients treated with the drugs as monotherapy. As a comparison, they used 76,811 diabetic patients who were treated with metformin.

There were 13.6 deaths per 1000 person-years with metformin and 44.6 deaths per 1000 person-years with sulfonylureas. This translated into a 58% increased risk for all-cause mortality among diabetics treated with sulfonylureas as monotherapy.

During a press conference, Dr. Currie said that although sulfonylureas — such as glipizide, glyburide, and glimepiride — are not used often as first-line therapy, as they have largely been replaced by metformin, the present study showed that approximately 17% of patients sampled were still receiving them as monotherapy.

"There is quite a bit of literature that supports this thesis if you're looking," said Dr. Currie about the results. For example, a similar study of 23 000 patients presented at ENDO 2012 showed a similarly increased risk for death with glipizide, glyburide, and glimepiride compared with metformin. "It's just a little bit surprising that this isn't looked at more closely by the regulatory agencies," he continued.

In the second study, the researchers compared second-line combination therapy in 33,983 patients treated with metformin and sulfonylureas against combination therapy in 7864 patients treated with metformin and a DPP-4 inhibitor. In total, there were 16.9 deaths per 1000 person-years in the metformin/sulfonylurea patients and 7.3 deaths per 1000 person-years in the metformin/DPP-4 group. This translated into a 35% increased risk for all-cause mortality among those treated with metformin and sulfonylureas compared with the other group.

"In my view, the safety of sulfonylureas needs urgent evaluation, because we are potentially increasing the risk of all-cause mortality," said Dr. Currie. Regarding the combination-therapy data, he doubts the DPP-4s are "wonder drugs," but rather that the sulfonylurea added to metformin increases the risk in this particular combination.

Sulfonylurea Use Varies Worldwide

To the media, Dr. Pfeiffer said the clinical guidelines highlight the potential risks and benefits of sulfonylurea use in diabetic patients, but there are still a number of healthcare systems, such as that in Germany, that require doctors to prescribe sulfonylureas if a patient cannot take metformin or if a second drug is to be added.

Treatment cost is the main reason the drug class is still used frequently, because the newer DPP-4 inhibitors can cost €2 to €3 per day, adding up to hundreds every month, according to Dr. Pfeiffer. The analysis by Dr. Currie, he said, makes the treatment decision a little bit harder for healthcare systems to justify treatment with sulfonylureas.

Personally, Dr. Pfeiffer doesn't use the drug class any longer, as first-line or second-line treatment, something he is able to do because of greater freedom at his academic hospital. For Dr. Currie, treatment with pioglitazone is a much better option for combination therapy with metformin, although that drug is not freely available in all European countries, including France and Germany.

http://www.medscape.com/viewarticle/811641

Graham

Drop the carbs and drop your trig levels !

"After years of low-carb dieting myself and of taking care of thousands of patients on low-carb diets, I can tell you one thing with pretty much certainty: Low-carb diets reduce triglyceride levels markedly. And I can tell you that low-carb diets reduce blood sugar levels as well. Most of the patients with the highest fasting triglyceride levels also have elevated fasting blood sugars. On a low-carb diet, these patients drop their triglyceride levels like a rock."

"You can eat saturated fat to your heart’s content and still markedly reduce your triglyceride levels as long as you rigidly reduce your carbs."

Michael R Eades MD

Great article here High triglycerides driven by carbohydrate consumption

Quote of the day from Noblehead at diabetes.co.uk

“I posted this a few weeks ago, it's an explanation from Gary Scheiner (Think like a Pancreas) about what happens to the liver when you eat a meal that is high in fat, it may/may not explain what is happening to yours and Scotty's bg:

''So what about after the carbohydrates are finished doing their thing? That's when the fat itself begins to exert its effects. The process goes something like this:

