Why is diabetes an imperfect science? The last 22 years of my life with diabetes have disproved as much (or more) than it has confirmed in conventional diabetes wisdom. The facts were in the studies - but researchers didn't know what to do with them, at the time. Here's where the mysteries will unfold..

The last year blogging with The Diabetes Blog has been an in your face demonstration of the imperfect science of diabetes. Many undisclosed details of studies from days gone by have proven to be a reason why diabetes has been an imperfect science. Since when has science been imperfect? When you don't complete your homework. Don't get wrong - science has done the homework, but you - the diabetic - have not been privy to every fact found in these studies. Nowadays, there's no excuse. The dog doesn't eat my homework.

It's time these facts made it to the light of day. I am taking my investigative curiosity and hanging a shingle over LoveDiabetes.com - because that's who I am: Allison Love Beatty! Let's buddy-up with the researchers and their homework. It's about time we solved the universal mysteries of diabetes. The facts are available. With combined knowledge, existential and pathological, we can make more of these studies from yesteryear and the days to come.

Someday soon we will see the trend of diabetes reverse - less diagnosis, less complications, and reduced costs. I've got Internet access, unlimited long-distance, and plenty of time. The fun is just getting started! This is my invitation to you - what's your diabetes mystery? Leave me a comment on LoveDiabetes.com so I know what's on your mind. Together we will prove there is no such a thing as an imperfect science.

Love always,
Allie B

A type 1 diabetic mystery is why do some Type 1s get complications and others seem to never get them? A massive Japanese study of Type 1 diabetics found that those with fulminant diabetes developed complications much faster and more severely than those with non-fulminant diabetes.

The difference between fulminant and non-fulminant is the speed and intensity at which the disease develops. Fulminant Type 1 diabetes typically develops suddenly with near total loss of beta cell function. This type of diabetes is confirmed with testing c-peptide levels. Non-fulminant type 1 diabetes has residual c-peptide levels that eventually taper to undetectable. Sometimes this is seen through many years of the Honeymoon Period.

This study may be the antithesis of conventional wisdom for preventing complications. Staking all hopes on blood sugar control is heavily optimistic. Yes controlling blood sugar does lessen the workload for existing beta cells, and thus extends the lifespan of each beta cell. Research suggests that c-peptide offers protection to beta cells, both from apoptosis (cell death) and encourages new cell growth. This new cell growth applies to beta cells and other cells of the body that endure long-term Type 1 diabetes complications.

Diabetics are instructed that maintaining normal blood sugars is the Holy Grail of preventing long-term complications. Yes and no. The truth is controlling your blood sugar will not allow complications of Type 1 diabetes to develop as quickly, presuming you still had some level of beta cell function upon diagnosis (i.e., c-peptide). That doesn't sound like a reward as much as it does a delayed punishment. I'd like c-peptide with my insulin, please. It's off the à la carte menu? That's fine - serve it up! I want to thank Klausen for bringing this study to my attention.

Dr. Bernstein, a world leading authority in diabetes, is hosting a live internet broadcasts to answer your questions on diabetes. Diabetes 911 is setup to stop the complications of diabetes before it's an emergency. Here's a link to the page where you can submit your questions, to be answered on his next broadcast -- September 19, 2007.

Just a heads-up for The Diabetes Blog reading community - AOL has announced they will be retiring The Diabetes Blog on September 14, 2007. So this is a preemptive blog to get your calendar out, send yourself a reminder email titled: OPEN ON SEPTEMBER 19th!!!!

This will not be my last blog shared with you, all mighty readers of the blogosphere. I'm working to get my proverbial welcome mat in place to continue unfolding the mysteries of diabetes on LoveDiabetes.com. More to come...

UCLA researchers report Nevada County, California residents have the lowest rate of diabetes in the state -- 2.6 percent. That's about one-third the state-wide average (6.8 percent), and slightly less than one-quarter the prevalence of diabetes in Imperial County (11.2 percent).

Take a few guesses why Nevada County's rate of diabetes is so much lower than Imperial County, and well under the national average of 7 percent. Do families eat less processed food around the dinner table? More jogging trails? Better health insurance coverage? Researcher Theresa Hastert states, "There is no one thing, but higher income is associated with better foods and exercise."

