Dr. Davis,
would you please explain, in layman's terms, why chiceking blood glucose can be so important for not only keeping track of blood sugar but for weight loss? I think I get it, but my mother, who was recently diagnosed as "pre-diabetic", says she is going to return the glucosometer she based bought upon my suggestion, as she is going to eat low-carb and track calories, etc.  Help me help my mom out!  Thanks so much,
emily

Dr Davis, thanks for the site.

There's a history of Diabetes in my family.
My dad and his father were both Diabetics and they both died of Pancreatic Cancer in later years.
They never watched any of their habits though.
My dad's doctor used to call him a "food and lifestyle" liar. Dad shrugged it off.. and kept on lying.

Yes, I know about the genetic odds here.
I do watch what I eat, Vit D3, no cigarettes and I exercise and live life.

I've never seen a conclusive study relating Diabetes and Pancreatic Cancer.
Any thoughts on that ?
I'm not Diabetic. FBG today of 89.
But I still watch myself and I have started to use a BG monitor to watch post-prandial numbers.
It's interesting how different foods affect everyones's BG differently.
I'm continually learning.
Thanks again for the site.

I'm new to all this but have a question if anyone is willing to indulge me an answer...

I frequently fall to sleep after lunch and/or after dinner, just "nod off" type of thing.  Is this a result of high BG and then the insulin response driving sugar low?

I am not diabetic and try to eat reasonable healthy meals, moderates amount of lean meat, vegetable and starch like rice or potato.  I wonder if I have insulin insensitivity...guess I need a meter. Thanks

Thanks for explaining why.

Could you maybe elaborate a little?

Carbs cause blood sugar to rise. Indulge in excess carbs, and you can walk, run and bike till you drop and not lose an ounce.

Awesome post Dr. Davis. I check my post-prandial BG constantly and have eliminated many so called low glycemic foods. ALso, nice simple explanation Lori.

@ Larry said...
I've never seen a conclusive study relating Diabetes and Pancreatic Cancer.
Any thoughts on that ?
It's not a straightforward connection, they are still arguing about it.
This abstract suggests  
the development of diabetes in subjects prone to pancreatic cancer could be a red flag for malignancy.

And this full text article
Is Type 2 Diabetes a Risk Factor for Pancreatic Cancer? explains why it's difficult to definitively identify type 2 diabetes mellitus as a risk factor for pancreatic cancer.

Worth pointing out for those with Diabetes who are concerned about the threat of Pancreatic cancer that Metformin monotherapy carried the lowest risk of cancer. However that was comparing medical diabetes treatments, so didn't include people using Dr Bernstein's or similar approaches to controlling diabetes through diet, exercise.

I found this paper Cancer as a metabolic disease worth studying. It's not specifically about pancreatic cancer. It makes the point that Reduced glucose availability will target aerobic glycolysis and the pentose phosphate shunt; pathways  required  for  the  survival  and  proliferation  of many  types  of  tumor  cells.
Maybe it isn't just the risk of heart disease that is reduced by lowering circulating  glucose levels.

@  Emily
Please try to persuade your mum the glucose meter is an essential tool to understand which foods really raise BG levels.
I thought, a bit like your mum, that because I followed a Low carb eating plan I wouldn't have a problem with high glucose.
Only after readingTo get low-carb right, you need to check blood sugars did I get a meter and start checking.
Despite eating almost exclusively low carb I was regularly spiking up to 199.8 ~ 11.1.
Adding into my diet a variety of things to slow gastric emptying has reduced the height of 1hr after meal spikes and I've now gone a week under 133.2 ~ 7.4 and the trend is towards lower numbers mostly under 108 ~ 6

I've not restricted my calorie intake nor am I able to exercise much but I have, unintentionally, lost weight. A month ago I was 168lbs and am now 163 lbs.

I went out and bought a glucose meter yesterday.  I bought the one Dr. Davis recommended, the OneTouch mini purchased at Walgreens.

In hindsight though, it turned out to be an expensive choice.  I had to buy the OneTouch test strips as well, and they are fairly pricey.

For anyone considering buying a glucometer, buy the Walgreen's version.  I think it had a mail-in rebate, cost a bit less than the one touch, and also, the generic Walgreen's test strips are half as much as the One Touch.

And thank you Dr. Davis for this great blog.

Consumer Reports magazine recommended the ReliOn Ultima and their strips. The meter is, like, $9 and the strips are very inexpensive (compared to "branded" ones). (I'm pre-diabetic.) I don't have any hesitation checking my b.g. anytime, because the strips are cheap.  (No insurance, I have to pay for all my supplies.)  If you have insurance but they limit your strips (as with my nephew, a Type 1), you can use the  cheap one to fill-in your testing.

