Category Archives: Uncategorized

New Insulin Delivery Recommendations 

Going in at a 45 degree angle with a 6 mm needle

Going in at a 45 degree angle with a 6 mm needle

“Many primary care professionals manage injection or infusion therapies in patients with diabetes. Few published guidelines have been available to help such professionals and their patients manage these therapies. Herein, we present new, practical, and comprehensive recommendations for diabetes injections and infusions. These recommendations were informed by a large international survey of current practice and were written and vetted by 183 diabetes experts from 54 countries at the Forum for Injection Technique and Therapy: Expert Recommendations (FITTER) workshop held in Rome, Italy, in 2015.”

Source: New Insulin Delivery Recommendations – Mayo Clinic Proceedings

Here are some bullet points that most insulin users need to know:

  • Average skin thickness is 2 to 2.5 mm, with 90% of people under 3.25 mm.
  • Use the shortest needles: 6 mm for syringes, 4 mm for pen injectors. The short needles help you avoid injections into muscle. Injection into muscle increases risk of hypoglycemia and wide blood glucose excursions.
  • Acceptable injection sites: abdomen, thighs, buttocks, upper arms (usually on the back of the arm).
  • If an arm site is chosen with a 6 mm needle, inject into a lifted skin fold (otherwise you might hit muscle).
  • When using the 6 mm needle, inject into a lifted skinfold if you are a child or normal-weight adult. Alternatively, insert the needle at a 45 degree angle.
  • The preferred site for regular insulin (soluble human insulin) is the abdomen, for faster absorption.
  • Use needles only once. (Admittedly, many get away with multiple uses without much trouble.)
  • Don’t inject into lipohypertrophy areas. Lipohypertrophy eventually is an issue in half of insulin users. It is a localized area of swelling or lumpiness at the site of prior injections. It’s often easier to feel than to see. Injection into these areas causes erratic absorption of insulin, with potential widely fluctuating and unpredictable blood sugar levels.
  • Rotate injection sites to avoid lipohypertrophy.
  • If using cloudy insulins (e.g., NPH and some pre-mixed insulins), gently roll and tip the vial or pen until the solution is milk white.

Click here to read about…

  • How to roll and tip a vial to make cloudy insulin milk white.
  • Proper needle disposal.
  • Insulin infusion sets for continuous subcutaneous insulin injection via pumps.

Steve Parker, M.D.

Leave a comment

Filed under Drugs for Diabetes, Uncategorized

Whole Health Source Blog: Do Blood Sugar Levels Affect Hunger and Satiety?

From Dr. Guyenet:

“You’ve heard the story before: when you eat carbohydrate-rich foods that digest quickly, it sends your blood sugar and insulin levels soaring, then your blood sugar level comes crashing back down and you feel hungry and cranky.  You reach for more carbohydrate, perpetuating the cycle of crashes, overeating, and fat gain.

It sounds pretty reasonable– in fact, so reasonable that it’s commonly stated as fact in popular media and in casual conversation.  This idea is so deeply ingrained in the popular psyche that people often say “I have low blood sugar” instead of “I’m hungry” or “I’m tired”.  But this hypothesis has a big problem: despite extensive research, it hasn’t been clearly supported.  I’ve written about this issue before.

A new study offers a straightforward test of the hypothesis, and once again finds it lacking.”

Source: Whole Health Source: Do Blood Glucose Levels Affect Hunger and Satiety?

The study at hand involved 15 healthy young men. Results may not apply to overweight post-menopausal women with T2 diabetes, but I bet they do.

Steve Parker, M.D.

2 Comments

Filed under Uncategorized

Mediterranean diet tied to lower risk of gallbladder surgery

“About 700,000 cholecystectomies are performed every year in the United States, according to the American College of Surgeons. Most are the result of blockage due to gallstones. “Gallstones are very common, but most of them are asymptomatic, meaning people have no symptoms. If you don’t have any symptoms from your gallstones, there’s no reason to have your gallbladder removed,” said Dr. James Lewis, a gastroenterologist at the University of Pennsylvania in Philadelphia who was not part of the study.

The vast majority of people with gallstones never have problems from them, Lewis said in a phone interview.”When they do cause problems, then having your gallbladder removed is completely appropriate,” he said.

64,000 women surveyedThe new study, led by Dr. Amelie Barre at the University of Paris Sud in Orsay, used information on nearly 64,000 women who were born between 1925 and 1950 and covered by a national insurance plan. Every two years, they answered questions about their health status, medical history, and lifestyle.

Over the course of 18 years, 2,778 of the women had their gallbladder removed.Women who ate the most legumes, fruits, vegetable oil, and whole grain bread were anywhere from 13 to 27 per cent less likely to have gallbladder surgery than were women who ate the least of those foods.”

Source: Mediterranean diet tied to lower risk of gallbladder surgery: study – Health – CBC News

Leave a comment

Filed under Uncategorized

The Telegraph Asks: What’s so healthy about a Mediterranean diet?

