May 6, 2017

For Diabetes, Is Agave Syrup Best?

Are you always trying to find a great sweetener for your sweet tooth, but not one that will spike of your blood glucose? Stay with me as we discuss some of the heavily promoted substitutes for table sugar and other traditional sweeteners.

Agave syrup is one of the heavily promoted sweeteners. For those with a sweet tooth, the promise of a better sweetener might seem too good to be true.  Unfortunately, that's exactly what it is. Agave is not a good alternative sweetener for people with diabetes.

Agave syrup comes from a succulent plant that grows in warm climates. It has a lower GI index than most sweeteners. Although it can be used as a sweetener, blue agave is high in carbohydrates, and produces nectar that is high in a type of sugar called fructose.

Some people in the alternative health community have turned to agave as a potential alternative to table sugar and other sweeteners. Support for agave stems from it being a vegan sweetener as well as its glycemic index (GI).

The higher a food's GI, the more it increases levels of glucose in the blood. Agave boasts a lower GI than most other sweeteners, which means that it is less likely to cause blood sugar spikes.

GI, however, is not the only - or the best - way to assess whether a food is healthful for people with diabetes. A 2014 study suggests that low-GI foods may not improve how the body responds to insulin.

For people already eating a healthful diet, the study also found that low-GI foods produced no improvements in cardiovascular health risk factors, such as levels of fats called triglycerides in the blood.

Agave contains higher levels of fructose than table sugar and most other sweeteners. The body releases less insulin in response to fructose. This means that blood sugar may remain higher after eating agave than other sugars.

A 2014 study of mice suggests that agave syrup might be a healthful alternative to table sugar. Mice who consumed agave nectar had lower blood glucose levels compared with mice that consumed table sugar. They also gained less weight.

However, not all research conducted on mice applies to humans. The study also only compared agave to table sugar, which is already known to be harmful to people with diabetes. Agave may be marginally better than table sugar, but this does not make it healthful. More importantly, agave is still a sugar and, like table sugar, high-fructose corn syrup, and the other sugars, people with diabetes should avoid it.

People following a healthful diabetic diet should reduce the use of sugar rather than switch one type of sugar for another. For people with diabetes who are tempted to try agave instead of table sugar, there is another reason to avoid the switch. Agave is a higher calorie sweetener than table sugar. It contains 21 calories per teaspoon, compared with 16 calories per teaspoon.

In addition to its high fructose content, agave poses other risks to people with diabetes. A number of studies have looked at high-fructose sweeteners. Fructose usually produces worse effects than another type of sugar called sucrose, which is found in table sugar. Fructose is broken down in the liver, so consuming too much can cause liver damage. People with diabetes already face a heightened risk of liver disease, making agave a high-risk sweetener.

In 2017, a study of mice linked fructose to liver damage, including fatty liver disease and liver cell death. The study also found a link between fructose consumption and inflammation, which is linked to a wide range of illnesses.
Another 2017 study also linked fructose consumption to fatty liver disease. The study emphasizes that fatty liver disease that is not linked to alcohol consumption has increased over the past decade.

A 2005 study linked fructose to insulin resistance. Researchers also found that high fructose consumption could trigger dyslipidemia, a syndrome marked by high cholesterol and triglycerides. This suggests that eating agave syrup, as well as high-fructose corn syrup and other fructose-based sweeteners, could lead to heart disease. A 2015 study cautions that fructose is linked to high blood pressure, insulin resistance, and other cardiovascular risk factors.

People with diabetes should work to avoid all added sweeteners, as well as sugar-rich processed foods. Lifestyle and dietary changes are effective ways to fight diabetes. Even though giving up sugar may be hard, it offers many health benefits.

While maple syrup is a great natural sweetener, it still contains sugar and should be used in small doses. Those who are seeking a sweet treat should choose their sweeteners carefully. Since artificial sweeteners contain no, or few, calories, doctors once thought that they might be a safe alternative to traditional sugar. New research undermines this recommendation.

