Glucose balance crucial for diabetes sufferers

Should everyone diagnosed with diabetes strive to have the lowest possible blood sugar? Not in every case.

New research suggests that in some individuals, the medications and treatments required to lower blood sugar to "optimal" levels may actually do more harm than good.

Approximately 26 million Americans have diabetes. Another 79 million are pre-diabetic — meaning they have abnormal glucose intolerance. Those with pre-diabetes are at serious risk of developing type 2 diabetes — the most common form of the disease.

Diabetes involves an elevation in blood sugar (glucose).

One reliable way to follow the overall "average" blood glucose is with a hemoglobin A1C level, which in normal healthy individuals is between 4.5 and 6 percent.

People with diabetes are at a higher risk of other health problems including blindness, kidney disease, heart disease, nerve damage and amputations.

Since high blood glucose is the cause of these health issues, it would seem logical that everyone with diabetes should strive to have blood sugar in a normal range, right?

The truth is that while some individuals with diabetes should strive for blood glucose values that are as close to normal as possible, for others "perfect" blood glucose may be difficult to achieve without causing additional health complications.


A study called Action to Control Cardiovascular Risk in Diabetes looked at the effect that aggressively lowering a patient's A1C could have on their health. The study used over 10,000 individuals with diabetes in their research.

When medications and insulin were used aggressively to get A1C down to less than 6, the risk of death went up, not down.

This phenomenon can perhaps be explained by the fact that aggressively lowering glucose may make patients hypoglycemic, leading to risks of blackout or adrenaline rushes that may be stressful to the heart.

Children with diabetes are particularly vulnerable to medication-induced hypoglycemia.

Children are more likely to have Type 1 ("Juvenile") diabetes, although the rate of Type 2 diabetes among children is presently rising.

People with Type 1 diabetes generally have to take insulin for life. It is very important to educate the child and the family, facilitate good communication between the patient, their family and health care providers, carefully monitor blood glucose and use all available tools to adjust the insulin dose to regulate glucose while avoiding hypoglycemia.

It is crucial that individuals with diabetes work closely with their health care providers to achieve balance in their glucose and overall health.

Even if glucose remains higher in the person with diabetes than it would be in a non-diabetic person, each case should be evaluated on an individual basis to determine exactly how low glucose can be pushed via medication and treatment, without triggering dangerous hypoglycemic reactions

101 Best Food Trucks in America 2012

The Daily Meal picks the 101 best food trucks in America in 2012. According to Smart Money, food trucks accounted for 37 percent of the $1.4 billion in street-vending revenue nationwide last year—a 15 percent increase over the past five years. The Daily Meal came up with a comprehensive pool of candidates by canvassing more than 30 cities, seeking out some 300 street vendors. Added to those were staff favorites and any trucks not already included that have been singled out for praise by organizations and national and local publications, both in print and online. The trucks were judged on four criteria: popularity, critical review, social score and originality. The top three are: Kogi BBQ, Los Angeles, Fojol Brothers, Washington, D.C., and Big Gay Ice Cream Truck, New York. Full Story

FDA: Sunland Knowingly Shipped Tainted Peanut Butter

The latest report from the U.S. Food and Drug Administration’s (FDA) inspection of Sunland, Inc., reveals inspectors found the presence of Salmonella in 28 environmental samples—three of which showed the presence of the outbreak strain of Salmonella Bredeney. The report also suggests the company knowingly shipped Salmonella-tainted products after its own testing program identified the presence of Salmonella.

Portales, N.M.-based Sunland, Inc., is at the center of a multistate outbreak of Salmonella Bredeney that has sickened 38 people in 20 states. The outbreak began in September 2012 and was traced back to peanut butter, nut butters and peanut butter products manufactured in its facility. An initial recall of food products was triggered Sept. 22, but has been expanded nearly 10 times to now include more than 100 brands and nearly 250 products.

During the inspection, conducted between Sept. 17 and Oct. 16, 2012, investigators found that conditions in the company’s facility, the company’s manufacturing processes, and the company’s testing program for Salmonella may have allowed peanut butter that contained Salmonella to be distributed by the company.

FDA inspectors found that between June 2009 and August 2012, Sunland had distributed, or cleared for distribution, portions of 11 lots, or daily production runs, of peanut or almond butter after its own testing program identified the presence of at least one of nine different Salmonella types—Arapahoe, Bredeney, Cerro, Dallgow, Kubacha, Mbandaka, Meleagridis, Newport, and Teddington—in those lots. Two of the lots showed the presence of the outbreak strain of Salmonella Bredeney.

Five product samples collected and analyzed by FDA from Sunland showed the presence of Salmonella, but had not been identified as containing Salmonella by Sunland’s internal testing. Among those products were peanut butter and shelled raw peanuts. Two of these samples showed the presence of the outbreak strain of Salmonella Bredeney. FDA also found the presence of Salmonella in 28 environmental samples—three of these samples showed the presence of the outbreak strain of Salmonella Bredeney.

Upon identifying the contaminated peanut butter, FDA investigators informed the company and called for corrective action. On Oct. 4, 2012, Sunland expanded its ongoing recall to include all products made in its nut butter production facility between March 1, 2010, and Sept. 24, 2012.

Upon identifying the contaminated shelled raw peanuts, FDA investigators informed the company and again called for corrective action. On Oct. 12, 2012, Sunland expanded its ongoing recall to include raw and roasted shelled and in-shell peanuts sold in quantities from 2 ounces to 50 pounds which are within their current shelf life or have no stated expiration date.

Investigators also found employees improperly handled equipment, containers, and utensils used to hold and store food. Employees handling peanut products wiped gloved hands on street clothes and other times failed to wash their hands or change gloves. There were no hand washing sinks in the peanut processing building production or packaging areas and employees had bare-handed contact with ready-to-package peanuts.

There were no records documenting the cleaning of production equipment. The super-sized bags used by the firm to store peanuts were not cleaned despite being used for both raw and roasted peanuts. There was a leaking sink in a washroom which resulted in water accumulating on the floor, and the plant is not built to allow floors, walls and ceilings to be adequately cleaned.

Investigators also found raw materials were exposed to potential contamination. Raw, in-shell peanuts were found outside the plant in uncovered trailers. Birds were observed landing in the trailers and the peanuts were exposed to rain, which provides a growth environment for Salmonella and other bacteria. Inside the warehouse, facility doors were open to the outside, which could allow pests to enter.

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