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Saturday, April 28, 2007

Millimoles and Milligrams

I live in a country that uses mmol/L (mmol per litre) as the units for measurement of blood glucose and cholesterol levels, the most common lab numbers used for diabetes management. Most of the world uses that system – but the USA does not. The USA and several other countries use mg/dl (milligrams per decilitre). I havent the faintest idea why, but it can be very useful to be able to convert from one to the other.

My source for the conversion numbers is GlobalRPh.com.


To convert from mmol/L to mg/dl for Cholesterol (total, LDL, HDL, VLDL) divide by 0.0259 or multiply by 38.6.

For Triglycerides divide by 0.0113 or multiply by 88.5.

Lipids ratios are mentioned in several papers discussing their relevance to cardiac risk and insulin resistance; remember to use conversions before applying US numbers. For example, based on those papers the triglycerides/HDL ratio should be under 1.3 for mmol/L and under 3.0 for mg/dl.

Blood Glucose

The conversion rate can be done either by multiplying by 18 (so 5.5 mmol becomes 99, but I usually round to the nearest 5, so 5.5 => 100) or divide by .0555 if you want to get totally accurate. The exact multiplier is 18.018. When accuracy is not critical, using a multiplier of 20 can be quick and useful.

Finally, a quick ready reckoner to convert blood glucose meter readings:

mg/dl mmol/L

Cheers, Alan

Tuesday, April 24, 2007

Wine and Serendipity

I added a PS to my entry on Red, Red Wine today. Sometimes things have totally unforeseen side benefits:-)

I also have CLL, a type of leukemia. Nothing to do with diabetes. But, after I made the changes I mention in this blog, something odd happened. Purely serendipity according to my haemotologists, and maybe it will change tomorrow and Damocles Sword will drop. My CLL numbers improved as my diet and fitness changed and as my diabetes numbers improved.

I became aware of this report today: http://www.physorg.com/news96550822.html
“Antioxidant found in many foods and red wine is potent and selective killer of leukemia cells
A naturally occurring compound found in many fruits and vegetables as well as red wine, selectively kills leukemia cells in culture while showing no discernible toxicity against healthy cells, according to a study by researchers at the University of Pittsburgh School of Medicine.”
I believe that this is the original study:
“These results indicate that cyanidin-3-rutinoside have the promising potential to be used in leukemia therapy with the advantages of being wildly available and being selective against tumors.”

Not just wine, also vegetables. Just serendipity - but the haemotologists tell me to keep doing what I'm doing.

Cheers, Alan

Friday, April 20, 2007

Testing on a Budget

I'm very lucky to be in a country where diabetics in the past have successfully lobbied for specific support within the government health system to assist good diabetes control. I'm eternally grateful for the pioneers who created Australian medicare and the NDSS.

However, I'm daily reminded that others overseas are not so fortunate. Consequently, some have difficulty following the full Test, Test, Test regimen as Jennifer suggests because of strip cost.

For them, I suggest a "one strip a day" method. This works more slowly than following Jennifer's advice completely - but it can still work. When I say "one strip a day" I'm not counting the FBG or other tests the doctor wants - discuss with the doc if you can cut back there. In hard economic circumstances I can't see that doing FBG every second or even third day is going to be a problem for the doc - but check to be sure. Let's face it, the "average" type 2 out there is testing FBG maybe once per week, doing absolutely nothing with the result, and wondering why their A1c goes up every 3-6 months.

This other daily test strip is purely to let YOU know what's happening when you eat.

First, it will take a few extra BG tests for two or three days to discover when your peak timing is. Once you know that for each meal, you can focus on that timing. Some reckon you also need to test before meals to see what the rise was; in these circumstances I would see the pre-meal test as a waste of a strip. Just concentrate on the absolute peak level. Target one meal per week. Most of us have problems with breakfast, so I'd recommend starting there.

Test at the peak spike time, just for breakfast, until you have modified your breakfast to the point where the spikes are acceptable to you. I use Jennifer's guidelines, which are similar to the AACE, but check with your doctor if in doubt. Concentrate on that meal for one week, by that time you should have something workable. I've given some alternative breakfast ideas here, but think outside the square and find what works for you. There is no law that decrees cereal, juice, milk or toast before noon. I just finished a kransky sausage with one dry-fried egg before typing this (it's 7:40am here:-) That will be followed with black, cinnamon-infused coffee.

Then concentrate on Lunch for week two, Dinner for week three and so on. Then repeat over the next three weeks. Over time you will find a range of foods that are OK - and a range of foods that aren't - and slowly build a safe menu base.

Cheers, Alan

Saturday, April 14, 2007

Dieting for Life - What's in a Name?

Hi All

Well, the news is out, here is the headline: Dieting Does Not Work! The scientists are sure of it. It mystifies me that research dollars needed to be spent to discover that. All they needed to do was ask me.

Part of the problem is the definition of that word: "dieting". It's fascinating how a word can change in meaning. A diet used to be just the description of what you eat. You can see the gradual change in the progression of Webster's definitions:
a : food and drink regularly provided or consumed
b : habitual nourishment
c : the kind and amount of food prescribed for a person or animal for a special reason
d : a regimen of eating and drinking sparingly so as to reduce one's weight

Dieting as described in "a" or "b", to regularly or habitually consume food and drink, obviously does work or we'd all starve to death. So in that sense the sensational headline is wrong. But slowly we've come to think of dieting as definition "d" and eating "sparingly" doesn't work because it is unnatural for the human animal to do that as a way of life forever.

I think "way of eating" is a better term for how I intend to eat for the rest of my life, not just to achieve a short-term goal. I think I first saw it used by Bernstein in his book on diabetes. I slowly changed my way of eating continuously since diagnosis; first to lose weight, then to minimise BG spikes, then to ensure that I was getting the best nutrition possible without gaining back the weight or jeopardising blood glucose control.

But to be sustainable, the way of eating has to not only satisfy nutritional needs but our other social and psychological needs: to be able to eat in company comfortably; to be able to munch absently on something while we think; to have "comfort food" occasionally without guilt. The only way to achieve that is to train oneself over time to the point where we like what is appropriate for our needs and no longer crave what is inappropriate. That does not happen overnight and may never happen for some - but, in my opinion, it is the only way to change a way of eating permanently.

I'm only part of the way there myself. But it's amazing what I learnt to like, and dislike, once I accepted that my life does depend on it. Just as an example, I now look on something like mud-cake in the same way that someone with a sea-food allergy would look on lobster. Not that I think it's bad food - just bad for me. So I no longer want it and I don't feel deprived at all. As Jennifer puts it - it's not that I can't have it, it's that I don't want it.

Mind games? Maybe; but possibly life-saving mind-games if you can learn to play them over time.

Cheers, Alan