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Books for Folks With Type 1 Diabetes

Roasted Radishes and Brussels Sprouts. For recipe, use search box.

Diabetes Daily has an article by Julia Flaherty that reviews books regarding type 1 diabetes. Just thought you might be interested. It didn’t review Cheating Destiny: Living with Diabetes, which I am mentioned in.

Steve Parker, M.D.

PS: Here’s another book for people with type 1 or 2 diabetes:

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Got COVID-19? You May Not Need That Pulse Oximeter After All

…per a letter to the editor at New England Journal of Medicine.

Study participants were enrolled from Nov 2020 to Feb 2021. So probably before the delta and omicron variants. Outpatients were assigned either to a “standard program” of home monitoring or the standard program + pulse oximetry. There was no difference between groups in terms of “number of days alive and out of the hospital.” For the 30-day trial, that number was 29.4-29.5. In other words, very few of the ~1000 enrolees got very sick.

Pulse oximeters are readily available in the U.S. for ~$40.

The standard program was “COVID Watch, a 2-week program involving twice-daily automated text messages inquiring about dyspnea and offering rapid callbacks from nurses when appropriate. This program has been associated with improved survival as compared with no remote monitoring.5

I spent about 10 mins trying to find the age of these patients. No luck. I don’t even now if they were adults. Thanks, NEJM. I’m not totally convinced that outpatient oximetry has no role in home treatment of COVID-19. But clearly not every patient needs it. Perhaps just those at high risk of hospitalization and death.

Steve Parker, M.D.

PS: Obesity is a risk factor for severe disease from COVID-19. Let me help you do something about it.

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R.I.P.: Dr Sarah Hallberg, a Low-Carb Hero

I was saddened to hear of the untimely death of Dr Sarah Hallberg even though I didn’t know her personally. DietDoctor has a tribute article about her in case you’re not familiar. An excerpt:

Dr. Hallberg first burst onto the low carb scene with a 2015 TED Talk: “Reversing type 2 diabetes starts with ignoring the guidelines” The video advocated using a low carb diet – eating minimally unprocessed whole foods like eggs, meat, and vegetables with butter or cheese – to improve blood sugar and reverse diabetes symptoms.

The video went viral and has now had more than 8.6 million views. As news of her passing spread, hundreds of viewers posted on the site saying how her advice had saved their lives.

Steve Parker, M.D.

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Merry Christmas!

Credit: Zvonimir Atletic / Shutterstock.com

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Is There Anything It DOESN’T Do?: Mediterranean Diet Improves Erectile Dysfunction

From EdenMagnet.com:

A Mediterranean diet is associated with improvements in erectile dysfunction, according to research presented at the European Society of Cardiology Congress 2021.

Erectile dysfunction primarily occurs when small arteries lose the ability to dilate and allow proper blood flow. It is more common in men with hypertension or declining testosterone levels.


“In our study, consuming a Mediterranean diet was linked with better exercise capacity, healthier arteries, and blood flow, higher testosterone levels, and better erectile performance,” says Angelis.

This is news to me.

Steve Parker, M.D.

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Researchers Looking for Volunteers With Type 2 Diabetes Who Want to Try a Mediterranean Diet

Steve Parker MD, low-carb diet, diabetic diet
Olives, olive oil, and vinegar: classic Mediterranean foods

Researchers at RMIT University in Australia, are seeking volunteer research participants to be involved in a study about the management of type 2 diabetes through an alternative dietary plan based on the Mediterranean diet.

Through the clinical trial scientists hope to learn whether a Mediterranean dietary pattern with or without intermittent fasting may better control diabetes, as compared with a conventional diet based on the current recommendations for patients with type 2 diabetes.

Click for brief details. I saw nothing that restricts participation to Australia residents. “Attend online appointments (via Zoom, phone or FaceTime) with the research nutritionist (PhD student) at the start of the study and again at 6 weeks, 12 weeks and 24 weeks.” This type of research is usually very safe and approved by university institutional review boards.