You eat a high-fat meal or snack (this is the fun part).
In a few hours, the fat begins to digest; this continues for several hours.
The level of fat in the bloodstream (triglycerides) rises.
High triglycerides in the bloodstream cause the liver to become resistant to insulin.
When the liver is insulin resistant, it produces and secretes more glucose than usual.
The blood glucose rises steadily as the livers glucose output goes up.
This is what causes the gradual, delayed blood glucose rise after consumption of large amounts of fat. The response seems to be dose-dependent the more fat you consume, the more insulin resistant the liver becomes, and the more glucose it produces. The type of fat also appears to play a role. Saturated fats (the type found in dairy and animal products) seem to cause more insulin resistance than monounsaturated and polyunsaturated fats (the type found in vegetable products).

So what can be done about it? The obvious answer is to cut back on portions of fatty foods, and choose foods containing healthier types of fats. But when confronted with your favorite culinary indulgence from time to time, you can still partake and manage your blood glucose level reasonably well.''

Far for me to contradict an expert such as Gary Scheiner and the information posted by Noblehead, but one fact, a very important fact has been forgotten about. Every lowcarber I have ever known has witnessed a plummeting in their trigs levels. Mine went from over three at diagnosis to around one within three months. The highest my trigs have been in over five years. My three month blood tests usually indicate, <one. This is typical for almost all lowcarbers. Of course if you are consuming fats and hundreds of carbs per day Noblehead’s post stands true. The consumption of saturated fats does not raise trigs, carbs are the number one reason for elevated trig levels. I repeat, every lowcarber I know, and I know many, has seen a reduction, very often drastic, in trig levels upon commencement of a lowcarb diet.

Eddie

Link to Noblehead's post here.

BTW folks, the give away was in the first line ''So what about after the carbohydrates are finished doing their thing?" 

Nobhead please try harder if you are going to fool our team ! 

Anti-depressants 'linked to type 2 diabetes'

People prescribed anti-depressants should be aware they could be at increased risk of type 2 diabetes, say UK researchers.

The University of Southampton team looked at available medical studies and found evidence the two were linked. But there was no proof that one necessarily caused the other. It may be that people taking anti-depressants put on weight which, in turn, increases their diabetes risk, the team told Diabetes Care journal. Or the drugs themselves may interfere with blood sugar control. Dr Matthew Hobbs of Diabetes UK
 
Their analysis of 22 studies involving thousands of patients on anti-depressants could not single out any class of drug or type of person as high risk. Prof Richard Holt and colleagues say more research is needed to investigate what factors lie behind the findings.

And they say doctors should keep a closer check for early warning signs of diabetes in patients who have been prescribed these drugs.With 46 million anti-depressant prescriptions a year in the UK, this potential increased risk is worrying, they say.

More on this story here.

Christmas is coming ! Stay well away from DUK !

Compare our Christmas pudding against the weapon of mass destruction as recommended by Diabetes UK

Ingredients:
100 grams ground almond flour
1 teaspoon baking powder
2 large eggs
1 tablespoon of melted butter
2 tablespoons of double cream

100 grams of lowcarb thawed frozen fruits. Blueberries, blackcurrants and strawberries.

60 grams of 90-95% cocoa dark chocolate

Two tea spoons of cocoa powder

One large shot of brandy

A handful of almond flakes and broken walnuts
Extra thick cream

Method:

Mix all dry ingredients in a bowl.

Melt the butter, I use a Pyrex jug, add the eggs, cream, and fruit. Add the dry ingredients and mix. Pour into a medium size Pyrex mixing bowl. Microwave in a 700watt for 5 minutes. Turn out upside-down onto five layers of kitchen paper on a flat plate. Zap in micro-wave for a further two minutes. Melt the chocolate in a heat proof bowl standing in a saucepan of boiling water. Pour over pudding and serve with a scoop of extra thick cream. Serves four. We made this last year and it tasted fantastic. Less than a quarter of the carbs per serving compared to the DUK article. Enjoy !

