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I'm a Fan
I read Diabetes Health and pass it on to those unable to subscribe due to financial reasons or those who don't know that you are out there. I have convinced my doctor's office to subscribe, and I also passed on a copy to an x-ray technician with diabetes at my local hospital. I am sure you already know you have a lot of fans out there—and I am one of them. I have had type 1 diabetes for 30 years and have used the pump for over a year.
I Like Diabetes Health As Is
It's great that you see ways to make Diabetes Health even better by making the size smaller, but please observe the medical precept "First, Do No Harm."
Diabetes Health is already the premium diabetes magazine for the layman. It covers controversial subjects fully and fairly. It doesn't pick fights with the American Diabetes Association, but it isn't cowed by it either. It pretty much "tells it like it is," and that's important to those of us trying to improve the management of our diabetes.
Diabetes Health is also pretty quick to report new information—faster than Diabetes Forecast or Diabetes Self-Management. I hope that "improvements" do not slow that reporting. A new magazine size might be more convenient for filing, but not if it slows the process. Currently, I just fold each issue in half and put it in a magazine file box anyway.
And Diabetes Health puts its money where its mouth is, making bulk shipments essentially free (cost of shipping only) to organizations that will help spread the word. I know of cases where recipients of free copies have subscribed, and that's great, but I'm delighted with a publication that goes out of its way and subsidizes distribution to reach and help those who need it.
The only thing I'd like added is an endnote with a research reference or Web address for more information about each article. Congratulations on an already great magazine!
A Cure for Type 1 Diabetes Only
People who do not have type 1 diabetes would object to the title of the article in the December 2001 issue of Diabetes Health ("The Diabetes Cure of Tomorrow," p. 33). The article equates diabetes with type 1 diabetes. Most people who do not have diabetes are ignorant about the types of diabetes (as I was at one time). For such people, having diabetes means having to inject insulin. Any such person seeing this article or the headline on the cover ("On the Quest for a Cure") would conclude that scientists have the problem well in hand.
The vast majority of people with diabetes do not have type 1 diabetes. Transplanting islets from pigs will do nothing for those of us who have insulin resistance. While everyone can be happy if type 1 is eventually cured, the accomplishment for those of us who have type 2 would be like having a cure for arthritis: good, but irrelevant.
San Francisco, California
Editor's note: We agree that type 1 and type 2 are different diseases, and we work hard to serve both audiences. You bring up a valid request that we need to take to heart: When we use the word "cure," we need to qualify it by specifying whether we are referring to type 1 or type 2.
Problem With the Format of Your Taste Test
While I applaud testing products for your readers in the article "Tasty Test" (December 2001, p. 42), the results should have been better shown. Rather than presenting the results as a mind-numbing list of percentages (p. 45), you should have presented them in a format that was easier to comprehend.
Editor's note: We agree and will do better next time.
Dieting Is the Way to Go
I feel compelled to respond to your guest editorial by Jan Chait in the November 2001 issue ("Fat and Lazy," p. 11).
If you have diabetes, it dictates a change in lifestyle if you want to live a long life. In November 1950, my doctor told me I had a "moderately severe case of diabetes." He wanted to put me on insulin, but I asked if I could try dieting, since I was overweight. He put me on a 1,500-calorie diet, and I went from 203 to 163 pounds in two years. Dieting is the best thing for anybody with diabetes who is overweight, because otherwise you are overworking your pancreas.
I visit people with diabetes in a nearby hospital and show them that you can live a long and healthy life with diabetes. I can sincerely say, "Thank God for my diabetes." If I had not been diagnosed at age 30, I don't believe I'd be alive today.
Ms. Chait admitted to being over 300 pounds at one time and still overweight. I've got news for every overweight person with diabetes: Get rid of the weight as soon as possible if you expect to live a long and good life.
Asheville, North Carolina
Here's What I Think About ‘Here Is the Rub’
I am sure your article on forearm testing ("Arm Testing—Here Is the Rub," November 2001, p. 31) caused quite a stir among your readers. I think the article lacked your usual editorial rigor. Reports on companies testing their competitors' products and not following directions do not qualify as insight. Forearm testing is a big break for little fingers and a big step forward.
San Mateo, California
Editor's note: Diane is referring to a study published by the American Diabetes Association that documented differences as great as 100 points in blood-glucose test readings taken on the forearm and on the fingertip. The researchers did not rub the arm first before testing, as the manufacturer recommends. Also, a person affiliated with a competitor conducted the study.
The U.S. Food and Drug Administration has decided to allow meter makers to use their own internal tests to prescribe when arm testing should not be used. Please refer to the chart on page 39 of our February 2002 issue ("Features of Blood-Glucose Meters Approved for Alternate-Site Use"), which includes warnings provided by the meter manufacturers themselves based on their own studies. Because of variations in arm testing versus finger testing, the companies are cautioning people with diabetes to avoid using alternative sites such as the forearm when testing for low blood glucose. We find this surprising and think it is important to let our readers know.
