Letters to the Editor
Promising News from Capitol Hill
I was thrilled to hear of President Clinton's allocation of $300 million more to diabetes research. Like you ("My Own Injection" April 1998), I too feel that the battle is only half won (maybe less than half), but for different reasons.
You may not yet know that the diabetes research group that is to decide how these funds are to be allocated is composed of over 50 delegates, including approximately 30 doctors, three parents of diabetics, and 18 representatives from the NIH. However, within this group of advisors there is no representative from the biologic replacement/transplant field - with the exception, perhaps, of Dr. Christopher Newgard, an expert in gene therapy who has some involvement in islet cell transplantation.
It will indeed be interesting to see what percentage of this $300 million will actually be allocated to translational, bench-to-bedside, pre-clinical or clinical trials in the field of transplantation. If this follows the pattern of what has been previously spent and allocated, we may expect less than five percent of this fund to be actually distributed for "cure-related research."
Camillo Ricordi, MD
Professor of Surgery and Medicine
Chief, Division of Cellular Transplantation
Scientific Director and Chief Academic Officer
Diabetes Research Institute
Preventing Pre-lunch Highs
Someone asked what to eat for breakfast to prevent pre-lunch highs in the Q&A section of a recent issue ("High Noon," April 1998). Well, I had high blood sugars after breakfast for 18 years. I got these highs no matter what I ate, or how much insulin I took (unless I managed to bottom out) until Humalog came along.
The questioner didn't say if she takes insulin, but if she does, Humalog might help. Now I can eat cereal or waffles with syrup, or even (gasp!) drink orange juice for breakfast, and three to four units of Humalog will give me a normal reading two hours after breakfast almost every time.
Also, Humalog does not work for me at lunch and supper, so I use Velosulin in my pump and take a shot of Humalog at breakfast. My quality of life has improved tremendously, as have my HbA1cs.
Two Cents Worth
I have two comments about the May issue:
- In Scott King's column ("Can Dr. Soon-Shiong Perform Miracles?") he writes of the work of Soon-Shiong and comments that pig islet cell transplants "could be a real cure for diabetes." This, in my opinion, is not true at all. There is no "real cure" until human islet cells are placed back into my body and protected from antibodies without the use of anti-rejection drugs.
- In the Q&A section, a reader asks about orange juice versus soda in the treatment of a low blood sugar ("Settling the Score"). While Dana Arnold correctly replies with the "rule of 15" for treatment, I'd like to add something regarding treating a low blood sugar with orange juice.
In a recent ADA support group meeting that I attended, a nutritionist (CDE) from the Warren Clinic of Tulsa commented that many health care personnel who provide dialysis treatment request that those needing dialysis not treat their low blood sugars with orange juice. Their reason: orange juice throws off the electrolyte levels in the blood and makes it hard to get a proper blood level balance.
Kudos on the Chromium Review
Thank you for publishing a review of Dr. Richard Anderson's study on the effects of chromium on type 2 diabetes. Since Dr. Anderson first presented the results of his study at the ADA convention in June of 1996, I have been recommending chromium picolinate to my patients at the 1000 mcg dose for a trial period of at least one month.
In this past year, four of my patients age 65 and over, have reduced blood glucose levels greater than 100 mg/dl in one month with this dosage. All four were newly diagnosed, not on oral medications and referred for initial diet and diabetes counseling.
One of my male patients, age 65, reduced glucose levels from 310 to 165 in one month with 1000 mcg chromium picolinate. Another 80-year-old patient saw results of 195 to 85 in just two weeks of chromium supplementation. And just last week, another patient, age 92, with one month of 1000 mcg chromium reduced blood glucose from 185 to 100. My younger type 2 patients see results as well, but not as dramatic.
I am also seeing an initial weight loss of two to five kg in my overweight patients that levels off after one month on chromium picolinate. It is becoming clear to me that a chromium deficiency is contributing to the epidemic of type 2 diabetes in the United States. The reason chromium supplements work well in older clients is the increasing potential of chromium deficiency with aging. Not only do I advise chromium supplements, but a full spectrum of vitamin and mineral supplements - especially antioxidants, B vitamins, magnesium and zinc as well.
When I first started recommending chromium supplements, I met with intense opposition from some pharmacists, physicians and dietitians at my facility and, in fact, had to stop recommending chromium supplements. Your article has helped me regain my credibility in this area. Since circulating this article to the staff at the hospital, I now have physicians prescribing chromium supplements. Thank you for your continuing balance and objectivity in your reporting in DIABETES HEALTH.
Joanne Shearer RD, MS, CDE
East Helena, Mont.
The following letters are in response to Scott King's June column "A Brave Soldier: Steven Craig is Gone but not Forgotten."
Your Stephen Craig story was sad and moving. However, it reinforces my conviction that transplants, grafts, etc. are not cures. There is much more to diabetes than replacing parts.
I do not believe that just because a person has diabetes that they will commit suicide. I do not believe that just because a person is in poor control (which they can control if they work at it) and has complications that they will commit suicide. But once again, only the individual will know.
Persons with diabetes are not victims, don't treat us as such.
I believe that Mr. Craig should be remembered as someone who helped our case in his own way, not as someone who committed suicide, had marital and financial problems. The latter is none of our business and I believe you lacked judgment in publishing this aspect of the story.