A 2015 study found that artificial sweeteners alter the bacteria that live in the gut, which could trigger insulin resistance.

While honey and maple syrup may be safer alternatives for people with diabetes, both are still sugar in the body.

A 2009 study linked 8 weeks of honey consumption to a reduction in weight and blood fat levels. However, blood sugar levels increased, suggesting that honey should only be used sparingly and certainly not as a remedy for diabetes.

Maple syrup has antioxidant and anti-inflammatory properties, which could make the effects of other sweeteners less harmful. Used in small doses, this may make it a good alternative to traditional sweeteners.

Whole fruit is the ideal way to sweeten foods since the sugars are packaged along with fiber, antioxidants, and other nutrients that can benefit health. Try fresh or dried berries mixed into oatmeal, unsweetened applesauce in plain Greek yogurt, or frozen bananas blended with cocoa powder to replace ice cream.

May 5, 2017

David Mendosa

I am happy that Gretchen Becker at Wildly Fluctuating was able to put her thoughts together and write her blog. It is well written and describes David very well. For those that are not aware, David has incurable cancer, angioscarcoma in the liver. He has recently been moved to respite care at a place with 24-hour care but may be able to return to his apartment if he can gain back some strength.

For those that want to read her blog, please do so.

For me, David was a mentor, and did his best to teach me how to find information and make use of this information. I do my best, but at times not to David's standards. He seldom made comments when I did something poorly, but always praised me when I did things correctly.

We often blogged about the same topic and did it from different points of view. We also corresponded when we found something related to a blog by the other we wanted to expand on what had been written. We often corresponded about blogs each other had written and I really appreciated this.

We also corresponded when I was diagnosed with prostate cancer and he wished me well. I am fortunate mine was treatable and the last PSA test came back at 0.8 in an official range of 0 to 6.0. I was wondering what my A1C was going to be because of all the comfort food I was eating while having radiation, but that too was a surprise. It is still higher than I wanted at 6.9 percent, but lower than it could have been.

I am going to miss him greatly when to finishes his journey as many have expressed in comments to the posts on the site he set up for his final journey. David has had a healing effect on many that read his blog and website, plus his blog articles on Health Central.

I think Gretchen's last paragraph is so important that I will quote it, as it is who David Mendosa is. “David has said that he hopes his legacy will be his promotion of low-carb diets for people with diabetes. Even at the end, he is thinking of the well-being of fellow patients with diabetes.”

May 4, 2017

Statins Don't Cut Heart Deaths Risk

When are doctors going to get the message? STATINS have done nothing to cut deaths from heart disease since being brought into widespread use more than a decade ago, a leading expert claims.

Professor Sherif Sultan, president of the International Society for Vascular Surgery, said millions of people should stop taking the heart drugs because side effects outweigh possible benefits. He told a conference in Brazil this month that the drugs should only be considered for patients who have had a heart attack and never for a child, woman or patient over 62 years old, as there was no evidence it could benefit them. He also said the medication did not reduce overall death rates in anyone.

His speech ‘Reality And Myth: A Tablet A Day Will Not Keep The Doctor Away’ analyzed studies on the cholesterol lowering drug and concluded the benefits were based on “statistical deception” and could not be relied upon because they were carried out by scientists employed by the drug companies.

Prof Sultan also highlighted studies showing a link with statins and increased risk of side effects including diabetes, cataracts, renal failure, liver failure, impotence, breast cancer, nerve damage, depression and muscle pains. He said: “People are taking this drug to prevent a problem and creating a disaster.”

Prof Sultan called on drug regulators to “rewrite” guidelines on the heart drugs prescribed to up to 12 million patients in the UK, or around one-in-four adults. He reignited the debate surrounding the drugs, the most widely prescribed treatment in the UK. The Queen’s former doctor of 21 years Sir Richard Thompson wants an inquiry.

Sir Richard, former president of the Royal College of Physicians, said: “Data needs to be urgently scrutinized. We are very worried about it and particularly side effect data which seems to have been swept under the carpet.”