From my research and experimentation, the Accuchek Aviva shown in picture is the most accurate and precise meter currently available.  Over the long run, an accurate and precise meter will save you money and a lot of trouble, versus one whose results are not as reliable, and which forces you to test more.

btw, most precision issues are due to the strips, and cheap strips will simply result in lots of unnecessary holes in your fingers if you're serious about knowing what's going on with BGs.

thanks

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Thanks for the knowledge sharing...it helps to be healthy.

Here is a link showing the atherogenicity in mice of different saturated fats in diets with 1% cholesterol. Look at page 1416 of the free full report that can be downloaded here:

http://www.ncbi.nlm.nih.gov/pubmed/8409772

On the opposite you can see bread not being atherogenic in baboons here:

http://www.ajcn.org/cgi/content/abstract/33/8/1869

By the way you can notice the effect of 0.1% cholesterol at the end of the article = 1 gm cholesterol per kg of food = 5 egg yolks.

Does it look a lot ? "There is evidence from animal experiments showing that if atherogenic dietary factors are reduced to levels comparable to man's intake, the same vessel changes occur as with higher levels, but more slowly."

Download the free full report here:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1938976/

In this report you can also see butter to be highly atherogenic to swine without additional cholesterol to their diet.

What about rice?  Does it also increase small LDL particles?

@x.ds: Humans aren't C57BL/6J mice (susceptible to diet-induced fatty streak lesions), baboons or pigs.

@x.ds

The strain of mice in the first study are predisposed to diet-induced obesity, type 2 diabetes, and atherosclerosis.

Likewise, here's an interesting quote from the last paper based on a porcine model: "Whenever there are three
animals from the same litter, they are divided equally among the three groups (ie, "control", "butter", & "egg yolk" groups)  In the present experiment, this occurred once. These three pigs had the most aortic atherosclerosis in their respective groups. The control pig with the most atherosclerosis was the brother of the pigs with the most disease fed egg and butter."  

The group of pigs with the highest rate of atherosclerosis was the egg yolk group - yet at most we see a vanishingly positive relationship, if any, in a large number of human epidemiological studies of moderate egg consumption and heart disease (too many to list here - many are recent and easy to locate, though).  Do we even have grounds to formulate a hypothesis of egg induced atherogenesis based on human observational studies? I don't know, really - though a casual glance suggests, "no".

Looking forward to reading the other study you pointed us to when I get the time.

x.ds:

Often times these animal studies don't translate well when applied to humans.

Also, like Dr. Davis pointed out in his blog, most (LDL) cholesterol lowering research doesn't use advanced lipoprotein testing like NMR so the data is misleading to say the least.

x.ds:

It would be nice for a change to see experiments on other than herbivorous (mice) or mostly vegetarian animals (both pigs and baboons on the wild).

Bobber--

While all carbohydrates increase small LDL, the effect of wheat is the most extravagant.

I generally agree with those who deny the universal applicability of experimental results in mice and rats to men. However, I do so with this one caveat; there is one fact I cannot deny: Many women are convinced that most men are rats.

Doc, does this mean that I ca sorta log my particle size by getting my apoB checked in quarterly labs? I'll never be able to convince primary to do the outright particle size test...yet (working on that). Thnx.

I admit I do not understand VLDL-C. What I would really like to find is a simple range scale. Mine shows up VLDL-C..7  Non HDL ..70
I do not know if that is good or bad. Is there such a chart showing like,  1 good ... 100 bad ??
LP(a) shows up by itself and I understand that because there is a range showing bad ..over 30.
Any help understanding appreciated

LynP -

Bypass your doctor and order your own NMR test. PrivateMDlabs has it for $79.99, minus a 15% discount.

http://www.privatemdlabs.com/lab_tests.php?view=search_results&show=865&category=2&search=nmr#865

Dr. Davis,

I honestly think you are doing God's work and have learned to appreciate the value of heart scans through your site.  However, it still bugs me that so many people in Asia can live off of large quantities of white rice with minimal atherosclerosis.  For instance, this study shows that American Whites have much higher atherosclerosis than Japanese despite the Japanese having much higher LDL-cholesterol, blood pressure, fasting glucose, and smoking rates:

http://ije.oxfordjournals.org/cgi/content/full/34/1/173


This other study (below) tries to explain this difference based on the Japanese consumption of fish. However, if you look at the data, those Americans who consume the most fish oil consume about as much fish oil as those Japanese that consume the least fish oil, and yet between these comparable groups in terms of fish consumption, the Japanese still have vastly lower atherosclerosis on heart scans.  And the Japanese American group consumes more fish than the White American group and has more coronary calcium.

http://content.onlinejacc.org/cgi/content/full/52/6/417


And here is another study showing much lower CAC in Japanese than in Japanese-Hawaiians even after controlling for a bunch of risk factors including fish intake:

http://aje.oxfordjournals.org/cgi/content/full/166/11/1280


Although in this other study looking at only at Americans, the incidence of CAC appears to be similar to that in Japanese - so maybe there was something unusual about the US samples in the other studies?

http://content.onlinejacc.org/cgi/content/full/49/20/2013

Dr. Davis,
What is your opinion of the LP-Pla2 test for arterial plaque?  If you've used the test, do any elements of your program reduce levels of this enzyme?

