We Did Have a June Meeting

Very few wanted a meeting on the fourth, but we agreed to a meeting on 10 June. No one was absent which we hoped for and we were fortunate to have a special visitor. This was our honorary type 1 member.

Allison was happy to see her and asked how she was doing with her meal plan? Ellie said that she was happy with her meal plan and would be living off campus next year so she could cook her own meals. This would allow her to avoid some of the problem people she was having disagreements with on her meal plan. She said she had discovered two other students that were following the same type of meal plan and would be living with them. Ellie continued that one is another type 1 and the second is MODY, but at this time, she hadn't stated the specifics.

Ellie asked if everyone could have a late July meeting that wanted to attend as both would be here and she would like the two to meet those that helped her. She said she knew Suzanne would not be available, but asked Allison if she could be. Allison said she would attempt to be present if it was on a Saturday as otherwise she would also be unavailable.

Tim brought up a calendar and read off the last two Saturdays of 23 and 30 July. Allison said she had 23 July available and Ellie said she could schedule that Saturday to have both here. Tim asked how many would like to attend and a show of hands was only 21 people. Ellie said that the people attending were the people she hoped would come and Tim made a list of those and said they would be reminded closer to the date.

Allen then asked Ellie how she was doing in her classes and Ellie said she would show him later. Max spoke and said we would like to know now and not wait until later. With that she handed me her semester grades and I asked Allen what he thought they might be. When he could not guess, I stated that we could only wish we were that smart, as there was nothing but A's. This brought a round of applause and Ellie seemed embarrassed. I said she should be happy that she could accomplish this as many of us would or did have a difficult time getting this close.

Tim took over the meeting and asked if anyone had recently had a meeting with a diabetes educator that was only about nutrition. Three hands went up and all three said they had contacted their insurance companies and explained what had happened. Tim asked if anyone else had this happen to him or her. One more had went up, and she explained that she had forgot to call her insurance. Tim asked when and she said the previous day. Tim asked if she had the number and she said she did and Tim told her to step outside and make the call immediately.

While she was out, Tim said we do this because they are trying to prevent you from seeing Allison or Suzanne and if they can get a billing through, then they will have prevented this. Alice raised her hand and then asked Tim if this applied to Beverly and diabetes education. Tim asked if Beverly had been present when the three or four of them had driven to Waterloo. Alice said yes, and Tim said then you are okay as Beverly is still in the learning mode and as long as she was present, there was no problem. The only problems we have is when CDEs switch to teaching only nutrition to use the hours Allison and Suzanne are entitled to bill for if you use them.

Beverly is still in training and she is providing names of CDEs for us to use that will stick to diabetes education. Once she has completed her training and is a CDE, then we will ask that you use her. With her husband having type 2 diabetes and her being a registered nurse, we know that the education will be what we need.

At that point, Julie came back and said the insurance thanked her and the CDE would not be paid for switching to nutrition. Tim announced to everyone that he had a list of approved CDEs to use until Beverly had her CDE license. He said I know that most are in the Waterloo area and travel is involved, but most have agreed to see two or three at one time. There were more questions for another half hour, but by then the room was clean and we were ready to leave.

Science, or the Lack of Science

Many of the dietary guidelines of the past 35 to 40 years have not been based on science, but the persuasive arguments of a few individuals. The American Heart Association has bought into these ideologies hook, line, and sinker and will not be persuaded otherwise.

Fat doesn't make you fat, but don't say this to a cardiologist if you want to keep this doctor. Butter is good for you, as well as cream. Many still consider skimmed milk what you should drink, but it is not a healthy food, but a way of making ourselves miserable which has taken over the world on the basis of an illusion.

The British National Obesity Forum has made a renewed attack on these mistaken attitudes. In the USA, the Academy of Nutrition and Dietetics puts forth similar information and promotes Coke products as being healthy for us.