However, proponents say hundreds of thousands are putting their lives at risk because they have stopped taking the treatment due to fears over their safety.

Mr. Sultan, professor of vascular surgery at the University of Ireland, questioned the link between high cholesterol and heart attacks, highlighting new data, which contradicted this. He also showed evidence from recent studies, which revealed statins accelerate hardening of the arteries, a key risk factor in heart attacks.

But Dr June Raine of the Medicines Healthcare Regulatory Agency said: “The benefits of statins are well established and are considered to outweigh the risk of side effects in the majority of patients.

“The efficacy and safety of statins has been studied in a number of large trials which show they can lower the level of cholesterol in the blood, reduce cardiovascular disease, and save lives. Trials have also shown that medically significant side effects are rare.”

This means that some experts are being paid, while others are doing research that is not funded by the statin manufacturers. Of all the articles I have read and blogs I have written, I can say that the statin side effects are real and not rare.

May 3, 2017

Intensifying Treatment of Diabetes

It is almost funny what both doctors and patients are doing to delay intensification of diabetes treatment. Both in the United Kingdom and in the United States, doctors are afraid to intensify diabetes treatment. Then patients are not doing what they should to manage their diabetes. With both patients and doctors not doing what they should, is it any wonder we are facing a diabetes epidemic?

Doctors are fearful their patients may have episodes of hypoglycemia and this keeps them from intensifying treatment. They also believe diabetes is progressive and many feel like - why waste money on these patients.

Patients by contrast, go to the doctor for more medications and expect the doctor to manage their diabetes. How naive patients can be? I have heard many of the excuses offered by patients and this tells me they are looking for that one pill that will allow them to return to their life, as they once knew it. A couple of these excuses are, “my blood sugar is out of control and nothing my doctor tells me will fix it” or “my doctor isn’t listening to me when I say my medication isn’t working.” Do these sound like the patient has taken ownership of their diabetes? Hardly, these excuses sound to me like they expect the doctor to manage their diabetes and it isn't happening and won't happen.

Doctors and patients both need to reconsider their positions and act accordingly. The doctors know from the A1c that the patients are not managing their diabetes. The patients are refusing to take ownership of their diabetes and expecting the doctor to manage it for them. I can only advise patients to take ownership of their diabetes and learn how to manage their diabetes.

Stop expecting miracles from the doctor. Your A1c tells them how you are managing your diabetes and gives them concern that more medications will not help. Start educating yourself about diabetes – start reading and acting, as you should by changing your lifestyle habits. See my blog here about the lifestyle changes that you can or should manage. Find someone that is managing their diabetes and ask for their help. No, I did not say do what they do, as this may not work for you. Learn how they manage their diabetes and try these ideas, but don't become tied to them as something may work better for you. Develop a food plan that works for you. If you are able to afford the extra tests strips, test more often and learn to trust your meter as it will show you what works and does not work in a food plan.

Remember, the diabetes is your diabetes and you must manage it. The doctor can offer suggestions, but you are the only person that can put the suggestions into practice.

Yes, better outcomes happen when doctors work with patients to intensify oral antidiabetic drugs (OADs). Many articles claim that type 2 diabetes is a progressive disease. The only time it is progressive is when the patients with their doctors', refuse to aggressively treat type 2 diabetes and let it get out of control. Treated aggressively, type 2 diabetes can be managed and prevented from becoming progressive.

May 2, 2017

Kellogg's Covers Up Health Crisis in Sugar

While I admit that I have not eaten Kellogg's cereals for over 50 years, this article about Kellogg was not a total surprise as they have been exposed before by sponsoring foods and having the Academy of Nutrition and Dietetics (AND) promote some of their foods as healthy.

While Kellogg's is the world's leading cereal manufacturer, it has spent millions on research to counter claims that its sugar-laden products are fueling the obesity crisis.

Kellogg’s has been attacked for putting more sugar in some breakfast cereals than is found in cakes, donuts and ice cream. A bowl of Crunchy Nut cereal can contain more than half the recommended maximum intake of added sugar for a six-year-old.

