New York City mayor, Michael Bloomberg, has proposed a tax of 12 cents per can of soda (a penny per ounce). During his weekly radio address, Bloomberg said the soda tax would discourage consumers from buying sugar-laden drinks. According to the NYT, Bloomberg noted research suggesting that such a tax would reduce consumption of the sugary drinks, and drive down obesity rates and their accompanying medical costs. The main thrust, however, was on finding a quick source of revenue for a city in serious need of one. “In these tough economic times, easy fixes to our problems are hard to come by,” he said. “But the soda tax is a fix that just makes sense. It would save lives. It would cut rising health care costs.”

Indeed it might, but taxing soda alone will not promote good health. Like so many others, Bloomberg is using health as the easiest disguise for raising revenue. A soda tax is a deceptive, easy fix – the last thing we should be seeking now. Instead of an easy fix, Bloomberg and other policy makers should seek a long-term sustainable program that educates people about nutrition. If giving up soda is going to save lives, then let’s do it for real. How about making it illegal for anyone under 21 to buy soda? Instead of having teenagers loiter around store fronts trying to get someone to buy them a few beers, let’s have them out there trying to score a can of Coke. And what would happen if McDonald’s couldn’t serve soda to children?

Pepsi and Coca-Cola recently announced they would improve nutritional labeling on their products. If soda is killing us, then let’s not kid ourselves and think that a more visible nutritional label is going to make a difference. We need to go for the skull and crossbones. No one is going to pay attention to anything less than that. You know why? Because no one knows anything about nutritional labels. No one knows that carbohydrates and sugar are the same thing. The people who drink six cans of soda a day have no idea what 28 grams of sugar per can means. They don’t know this because lawmakers are looking for a quick fixes instead of going through the long and difficult process of educating people.

I’m not a Coke or Pepsi advocate. I think they’re selling crap, and I think they know they’re selling crap. But why are we picking on them? Why not tax all food that is crap, including breakfast cereals like this one?

(Apparently regular Froot Loops weren’t sweet enough for Americans, so Kellogg’s kindly created a marshmallow version.) Or how about this – instead of singling out only one of the causes of obesity, why not make it difficult and expensive to sell all sugared products? Why not treat all sugars equally, as we treat all cigarette brands equally? Perhaps we can institute laws that require supermarkets to make a junk food section, with a tollbooth at its entrance and charge $5 per person to enter. Such a draconian and expensive measure might really lead to real reduction in the consumption of all junk food.

America’s obesity (and diabetes) problem runs so deep that pointing a finger here or there isn’t going to solve anything. Soda is junk, but it’s merely the junk at the top of the pile.

Cross-posted on ASweetLife.

I’m a type 1 diabetic and I support JDRF.  I think it’s a fantastic organization and I’ve recently been talking to my husband, also type 1 diabetic who is training for the Rotterdam marathon, about whether we could use his marathon as an opportunity to raise funds for JDRF – the organization whose mission is to find a cure for diabetes and its complications through the support of research.   This morning, however, I thought I was reading The Onion as I read the article Donuts for Diabetes and saw this picture of the cute JDRF shoes logo topped with a doughnut.

Apparently, the second annual Krispy Kreme Challenge has just taken place.  What is the Krispy Kreme Challenge?  It’s a diabetes event centered around doughnuts. No, that doesn’t mean a bunch of people got together ate doughnuts and tried to bring on type 2 diabetes.  Surprisingly, it was an event which took place in order to raise money for JDRF.  Krispy Kreme Challenge participants ran a mile or so, ate up to a dozen doughnuts, and then ran back.  I asked my husband, a serious runner who knows as much as anyone about balancing blood sugar levels, insulin, and exercise, what he thought would happen to him if he ran a mile ate a dozen doughnuts and then ran another mile.  “I think I would die,” he said.

On that note, let’s stop for a moment and look at this chart which includes nutritional data for Krispy Kreme glazed doughnuts.