Sugar, not fat, is the menace to our lives. And this has been known since 1972 when a brave scientist, John Yudkin, wrote a book – Pure, White And Deadly – showing it was so. He and his unfashionable message were buried in abuse. It may be that some in the sugar industry might have been involved. These days he would have been called a ‘fat-threat denier’, or something of the kind. He died in 1995, too soon to see his ideas rescued and taken seriously again.

Even today, people are becoming fat and dying of horrible diseases because the anti-fat pro-sugar lobby still hasn't been stopped. It will be, but these things take time. I mention this not just because it’s true, but because it’s an example of how thoughtless worship of scientists gets us repeatedly into trouble. Doubters like me are told not to dare criticize the sacred men in white coats.

But scientists often disagree among themselves and are often wrong. In fact, science progresses by exploding dud theories of the past. And laymen are perfectly entitled to apply facts and logic to what these people say. The obvious argument against the skimmed-milk fanatics is that decades of this policy have left us with more fat people than ever. But we should not have had to wait so long.

There is powerful evidence against many other things now accepted as true, and often very weak evidence for them. I’d name ‘antidepressant’ pills, ‘dyslexia’, ‘ADHD’ and ‘man-made climate change’.

Those who criticize these things are angrily hushed, with righteous cries of ‘How dare you!’, and if they won’t shut up, they are punished – as was John Yudkin. Yet I believe in all these cases the critics will be proved right, as Professor Yudkin was. The miserable thing is that so much damage will be done while we wait for the truth to get the upper hand.

Be less trusting of all fashionable ideas, is my advice. Gullibility and conformity never advanced civilization by a single step.

Malnutrition Affects Many Older People

Many people figure they are immune to malnutrition. What they are not aware of is that malnutrition can affect anyone. A group that is especially at risk is older Americans. As many as one in two older adults are at risk for malnutrition.

The nonprofit Alliance for Aging Research has launched a campaign to spotlight this hidden epidemic through an animated "pocket film" about malnutrition in older adults. The film, titled "Malnutrition: A Hidden Epidemic in Older Adults," shows how this condition, often without obvious symptoms, can jeopardize the health and independence of older adults. It also informs viewers about how to prevent malnutrition, how to spot the signs of the condition, and steps to take to regain their nutritional health.

Malnutrition does not just happen to seniors who suffer from hunger, or who do not have access to healthy food. Older adults are more likely to have chronic conditions that put them at risk for malnutrition. Cancer, diabetes, Alzheimer's disease, and other conditions can impact appetite, make eating difficult, change metabolism, and require dietary restrictions. Alarmingly, the increased economic burden in the U.S. for disease-associated malnutrition in older adults is estimated at $51.3 billion each year.

Older adults are also hospitalized more frequently and are more likely to be in long-term care facilities, both factors that put them at heightened risk of malnutrition. As many as 65 percent of hospitalized older adults could face malnutrition. The percentage of older adults in long-term care facilities is not mentioned, but having been in many I believe more than 65 percent could face malnutrition.

Alliance Vice President of Health Programs Lindsay Clarke says, "We do not often think about malnutrition as a problem in the U.S., which contributes to the fact that this serious issue is frequently overlooked in older adults. Without proper nutrition, our bodies cannot stay healthy or fight off disease. Malnutrition can cause compromised immune systems, frailty and sarcopenia (a condition of age-related loss of muscle mass and strength), loss of independence, and further complicate treatment for other diseases. Our new pocket film is a much-needed educational resource about both the seriousness of the disease and how it can be prevented and treated. For health care professionals, this film can serve as a valuable teaching tool to share with patients and their family caregivers."

Some of the areas the film covers include:

• Who is at risk for malnutrition
• The debilitating impact of malnutrition on older adults
• Tips for identifying malnutrition
• How malnutrition can be treated and prevented

Malnutrition is not something to take lightly. Many things can contribute to malnutrition and many parts of malnutrition are overlooked. Doctors just suggest adding certain foods to their patient when they have not looked at the medications being used by the patient.

The easiest example is the many people that are vitamin B12 deficient, because of the prescribed antacids being taken that prevent the acids in the stomach from absorbing the vitamin B12 in the foods they are eating.