Eddie

Check out our low carb recipe and food information blog here.

Click on screen shot to enlarge.

Type 2 Diabetes Market to Grow Significantly, While Remaining Highly Competitive.

The global type 2 diabetes market is expected to grow from $20.4 billion in 2012 to $38.8 billion by 2019, at a Compound Annual Growth Rate (CAGR) of 10.2%, forecasts business intelligence provider GBI Research. The company’s latest report* states that the US currently has the highest market share, which will rise from $12.7 billion in 2012 to $27.2 billion by 2019, at a CAGR of 11.6%, followed by the top five EU markets (the UK, France, Germany, Italy and Spain), which will grow from $4.5 billion to $7.1 billion, at a CAGR of 6.8%.

This increase, according to GBI Research, is due to the anticipated approval of products in relatively novel treatment classes, such as GLP-1 agonists, DPP-4 and SGLT-2 inhibitors. Should these expensive drug classes capture substantial market shares, this would be expected to result in an even more robust level of market growth.

Furthermore, due to the increase in the number of obesity cases and with people living longer, the prevalence of type 2 diabetes is also expected to rise.

Dominic Trewartha, GBI Research’s Associate Analyst, says: “The strong forecast for the type 2 diabetes market is reliant upon the ability of late-stage pipeline drugs, such as gemigliptin, to reach expectations created by promising clinical trial results, and of newly marketed products, including Nesina and Tradjenta, to capture a significant share of the market. In order to do this, they will need to balance clinical efficacy with safety and tolerability profiles.”

However, the sulfonylureas and metformin classes, both widely used among type 2 diabetes patients, are strongly penetrated by generic and low-cost products, presenting a potential major barrier to the market.

Sent to us from  GBI Research 24 September 2013

Eddie

Statin use tied to cataract development: study

NEW YORK (Reuters Health) - The risk of developing cloudy lenses in the eyes may be linked to the use of cholesterol-lowering drugs known as statins, according to a new study.

While the researchers can't prove the drugs caused the eye condition, they found that people who took statins - such as Zocor and Lipitor - were about 27 percent more likely to develop cataracts, compared to people who didn't take the medication.

"The results were consistent that there was a higher risk of being diagnosed with cataracts among statin users," Dr. Ishak Mansi, the study's senior author from UT Southwestern Medical Center and the Dallas VA Medical Center in Texas, said.

Statins are popular drugs that block a substance the body needs to make cholesterol, which can get trapped in arteries and ultimately lead to heart attacks and strokes.

About one-quarter of U.S. adults aged 45 and older take statins. The drugs are especially recommended for people with diabetes or a history of cardiovascular problems.

Researchers have looked at the link between statins and cataracts before with mixed results. While some studies found that taking statins lowered the risk of developing cataracts, other studies found the drugs increased the risk.

For the new research, Mansi and his colleagues used data collected from the medical records of people between the ages of 30 and 85 years old who were enrolled in one healthcare system in San Antonio, Texas, and received care between 2003 and 2005.

In one analysis, they compared about 7,000 people who were on statins for at least 90 days to about 7,000 people who were not on statins but were similar in about 40 other characteristics, including other health conditions, medications and healthcare use.

About 36 percent of statin users were diagnosed with cataracts, compared to about 34 percent of people not taking statins.

In a second analysis, the researchers looked at people with no other known health conditions. It included 6,113 statin users and 27,400 people who did not take statins.

After adjusting the results for the participants' age, sex, weight, medications, healthcare use, other vision conditions and cigarette, alcohol and drug use, the researchers found about 34 percent of statin users were diagnosed with cataracts, compared to about 10 percent of people not taking statins.

What's more, the researchers found that the risk of developing cataracts increased with the length of time a person took the medication.

While Mansi and his colleagues can't say how statins may affect the formation of cataracts, they write in JAMA Ophthalmology that there are a few possible explanations.