Now an investigation has established that Kellogg’s helped fund a report, published in a medical journal in December, attacking the British government’s recommendations to cut sugar intake. It also funded studies suggesting eating cereals may help children stay at a healthy weight.
Simon Capewell, a founder of Action on Sugar and professor in public health and policy at Britain’s Liverpool University, called on Kellogg’s to publish a list of the scientists and research organizations to which it pays fees and research grants. Coca-Cola published such a list in 2015 after a row over how its research funding influenced public health debate.

They are funding scientists and organizations to undermine the established evidence that eating too much sugar is harmful,” Professor Capewell said.

One of the food-research organizations funded by Kellogg’s is the International Life Sciences Institute. Last year it funded­ research in the journal Annals of Internal Medicine that said the advice to cut sugar by Public Health England and other bodies such as the World Health Organization could not be trusted.

The study, which claimed official guidance to cut sugar was based on “low-quality evidence”, stated it had been funded by an ILSI technical committee. Only by searching elsewhere for a list of committee members did it become clear that this comprised 15 food firms, including Kellogg’s, Coca-Cola and Tate & Lyle.

In 2013, Kellogg’s funded British research that concluded “regular consumption of breakfast cereals” might help children stay slimmer.
The study, published in the journal Obesity Facts, relied on evidence from 14 studies. Seven were funded by Kellogg’s and five were funded by the cereal company General Mills. Margaret Ashwell, a consultant to the food industry and one of the auth­ors of the study, said all interests had been correctly disclosed.

Terence Kealey, a former vice-chancellor at Buckingham University and author of Breakfast Is a Dangerous Meal, warned last month that the scientific community had “fooled itself” about the benefits of breakfast.

Kellogg has said it was committed to “slowly reducing sugar”. A spokesperson said: “As a low-calorie, grain-based food choice we believe cereals have a role to play in tackling obesity. We follow appropriate guidelines for transparency and disclosure.”

If only this were, correct!

May 1, 2017

Financial Barriers for Diabetes Patients

For unknown reasons the last few years, doctors seem only interested in how fast they can work you through the system. As long as they receive money and co-pay for your appointment, they are not interested in whether you, the patient, can afford the medications they prescribe, and many are not aware that some patients are having financial burdens.

The author of this article lists many of the financial barriers to care:
  • Often this is what doctors call “non-adherence” symptoms, meaning that patients may stretch out the use of their test strips or take medications inconsistently to save money.
  • Often, simply prescribing a less expensive medication may overcome some barriers.
  • Other barriers can include:
    • 1. Testing frequency
    • 2. Transportation availability
    • 3. Medical supply costs
    • 4. Copay costs
    • 5. Housing and utility bills
    • 6. Stress
    • 7. Depression
    • 8. Missed work days
Supposedly, doctors are trained to ask questions, but many doctors assume they know the answers, but with financial barriers, they may have no clue. I hope that I can provide some resources that will help you meet your goals.

One strategy is to switch to a less expensive medication, such as changing to NPH or regular insulins from the analog insulins or combined therapy, such as 70/30 insulin. Metformin, sulfonylureas, and pioglitazone are economical drugs that can help reduce your costs. Vouchers or savings programs may also be used.

Testing supplies, if they do not align with what the insurance company is paying for, can be an additional and often insidious cost. Many patients often do not realize that their co pays change because of formulary changes. You just know that when you went to the pharmacy last month, it was covered, and now it is not. Being willing to tell your doctor about what is holding you back or keeping you from moving forward is critical.

In this case, it is valuable to tell your doctor how often you test, to help the doctor find out whether buying test strips, lancets, and other supplies is a problem. Learning whether the your blood glucose meter and test strips are covered by insurance can help open up a dialogue about how often you need to be testing based on the medication you are taking. This provides an opportunity to change medication on the basis of your needs to reach your goals.

Using prescription programs, such as,, and state-sponsored prescription savings programs also can be helpful. The paperwork is a little burdensome and may require an investment of time and energy, but if your doctor uses a team-based approach to care and has a staff member who can help you with the paperwork, the pay-off is quite significant.