Nutritional Facts

% Daily
 Value* 

 A Dozen Glazed
 Doughnuts

%Daily
Value *

One Glazed
Doughnut

120%

2,400

10%

200

Calories

1,200

100

Calories from Fat

216%

144

18%

12g

Total Fat

348%

72mg

29%

6g

Saturated Fat

12%

60mg

1%

5mg

Cholesterol

48%

1140mg

4%

95mg

Sodium

84%

264g

7%

22g

Carbohydrate

120g

10g

Sugars

24g

2g

Protein

*Percent Daily Values (DV) are based on a 2,000 calorie diet. Your daily values may be higher or lower depending on your calorie needs.

**source: Krispy Kreme

Yes, you did read that correctly – 12 glazed doughnuts contain 2,400 calories, 264 grams of carb, and 144 grams of fat.

Now factor in this:

According to FitSugar, “Syracuse University did a study that involved 12 men and 12 women. Their caloric burn was measured when both walking (19:00 minute miles) and running (9:30 minute miles), for a distance of 1,600 meters (about a mile). The men burned an average of 105 calories while running, and just 52 while walking; the women burned 91 calories while running and 43 walking.”

In summary:  A man who completed the Krispy Kreme Challenge consumed 2,400 calories.  If he ran the course, he burned 210 of them.  If he walked, he burned 104 calories.  (And eek – 264 grams of carb in 12 doughnuts!  How much do you bolus to cover that?)

Annette Peery, organizer of the Krispy Kreme Challenge knows that some of us might be raising our eyebrows at her event.  Her comment to Eye Witness News 9, “A lot of people are saying, ’why would you be running and eating donuts for diabetes.’ She explains that type 1 diabetes is not related to obesity and physical inactivity, but rather, it’s an autoimmune disorder.  Dear Ms. Perry, type 1 diabetes might not be caused by obesity, but eating foods like doughnuts which are high in sugar, fat, and carbohydrates, are poison for all people, and especially for type 1 diabetics who are trying to avoid complications of diabetes by controlling their blood sugar and cholesterol.

It’s true, type 1 diabetics *can* eat sugar, so long as they can cover themselves with the proper amount of insulin.  But that’s not an easy thing to do.  And while almost all type 1 diabetics do sometimes eat sweets, I believe it is important to acknowledge that these foods are not good for us.  We have to avoid falling into the “equality” argument which goes something like… I might have diabetes, but that doesn’t mean I can’t eat just like everyone else. As diabetics, we aren’t equal.  This isn’t a matter of gender or race.  This is about survival with a very serious, chronic illness.  No diabetic of any type should be encouraged to eat doughnuts, no matter how good the cause.

Finding a cure for diabetes is no simple thing.  But keeping diabetic complications to a minimum is possible for those of us who manage –overall- to keep our blood sugar levels in the target range.  My husband and I work hard to do this.  And the way we succeed is by avoiding foods high in sugar and carbohydrates.  The formula is pretty simple:  the less sugar you eat, the less insulin you need to process it.

Meanwhile, I’m inspired.  The Krispy Kreme challenge has led me to think of other fund raising ideas.  Tomorrow morning I think I’ll approach Phillip Morris and suggest they sponsor the Marlboro Challenge to raise funds for cancer research.  Participants will run a mile, smoke a dozen cigarettes, and then run back.  Double the money for anyone who completes the course without coughing.

Cross-posted on ASweetLife

]]> http://thefastertimes.com/diabetes/2010/03/01/doughnuts-for-diabetes/feed/ http://thefastertimes.com/diabetes/2010/02/10/thank-you-michelle-obama/ http://thefastertimes.com/diabetes/2010/02/10/thank-you-michelle-obama/#comments Wed, 10 Feb 2010 09:54:10 +0000 Jessica Apple http://thefastertimes.com/diabetes/?p=319 I read this New York Times article, “Childhood Obesity Battle Is Taken Up by First Lady,” which details Michelle Obama’s Let’s Move campaign - America’s Move to Raise a Healthier Generation of Kids.  Thank you so much for doing this, Michelle Obama!