One is that the body needs high levels of cholesterol to maintain a clear lens and statins may interfere with the cells that control that process.

Dr. Jack Cioffi, head of ophthalmology at Columbia University Medical Center in New York, said the study is very well done, but has some limitations, including that the researchers used billing data rather than medical records, so they can't say how severe the cataracts were.

"I don't think we should overstate the significance of this. It goes back to if there is a good reason for you to be on that statin, it outweighs the risk of a mild increase in risk of cataract," Cioffi, who was not involved in the new study, said.

He added that the treatments for cataracts have evolved over time. The National Institutes of Health says the procedures to remove cataracts are some of the most common and safest surgeries performed in the U.S.

"For patients themselves, my advice is to discuss what your benefit and risk ratio is for you with your doctor," said Mansi, who added that he hopes the results will also encourage people to improve their cholesterol levels through lifestyle changes.

"This should motivate patients to do their part. Quit smoking, eat healthy and be active so doctors don't have to give you a tablet that may have some side effects," he said.

http://news.yahoo.com/statin-tied-cataract-development-study

Graham

The new blog.

Recently I have needed to look up various health-related matters on the internet. As everyone who has done this will know, it is a potential minefield. If you have no prior knowledge of the subject one thing leads to another and literally hours can be spent browsing and reading for very little gain. This is where I think our new blog is going to prove invaluable for anyone seeking information about matters pertaining to diabetes and diet. Naturally, it won't ever be fully comprehensive - nothing is - and will need continual updating, but basic information and the most relevant studies will be available. This will provide a useful starting point for further study and I am sure readers will be able to alert us to any errors or updates. Some have already begun to make us aware of useful information and I am sure this will continue.

We are all low carbers, of course, and all except Jan, are diabetics.  The new blog will, we hope, also continue to appeal to a wider readership, including those not diabetics but who are interested in a low carb, healthy diet and lifestyle.

The blog is already open for viewing and comments, but there is still a lot of work to be done. I have to say I feel quite useless in this situation, as problems with my vision mean much of the hard work has to be left to the others. So thank you for all your hard work and patience, team!

The best thing about the new blog for me, is the categorisation which allows easy access to information. Many blogs and forums contain excellent information, but it is sometimes far from easy to access, and its search facilities often require very precise terms to be successful. Even on this blog, with archives readily available it would be necessary to know exactly what you were looking for as titles are not always self-explanatory. We hope that the new blog will be a useful resource for some time to come and envisage some expansion of the team.

My purpose in writing this is merely to explain our aims, and how the new blog will differ from the current blog, which will run alongside it for a while. The most useful and informative articles may be posted on both. I hope that clarifies matters for anyone who is in doubt and that even old opponents will be prepared to keep an open mind and appreciate that any assistance they care to offer, is for the benefit of all and nothing to do with the somewhat introverted world of diabetes forums and blogs.

Kath

The new blog is here.

DUK the diabetes charity, sleepwalking towards a public health disaster !

An article in the Daily Mail tells us today. "Ignorance of diabetes is 'a disaster in waiting': 70% of Brits don't know disease can lead to amputations and blindness"

"The lack of awareness comes despite the fact that those with the illness are 36 per cent more likely to die in any given year than those without it of the same age. Diabetes UK commissioned the survey as part of a £2million campaign funded in partnership with Tesco to raise awareness of the risk factors.


The charity’s chief executive Barbara Young said the aim is to ‘lay to rest the myth’ that type 2 diabetes is a mild condition.‘This is a misconception that is wrecking lives and is the reason that as a country we are sleepwalking towards a public health disaster of an almost unimaginable scale,’ she said."

That's very rich coming from the chief executive Barbara Young. I ask myself, who has done more to perpetuate the gruesome outcomes and lamentable HbA1c results, published in the NHS audits for diabetics than Diabetes UK ? And Tesco, what a paragon of virtue that outfit is. Anyone who believes Tesco, is interested in diabetics, is in need of psychiatric counseling. Jeez you couldn't make it up. If Tesco really want to help, they can stop selling the high starch/sugar junk that fills most of their shops, and Diabetes UK can stop promoting the diet of slow death. 