Steve Parker, M.D.

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“Thank You” for Your Support!

I published my first book in 2007 to extend my healing reach beyond the confines of the clinic and hospital room. I’m certain my writing has improved the health of many folks I’ll never know about, and that means more to me than any financial success I’ve had with the books.

In 2020, my net profit from writing was $937.08, which is admittedly pitiful. The prior year profit was $5,802.48. Pandemic effect, maybe? To lower my expenses in 2021, I’ll look into a private PO box instead of US Postal Service ($168/year), drop Amazon Prime ($129/year), and negotiate lower fees with Network Solutions.

I am blessed to have a hospitalist job that pays well. COVID-19 has caused major economic hardship for many of you, including unemployment.

My primary means of advertising has been blogging. Cross-posting on Facebook, Twitter, and LinkedIn has done almost nothing for book sales. A few years ago I could give my hospital patients a business card with links to my books, but my employer insisted I stop.

If you care to support my writing, buy a book. If not for yourself, then for someone you care about.

Steve Parker, M.D.

PS: All my books are here and at Smashwords.com.

PPS: Guesstimating my combined federal and state taxes being 40%, I have $562.25 left after paying taxes. And don’t forget sales tax on many things I might buy with that $562.25. 

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Hospitalized Elderly Patients Benefit From Mediterranean Diet

…at least in Greece, where the study was done.

Santorini, Greek seaside

In an observational study of folks over 65 admitted to a hospital, the Mediterranean diet was linked to:

  • Shorter duration of hospitalization
  • Reduced healthcare cost
  • Improved longevity

The study at hand lasted two years.

Click for details of the traditional Mediterranean diet.

Objective:

Mediterranean diet (MD) has been related to reduced overall mortality and improved diseases’ outcome. Purpose of our study was to estimate the impact of MD on duration of admission, financial cost and mortality (from hospitalization up to 24 months afterwards) in elderly, hospitalized patients.

Research Methods & Procedures:

One hundred eighty three elderly patients (aged >65 years), urgently admitted for any cause in the Internal Medicine department of our hospital, participated in this observational study. Duration of admission and its financial cost, mortality (during hospitalization, 6 and 24 months after discharge), physical activity, medical and anthropometric data were recorded and they were correlated with the level of adherence to MD (MedDiet score).

Results:

In multivariate analyses, duration of admission decreased 0.3 days for each unit increase of MedDiet score (p<0.0001), 2.1 days for each 1g/dL increase of albumin (p=0.001) and increased 0.1 days for each day of previous admissions (p<0.0001). Extended hospitalization (p<0.0001) and its interaction with MedDiet score (p=0.01) remained the significant associated variables for financial cost. Mortality risk increased 3% per each year increase of age (HR=1.03, p=0.02), 6% for each previous admission (HR=1.06, p=0.04) whereas it decreased 13% per each unit increase of MedDiet score (HR=0.87, p<0.0001).

Conclusion:

Adoption of MD decreases duration of admission and long-term mortality in elderly hospitalized patients with parallel reduction of relevant financial cost.

Source: The impact of Mediterranean Diet on duration of admission, medical expenses and mortality in elderly, hospitalized patients: A 2-year observational study – ScienceDirect

I haven’t read the entire article. Didn’t see any need, based on my prior knowledge of the Mediterranean diet. The findings are not unexpected.

Steve Parker, M.D.

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How About Melatonin for Insomnia?

sleep, sleeping, girl, young woman
Dr. Emily Deans says if you need an alarm clock to wake up, you’re probably not getting enough sleep

I often get pages from hospital nurses regarding a patient’s request for a sleeping pill. (Or is the request really from the nurse because a sleeping patient is less hassle? LOL.) My hospital’s formulary limits me to ambien, restoril, trazodone, benadryl, and melatonin. Of those, melatonin seems to be the safest in terms of adverse effects and drug interactions. But does it work?

