May 3, 2014

Helping Others

This last weekend, on April 26, I was shopping for a few groceries and I met a person I knew had type 2 diabetes. I knew this person was older than I am and was not prepared to his first question. He asked what my A1c on the latest VA report happened to be. I told him and since I knew he had been to the VA and had an appointment ahead of me, I was aware that his had not been good as I could hear him sputtering to his doctor as he was leaving his appointment.

He admitted his had been over 10.0%, but would not give me the actual result. He then stated that his doctor had wanted to put him on insulin, but he said he had refused. I asked if he had neuropathy and he said it was just starting. I asked if he was having vision problems and he finally admitted that he had not been to an eye doctor in several years.

He said that the doctor had prescribed two additional medications to take and that he would be starting a sulfonylurea and Januvia when his prescriptions arrived in the mail. These would be in addition to the metformin which would be reduced from the maximum to 1000 mg – 500 mg two times per day. He did not know the dosage of the other two medications and would know when he received the medications.

Then I started asking him questions about the number of carbs he was eating per meal and he said about what the registered dietitian had ordered him to eat. He said his wife was knowledgeable there and he relied on her for this. At that point, I became difficult and asked him if he even had an eye doctor. He admitted he did not. I asked him if later in the week a couple of us in our support group could stop by in the evening and talk to him and his wife.

When he was hesitant, I asked if Thursday would work. He continued not answering and I asked if he would give me his phone number so that I could talk with his wife and set up a time that would work for them. He finally gave me his phone number and said he would not be home until after 6:00 PM. I said I would call about 7:00 then and we parted company.

As soon as I arrive home, I called Allen and relayed the information to him. Allen asked if we were becoming advisors to too many people. Allen said he was also working with Barry to help another person. When I gave Allen the name, he said this was the person Barry had asked for help with, and I said I would back off then, as he did not need so many working with him. Allen did say his wife was the registered dietitian and was creating the carbohydrate problem.

I then told Allen to keep me out of the discussion and I would tell him that he was already working with two of our members. Allen said okay, and that Barry was a good friend of the person and had good relations with the family. Allen continued that Barry was the person who was working with his wife to bring down the amount of carbs and was better at this than even he was. Allen did say that Barry knew what his A1c had been and that it was not good. His last two had been very high so he was not surprised that the VA had added more medications.

I asked Allen to check on the number of test strips they were allowing now that he was on a sulfonylurea. Allen said he would and he hoped it would be more as they were not allowing sufficient on metformin. I said with both being retired they probably could not afford extra test strips. Allen said he would discuss this with Barry and see what needed to be done. I said I would send him and Barry a URL for a blog that might become helpful. With that, we ended our conversation.

May 2, 2014

Sodium, What Some People Want It to Represent

I have to wonder what is happening that the anti-sodium people are pushing hard to promote what sodium looks like. I have been approached to do a different sort of blog, but in all fairness, I cannot promote what I have found.  It is important to note that the examples used on the website, except the fast food items, were from the USDA database. This means that the errors can be as high as 20 percent. I will use three examples from the link provided me, but the range is not accurate and no rounding ranges are given.

I feel that the intentions were good, but I am concerned about the accuracy. Example for three chicken breasts. The claim is that three chicken breasts equals 1200 milligrams of sodium.

What upsets me about the website is except for the fast food items, nothing is spelled out about the items they are using for examples. The first item below only states chicken breast and three pieces. Are they talking about three full chicken breasts or are they using three pieces – meaning one full chicken breast and half of another.
Chicken Breast:
3 pieces=1200mg sodium

So let's take three full chicken breasts that are fresh. In checking with my local grocery stores, both divided a chicken breast into two, four-ounce pieces. Both said that as fresh, a four-ounce piece had 40 mg of sodium. For three full chicken breasts, this would mean six of the four-ounce pieces or a total of 240 mg of sodium. If they are counting only 3 four-ounce pieces, then there would be a total of 120 mg of sodium. Both ways, their calculations are far short of the 1200 mg of sodium used in the example.

If the chicken breasts are from the frozen food section, then it is another ball game. There the pieces are not full chicken breasts and are injected with a solution before freezing and each four-ounce piece contains 250 mg of sodium. Six pieces or three full chicken breasts would have 1500 mg of sodium. Three pieces would have 750 mg of sodium.

Both grocery store representatives stated that the amount injected could vary by the Company which provided the frozen pieces. It is obvious from the information that I have been able to obtain, that there is potentially large errors in this example. By not using more detail in this example they have given cause for concern about how they measure and talk about food.

Soy Sauce:
1 1/3 tbs=1200mg sodium

In this example, I used two different brands of soy sauce that I have in my own food stock. As such, with the two examples I have, variances exist because one brand is advertised as less sodium. Both use tablespoon (tbsp) as a serving. The less sodium is Kikkoman and contains 575 mg per serving. This would mean that two tbsp would be 1150 mg of sodium and not the 1 1/3 tbsp from the example.

The second brand is La Choy and one tbsp is 920 mg of sodium. One and one-third tbsp would equal 1227 mg of sodium. I can forgive the rounding error, but not the fact that we need to know what soy sauce was used in their calculations.

The difference between the two brands is significant and points out how mistakes are made in tracking sodium use by individuals unless they read the labels and accurately measure the amount of soy sauce used in a recipe.