What struck me as I was reading the article was that, while kids are the focus of Mrs. Obama’s efforts, much of what she said applies to adults too, especially to diabetic adults.  Take this quote for example: “The truth is, our kids didn’t do this to themselves,” Mrs. Obama said. “Our kids didn’t choose to make food products with tons of fat and sugar and supersize portions, and then to have those foods marketed to them wherever they turn.”

I know that as adults we bear responsibility for our choices, but you know — when there’s a pile of donuts in the office, or fifty different candy bars to choose from at supermarket check-out, it’s pretty hard to resist, even for someone with a lot of willpower.  In other words, if the sugar and fat and Jupiter-sized portions are at our fingertips, and these things are among the primary causes for the rise of diabetes, then please don’t blame diabetics for the fact that they are diabetic, any more than you would blame a child for being overweight.

The key is to have healthy choices available, and not to have junk food marketed to us wherever we turn.  And we must do our best not to have junk food in the house!  I find that if I have apples in the house, I will grab one as a snack without thinking twice.  If I don’t have them around, I begin to look for other things, and if there are cookies in my kitchen - even if I don’t eat them - the fact that they are within arm’s reach drives me a little crazy.

Another New York Times report says the Obama administration will begin a drive this week to expel Pepsi, French fries and Snickers bars from the nation’s schools in hopes of reducing the number of children who get fat during their school years.  Once again, I say thank you!

When my son began first grade in 2006, there was a vending machine outside of his classroom - not near his classroom - but directly across from the classroom door.  What that meant was that when the kids opened the door to step into the hallway, the first thing they saw was the word Coke.  There were six-year-old kids who sat down with a Coke before the bell rang.  My son knew there was no chance he would get a soda, and for the most part, he accepted it.  But there were days when he was angry and jealous of the kids drinking Coke.

A group of parents worked to have the vending machine removed from the school.  We were successful, and I am happy to say that since its departure I have not seen a soda can in the classroom.  It won’t be easy, but we must teach our children, and ourselves, that drinking water is not a punishment -and neither is eating a carrot instead of a cookie.

Cross-posted on ASweetLife

Last year while pregnant with my third child, I felt unusually tired. I reasoned that taking care of my two sons and growing a third was more than my body could handle. But then I noticed something else—my exhaustion peaked just after meal times. If I ate pizza, pasta, or a bagel, not only did I feel drowsy, but I felt like I had weights attached to my body. Every movement was sluggish, almost impossible. I couldn’t keep up with my daily routine, and my kids were spending time in front of the TV instead of with me. I went from one doctor to the next and did one blood test after another. I finally received a diagnosis from an endocrinologist at a clinic for high-risk pregnancies in Tel Aviv.

Dr. Tal was small and bald. He sat beside a giant poster featuring the female reproductive system, and while he read through my test results on his computer, I stared at the poster. Pretty soon the diagram began to resemble the Longhorn, Bevo, the University of Texas mascot.  His head was a perfect uterus, and those long and angled horns fallopian tubes anyone would be proud to sport. Gynecological Bevo led me right back to my Texas childhood. In my daydream my grandmother, Bashy, appeared, dressed in a bright pink beaded sweater. She said, “Eat, Snookie. Eat and you’ll feel better.” Food was her all-purpose cure. In reality, Dr. Tal was saying the exact opposite. He told me I had type 1 diabetes.

Formerly known as juvenile or insulin-dependent diabetes, type 1 is an autoimmune disorder that destroys beta cells, the insulin producing cells of the pancreas.  Beta cells release insulin into the bloodstream when sugar goes up, as it does after a meal. Insulin’s most important job is to carry nutrients, particularly sugar, from the blood and into the body’s cells.  The more sugar you eat, the more insulin your body needs to move it out of your bloodstream and into your cells.

