Greate Diabetes Resource

Another great resource for those with type I or II diabetes, LADA diabetes or low carb dieters interested in the peer-reviewed research is created and maintained by Janet “Jenny” Ruhl at, and is called “Blood Sugar 101.”

Jenny explains the reason the site exists:

After losing 30 pounds with a low carb diet, I have maintained that weight for many years. My current BMI is within the normal range for my height. At one point I exercised daily for a year and got my body fat down to 24%, which put me into the “Fitness” category for a woman my age. Despite what my doctors had told me, weight loss and intense fitness didn’t do a thing for my blood sugars, which got worse.

This raised my curiosity. I started tracking through the research articles available for free on the web. (many of them, now, alas, are no longer free, but I was lucky that I started my research back in 2004 when they were.)

The information I found, much of it differing dramatically from what doctors were telling patients about what caused diabetes and how it should be treated, became the kernel of this web site. My goal was to answer these questions: What do scientists actually know about Type 2 diabetes? Why do doctors miss diabetes diagnoses until long after people already have diabetic complications? And what blood sugar levels are truly low enough to prevent further damage to the organs and beta cells?

The site is a treasure trove of information. While Low Carb Age attempts to provide the latest news chronicling the end of the low fat craze, Jenny’s site provides a wide and expansive view of the research spanning back decades. Under the general heading of blood sugar control, Jenny ventures into nearly every area a low carb dieter is concerned about. The site is extensive enough to have been put out in book format:

Jenny maintains a blog also at Diabetes Update where new information is presented.

Both the blog and the Blood Sugar 101 website are highly recommended.

Low Carb on a Cruise?

Chris Dikmen has some great advice on staying on plan during a cruise:

So when preparing for a low-carb cruise, there are really two things that you have to keep in mind:

1. Define a plan for limiting the carbs during your cruise.

2. Accept that cruising without carbs can be enjoyable. You don’t have to have the pies, cakes and breads to have a great time on a cruise. Look at it this way, it is better to be on a low-carb lifestyle and on a cruise than on a low-carb lifestyle and be at home!

He has specifics in the post, and you can tell he’s a pro at this; he has had more than 15 cruises since starting a low carb lifestyle back in 2002.

Loser: Biggest Loser

I’ve avoided the show The Biggest Loser on purpose, but Dr. Doug McGruff happened upon it in the break room between patients in the emergency ward:

I have never watched this show, as I assumed it would be ridiculous. I was shocked how much I had underestimated. I could not believe the amount and types of exercise these poor people were being put through. They even showed one contestant collapsing on a treadmill and being spit off the back of the machine by the spinning tread. Then there were multiple scenes of the contestants being screamed at by that Gillian lady in the tank-top/midriff shirt (talk about narcissistic) and some sadistic guy with tattoos all over his arms. The instructors’ contempt for the obese was obvious as they spewed insults (and saliva) in the faces of the contestants. I don’t care how fat or desperate I was, if someone did this to me I would punch them in the face and storm off the set. I checked in on the show between patients. The diet and exercise shown were prescriptive for ravenous hunger and ultimate failure. As I continued to work, I kept thinking about the importance of biologic signaling, and why it does not have to be this hard.

Dr. McGruff graduated from the University of Texas Medical School at San Antonio in 1989 and studied Emergency Medicine at the University of Arkansas in Little Rock, where he served as Chief Resident. He is one of the “smart guys” I like; not a researcher in some academic office running computer queries to do some fancy meta analysis, but a practicing physician who sees real people with real problems every week.

Every person who has struggled with a “diet and exercise” program to lose weight knows the problem Dr. McGruff identifies:

Overtraining (especially in the obese) triggers cortisol and other stress hormones. A low fat, high carbohydrate diet signals insulin release. These signals defend a high level of stored fat and drive huger…a true prescription for misery and failure.

Theories abound in what passes for dietary science. The ones based on science rather than just observation appeal to me the most. Dr. McGruff explains why a short high intensity workout is better than the Biggest Loser’s cardio-based workouts:

The key to turning around these sorts of metabolic disasters is to send the correct biologic and hormonal signals. If the correct signals are given, there is a disproportionate improvement in the metabolic state and body composition. This disproportionate response is courtesy of a second messenger system. Most hormones do not act directly on their target organ or tissue.

The cell wall protects the cell; most hormones cannot pass through the cell wall easily. Instead, the hormone’s fat soluble receptors bind the hormone on the outside of the cell wall and transmit the signal to a messenger inside the cell itself. I always think of the way an amplifier can take the puny signal from an iPod, process it, and play it through big, power hungry speakers. And in this case, amplification does indeed happen. The second messenger, on the inside of the cell, amplifies the signal:

The unique thing is that the second messenger then activates a chemical cascade that multiplies the signal at the target. This way a single molecule of primary messenger can produce thousands of second messenger signals at the target.

In other words, your cellular stereo amplifier is set on “10” (or “11” if you are a This is Spinal Tap fan).

This is why a proper signal is so important…the beneficial effect is hugely magnified. A brief, but intense workout that fatigues the musculature activates growth hormone, testosterone and adrenaline which all signal to empty glycogen and fat, both short and long-term. A hunter-gatherer diet creates a low insulin signal which triggers the body to defend a lower body fat set point.

The fact is, you don’t need a skinny person who has never fought a weight battle yelling at you to lose weight or become healthier. And chances are, even after that ordeal, your weight problems will return:

On camera, Zwierstra seemed giddy and brash, interrupting host Caroline Rhea, hollering at her friends in the audience, tipsy on her 3-inch heels. Secretly, she was woozy, having dehydrated herself by avoiding liquids, baking in a sauna and fasting for days to skim off those last few pounds.

The studio audience went wild as the cameras panned in. Zwierstra stepped on the scale. Rhea hollered, “Your current weight is …”

The scale heightened the tension: Beep. Beep. Beep.

144 pounds!

She’d lost 45 percent of her body weight.

But it wasn’t enough.

In the end Erik Chopin, a New York deli owner, took home the big check, losing more than 200 pounds from a starting weight that topped 400.

In January he appeared on Oprah to describe how he’d gained half of it back.

The top two contestants of The Biggest Loser’s third season have not solved their problems. The impossible standard set by the program’s extreme exercise program won’t work for them, or for many people. At its heart, The Biggest Loser uses the “calories in / calories out” principle, comparing the human body to a gas engine rather than to a metabolic organism. It is rooted in the 19th century science that measures food content in how much heat it gives off when burned in a furnace, rather than using modern science to understand how the human body actually works.