Blood Sugar

At first glance, Susan and Herb Eckerling's kitchen doesn't look that bad, food-wise. A bowl of fresh fruit graces the tan tile counter, there's leftover steamed cauliflower in the refrigerator and some quick-cooking oats in the pantry. But scratch the surface and signs of poor choices and unnecessary deprivations emerge: Susan's diet is extremely short on whole grains, and neither eats much red meat - even though they like it - because they fear every cut is bad for their health.

On Thursday the Food and Drug Administration issued draft guidelines for researchers and manufacturers working to develop and build an artificial pancreas to help patients with Type 1 diabetes control their blood sugar. About 3 million Americans have Type 1 diabetes, which develops when cells in the pancreas stop producing enough insulin to control blood sugar.  Patients with the disease must monitor their blood glucose aggressively.  If it goes too high, they have to carefully calculate how much insulin they need to bring it in line -- and then get an injection.  If a person with Type 1 diabetes' blood sugar drops too low, he or she could require a dose of another hormone, glucagon, to raise it back up. The unrelenting and error-prone process can be exhausting, so patient advocacy groups such as the Juvenile Diabetes Research Foundation have been pushing the development of an artificial pancreas that would tightly control blood sugar levels much as the actual organ: monitoring glucose levels continually and automatically delivering the right dose of insulin, through a pump, into the body.  The system would work by connecting the monitoring system to a computer, which in turn would calculate the correct insulin dose and send a signal to the insulin pump to deliver the needed hormones.

Willow Shawl doesn't like to draw attention to her Type 1 diabetes. If a stranger asks about the insulin pump clipped to her jeans, the 10-year-old will say it's an iPod. Sometimes she'll forgo checking her blood-sugar levels to avoid the stares of her classmates as she pricks her finger. So for a while in third grade, when she started coming home from school with unusually high blood-sugar levels, her parents suspected she was slacking in her daily routine, even though Willow insisted otherwise.

Two of the most worrisome trends in healthcare - the soaring rates of Type 2 diabetes and dementia - share several key biological processes. And scientists are beginning to think that is more than just a coincidence. Many researchers now believe that proper control of blood sugar could pay dividends in the future by reducing the number of people stricken by Alzheimer's disease, other forms of dementia and even the normal cognitive decline that comes with age. The concept that brain diseases share little in common with diseases arising elsewhere in the body is rapidly crumbling, says Debra Cherry, executive vice president of the Alzheimer's Assn.

A new study found that people who'd had coronary bypass surgery were more than three times more likely to be alive 15 years later if they were happily married than if they were not married. A big part of this effect could be due to the positive influence of a supportive spouse, the authors say -- in getting the patient to live better, take meds, get to doctor appointments, etc. Plus marriage could give someone heightened reason and feeling of responsibility to look after themselves.

Diabetes and heart disease are intertwined in ways that are still not fully understood. The most recent example of this complicated relationship is a study published Monday that finds an experimental medication designed to raise HDL cholesterol (the "good" kind) also appears to control blood sugar and may be helpful to people with Type 2 diabetes. The drug is called torcetrapib -- and it will never be approved. That's because, in clinical trials, the drug caused severe side effects even though it did raise HDL cholesterol.

A diagnosis of diabetes can be devastating, but there are ways to manage the disease--and  exercise is one of them. Join a live Web chat on diabetes and exercise Monday, July 11, at 11 a.m. Pacific time (1 p.m. Central time, 2 p.m. Eastern time) with Dr. Ruchi Mathur and learn how even moderate workouts such as walking can go a long way toward controlling blood sugar and maintaining health overall. We asked Mathur, director of the diabetes program at Cedars-Sinai Medical Center and an endocrinologist at the facility's Weight Loss Center , if people with diabetes should take any special precautions before embarking on an exercise program.

The first time Sonia Sotomayor was tested for diabetes, a lab technician sat her down in a big chair and assured her the needle in his hand would not hurt her. "I kept watching this big needle coming to my arm, and I looked at him and I said, 'Oh, it's going to hurt.' " The 7-year-old Sotomayor hopped off the chair and ran out of the hospital, hiding under a parked car, the hospital staff in pursuit. When they finally dragged her out to draw blood, "I was screaming so much I didn't feel the needle," she said, to knowing chuckles from the audience.

Exercise is beneficial for diabetics, but some questions remain -- how much exercise is needed, and what kind? A study finds that structured exercise programs lasting 150 minutes or more a week may be best for those with type 2 diabetes. The meta-analysis released Tuesday in the Journal of the American Medical Assn. examined 47 randomized clinical trials that included 8,538 patients and lasted at least 12 weeks. Of those studies, 23 focused on structured exercise training and 24 looked at physical activity advice, and all assessed how much the programs lowered hemoglobin A1c levels, a test used to evaluate blood sugar control over several months.