A little more information when I went to the store. Kikkoman regular was 920 mg of sodium, La Choy lite was 550 mg of sodium, and a store brand was 840 mg of sodium. All were for one tablespoon of soy sauce.
McDonald's Cheeseburger:
1 3/5 burger=1200mg sodium

For the last example I will use a fast food item available locally and around the world. Yes, I am using a food choice at McDonalds. According the nutrition fact sheet, a PDF file, one cheeseburger has 680 mg of sodium. Using the example of one and three-fifths, the sodium is 1088 mg of sodium. Even this is short of 1200 mg of sodium. This has to be another rounding error and it is more significant than the soy sauce above, but still within the 20 percent error factor.

I could go on with other examples, but this could be an extremely long blog. My advice before using the page in the above link as an example of tracking your sodium intake would be to use more common sense and investigate the serving size and reading the food labels. Also, do not forget to look at the items you purchase for the variances that exist on the grocery store shelves.

In addition, have a good discussion with your doctor about the amount of sodium you need. Both the FDA and American Heart Association have guidelines available, but these guidelines are for healthy people and not all people.

May 1, 2014

Junk Science Is Big Business

Junk science and studies are big business and the number of fabricated studies is growing by the day. What drives this big business? Money supplied by Big Pharma, Food, and Ag. What makes it so easy to fund these phony studies and obtain the ridiculous results? Money supplied by – you guessed it – Big Pharma, Big Food, and Big Agriculture. Then add to this Big Chemical.

Today it seems the mainstream media is always screaming about the latest study “proving” that supplements are bad and drugs are good. However, the “research” behind these headlines has been funded, manipulated, and packaged by Big Pharma.

Some to the techniques behind this include publication bias, “seeding” trials, ghostwritten studies, “perfect” patients, deceptively low doses, questionable methodologies, cherry-picking conclusions, skewed meta-analyses, tiny sample sizes, overly brief study periods, parroting press releases, reliance on Big Pharma’s advertising dollars, and hidden funders.

There are other methods used, but all are driven by money and how easy it is to hide conflicts of interest. All “researchers” are subject to this and don't argue that some are exempt. Even universities are part of this and have highly concealed conflicts of interest.

Many studies using participants strive for the “perfect” participant (or patient) who will provide the desired result. This is the reason that many participants are rejected. Think of the studies to undermine self-monitoring blood glucose (SMBG) where people that knew the value of blood glucose testing are eliminated from studies. Little or no education is given to the participants to prevent them from learning how to evaluate the testing and improve their lives by testing with a purpose. In addition, once the study is over, they receive no additional testing supplies or test strips.

Cherry-picking conclusions, skewed meta-analyses, tiny sample sizes, and overly brief study periods are often used together, but don't be surprised if only two of the four are used. Skewed meta-analyses and cherry-picking conclusions are often used together when there are many studies available. This allows the researchers to look for studies that arrive at the conclusions they want to promote.

Tiny sample sizes and overly brief study periods are popular when they know that longer study periods will yield results that don't fit what they are looking for reporting. They reduce the number of participants to have people that will also fit what they are attempting. What they are trying to prevent is having unexplainable outliers that would easily negate the study results.

If it had not been for Gretchen Becker and Jenny Ruhl, I would have continued learning only from the College of Hard Knocks and I urge you to read my blog and the links. When you have completed that, then you may have interest in this article of how Big Pharma and the Media sell junk science. Some of the headlines at the bottom of the article have crossed my computer screen and I have much the same reaction and moved on looking for reliable research.

This also helps explain why I get snarky with some of my blogs when I realize they are fake science. Reliable research is becoming scarce and harder to find. I enjoy reading a blog by Dr. Malcolm Kendrick as he does a lot of research on the topic of fake studies and he likes to report on misconduct by researchers and Big Pharma. He also writes about conflicts of interest.

April 30, 2014

Many Questions on Testing

In the last three weeks I have received over five emails asking why I am not writing about testing more often and one was rather insisting that I write more. First I will refer readers to several blogs that I have written in January 7 to 10, 2013. This is the link to the first one.

First, I would advise everyone to properly wash his or her hands with soap and warm water and dry thoroughly. The temperature of the water will vary with the season and in general you will want to use the hottest water during the winter months to help increase blood circulation. It is not desirable to use alcohol to clean the area to be tested as fruit juice will not be removed by alcohol and the person testing will have a higher reading in that case. Alcohol also dries the skin and unless you use a moisturizing hand lotion, your fingers will crack and not heal quickly causing more pain for testing.

The above demonstrates the correct place on either side of the finger to prick with the lancet device. There are less nerves in this area making this less painful by a lot. Be sure to rotate on either side of each finger and then move to another finger. Do not test in the same place or on the same side of the finger more than once until you have rotated to all the fingers and thumbs. 

The above picture shows the incorrect area to prick your finger as generally on most people there a more nerves in this area making for more pain. Remember these two images as many people just write “finger tips” meaning the bottom of the two above images.

This does mean that you cannot experiment on yourself and some people are able to test on more of the area from the first joint to the finger tip. Many people find that their nerves will not allow this much latitude in testing area. 

The above image and the image below is the lancing device that I use. Most meters allow you to select the lancing device you desire, but many also come with their own lancing device. Most allow for adjusting the depth that the lancing device penetrates. It is normally suggested that you start with the lightest setting and increase the setting until you receive sufficient blood for the test strip.

In the image above, please notice the white lancet. The round tip on the left side needs to be removed after the lancet has been inserted in the lancing device by twisting it off. Most lancets are very similar in size and operation.