Have Diabetes; Do You Eat to Your Meter?

Many people do not eat to their meter. Why won't they at least do something to make it easier to manage their diabetes? Here are some of the excuses I hear:

1. The doctor doesn't want me to test.
2. The cost is too high.
3. I forget to test too often.
4. I am not that interested.

My feeling on this is you are not concerned about your health and are not taking your diabetes seriously. That being said, I have met a couple of people that could not find the money for testing and for that matter even their medications. Both did afford shelter and most of the food they needed. They lived on very limited income, did their own cooking, and stretch their money very well. Several of us did write some testing supply companies and the companies for their medications.

The doctor for one of the individuals would not support the request for testing supplies and this prevented her from obtaining them. It took convincing her to change doctors that finally got her the testing supplies. The doctor was highly put out and told her that the ADA advised using the A1c only and she did not need to test. He even continued trying to block her obtaining testing supplies until someone asked her if she had been in the military to which she answered yes. Once we had her apply for benefits and they looked at her income, she will received all her medications and testing supplies for no copay.

We talked to the other individual and he said his doctor had asked him the same question and when he said yes, he had been sent to the local VA office and was also receiving his medications and testing supplies for no copay.

Both are testing more frequently and are trying to eat to their meter now and like both have reassured us, they are bringing their A1cs down into the 5's and one hopes to be in the 4's by the next A1c. Both are happier and thanking those of us that helped them.

I would urge anyone to read this by Kelley Pounds on “eating to your meter.” It is more complete than many other sources.

The best selection from her blog is this - “If you have diabetes, you may also be familiar with the ADA (American Diabetes Association) targets of less than130 mg/dl pre-meal and less than 180 mg/dl post-meal. PLEASE DISREGARD THESE TARGETS. These targets WILL NOT protect you from serious diabetes complications. Just because these are considered “average” or “normal” diabetic blood glucose levels, it is also “normal” for many with diabetes to develop heart and kidney disease, strokes and undergo amputations. These are considered just part of the “normal” progression of diabetes by organizations like the ADA. PLEASE, disregard these targets!

So let’s review:

Normal BG: Pre-Meal – less than 85 mg/dl, Post-Meal – less than110 mg/dl BEST

AACE Targets: Pre-Meal – less than 110 mg/dl, Post-Meal – less than140 mg/dl ACCEPTABLE*

ADA Targets: Pre-Meal – less than 130 mg/dl, Post-Meal – less than 180 mg/dl UNACCEPTABLE

*Acceptable - as a starting point for those with advanced diabetes. This should be the maximum acceptable blood glucose level for those with diabetes.

So, if you look more closely at these targets, notice that this leaves you NO MORE than about a 25 point spike in blood glucose to maintain normal blood glucose and NO MORE than about a 30 point spike in blood glucose to maintain “diabetic normal” blood glucose. We will discuss the ADA targets NO MORE.”

Bariatric Surgery Now Recommended For Many Type 2's

Do we need these guidelines giving surgeons the right to do surgery when the patients don't want it?  You will have to think fast to avoid this surgery.  These surgeons must be so desperate for money they are trying anything to bring in the dollars.

The new clinical guidelines were published May 24, 2016. The sad part is that they are endorsed by leading international diabetes organizations, including the International Diabetes Federation (IDF). The guidelines call for bariatric surgery, involving the manipulation of the stomach or intestine and this is to be considered a standard treatment for type 2 diabetes.

The guidelines, published in Diabetes Care, recommend surgery to induce weight-loss for certain categories of people living with type 2 diabetes, which accounts for the majority of the estimated 415 million cases of diabetes worldwide. The recommendation is based on evidence from multiple clinical trials that bariatric surgery can improve blood glucose levels more effectively than lifestyle or pharmaceutical interventions in obese people with type 2 diabetes.

