What do you think of when you hear the phrase “herbal supplements”? Quack medicine? Snake oil? One of those cheesy natural-method pitch emails we all get? When I first heard about NaturEra from some colleagues who are highly respected diabetes educators, I have to admit, I was very skeptical. But the company was allowed to present this summer at both the American Diabetes Association Scientific Sessions and at the poster session for the American Association of Diabetes Educators’ conference, so I decided to do a little digging to see what exactly the buzz was about this unconventional diabetes management treatment.

An Israeli-based company, NaturEra has launched two products for people with diabetes, aptly named Sugar Crush (for people with type 2) and Sugar Crush Daily (also for people with type 2, but people with type 1 can use it as well). Both products are “liquid dietary supplements” taken twice a day, designed to help PWDs lower fasting blood sugar, prevent post-meal spikes, and lose weight.

Initially selling their products only overseas, NaturEra is now making their debut in the United States. Looking at the ingredient label might make you think this is some kind of science experiment using ingredients from the grocery store, but Uri Man, President of NaturEra, tells me otherwise:

“Sugar Crush and Sugar Crush Daily are so effective because of their unique, and proprietary formulation of herbal ingredients. There are no gimmicks. Instead, it is the exact percentage or concentration of the active material in each ingredient that makes the Sugar Crush formulas the most advanced products available.”

A likely pitch, I suppose… but unlike most bogus “alternative treatments,” Uri and his team have actually attempted to scientifically quantify their claims with a clinical study, which was presented by the ADA and AADE. Their research has shown that for people with type 2 diabetes, Sugar Crush products reduced fasting blood glucose levels by 15-20% in 10 days of use, and by 30-40% in 30 days of use.

Still, what mainstream medical professional would recommend something not FDA-approved for diabetes? Well, I talked to one such Sugar Crush fan, Janis Roszler, RD, CDE and winner of 2009 AADE Diabetes Educator of the Year Award, to find out what she thinks:

“I first heard about Sugar Crush when Uri… emailed me about their products.  I was impressed to hear that their research was going to be featured at this year’s ADA Scientific Sessions and American Association of Diabetes Educators’ conference.  Because their products are made in Israel, I contacted Nechama Cohen, founder of the Jewish Diabetes Association to see if she had heard of Sugar Crush.  She is an award-winning diabetes author, lives in Israel, and has type 1 diabetes.  To my surprise, she told me that she has used Sugar Crush for more than 3 years to help improve her diabetes control.  I then had a member of my website, dearjanis.com, try it.  He has type 2 and had been struggling with his control. After several days, he experienced a significant improvement in his morning glucose levels and began to lose weight.  Over his trial month, he lost about 3 pounds per week.  Not a scientific study, but I sure took notice!”

We spoke to one PWD currently using Sugar Crush, Harry Zuker (whose last name ironically means ’sugar’ in German). He reports that after taking Sugar Crush, his average blood sugar started to drop without having to change his diet or exercise more. His Lantus intake dropped by 12 units, but he said he still used his Glybride-Metformin as usual. He also complained about the bad taste of the product, but with that hodge-podge of herbs and supplements, I suppose you can’t expect gourmet flavor!

For those of you intrigued enough to purchase Sugar Crush, it’s not going to come cheap. Sugar Crush and Sugar Crush Daily together (the recommended combo for people with type 2) will run you $129.95 for 30 days, while Sugar Crush Daily alone, all you’d need if you have type 1, runs $64.95 a month.

Anyone who uses Sugar Crush, or decides now to give it a try, please report back on your experience.

Seeing as how all of my creative mindspace is currently going into selecting bathroom tiles and countertops (oy, remodel madness!), I almost dropped the ball on today’s special holiday: Diabetes Art Day.

This movement is the brainchild of D-blogger and Diabetes Art Therapist Lee Ann Thill. “Diabetes art therapist?!” you say. Yes, indeed. Please review Lee Ann’s recent guest post here about the therapeutic qualities of art expression for people living with the ultra-frustrating and oft-depressing condition of diabetes.

The diabetes online community has jumped on board to share their creative juices via various artwork forms today. Google the term “Diabetes Art Day” today to discover the many, many contributions.  You can also check out the dLife-based group that Lee Ann has created called Art of Diabetes.

If you are one of the creative — yet organized! — types posting original art for the occasion today, don’t forget to link back to Lee Ann’s site for a chance to win a copy of the fabulous new book No-Sugar Added Poetry, a collection of diabetes prose created by the Diabetes Hands Foundation and TuDiabetes.

Personally, I’m more of a wordsmith than a painter or sculptor. But I wanted to share a few of my favorite D-Art genrés today:


First off, Kids’ Art, made with love by my very own 11-year-old daughter:

In the general “Cartoon” category, we have a “MindMap of New Diagnosis” by Paul Forman of MindMapInspiration.com:

In the “Oils” category, have a look at “Glucose” by molecules artist Klari Reis:

In the “Glassworks” category, here is a a 3D model of human insulin by G. David Smith:

And last not least, in the “Warhol” category (?), “Blood Test” by an unknown artist:

As you can see, art invokes psychological exploration, intellectual curiosity, and venting of emotions.

Who knew there was already so much diabetes-inspired art?