The hypocrisy in all this stinks like four pound of condemned veal, and to think, Barbara Young is paid a hundred grand a year plus expenses to peddle this bilge ! If anyone is sleep walking it's Barbara Young and her charity has been in a self induced coma for years. As I so often say, welcome to the crazy world of diabetes.

Eddie

Daily mail story here.

 

Self appreciation society !

Us low carbers are certainly a loyal bunch, well our team is. We agree on just about everything regarding the best way to control diabetes. Let’s face it, we are 100% right ! I can sense buttocks clenching in certain quarters, with cries of cocky SOB, but think on this. For over five years I have lost count of how many times I have asked healthcare professionals, and members of forums and other blogs, this question, how can I control my diabetes on two metformin a day other than low carb ? The silence has been deafening !  I will never ever receive an answer, because there is no answer, other than low carb, full stop.

Forum low carb antis and anonymous negative posters on this blog, have been squawking total nonsense for years, but never one straight answer, never one shred of useful information, and that’s a fact. Sure, we know we can scoff the starchy carbs and junk that the antis defend 24/7, we can turn medication taking into a full time job and into an art form, but what is the point. What kind of person continues to eat food that so often leads to obesity and  often linked type two diabetes. More to the point, what sort of healthcare professional helps to send so many diabetics to an earlier grave ?

Top of our list and our number one star in our appreciation society is Franziska Spritzler, RD, CDE. For us low carb diabetic bloggers and non medical professionals, our downside is minimal, we only give our time. When a medical professional sticks their head above the parapet, of bent science and outdated dogma, the risks are much higher. Increasingly more medical professionals are speaking out, they are brave people, and must be supported at every opportunity. They will bring about the much needed changes in diabetic care and sound dietary information. Check out and comment on Franziska’s great site if you want to make a difference, just ten minutes of your time, that’s all it takes. You will not only be giving a thumbs up to Franziska, you will also encourage other professionals to stand up and be counted.

Eddie

Link to Franziska’s site here.

The clean food diet

“Fresh meat, fish, eggs, cheese and cream, at least ten vegetables or salad items a day. Use good oils and nuts. We call this diet the clean food approach.”

I wrote the above five years ago and the words have been on our website ever since. It occurred to me at the time, when the very mention of a lowcarb diet in some places, meant an almost instant bun fight. At the very least a small bunch of vehement anti lowcarbers would be spreading the doom and gloom. But if you think about it, a lowcarb diet is exactly that, a clean food diet. Most lowcarbers base their meals on non starchy fresh vegetables, add some meat, chicken and fish, and you have a meal that has received minimal intervention by man. How can a meal made from foods that have been with us from the beginning of time, be an unhealthy option compared to foods made in a factory, and more akin to a failed science experiment, than real wholesome natural foods ?

A member at diabetes.co.uk ‘the same place’ started a thread today called ‘Looking for fellow clean unprocessed healthy eaters.’ I reckon I understood exactly what the member was saying. To me she was saying I don’t eat junk from a factory. Long term lowcarb anti Noblehead was straight on the case, firing in two posts in succession. Clearly he felt a lowcarb sermon was coming up soon. His third post on the thread included these words “I wasn't being negative in any way as I was just curious as to what you meant by the title of the thread as it wasn't clear” The thread was very clear to Paul one of the team members on this, and our new blog, when he stated.

“Type 1 myself and also try and eat as clean a diet as possible based around vegetables, berries, nuts, dairy and meats. Although I do like a bit of organic peanut butter every now and then.

Our methods differ as I'm not veggie and I low carb but I think we're singing from the same hymn sheet regarding eating 'clean' food.”

