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News Roundup

David Spero

June 10, 2009

I’ve been dealing with a bad cold of late, but I’m still keeping an eye on the latest diabetes news. Here are some headlines that have caught my attention recently:

Gingko biloba
People who look to herbs and supplements for aspects of their diabetes management may be interested in several new studies that investigate the effects of alternative remedies on a variety of diabetes-related conditions. One study, published in the Archives of Internal Medicine, explored the use of vitamin D as a pain reliever in people with Type 2 diabetes and neuropathy (nerve damage). All 51 people enrolled in the trial were deficient in vitamin D, a common condition in those with Type 2 diabetes. After three months of supplementation with vitamin D tablets, a significant decrease in neuropathy pain was reported among the study’s participants.

Another recent study out of Korea found that gingko biloba reduced neuropathic pain in rats. Dr. Yee Suk Kim of The Catholic University of Seoul, South Korea, exposed rats with neuropathic pain to cold and pressure in their feet. Rats who had been given a gingko extract exhibited less pain response than rats who had been given a placebo (inactive treatment).

And according to the University of Maryland Medical Center’s Web site, “Ginkgo has been used in traditional medicine to treat circulatory disorders and enhance memory.” There is some scientific support for this use as well, such as a study done last year in China, which showed that ginkgo biloba extract improved coronary blood flow in older adults.

Magnesium
The mineral magnesium is another supplement that shows promise. According to an analysis published in the Journal of Internal Medicine, magnesium may protect against Type 2 diabetes. Research has indicated that for every 100-milligram increase in daily magnesium intake, the risk of developing Type 2 diabetes decreases by 15%. Another study published in the American Journal of Epidemiology indicates that this mineral may protect against stroke.

We all know you shouldn’t jump at every piece of “scientific” dietary advice that comes along. In this case, however, magnesium is easy to get, often comes along with other healthful minerals and vitamins, and is associated with strong bones. So why not? Dietary sources of magnesium include green, leafy vegetables, meats, starches, grains, nuts, and milk. Previous dietary surveys have shown that a large portion of adults do not meet the Recommended Daily Allowance for magnesium (320 milligrams per day for women age 31 years and older and 420 milligrams per day for men age 31 years and older).

Dietary approach
In other dietary news, a new program known as “Diabetes DTOUR” may be worth some investigation. It does not require you to stop eating any particular food. Instead, it focuses on an increased intake of omega-3 oils, fiber, calcium, and vitamin D. On Diabetes DTOUR, you eat five times a day, so you don’t feel deprived. Personally, I like a diet that is about more rather than less. [Editor's note: Although this eating plan may be helpful for some people, its inclusion in this blog post should not be construed as an endorsement by Diabetes Self-Management.]

Drug research
With the 69th Scientific Sessions of the American Diabetes Association recently concluded, research looking into diabetes drugs has also been popular in the headlines. For instance, one study out of the Scientific Sessions showed that in people with Type 2 diabetes, a drug that is being researched (and is not currently on the market), known as liraglutide, caused a greater drop in A1C than Byetta (exenatide). Another study from the Scientific Sessions, this one involving once-weekly Byetta, showed that Byetta seemed to control A1C better than Actos (pioglitazone) or Januvia (sitagliptin). The Byetta injections lowered A1C about 1.70% on average, compared to 1.42% with Actos and 0.98% with Januvia.

Glucose control debate
However, some scientists are now saying that tight glucose control may be a bad thing! In a report recently published in the Annals of Internal Medicine, Victor M. Montori, MD, MSc, and Mercè Fernández-Balsells, MD, say that, “tight glycemic control burdens patients with complex treatment programs, hypoglycemia, weight gain, and costs, and offers uncertain benefits in return. We believe clinicians should prioritize supporting well-being and healthy lifestyles, preventive care, and cardiovascular risk reduction in these patients.”

But there’s a problem with this finding, which I’ve exposed before. What the studies included in this analysis show is that controlling glucose with various drugs doesn’t give any health advantage. They don’t say anything about controlling blood glucose with food, exercise, and stress reduction.

Nonetheless, there is a strong element of truth in this report. Focusing on a number such as A1C or weight can distract us from focus on the overall health and the quality of our lives. And that is a mistake. Risking medicine side effects and hypoglycemia may not be worth a 0.5% reduction in A1C. The paper calls for individualizing A1C goals and medicine choices and allowing patients to decide what is right for them. I think we can all agree on that.

Intimacy program meets barriers
On a different note, my partner Aisha and I have been marketing half-day programs on sex, intimacy, and diabetes to various diabetes centers. It’s amazing how uncomfortable this topic makes some health professionals! They rarely even reply. As a result, people may be denied a very helpful program. I think we’ll have to call it something else.

You can check out our new sex advice column here. This one focuses on medical treatments of erection problems.

Well, I hope you are all pursuing your “Tastes Good” and “Feels Good” diets. This cold has made it so that I can’t taste anything anyway, but I wish you all some pleasurable eating!

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