Both Sides Now

You’ll find this months “letters to the editor” to be very interesting. On several topics, our readers are clearly divided. Our article on nighttime hypoglycemia shocked one reader and drew praise from another.

Another important observation comes from looking at this same section. Like our subscriber list, a significant number of our letters come from diabetes health-care professionals.

Sometimes a difference of opinion falls neatly into patient versus professional, but more often this is not the case.


Here’s where a controversy may not exist-the DCCT. Last month I complained that this expensive study ($300 million) told us what we already knew-that keeping BGs near normal levels prevents complications. I got roundly spanked and chastised for this. Most of you thought this study was extremely valuable. I especially enjoyed a letter from a retired endocrinologist, William Law MD, who began practice in 1956. He shares that most doctors, until 7 years ago, were not concerned with BGs in the 300 range and HbA1cs at 10%. “This didn’t seem to cause worry,” Law writes. He has noticed a big change in this thinking since the DCCT results.

Lower-Carb Diet

Dr Law also thanked us for our coverage of another controversy: the lower-carb diet. “It was time that someone mentioned the unmentionable,” he states. Many readers with diabetes have told us that by using the lower-carb diet, they lost weight and controlled their BGs better than ever.

Both Sides Now

We know that our consumer readers are often sharply divided on certain topics. It has also become clear that our professional readers are divided on many topics as well. This confirms our commitment to providing all our readers with both sides of every issue.

After we published an article on the diet issue in February, we felt a big backlash from our readers who are Registered Dietitians. The ones who wrote to us were very upset with our coverage of this diet. This month, on page 33, we present a well-documented support of the food pyramid diet, written by registered dietitian Elizabeth Rhodes.

Industry “Helps” with Diet Recommendations

Supposedly, our government officials “update” the food pyramid diet’s recommendations every five years based on the latest research findings. These diet guidelines were recently updated and in the news. I was very surprised to find out the sugar and soft-drink industry played a large role in this update. They didn’t want the government telling Americans to “limit” sugar intake, so they lobbied hard and won. The guidelines that were released only recommend that we “moderate” sugar intake instead! The dairy industry was able to keep calcium-enriched soy milk off the pyramid and only listed in a footnote instead.

It makes me wonder about the science in all of this, if the lobbyists have so much say in the diet guidelines.

Keep Sending Your Suggestions

I want to thank all of you who emailed me this past month. Whether you had complaints about my column or recommendations for finding something really helpful for diabetes, I was happy to get your letters, and I tried to answer every one.

Scott’s Bonus Tip

Are you in danger of hypoglycemia without even knowing it? A study of type 1s revealed that most NPH-insulin users shake or roll their insulin only four times before injection-16 times less than is necessary. This can result in concentrations of NPH that could be either too low or high, and can cause day to day blood sugar fluctuations.

All NPH-insulins, as well as lente and ultralente insulins, contain crystals that settle to the bottom of the mixture. These crystals must become resuspended before injection by rolling, tipping or shaking the insulin container.

The findings from this study, presented at the 1996 European Association for the Study of Diabetes (EASD) meeting in Vienna, Austria and reported in Novo Nordisk and LifeScan’s publication, Daily Review, show the insulin must be rolled, tipped or shaken 20 times to achieve a satisfactory mixture.

Please pass the bind-in card between pages 46 and 47 to someone you might know with diabetes. New subscribers can also get a sample issue by emailing me, or calling 800-488-8468.

Have a great summer.

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