Hastert explained Nevada County is mostly white, affluent, educated and insured. Imperial County has a large population of Latinos and migrant farm workers. Nevada County's numbers support general findings that minorities without affordable, continuous health care are more prone to the disease. Who's got time for the dinner table -- Hastert openly speculates eating more junk food may be a consequence of dodging between three jobs just to get by. Also, Nevada County is a beautiful area -- she wonders if environmental factors play a role.

Is diabetes a socio-economic disease? If so, we're in trouble. The gap is widening between our nation's haves and have nots, and large concentrations of poor minorities may explain the disproportionate rates of diabetes from county to county. Read more in The Union.

Diabetic foot complications are responsible for many lower extremity amputations. But this last drastic step can be prevented up to 85 percent of the time with early diagnosis and proper care.

Now Thai researchers and physicians have shown using a patient's own stem cells can effectively heal chronic foot wounds. Diabetes patients with chronic foot wounds, aged 50-72, were injected with stem cells obtained from their own blood. Most excitedly, the wounds healed nicely within three to four months. The stem cell treatment also makes fiscal sense. According to this article, stem cell treatment for wounds in a patient with diabetes costs about $6,000, one-fifth the cost of conventional treatment for a leg wound.

Studies have shown primary care physicians often fail to examine the feet of patients with diabetes. It's a shame, as this step is the least costly and most effective way to prevent foot wounds and potential amputations. But at the same time, it is nice to know there is a promising, cheaper treatment utilizing patient-donated stem cells.

Creator of Diabetes Health Magazine, Scott King, has been a type 1 diabetic for over 34 years. Needless to say, he knows diabetes, and he is doing a remarkable job of introducing cutting-edge treatments for diabetics. In the first Diabetes Health TV broadcast, he shared interviews from the recent AADE Conference. A really exciting product he featured is called Neuragen - a topical treatment for diabetes neuropathy.

With diabetes neuropathy, people experience pain due to damage to the peripheral nerves. Neuropathic pain is often characterized by burning sensations or shooting pain, or may occur as numbness or chronic itching. Clinical trials have shown Neuragen to be effective in 70% of patients for the pain associated with diabetes. The ingredients are pretty kosher, too. Neuragen is made of a proprietary blend of essential oils from special species of geranium, lavender, bergamot, eucalyptus, and tea tree.

The Neuragen rep was blunt when he described the effective nature of this all natural product - using more does not make it any more effective! You have to admire his refreshing honesty. But like I said upfront - if Scott King is willing to spend the time getting the scoop on this product - it's probably worth your time using it. For more interviews, checkot the full coverage of the AADE Conference on Diabetes Health TV!

Recently I posted on the California Department of Education's recent lawsuit settlement with the American Diabetes Association. CDE promised students would have access to legally-required diabetes care on campus. With a shortage of school nurses, CDE agreed caregivers could include trained volunteers. I came away from the agreement thinking, "Good! It may have taken a lawsuit, but problem solved." But this settlement is hardly a neatly wrapped package.

Liability drives many decisions. Now the California School Nurses Organization has advised school nurses to seek guidance from district lawyers before training volunteers. Nurses are concerned they could lose their licenses if they train non-medical staff. Executive Director Nancy Spradling stated insulin injections should be monitored by licensed personnel -- incorrect calculations can be fatal or trigger a coma. They've got a point.

Student diabetes care varies widely in California. With a student population of 22,000, Lake Elsinore Unified School District is doing a good job. They have eight nurses taking care of 70 students with diabetes. Last year, Palm Springs Unified School District had only 3 nurses for 24,000 students, requiring parents to visit district schools daily to inject children too young to handle the task themselves.

Arlene Mayerson, directing attorney with the Disability Rights Education and Defense Fund (they represented the ADA in the lawsuit), stated California has one of the lowest nurse-to-student ratios. Perhaps a new certification for a 'School Diabetes Specialist' is on the horizon. Regardless, I hope the CDE figures out a solution to honor the settlement. I bet school districts across the country are watching -- the health of students with diabetes is at stake. Don't forget the nurses' concern. Beyond losing their licenses, no one wants to see a student with diabetes hurt or killed due to an improperly trained, unlicensed adult volunteer. Read the full story in The Press Enterprise.