So often we see lowcarb antis, clearly demonstrating they have no idea what a low carbing person eats. They are either too thick to understand, or don’t want to understand. Maybe it is easier to look at the situation from the other side, maybe it is easier to state what we don’t eat. We don’t eat the sort of low nutrition, factory made, starch and sugar laden junk, that has lead to the twin epidemics of type two diabetes and obesity. We don’t eat the foods that rapidly raise blood glucose levels to a dangerous high and then require medication to bring back to normal. For me total madness is eating a doughnut and then using powerful and expensive medication as an antidote. But hey, as the antis love to tell us so often, we are all different. Ain’t that a fact.

Eddie

Please check out our other sites.

Our website aimed at newly diagnosed and long term out of control type two diabetics.

www.lowcarbdiabetic.co.uk

Our low carb recipe and food idea blog.

www.lowcarbdietsandrecipes.blogspot.co.uk

Our new blog for diabetics and people interested in low carbing.

 www.lowcarbdiabetic.wordpress.com

Imelda May (Hyde Park Elvis Forever) My Baby Left Me

Graham

Metallica - One

Enjoy-Paul.

For Kath

Saturday night is music night on this blog !

Annie Lennox- Pavement Cracks 

Kath's Cake !

Let Them Eat Cake!

The thing I hate most about having diabetes - and especially being treated by oral medication is that I have to spend so much more time thinking about food. Food has never been very important to me. I always tried to eat well - that is to eat quality produce and to ensure my family ate well too - but apart from that I almost resented the time spent on shopping and cooking etc. Don't get me wrong - I enjoyed cooking for guests and other social aspects but often had to be reminded to eat and if I happened to be alone would never think about eating. When I first came across the GI diet it seemed to make sense and so that is how we ate for some years.

Events -food scandals, recession, mad cow disease - and some moral scruples encouraged me to try vegetarianism. Possibly this would have worked for me had I been catering only for myself but that wasn't the case. Just as well really, as my food intolerances and allergy are all vegetable based. When trying to cater for us all on a veggie diet I became anxious about the possible effects and nutritional value of some of the protein alternatives so there was no room for complacency in eating that way either.

Low carb is no problem for me. I think I was a natural lowcarber before I even heard the term. I would never have believed, though, that my tiny intake of starchy carbs could have been a problem. When I finally discovered how my meter should be used, I found it difficult to believe how carb sensitive I was, especially to bread. Adapting to this knowledge wasn't too difficult, - I didn't have to give up much!

Most people when adopting a particular diet will compromise in some way - adapt it to suit themselves. Of course we are all conditioned to eat the food we have eaten from childhood. Food has many associations for us often connected with comfort and pleasure. Because of this I have often wondered if trying to adapt a diet to appear as similar as possible to our previous diet is a good or bad idea.

In the non-meat areas of the supermarket any number of what I call 'spoof foods' are available. Meat free steaks, chicken burgers, bacon etc. Some of this may have its uses as it not only has some visual resemblance but sometimes even tastes like the real thing. This may help some with the weaning or transitional period. Its veggie fast food of course, and the aim should be to eat properly balanced vegetarian meals with fresh ingredients. A veggie diet can cause weight gain - the old image of the skinny vegetarian is a stereotype and we know all about those don't we?

But what of low carb? The emphasis is on fresh natural ingredients - so how could there be a problem? I hate to say this - but-could it be the CAKE?

I like cake as much as anyone - well no, perhaps not quite as much as anyone. I am very grateful for lowcarb recipes, particularly for desserts which can be adapted in different ways and on different occasions. As most of us will have learned non lowcarbers can seldom tell the difference and may even prefer the low carb versions. Sometimes, however, in the rush to persuade us that we don't have to forgo anything, we find recipes requiring vast amounts of time and expensive ingredients - all for very little reward. Its great that we have access to these things and there may well be occasions when we are prepared to spend hours of our time and a good proportion of our income on a tiny amount of unnecessary treats - but what is this really saying? That we are brave soldiers struggling to overcome our problems, or that we can't face up to facts and accept that there are more important things in life than being able to eat whatever we want, whenever we want? Does food assume a disproportionate importance after a diabetes diagnosis in many different ways?