Dr Harriet Hall over at SBM writes this:

The evidence is mixed and weak. There is some positive evidence for melatonin, and side effects are mild. I wouldn’t discourage anyone who wants to give it a try, but I think good sleep hygiene measures would be a better first step for treating insomnia.

Furthermore…

The optimum dosage has not been established. In studies, the doses have ranged from 1 to 12 mg. Supplements typically contain 1-3 mg. Dosages between 1 and 10 mg can raise melatonin levels to 3-60 times the levels normally found in the body.

Caution is advisable, since quality control is a documented problem. 71% of products did not contain within 10% of the labelled amount of melatonin, with variations ranging from -83% to +478%, lot-to-lot variability was as high as 465%, and the discrepancies were not correlated to any manufacturer or product type. To make matters worse, 8 out of 31 products were contaminated with the neurotransmitter serotonin.

If melatonin works by placebo effect alone, it will help ~10% of users, almost always without adverse effects. I dose it at 1.5 mg, with a repeat dose an hour later if needed.

Steve Parker, M.D.

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The 1976 Swine Flu Vaccine Fiasco

elderly, face mask, surgical mask, corona, epidemic, pandemic, couple
Vaccinate or not?

Most of you don’t remember the 1976 flu epidemic. Early on, it appeared to be on track to equal the 1918 Spanish Flu death rates. Politicians and public health authorities felt like they better do something, anything, to avert disaster. Their response didn’t work out too well. COVID-19 isn’t the flu, but it’s a viral illness that often looks like the flu clinically.

From Discover magazine:

Vaccines were once thought of as an axiomatic good, a longed-for salvation in the form of a syringe, banishing crippling and deadly infections like polio, smallpox and tetanus. But within the past few decades we have seen the emergence of anti-vaccination movements and a rise in cases of childhood diseases that are entirely preventable with a quick jab to the arm.

Over the past five years, outbreaks of mumps, measles and whooping cough have cropped up throughout the country. And then, of course, there is widespread skepticism among the general public on influenza and the merits of a seasonal flu shot. Even as outbreaks of avian and swine flu have periodically emerged in this country, there are still people who resist vaccination against the flu. This seemingly pervasive opposition to flu vaccination is not without its historical and sociological roots.

Some of the American public’s hesitance to embrace vaccines — the flu vaccine in particular — can be attributed to the long-lasting effects of a failed 1976 political campaign to mass-vaccinate the public against a strain of the swine flu virus. This government-led campaign was widely viewed as a debacle and put an irreparable dent in future public health initiatives, as well as negatively influenced the public’s perception of both the flu and the flu shot in this country.

* * *

But while the World Health Organization adopted a cautious “wait and see” policy to monitor the virus’s pattern of disease and to track the number of emerging infections, President Gerald Ford’s administration embarked on a zealous campaign to vaccinate every American with brisk efficiency. In late March, President Ford announced in a press conference the government’s plan to vaccinate “every man, woman, and child in the United States” (1). Emergency legislation for the “National Swine Flu Immunization Program” was signed shortly thereafter on April 15th, 1976 and six months later high profile photos of celebrities and political figures receiving the flu jab appeared in the media. Even President Ford himself was photographed in his office receiving his shot from the White House doctor.

* * *

The American public can be notably skeptical of forceful government enterprises in public health, whether involving vaccine advocacy or limitations on the size of soft drinks sold in fast food chains or even information campaigns against emerging outbreaks. The events of 1976 “triggered an enduring public backlash against flu vaccination, embarrassed the federal government and cost the director of the U.S. Center for Disease Control his job.”

One aspect of the fiasco was that of the 45 million U.S. residents hastily vaccinated against Swine Flu, 450 developed a severe neurological disorder called Guillain-Barre syndrome.

RTWT.

Steve Parker, M.D.

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