Previous studies have examined visual impairments of Caucasians with type 1 diabetes, but this is the first study analyzing vision loss for African Americans with type 1.

The vision and associated risk factors of approximately 500 African Americans with type 1 were studied over a 6-year period. At follow-up, 4.3 percent of patients realized vision loss in their better eye (visual acuity of 20/40 or worse) and 0.6 percent became blind in their better eye (visual acuity of 20/200 or worse). Nearly 10 percent lost 15 or more letters on the eye chart due to a doubling of the visual angle in their better eye. Another 13.5 percent had this doubling in either eye, which the researchers stated was "particularly high".

Independent predictors of vision loss over the six years were identified as poor blood sugar control, older age, high protein levels in the urine (symptomatic of kidney disease) and diabetic retinopathy, a common degeneration of the retina seen in people with diabetes.

Do not miss this recent NY Times article by Gina Kolata, Looking Past Blood Sugar to Survive With Diabetes. It is a must read for anyone associated with type 2 diabetes, including patients, family caregivers and doctors. I am very encouraged to see a feature on type 2 diabetes in such a well-read newspaper. Many doctors are uninformed on the best ways to treat a person with type 2 diabetes, they spend much more time with type 1 patients. Furthermore, type 1 and type 2 are very different diseases, but since they both end in 'diabetes' there is deep confusion -- see Diane's previous post on this topic. Undoubtedly, we need Big Media to provide greater coverage on the differences and unique treatments for both type 1 and type 2 diabetes.

First off, type 2 diabetes is a form of the disease that usually appears in adulthood where the body does not produce enough insulin or the cells are resistant to insulin. Kolata's article focuses on one man's battle with type 2 diabetes, as well as the importance of other treatments beyond blood sugar control that can markedly prevent heart disease -- the number one threat to a person with type 2. Dave Smith, a pastor from Fairmont, Minnesota, has dealt with type 2 diabetes for nine years. From the start, his doctor advised him to control his blood sugar, so he was a faithful carbohydrate counter, finger pricker, type 2 pill taker. Nothing worked, so he added insulin.

Unfortunately, his fixation on controlling blood sugar ignored the most crucial treatment of all -- lowering cholesterol. According to Kolata's article, heart disease kills nearly everyone with diabetes. The second treatment Smith did not consider was the importance of controlling blood pressure. The third treatment is taking aspirin to control blood clots. Last October, Smith had a major heart attack and nearly died. He had never thought about heart disease, and his doctor never advised him to take a cholesterol-lowering statin or a blood pressure drug. The American Diabetes Association reports only 18 percent of people with diabetes know their increased risk for cardiovascular disease. Grrrr! This lack of awareness among patients and doctors must change for lives to be saved. It took a near-fatal heart attack for Smith to receive the combination of drugs he should have been prescribed at diagnosis: a statin, two drugs to lower blood pressure, aspirin, insulin and two drugs to reduce his blood sugar level.

Yes, I'm back on the topic of diabetes and car crash liabiity. Here's a case from Montana that's become particularly ugly. Eleven-year-old Cady Tucker was killed in a head-on collision five years ago. The driver of the car that caused the crash has diabetes. Now, usually in these situations the diabetic (sorry, BetterCell!) driver was experiencing low blood sugar. But in this case, the driver had extremely high blood sugar.

Ever since the crash, the girl's mom, Pat Tucker, has been trying to press criminal charges against the woman. Tucker likens the crash to a DUI. The driver, she says, was "drunk on sugar." The Tuckers have even founded an organization devoted to changing the law: People Against Impaired Drivers.

Now Tucker is very upset because she was not able to get to court before last week, when the statute of limitations ran out on the case. "I couldn't believe a crime wasn't committed when a child's life was taken," says Tucker.

There's a ton of sympathy out there for grieving mom, Tucker. But no one's going to bat for her. Attorney General Mike McGrath has said that while he's sorry for Tucker, the accident was just that: an accident, and not a case of negligent homicide. "We don't put people in prison for high blood sugar," says McGrath.