Dr. Tal began to list foods I should no longer eat, which—of course—included not just anything with sugar, but most carbohydrates, including all of my favorites: pasta, pizza, pita, burekas, and cereal.  To make it even more depressing, it was Hanukkah season, so Dr. Tal said potato latkes , jelly doughnuts, and the traditional chocolate coins wrapped in gold foil were all out of the question too. I was somewhat horrified at the idea of Hanukkah without latkes , and I knew Bashy would have been horrified too. I also knew exactly what she’d have said had she been beside me: “Whoever heard of a doctor that tells you not to eat?”

A few days later in a Tel Aviv supermarket I was eye-to-eye with a long tray of fresh Hanukkah doughnuts sprinkled with powdered sugar. As I instinctively reached for them, Dr. Tal’s words ran through my mind. “Be afraid of sugar,” he’d said. My first thought was that it was impossible to view a doughnut as a threat, but then I realized this was not the first time in my life I’d needed to be afraid of a snack. I began to understand that my upbringing, my entire childhood, had prepared me for exactly this moment. I grew up keeping kosher in Texas. I’ve always known how to be afraid of food.

I came from a city where people ate pork chops, ham steaks, and sausages for breakfast, but from a family where the word pork was synonymous with danger. Bashy never specified what would happen to me if I ate something that wasn’t kosher, but I imagined all sorts of consequences, from vomiting to choking to being struck by the lightening bolt of God’s wrath. And in the supermarket where Bashy and I were regulars, I had to be especially careful. Non-kosher products were everywhere. Bashy knew I was interested in them. I’d trail behind her as slowly as I could and linger around the Twinkies, which I believed every kid (even every Jewish kid) except for me was allowed to eat. This was in the days before partially hydrogenated vegetable oil took over the universe, and all good junk food was made with animal fat. In my opinion, lard was by far the worst four letter word in the English language.

If I was lucky, Bashy would stop to talk to someone in the store, giving me a chance to fondle a box of Oreo cookies. I knew Bashy didn’t approve, but I took the risk.  She always caught me. When I eyed Hostess cupcakes or ran my fingers over a package of Kraft cheese and crackers, she’d shout “traif,” the Yiddish word for non-kosher food.  Humiliated and fearful, I’d follow her straight to the Empire kosher frozen chickens.

A few decades later, the guilt and fear I felt when I thought about buying the ‘dangerous’ Hanukkah doughnuts ran far deeper than any childhood mortification. There was a baby in my womb and I knew that if I did not control my blood sugar, I’d harm not only myself, but him too. Unlike the consequences of eating non-kosher, the consequences of diabetes are very clear cut.   And while memories of Bashy’s supermarket antics have always made me smiley and nostalgic, until last Hanukkah, I hadn’t understood that there was a life lesson in self control coded for me within them.  As a modern woman in the 21^st century, however, I hope I’ll be able to resist food with grace, and never feel the need to publicly disparage baked goods.  If I do, however, I won’t shout out traif .  I’ll take Dr. Tal’s advice, and quietly tell myself to be afraid of sugar.

Cross-posted on A Sweet Life

The Swiss -based pharmaceuticals and diagnostics company Roche Holding AG announced headline results from the second and third of eight T-emerge Phase III studies for taspoglutide.

Taspoglutide is the first once-weekly human glucagon-like peptide-1 (GLP-1) analogue being developed to address the important unmet needs of patients with type 2 diabetes. Taspoglutide is similar to the naturally occurring human hormone GLP-1 which plays a key role in blood glucose modulation while slowing down food absorption and suppressing appetite, resulting in glycemic control, weight loss and no incremental risk of hypoglycemia. Taspoglutide is currently in Phase III clinical trials.

The trials show that Roche’s weekly taspoglutide met its primary end-points in a head to head study with sitagliptin (Januvia®), and demonstrated superior HbA1c reduction.

