Letters to the Editor

Sep 1, 1996

High-Protein Diets-Hype or Help?

I am 33 years old, have had type I diabetes for over 25 years, and am also a practicing registered dietitian. I was quite surprised and dismayed when I read the responses Dr. Bernstein gave in the July '96 Q & A column regarding insulin dosages and low-carbohydrate diets, for the following reasons:

  1. I am an avid athlete who runs six to 12 miles per day and have thought that my four insulin dosages of seven to 13 units each were quite low. However, Dr. Bernstein is recommending that insulin dosages should be no more than seven units. "With the modern low-carbohydrate diets, industrial doses of insulin are no longer needed," says Dr. Bernstein. I know of no diabetic (and I have counseled quite a few) who requires less insulin than myself, so how is Dr. Bernstein recommending that each injection be less than seven units, unless he is recommending six or more shots per day?
  2. Secondly, we dietitians are recommending high-carbohydrate diets for diabetics. To which "modern low-carbohydrate diets" is Dr. Bernstein referring? A "low" carbohydrate diet calls for a diet high in protein and fat. Consumption of high levels of protein and fat has been shown to lead to heart disease, colon cancer, arteriosclerosis, etc. Fruits, vegetables, and whole grains, all high in carbohydrate, should constitute the bulk of a diabetic's diet.

I would like to be enlightened as to which diets Dr. Bernstein is referring to. His recommendations seem out of line with what is actually being practiced and recommended here in California.

Santa Clara, Calif.

* * *

Though the jury is still out, so to speak, on the "miracle diet," Dr. Bernstein's low carbohydrate diet is now receiving national recognition. Books such as Protein Power by Drs. Michael and Mary Eades and The Zone by Dr. Barry Sears recommend low carbohydrate diets similar to Dr. Bernstein's and are topping best seller lists across the country. Though the American Diabetes Association recommends a low-fat, high-carbohydrate diet, DIABETES HEALTH has received many positive responses to Dr. Bernstein's diet. For more information, please see the article about diets on the cover of this issue. - The Editor

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Diabetes Management for Type 2 Native Americans

The article "Type 2 Diabetes Continues to Plague Indian Reservations" by Robert Capps (DIABETES HEALTH, July 1996) mentions that programs to prevent complications and ultimately prevent the disease are desperately needed. There is, however, a program, Staged Diabetes Management (SDM), being implemented throughout Indian Health Service sites in the United States. The program was developed through an educational grant from Becton Dickinson at the International Diabetes Center by Dr. Roger Mazze.

SDM provides the information, materials and guidance needed by all health care professionals involved, to assist the diabetic patient in achieving blood glucose control. The program is community-based which encourages doctors to customize their guidelines within the SDM framework and use the resources of their particular community.

The SDM program is currently in the final stages of publishing a Complications Manual that uses the SDM format to guide health care professionals. With this brief summary of the SDM program, I hope I have informed you of at least one program that is directly working towards the prevention of diabetes complications plaguing Indian reservations.

Stuart Sundem
International Diabetes Center

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Controlling Blood Sugars-Start Today!

I have been reading articles in DIABETES HEALTH about people experiencing complications who might need to have a kidney transplant in the future.

I was diagnosed with diabetes when I was in my middle 20's and I will be turning 60 on my next birthday. For most of my life I didn't take care of myself and often ran high blood sugars. I've had lens implants in both eyes and laser surgeries performed many times. I started leaking protein in 1983 and in January of 1985 I started peritoneal dialysis.

In December of 1987 I had a kidney transplant. My husband had insisted on having his blood checked to see if his blood matched mine so that he could give me one of his kidneys. But I didn't want him to have surgery along with me and I was glad when our blood didn't match. I also have four grown children but would not ask them to be tested. A donor was found who matches me well and the surgery was successful.

Since the operation I have had no problems with the kidney. They only give me one of the donor's kidneys and gave the other kidney to someone else. I met the boy who got the other kidney and we have stayed in touch. He was from Oklahoma and has had no trouble with his kidney either.

Thanks for letting me share my experiences.

Marjoram Bailey

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Tricky Blood Glucose Meter

I love my new One-Touch Profile meter but I frequently notice that my 14- and 30-day averages are the same. Of course that makes me concerned that my blood glucose readings are not right, and I often check them against another meter and find out that they are, in fact, correct.

Once, when the 14-day average and the 30-day average came up the same, I finally decided to figure it out. I went into the memory and started going back and counting the number of readings. I said to myself, "Does this meter hold 250 BS readings or 250 total entries?" I went back into the memory and started counting all the entries-BS readings, insulin, check strip tests, control solution tests and, sure enough, there were 250 entries.

The instructions say that the meter stores up to 250 entries, but they don't say that's all you're recording. The One Touch can record meals, snacks and insulin. If I test eight to ten times a day, record six or seven meals and snacks and five or six insulin entries, it all adds up to 250 in a shorter period of time than 30 days-more like ten days. Even someone who only tests four times a day, eats three times, and takes insulin twice with some control tests in between, can't get a 30-day average.

Larry Spiegel

* * *

Ray Tuazon, a customer service representative for LifeScan, confirms that the One Touch Profile records 250 total entries rather than 250 blood sugar readings. He says that if a person were to limit the meter to three blood sugar tests a day, the One Touch Profile would record more than enough blood sugar readings to give a 30-day average.

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