Thank You for the Article on Health Insurance
Thank you for the great article on health insurance ("A Question of Coverage," November 2001, p. 34) in the magazine and on your Web site. I have referred many people to the article. It is a great service. Keep it up.
What's Wrong With Exercise
Regarding the exercise column in your November 2001 issue ("Stop Blaming! Start Becoming the STAR You Are," p. 62), one of the problems with exercise is that it is viewed as punishment. Fat women have always hated going to the gym because people made fun of us. As a fat woman in our society, I experience contempt, repulsion and bias. Imagine how I feel to be blamed for my diabetes by my diabetes professional. Until the diabetes professionals adopt an attitude of love and kindness for others, we will continue to blame each other for being fat. We need to develop places of movement where fat people are not judged. What a difference it would make in my attitude toward exercise if I could go someplace where people were happy to see me. Movement can be fun, but it is not working in the "STAR" punishment system or any other place.
Thank You for the Law Enforcement Article
Thank you for publishing the article in your October 2001 issue ("Officers of the Law Ignore Special Needs of People With Diabetes," p. 37) concerning law enforcement and people with diabetes. The timing of your article was especially appropriate to me.
Being relatively new to the world of diabetes, I am a novice in the details of diabetes treatment. You might also say that I'm naive concerning fair treatment of people with diabetes by law enforcement officials.
I was arrested on October 5, 2001, by the San Diego County Sheriff's Department for a probation violation. After spending a whole day in a substation with no real medical facilities, I was transferred to San Diego's central jail facility, where I spent more hours in a holding cell. By the time I saw the intake nurse, it had been approximately 13 hours since I had any food or medical attention.
While I was handcuffed to the intake nurse's station, I explained that I was a diabetic and needed food quickly, as I felt weak and dizzy. A passing deputy I had not seen before overheard and stopped to tell me that I was lying and had been fed. When I verbally challenged him, he put me in a choke hold, handcuffed me behind my back, forcefully lifted my arms and put me in an isolated holding tank—still without any food.
Sometime in the next 24-48 hours, I awoke in a freezing cell and had to beat on the door to alert the deputies that I was there. Finally, I was fed and moved into the general population.
Although I was shocked at the treatment, I didn't realize that my rights had been violated. I recently filed a complaint as I have had a persistent injury to my left shoulder since the incident. After reading your article, I felt compelled to write. It's appalling how many others are receiving similar injustices. It would be interesting to know what training law enforcement officials receive about medical conditions such as diabetes.
Thank you for making the public aware. Perhaps some changes will be made so other people with diabetes will not have to go through the pain and torture I suffered.
San Diego, California
My Experience With Medications
In reading my first issue of Diabetes Health, borrowed from my diabetes counselor, I ran across the statement that insulin is an anabolic hormone. Bingo! The article went on to discuss something of the situation of muscles building up when one is on insulin.
Since August 2000, I have gained about 12 pounds. I am not fat; indeed, it is hard for me to put any fat on my normal frame. I am 5 feet 8 inches tall and am 78 years old. My wife and I are very active people. We go swimming and water exercising, and I go on the treadmill for 15-20 minutes several times a week. I had noticed that I was getting more muscular and could not account for this.
I weigh more now than I have ever before and am in much better physical shape than in recent years. Although I have coronary artery disease and had a double bypass 10 years ago, my arteries have stayed clear, as have the bypasses. All in all, the exercise, along with the 10 units of NPH insulin injected every 12 hours, seems to keep my blood glucose under reasonable control. I have been working to get my A1C below 8%, and I think it is down into the 7% level. I have been on insulin for almost two years and take Actos and Tolazamide. I was taking large doses of metformin, but I started having serious diarrhea and had to stop taking it fast! I enjoy a glass of red wine almost every evening at dinner. I have to be careful about having it closely after taking medications. It would be interesting to learn more about the muscle gain, as it is really obvious on me.
Richard E. Panzer, PHD
Napa Valley, California
Correction and a note from our clinical adviser: In the November 2001 issue, the letter to the editor from Elza B. Ulpis about treating neuropathy (p. 14) should have read, "I take Lipitor, not Baycol. Baycol is also a cholesterol-lowering drug, but one that causes muscle disintegration." The FDA removed Baycol, a "statin" drug, from the market in the summer of 2001 because of the side-effect rhabdomyolysis (muscle damage) related to 31 deaths in the United States. This side effect can occur, though rarely, with all the other "statin" drugs: Mevacor, Zocor, Pravachol, Lipitor and Lescol.
Mar 1, 2002