Cross-posted on ASweetLife
]]> http://thefastertimes.com/diabetes/2009/12/04/phase-iii-trials-show-roche%e2%80%99s-type-2-drug-better-than-januvia/feed/ http://thefastertimes.com/diabetes/2009/11/30/should-i-screen-my-sons-for-diabetes/ http://thefastertimes.com/diabetes/2009/11/30/should-i-screen-my-sons-for-diabetes/#comments Mon, 30 Nov 2009 21:12:52 +0000 Jessica Apple http://thefastertimes.com/diabetes/?p=244 There’s a lot of guilt involved in parenting, and I tend to find myself feeling guilty even over small things, like telling my sons a white lie in order to do something beneficial for them.  Last night, for example, as I kissed six-year-old Guy goodnight, he said, “Come check me every five minutes all night.”  I didn’t know what he was afraid of at that moment, but I knew that he needed to sleep, and the best thing I could do was to reassure him that I’d check him all night long, and let him drift off into sleep feeling secure.  And so I said I would check him every five minutes (Guy did say that if I was feeding Baby Adam, then I was allowed to be late).

As you can probably guess, I didn’t check Guy every five minutes all night long, though I may as well have checked him since I thought of him all night while I fed Adam (the baby who likes to do his sleeping in the morning).  What I was thinking about last night wasn’t  about checking Guy every five minutes to make sure he wasn’t falling out of bed, but about checking him (and his brothers) for diabetes.

A few days ago my husband Mike and I had the privilege of having tea with the world-renowned pediatric endocrinologist, Dr. Francine Kaufman.  One of the first things Dr. Kaufman asked us was if we’d tested any of our three sons.  No, we have not.  According to TrialNet, “relatives of people with type 1 diabetes have a 10 to 15 times greater risk for developing the disease than people with no family history.”  I don’t know if there are statistics on having two parents with type 1, but my guess is it’s safe to assume our kids are in a fairly high risk group.  And let me be fully upfront with you here: I have thought about this issue many times, but since thinking about my sons getting diabetes sickens me, I tend to not get very far with the thoughts.  I’ve read about various studies being done, I’ve emailed some questions to researchers, and that’s about it.

Now here is where the aforementioned guilt jumps in: Dr. Kaufman said our sons should be should be screened for the autoantibodies associated with type 1 diabetes. (Autoantibodies are proteins made by the immune system.  Their presence is a sign that the immune system may be attacking the insulin- producing beta cells in the pancreas.  But, here’s the catch: testing negative for autoantibodies doesn’t mean you will never get diabetes, though it does mean that your chances for developing type 1 diabetes are lower than if you had autoantibodies.   And testing positive doesn’t mean that you will get type 1 diabetes. It just means that you have a greater chance of developing diabetes than if you tested negative).  So nothing 100% conclusive comes out of the screening.  A world expert, however, confirmed something I already knew- I should test my sons.   I could list reasons why it was okay not to, but ultimately it would be nothing but fear getting the better of me, as it often does.  So…

If my sons were to test negative for antibodies, it wouldn’t mean they would never get diabetes.  And if they were to test positive for autoantibodies, I would then have to weigh the benefits and risks of entering them in trial studies - i.e. guinea pigging them- since there isn’t any proven way to prevent type 1 diabetes in man.  And by not entering them in a study, I might be keeping them from something beneficial.  I also do believe that in order to find a cure, people have to participate in studies, so in that sense I feel an obligation to do it.

There is one point that strongly sways me in the direction of testing them, and it comes from this study published in Diabetes Care.  The study, which screened relatives of patients with type 1 diabetes for islet cell autoantibodies,  concludes that he majority of subjects diagnosed with type 1 diabetes through the DPT-1 [Diabetes Prevention Trial-Type 1] “were asymptomatic at onset and had normal fasting glucose and A1C levels. This suggests that intermittent screening (IA followed by OGTT) may allow diagnosis of diabetes before severe metabolic decompensation.”  In other words, diabetes could be identified and controlled before it had a chance to make my child sick.

I’m definitely not going to check my sons for diabetes every five minutes, but finding the courage to screen them now, and perhaps with yearly follow-ups, seems like the right thing to do.  Unfortunately, the idea of taking them for a blood test makes me feel guilty, as does the fact that I might terrify them by making them think they could get diabetes.  And then there’s the guilt involved with passing on lousy genes….