I am sure we are all grateful to those who invent, find and publish the recipes for lowcarb versions of every variety of cake or biscuit but could this, taken to extremes, be counterproductive - or is that already the case?

Kath

Hope is a good thing, and no good thing ever dies !

Get busy living, or get busy dying !

Deadly Medicines and Organized Crime by Peter Gøtzsche

The main reason we take so many drugs is that drug companies don't sell drugs, they sell lies about drugs. This is what makes drugs so different from anything else in life...Virtually everything we know about drugs is what the companies have chosen to tell us and our doctors...the reason patients trust their medicine is that they extrapolate the trust they have in their doctors into the medicines they prescribe. The patients don't realise that, although their doctors may know a lot about diseases and human physiology and psychology, they know very, very little about drugs that hasn't been carefully concocted and dressed up by the drug industry…If you don't think the system is out of control, then please email me and explain why drugs are the third leading cause of death…If such a hugely lethal epidemic had been caused by a new bacterium or a virus, or even one hundredth of it, we would have done everything we could to get it under control.'​

From the Introduction

Prescription drugs are the third leading cause of death after heart disease and cancer.
In his latest ground-breaking book, Peter C Gøtzsche exposes the pharmaceutical industries and their charade of fraudulent behavior, both in research and marketing where the morally repugnant disregard for human lives is the norm 1. He convincingly draws close comparisons with the tobacco conglomerates, revealing the extraordinary truth behind efforts to confuse and distract the public and their politicians.
The book addresses, in evidence-based detail, an extraordinary system failure caused by widespread crime, corruption, bribery and impotent drug regulation in need of radical reforms.
Peter is Director of The Nordic Cochrane Centre.
Professor Peter C Gøtzsche graduated as a master of science in biology and chemistry in 1974 and as a physician 1984. He is a specialist in internal medicine; worked with clinical trials and regulatory affairs in the drug industry 1975-1983, and at hospitals in Copenhagen 1984-95. He cofounded The Cochrane Collaboration in 1993 and established The Nordic Cochrane Centre the same year. He became professor of Clinical Research Design and Analysis in 2010 at the University of Copenhagen.
Peter has published more than 50 papers in ”the big five” (BMJ, Lancet, JAMA, Ann Intern Med and N Engl J Med) and his scientific works have been cited over 9,000 times. He is author of Rational Diagnosis and Treatment. Evidence-Based Clinical Decision-Making (2007) and Mammography Screening: truth, lies and controversy (2012).

Peter has an interest in statistics and research methodology. He is a member of several groups publishing guidelines for good reporting of research and has co-authored CONSORT for randomised trials (www.consort-statement.org), STROBE for observational studies (www.strobe-statement.org), PRISMA for systematic reviews and meta-analyses (www.prisma-statement.org), and SPIRIT for trial protocols (http://www.equator-network.org). Peter is an editor in the Cochrane Methodology Review Group.

Read a chapter for free:  http://www.radcliffehealth.com/sites/radcliffehealth.com/files/samplechapter/gotzsche_chpt18.pdf

Source: http://pharmagossip.blogspot.co.uk/2013/09/deadly-medicines-and-organized-crime-by.html

Dr Malcom Kendrick has a blog post about the book:  http://drmalcolmkendrick.org/

Graham

Departures

This Japanese film is another gem. It tells the story of a young professional musician made redundant. He needs to earn a living and gets a job at a firm called departures. He thinks it is a travel agent or the like. He swiftly learns it is a company that specialises in preparing people to go from this world to the next. At first he is repulsed, but soon realises he has a talent for a new art form. A highly recommended film. Eddie