What few of the studies addressed are the nutritional problems caused by bariatric surgery. Another missed topic is the percent of bariatric surgeries that are undone by patients overeating and stretching the stomach. These are two of the serious problems created by bariatric surgery, which are seldom addressed until too late. This often causes serious health problems for the surgery patient as I talked about in this blog on vitamin D deficiency.

While being overweight and obesity are major risk factors for type 2 diabetes, many of these people don't develop type 2 diabetes and I fear that many will be bullied into surgery with the nutritional problems becoming worse for people under going bariatric surgery.

At least the authors admit there are risks of complications and long-term nutritional deficiencies that require rigorous long-term follow-up by expert teams. The IDF estimated that in 2015 over $670 billion was spent globally to treat diabetes and prevent complications. Despite this, less than 50% of people with type 2 diabetes currently achieve the appropriate blood glucose levels to avoid or reduce the risk of long-term complications.

The new guidelines, which emerged from the Second Diabetes Surgery Summit (DSS-II) held in London in September 2015 as a collaboration between IDF, Diabetes UK, American Diabetes Association, Chinese Diabetes Society and Diabetes India, recommend bariatric surgery for people with type 2 diabetes who have a BMI of 40 and those with a BMI of 30 who are not able to adequately control their blood glucose levels through other means. This threshold is lower for people of Asian descent.

This is the first time that guidelines recommend surgery as a specific treatment option for type 2 diabetes.  Also read this article which they label as metabolic surgery.  This is becoming the hot topic in most medical sources and WebMD has an article about weight loss surgery for people with type 2 diabetes.

Polypharmacy, the Unbelievable Pile of Pills!

With the baby boom generation now on social security, polypharmacy is becoming rampant. Those of us with diabetes already have problems with polypharmacy. Moreover, I am not limiting this to prescription drugs. Herbal medications and over-the-counter drugs also count. Yet, many people ignore herbal drugs, vitamins, and minerals because they are supposedly natural.

Geriatricians and researchers have warned for years about the potential hazards of polypharmacy, usually defined as taking five or more drugs concurrently. Yet, it continues to rise in all age groups, reaching disturbingly high levels among older adults.

Doctors spend an awful lot of money and effort trying to figure out when to start medications, and shockingly little on when to stop. Most keep adding medications and never stop.

The average senior is now taking more medicines than ever before. Many are for complex conditions or diseases, and others are for what they think will help them remain healthier.

Tracking prescription drug use from 1999 to 2012 through a large national survey, Harvard researchers reported in November that 39 percent of those over age 65 now use five or more medications — a 70 percent increase in polypharmacy over 12 years.

Many factors probably contributed, including the introduction of Medicare Part D drug coverage in 2006 and treatment guidelines that (controversially) call for greater use of statins.

Nevertheless, older people don’t take just prescription drugs. An article published in JAMA Internal Medicine, using a longitudinal national survey of people 62 to 85, may have revealed the fuller picture.

More than a third were taking at least five prescription medications, and almost two-thirds were using dietary supplements, including herbs and vitamins. Nearly 40 percent took over-the-counter drugs.

Not all are imperiled by polypharmacy, of course. But, some of those products, even those that sound natural and are available at health food stores, interact with others and can cause dangerous side effects.

How often does that happen? The researchers, analyzing the drugs and supplements taken, calculated that more than 8 percent of older adults in 2005 and 2006 were at risk for a major drug interaction. Five years later, the proportion exceeded 15 percent.

All of this points out how dangerously the older generations are living and possibly causing their own death because they have concealed information from doctors or use too many doctors to hide what they are taking. Many also use several pharmacies.

While I am a senior, I would urge all my readers to read the full article about polypharmacy and if you have a parent still alive, you need to check out the drugs in their possession. If necessary make a list of the drugs being used and the frequency being used, the pharmacy used and then talking to at least one pharmacist using this list. Take action if anything is found that could be dangerous for the elderly parent.

Thoughts On Real Food

I must give all the credit for this to Jan at the Low Carb Diabetic. I really must promote the website for this and other low carb information they post. This is one reason I follow this daily posting site.

Thought for the day.