If you’d like information about screening for yourself or a family member, visit the TrialNet website.

cross-posted on A Sweet Life

The International Diabetes Federation’s 20th World Diabetes Congress, currently meeting in Montreal, released new data that shows 285 million people worldwide have diabetes, with residents of low-and middle-income countries bearing the brunt of the epidemic. Diabetes claims the lives of four million people a year, and is a leading cause of blindness, renal failure, heart attack, and amputation.

IDF Diabetes Atlas, 4th edition, © International Diabetes Federation, 2009.

According to the IDF, “Diabetes now affects seven percent of the world’s adult population. The regions with the highest comparative prevalence rates are North America, where 10.2 % of the adult population have diabetes, followed by the Middle East and North Africa Region with 9.3%. The regions with the highest number of people living with diabetes are Western Pacific, where some 77 million people have diabetes and South East Asia with 59 million. India is the country with the most people with diabetes, with a current figure of 50.8 million, followed by China with 43.2 million. Behind them the United States (26.8 million); the Russian Federation (9.6 million); Brazil (7.6 million); Germany (7.5 million); Pakistan (7.1 million); Japan (7.1 million); Indonesia (7 million) and Mexico (6.8 million).”  See here for more statistics.

The economic burden of diabetes is tremendous, and the IDF predicts that in 2010 it will cost the world economy $376 billion dollars.   With annual spending of $198 billion, the United States accounts for 52.7% of total diabetes spending worldwide.  India, which has the largest diabetes population, spends $2.8 billion or 1% of the total global expenditure.

Professor Nigel Unwin, who leads the team of experts behind the IDF Diabetes Atlas, said that without effective prevention, diabetes will overwhelm health systems and hinder economic growth.  And IDF President Mbanya said, “The epidemic represents nothing short of a global health emergency.”

IDF Diabetes Atlas, 4th edition, © International Diabetes Federation, 2009.

cross-posted on  ASweetLife

I know faith is a powerful thing, but as a parent, and as someone who has seen up close how devastating the symptoms of untreated diabetes are, I can’t begin to understand how Dale and Leilani Neumann avoided seeking medical assistance for their child.  Nor can I understand the lenient sentence handed to them this week by Judge Vincent Howard.  The truth is, the entire story disturbs me so deeply I find it difficult to write about, but Catherine Price wrote a piece that says the same thing I would.

cross-posted on A Sweet Life

Below are highlights from the Government Accountability Office’s September 2008 report:

• The FDA does not have reliable data on the number of labels reviewed; the number of inspections, which include label reviews, has declined. For example, of the tens of thousands of foreign food firms in over 150 countries, just 96 were inspected by the FDA in 11 countries in fiscal year 2007—down from 211 inspections in 26 countries in 2001.

• The FDA’s testing for the accuracy of nutrition information on labels in 2000 through 2006 was limited. The FDA could not provide data for 2007.

• Although the number of food firms in the FDA’s jurisdiction has increased, the number of warning letters the FDA issued to firms that cited food labeling violations has held fairly steady.

• The FDA does not track the complete and timely correction of labeling violations or analyze these and other labeling oversight data in routine reports to inform managers’ decisions, or ensure the complete and timely posting of information on its Web site to inform the public.

The bottom line: If you don’t know what that long unreadable ingredient, E-polypapasmurfmonoglyceride #6242, listed on your sandwich bread label is, or how many grams of carbs it has, you shouldn’t feel uninformed and stupid; the FDA doesn’t know either. The best thing you can do is eat natural food whenever possible. An apple, a handful of raw almonds and a glass of filtered water might not be as much fun as an orange drink manufactured in China (that contains a whole 10% real fruit and 90% E-polypapasmurfmonogylceride #6424), but at least you can identify and account for what you’re putting in your mouth.

cross-posted on A Sweet Life