Great strides have been made in the field of cardiology in recent years. However, according to a new study just out, people with diabetes remain dangerously at risk for heart-related problems like angina and heart attack. The results of the study have been published In the latest issue of the Journal of the American Medical Association (August 2007).

It's quite disturbing to read the numbers on this. Example? For every hundred diabetics who experience severe heart attack, just over eight will die within thirty days. For non-diabetics, that number goes down to around five. I could go on, but you get the picture.

The solution? Says the author of the study, Dr. Elliott M. Antman: "We need aggressive strategies to manage the diabetic population. What we need to do is everything to halt the epidemic of diabetes and find through research what therapies are most helpful for diabetic patients. We've got to do better for those patients." Hear, hear.

But what should those "aggressive strategies" be? And how do you implement them? That's the sticking point. The Washington Post caught the American Diabetes Association's Larry Deeb in a moment of remarkable frankness, saying he really doesn't know what can be done to get cardiologists and endocrinologists working together on this. C'mon, Larry. That's not exactly encouraging news for all the people out there with diabetes!

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!

Diabetic ulcers are the most common foot injury leading to amputation in the lower extremities. Encouragingly, early detection and proper treatment of a foot ulcer can prevent up to 85 percent of amputations. It is important for physicians to perform regular, thorough foot exams, however people with diabetes can also rely on a foot thermometer for early detection of inflammation and potential ulceration.

Xilas Medical Inc. manufacturers the TempTouch (R), an infrared temperature measurement device for at-home use. In previous clinical trials, TempTouch (R) successfully detected inflammation before an ulceration perforated the surface skin. Patients compared temperatures of each foot in like positions. Spikes in skin temperature signal foot ulcers -- this early warning allowed patients to purposely reduce activity levels or off-load to prevent ulceration.

Approved by the Food and Drug Administration in 2005, the TempTouch (R) requires a doctor's prescription, costs around $150 and is 16" long for easy reach. Unfortunately, the device is not covered by insurance. Health insurance companies prefer to pay for costly ulcer treatments and possible amputation versus a preventive device? The product is intended for daily use -- perhaps daily compliance is a challenge. At the very least, the device should be covered for people at high risk for foot ulcerations. Read more at WKRG News.

Menopause means the end of estrogen production in women. One of the changes resulting from that loss is a rise in blood sugar. Other undesirable side-effects include a tendency to overweight and high blood pressure (hypertension). That news comes courtesy of a new study conducted on female rats.

The lead researcher for the study was Dr. Lourdes A. Fortepiani of the University of Texas Health Science Center at San Antonio. According to Dr. Fortepiani, simulating menopause in rats caused a thirty-five percent rise in blood sugar levels. Other changes included significantly higher blood pressure and weight gain at double the normal rate.

Yikes! Is that what we ladies have to look forward to?? This is certainly something to keep in mind if you have diabetes. But wait. There is a silver lining. Estrogen replacement therapy erases all these nasty hormonal and metabolic side effects, says Dr. F. Could this mean that hormone replacement therapy, which has lately fallen really, really out of favor, might be making a comeback?

A United Kingdom woman's death by diabetes made the news recently. But empathy had no place in the story. Instead, she was recorded as having died of natural causes, yet also convicted of her own murder.

The point of the story, which was reported nearly six months after she was found dead in her home, appears to be the fact that her boyfriend was found not to be responsible for her death. The death was originally ruled suspicious because the 41-year-old woman who lived alone was found partially disrobed in her home. Turns out, the boyfriend didn't kill her, but saw her dead through a window and decided to rob her. That's not all he did. He paved the way for her to be publicly ridiculed for struggling with a chronic illness and ultimately dying from it.

A coroner's examination "revealed that due to diabetes and a lack of its treatment, she had a chemical imbalance in her blood" and that she "failed to co-operate with doctors who advised her about how to control the condition" and then died "after she let her diabetes get out of control." The coroner recorded that the woman died of diabetic ketoacidosis, apparently considered a "natural cause."