Click the link at bottom for details about the healthy Mediterranean diet. You’ll see a reference to a low-carb Mediterranean diet that helps newly diagnosed type 2 diabetics avoid drug therapy. Click here my free low-carb Mediterranean diet.

Some quotes:

“A diet with a name that conjures up memories of suppers in the sunshine, the Mediterranean diet plan celebrates the fresh, colourful produce of a region that boasts an enviable life expectancy. Hence why it has been heralded as one of the world’s best diets – but what makes Med cuisine so healthy?

What is a Mediterranean diet? The diet plan consists mostly of fruit, vegetables, whole grains, pasta, rice and olive oil, with a moderate amount of cheese, wine, yogurt, nuts, fish, eggs, poultry and pulses, and meat thrown in.

Unlike our diet in the UK, which tends to be very high in saturated fats (pies, pastries, meats, pizza and take away foods like kebabs and burgers), the Mediterranean diet includes more monounsaturated fats, such as plant oils, nuts, seeds and oily fish.”

Source: What’s so healthy about a Mediterranean diet?

Leave a comment

Filed under Uncategorized

Improve or Prevent Knee Arthritis With Quad Strength

Osteoarthritis, aka degenerative joint disease, is quite common in folks over 45 and eventually may require knee replacement surgery. Recovery from that surgery is slow and painful; best to avoid it if you can.

Having good strength in the muscle that extends the knee helps to preserve the knee joint. That muscle is the quadriceps.

Click below for the evidence:

“Although limited, the reviewed studies suggest that participation in a resistance training program can potentially counteract the functional limitations seen in knee osteoarthritis; positive associations were found between increased muscle strength and walking self-efficacy, reduced pain, improved function, and total WOMAC score. Notably, improvements were greater in maximal versus submaximal effort testing, possibly due to a ceiling effect.”

Source: Strength training for treatment of osteoarthritis of the knee: A systematic review – Lange – 2008 – Arthritis Care & Research – Wiley Online Library

To get started on strengthening the quadriceps muscle, consider the following four-minute video that is two minutes too long:
Note her mention of ankle weights.

Steve Parker, M.D.

PS: If you’re overweight or obese, you lower limb joints will last longer if you lose the fat by following one of my books.

Leave a comment

Filed under Uncategorized

Experts Advice: How To Better Cope With Diabetes

“Life is hectic as it is. There is the stress of school, the stress of job, the stress of doing a good job, the stress of being a good parent, child, friend, employee… you name it.

However, imagine, the added level of stress one has to deal with when it comes to diabetes and its management.

Having diabetes can cause both physical and emotional stress on the body, which in turn can further deteriorate ones’ health. When you are stressed, your blood sugar levels rise. When your blood levels rise, we all know the implications and complications it can cause to your body.

In order to respond better to our readers. we recently interviewed experts in the field of mental health for some of their wise advise.

We asked 28 experts (psychologists and psychiatrists) to answer the following question we are asked often: How people with diabetes can better cope with the stress that diabetes can lead to?

Please read below their responses.”

Source: 28 Experts Share Their Advice: How To Better Cope With Diabetes

Comments Off on Experts Advice: How To Better Cope With Diabetes

Filed under Uncategorized

Another Study Demonizes Red Meat: Justifiable?

I don't know about these, but some fish have white meat (flesh), too

Lobster meat is white, too

If you hear elsewhere about a recent study blaming red meat for kidney failure, be aware that the headline should read “pork.” Read on for details.

Wait, what? I thought pork was “the other white meat.”

First they told us red meat caused cancer. Then cardiovascular disease. Then diabetes. And now kidney failure. Why eat it at all? I still do, but in moderation.

You have to take studies like this with a grain of salt. There are numerous confounding factors that may invalidate results. For instance, if you’re not Chinese and living in Singapore, results of this study may not apply to you. For another instance, Chinese pork may be different from English, Indian, Canadian, and U.S. pork.

A quote from the article at MNT:

“Researcher Woon-Puay Koh and her team delved into data from the Singapore Chinese Health Study, which included more than 63,000 adults, aged 45-74. They linked the data with the Singapore Renal Registry, which holds the records of all Singapore ESRD patients. The overall aim was to uncover the role of different protein sources on kidney health outcomes.

“We embarked on our study to see what advice should be given to chronic kidney disease patients or to the general population worried about their kidney health regarding types or sources of protein intake,” explains Koh.

In China, the primary red meat is pork, accounting for 97 percent of red meat intake. Other popular protein sources included eggs, dairy, shellfish, fish, soy, legumes, and poultry.

The participants were followed up for an average of 15.5 years. During that time, 951 cases of ESRD [end-stage renal disease] occurred; the resultant data showed a clear trend.

Red meat intake was associated with a dose-dependent increased ESRD risk. Individuals who consumed the highest amounts of red meat – the top 25 percent – showed a 40 percent higher risk of developing ESRD than those who consumed the least red meat – the bottom 25 percent.”

Source: Red meat consumption linked to kidney failure – Medical News Today

1 Comment

Filed under Uncategorized