Letters to the Editor
To Your Health
Thank you to Hope Warshaw for her new book, "Guide to Healthy Restaurant Eating" (Book Review, November 2002, p. 83). Having the food facts at hand helps take the guesswork out of eating.
But in our society, where one in three adults is obese, where the rate of obesity in children is at new highs, where diabetes is becoming epidemic, where cancer and heart disease (the top two killer diseases) are linked to diet, one would hope that all food-related establishments—from grocery stores to magazines and newspapers that print recipes—would prominently feature the nutrition information that Warshaw has compiled in her book and that may, in some cases, be available online.
While we have nutrition labels on most grocery items, that is not the only way people eat. Envision a world where food facts are readily available for all to see at the point of purchase. This is possible, but it would take commitment on the part of publications that print recipes, stores that sell foods by the pound, restaurant chains and other eating establishments.
With greater disclosure of nutrition information, consumers have a tool to make informed decisions for themselves and their families. And when nutrition facts are readily accessible and easy to see, consumers are more likely to use them. Those who refuse to supply this information are part of the problem, not the solution. Please help us urge them all to make the information available.
Chevy Chase, Maryland
Good Things and Bad
As usual, I have nothing but great things to say about your magazine! Even after 30 years with this disease and with no complications, the information helps me to do well with life and diabetes. I think it is so important to keep focused on the things that do work with this disease, which your magazine does.
I run the North County Diabetes Support Group in San Diego and think your emphasis recently on the good things diabetes does for people is a wonderful way of giving a new perspective on the disease! From the support group, I know people who often get mired in their "victimized" role, which does nothing for their diabetes or for the problems they (or their children) face.
Cyndee Fena, RDH-MT
U Be the Judge
I just read the article "Could U Be in Danger?" (November 2002, p. 74) and applaud the efforts to remove the shorthand "U" as an abbreviation for "units" of insulin. However, I was shocked by your concluding sentence: "By now, you probably realize that the original dispensing pharmacist misread the doctor's handwritten ‘Lantus 20 U’ as ‘Lantus 200.’"
I don't profess to understand the rules that pharmacists are obligated to follow, but it would seem to me that they should be transcribing the physician's order exactly. A pharmacist who read the prescription as "Lantus 200" must have been inferring the units, and it's not a pharmacist's job to infer.
I've never encountered a pharmacist error, as all pharmacists I've worked with are required to verify prescriptions and dosages before dispensing.
Spokane Valley, Washington
I enjoyed your article "Remembering Mom" (My Own Injection, October 2002, p. 10). I, too, was in the service and when I was widowed in 1954, I still had two boys, ages 2 and 7, to raise. But in 1955 I was able to get a G.I. loan for a house in Phoenix, Arizona—brand new, too! I was employed by an aircraft company that submitted a letter supporting me. I don't know if that made a difference to the government. It disturbed me that your mother met with defeat.
Also, have you heard of the Foster Grandparent Program? It is great for retirees who want to work in schools, nurseries, etc., allowing them to assist in many ways. It is a government program, and we do receive a small stipend that we do not have to "declare" in taxes. I have been in it for eight years. It's the best thing for retirees to come down the pike! It might make a good story for some who might be depressed after hearing they have diabetes.
Mable E. Ludwig
Type 2 Meds
I appreciated the article "Oral Medication Options for Treating Type 2 Diabetes" in the August issue (p. 40). One point is important to correct. There is only one meglitinide: repa-glinide (Prandin). Nateglinide (Star-lix) was assigned a name with an unfortunate similarity to repaglinide. Because they sound the same, multiple authors assume that they belong to the same class.
Nateglinide is a D-phenylalanine derivative, a new class of insulin secretagogues. If authors want to refer to them in the same group as repaglinide, the more appropriate label would be "insulin releasers" or "insulin secretagogues."
Robert J. Anderson, MD, FACE
Chief, Omaha VA Section of Endocrinology, Diabetes and Metabolism
Professor of Medicine, Creighton University School of Medicine
We asked R. Keith Campbell, author of the article, to respond.
Dr. Anderson is absolutely correct. In publications for diabetes patients, many authors with space limitations throw these two medications into the same category since they act in a basically similar manner. It would be correct to have these two different chemical classes of drugs put under the category of insulin secretagogues. However, that could become a bit confusing since sulfonylureas are also secretagogues.
R. Keith Campbell, RPH, CDE
Professor, Pharmacy Department
Washington State University