Coupons and vouchers have their limitations but also play a role, particularly when looking at comorbid conditions and symptom reduction.

Polypharmacy is another area where co pays can become burdensome. Putting medications in combination or changing to a formulary alternative that may reduce the number of times the you have to take a medication may also help you, the patient, reduce the financial burden. Walmart, Costco, and others carry store brands of meters and test strips, which can also be more economical.

Utility support, such as the Low Income Home Energy Assistance Program (LIHEAP) and the Universal Service Fund (USF), can be very helpful. The Medical-Legal Partnership is a resource to help with advocacy and legal issues, landlord/tenant relationships, and work absences.

Food pantries are a great source of healthy foods. The Coalition Against Hunger is a national resource that supplies food pantries and fresh produce programs. Community hospitals and local agribusiness programs may also offer produce boxes during peak seasons, and supermarket surplus is often available at certain times of the year.

Diabetes is a journey. Do not be afraid of not having the answers. We can always find those. We just need to make sure we are building trust and moving in the right direction.

April 30, 2017

Don't Buy 'Diabetic' Cookbooks

For people recently diagnosed with diabetes, most look for carb count and fiber content. They think that maybe cookbooks with diabetic in the title are the answer. Most soon find out as I did that this route is not the answer. Many, if not most, have recipes that are not friendly to people with diabetes, as most are too high in carbohydrates. These cookbooks masquerading as diabetic friendly exist for one purpose only. That is to extract money from unsuspecting newly diagnosed people with diabetes and their families. Unlike the Sears-Roebuck catalogs of old, they do not have a dual usage.

There are many websites that have good recipes, but many do not have the nutritional information with them. Some do, but often take much research to find them. I am aware of some of the diabetes forums that have a library of recipes. Some have nutritional information, but not the number of servings. Some have now gone the extra mile and made it possible to calculate the ingredients for varying servings. Two forums that have recipes with nutritional information and servings number are dLife and diabetes daily.

People should not overlook cookbooks that have been around for many years. Betty Crocker's Cookbook, ninth edition and some later editions have the nutrition and servings number with each recipe. Better Homes and Gardens New Cookbook copyright 1996 and later has the nutritional information and includes the servings number. I have found these two cookbooks to be invaluable and have used them to approximate the nutritional value for some of the recipes in the older editions, which I find to be healthier. While the older recipes often use ingredients sometimes not available on today's grocery shelves, most are available.

Another cookbook now available today is The Taste of Home Cookbook. Be sure to read the guidelines printed on the copyright page for how the nutritional data is calculated. I have tried to ask questions, but their editors have not felt it necessary to answer my emails. There may be other cookbooks that have the nutritional information and servings number; however, these are the only cookbooks in my collection that do.

When I use a recipe, I try to use those for two or three servings, realizing that I will need to cut that in half for me and possibly even more. That makes a recipe that says serves two a recipe serving at least four or six. I always plan on freezing a portion for use later if the food is something that can be frozen.

There are more resources available to help you today than even ten years ago, so don't become discouraged and let denial get in your way of eating healthy for control of your diabetes. Alan Shanley, an outstanding blogger from Australia has some excellent pointers for people new and old to diabetes. Get started by following him here – be sure to follow his links to more information. When a fellow blogger has excellent information, I don't like reinventing the wheel, so I will always recommend reading them.

There are other ways to determine the nutritional value. Here are a few sites to assist you. On these sites, you will need to join to be able to use their information.

1.Site one - I believe this one is free
2.Site two - This one is free

There are many nutrition and calorie calculators available on the web, just use caution and realize that you will not be 100% accurate as they all read from the same nutritional database and you may be off +/- 20%. Use your search engine and get started by typing in “nutrition calculator”.

And there is always the best way, using your meter to determine the serving size for you. And always follow the rule of what works for one person may not work for you.

If you don't like bland foods, check out my post of May 30, 2010. There will be more.