However, the effect will not be fully evident if you just look at the crude conventional calculated (Friedewald) LDL cholesterol. This is because restricting carbohydrates not only reduces small LDL, it also increases LDL particle size. This make the calculated Friedewald go up, or it blunts its decrease. Conventional calculated LDL will therefore either underestimate or even conceal the real LDL-reducing effect.

"Necessary to pay for the services we provide."

This sounds odd to me. Blogger is free. I manage to provide a very high level of service to my bloodsugar101.com visitor base which is huge and growing monthly without charging a penny.

I earn enough from Google ads to pay overhead. The amount of time it takes to keep the site updated is no more than most people spend watching a favorite TV show or playing golf each week.

I respond to emails for perhaps half an hour a day, occasionally more, where I help people clarify the issues they need to discuss with their doctors and occasionally direct them to resources relevant to a rare condition my site mentions.

I can see charging for individual medical consultation, but not for providing a web forum where people discuss topics and where you explain concepts that do not involve personal medical counsel.

The for-fee nature of your site buys you income at the cost of greatly limiting the number of people who can benefit from the non-specific information you have to share.

Too many of your posts seem to tantalize with hints of information but conclude with statements making it clear people have to pay to find out the facts.

That is NOT how the web works and it greatly limits the helpfulness of what you offer.

Dr. Davis,

In a short time, your blog, all by itself, has become the best source of information for dealing with cardiovascular disease on the internet.

Thank you for having the vision and commitment for sharing your depth and breadth of knowledge of this disease.

Dear Dr. Davis
I plead guilty to immoderation in my response to your "Hammers and Nails" piece.

Here's my bottom line:
I simply believe that your 'bottom up' approach (to identifying both problems and their solutions) could potentially grow to influence the entire profession for the better. I hope it spreads.
Thanks for listening.
MikeV

Hi Dr. Davis

I read your blog all the time and am surprised to see that you answer blog comments at all.

I would always think . . . . how does he have time to do that ?

I for one, understand your situation exactly and I am just thankful that you write your blog at all. I'm sure the course of my health will be forever changed by reading your words, and following them.

On behalf of all the people who are deeply thankful for what you do, I apologize for the few "who always want more".

You have my heartfelt appreciation (pun intended).

Brian - Syracuse, NY

Dr. Davis,

Just a note of thanks for all you do on this blog and on the members forum.  My doctor was amazed when I told him that you responded personally to my query on the forum.  I've learned a tremendous amount thanks to you.

Rick

Dr. Davis
I agree with the previous writer - surprised you have time but also thankful.
In case you wonder if it's worth your time - You have changed my life!
After reading your column and recognizing myself in many issues, I went out and had my vitamin D tested and it was 23 ng. So now, I also  have my husband and 4 friends on Vitamin D supplements who are also grateful.
p.s.
Nice of you to let "Jenny" plug her google ad site

This comment is to Jenny.  Wow, just wow!  You have an overgrown sense of entitlement.  Dr. Davis is providing a lot of great information on his blog as well as in his TYP community.  He also has a full-time cardiology practice.  If you don't like what he is writing and that he would prefer to spend his energy on TYP, which I am fairly certain does not net him a profit, don't read this blog.  Not everyone has to follow your model for blogging and you ought to be respectful of that.

-Russ

It's a fair deal as your posts alone help guide a lot of people.

As a suggestion, since comments are still flying about about vitamin D, erroneously, being bad for you, and that L-form bacteria being touted as the core cause of heart disease by the same camp, it's worth doing an article about that. Approaching it with undemeaning neutrality, but it would be useful as some people have taken to heart the words of the dubious Marshall Protocol.

I can understand your need for more time but while your postings are excellent I have learned far more from your comments on other peoples comments then from the original postings. What a loss.

Well Dr D, as we say....Dr heal thyself. I have read all the blog and joined TYP. Best fee( and small amt I might add) I ever spent and yes to do all you provide on your forom does cost, I doubt J knows what she is talking about as I don't think she is a member of TYP. You have saved me from an early death and all I can say  since day one of coming here is I wondered how you did it all. You answer all the posts on TYP at least twice a day, you always write new articles, you volunteered your time for our web show, and your attitude is always so supportive and so wise. You know our sacred and healing VIT O
I have honoured you since the day I met you and I honor you even more now or making good choices to look after yourself thus in the end enable us to look after ourselves.

I FEEL SOMEWHAT EMBARRASSED BY j's INSENSITIVE COMMENTS.........if only she knew all the work you have done for us in the past 6 months since I have been here. Thank you sooo much and I;ll read you daily on TYP website.

Goodonya!!!!

chick