A list of galleries to visit, courtesy of Lee Ann:
Drawing Diabetes
Diabetes Supplies Art
Type 1 Diabetes Revealed
Diabetes Art on flickr
Diabetes Art At Justice’s Misbehaving Pancreas

I wish you all and inspired — and inspiring — Diabetes Art Day!

According to Innovation.org, the Pharmaceutical Research and Manufacturers of America (PhRMA) has a new report out on diabetes, which states:

“A record 235 new medicines to treat diabetes, one of the fastest-growing diseases in America, are being developed by America’s pharmaceutical research and biotechnology companies.”

Wow. Do we really need that many new medicines? What about innovations in the devices and technology that help us manage better? And I can’t help wondering, in all of this multi-million-dollar innovation, to what degree actual patients are being asked what they really care about…?

On that note, I am way overdue to review some of the excellent runners-up in the 2010 DiabetesMine Design Challenge, a patient-led innovation competition.

As a reminder, we had over 130 entries from around the country and around the world this year.

In our community voting (over 6,000 online votes cast right here!), three top faves, beyond the actual winners, were as follows:

Touch

An all-in-one lancing device/glucose meter about the size and shape of a mascara applicator. Integrates with the iPhone, too!

{Viewable on Sribd here.}

Type Me

A handheld “organizer” device for kids and young adults with diabetes.

EasyView SportLink

A wristband viewer for your continuous glucose monitor (CGM).

To share our esteemed judges’ review of these concepts in brief, I’m going to borrow from Wired magazine’s playbook by using their “Wired / Tired” method of highlighting the pro’s and con’s. Remember, this feedback came from different individual judges, who naturally didn’t agree on everything:

Touch

Wired: “Nice thought to simplify the process and good aesthetic execution. Bluetooth concept is nice…”

Tired: “… but unfortunately we can’t yet measure BG through the skin using infrared!”

Type Me

Wired: “Nice work thinking through features and interactions, and I really like the avatars and characters to engage with the demographic.”

Tired: “Too big & childish for teens, too complex for young kids. Automated record keeping rarely works.”

EasyView Sportlink

Wired: “Extremely practical and conceptually smart…”

Tired: “… but the design of the actual device is not part of the submission. Wish he would have taken it further and shown us a prototype or at least explained the buttons he’d like on it.”


Here we are, four months out from the close of this year’s contest, and just under seven months ahead of next year’s. That gives all you D-Innovators quite a headstart, if you’re enterprising.

Tune in later this week for a look at the best-of the 2010 “Most Creative Idea” category.

I personally wasn’t able to attend the annual meeting of the American Association of Diabetes Educators this summer.  But I’ve been there a few times. It’s quite the experience for a patient to witness thousands of experts in life-with-diabetes running around between lectures, demos, and expo booths. What are they all buzzing about? Today, a wrap-up from Kelly Rawlings, a type 1 diabetic who happens to be editor of Meredith Publishing’s Diabetic Living magazine.


A Guest Post by Kelly Rawlings of Diabetic Living magazine

I’ve attended three AADE annual meetings. Each time, I have been impressed with the dedication these health care professionals (mainly registered dietitians, nurses, and pharmacists—a few doctors and even an occasional LMSW!) show toward helping their clients—people with diabetes or people at risk for diabetes — treat and live with various forms of the condition.

In the breakout sessions these professionals avidly listen to the presenters, ask specific questions, and frantically take notes about resources for themselves and their clients. They’re hungry for the latest research and treatment options, strategies for behavior change, improved techniques for communication, etc. They also appear to be overworked and underfunded, constricted by too-short patient minutes, and barely keeping their heads above the rising tide of people living with diabetes. AADE expected about 8,000 attendees. Each one of those CDEs would need to see 2,250 different patients annually in order to provide coverage to every person diagnosed with diabetes (and that’s not counting the 6 million or so unaware they have diabetes) in the United States.

I don’t know about you, but I’m often confused about my diabetes. There are so many variables and my life as an ongoing scientific study of one is … messy. Little wonder it’s a tough job for a diabetes educator to help me — or you — untangle the realities of life (often with minimal or no logging — and hey, an educated guess is still just a guess) and adjust treatment to help diabetes fit into our lives instead of molding our lives to fit around diabetes.

So, thank you. To the nurse from a cardio rehab facility whose clients have LOTS of questions about what to eat with diabetes. It’s not his job to provide that info, but he attended a nutrition class in order to better understand the topic. To the licensed master of social work who was shocked that so few educators have experience or training in mental health (I vote for more mental health counselors and therapists to get their CDE certification!). To the tired and footsore attendees (it was a big exhibit hall!) at an Accu-Chek presentation about using paired blood glucose testing to show people with diabetes how their food choices or exercise choices or medications directly affect blood sugars.

I appreciated that the emphasis was on showing, not telling. Listening, not talking. Sharing, not withholding. As one spokesperson from a major pharmaceutical company stated, there are at least 131,000 minutes between office visits (if you see an educator quarterly). Now, if only AADE would show interest in training and certifying a helpful army of volunteers — peer counselors who could assist the professionals and provide support, encouragement, and resources during some of those minutes.


You can find Kelly on twitter @KellyRawlings

This recent testimonial in the Boston Globe, about a writer with type 1 diabetes who chose to keep his illness secret from girlfriend for quite some time, has stuck in my head. I can’t seem to stop thinking about the why’s and how’s of concealing your diabetes from people close to you. What a lot of work that would be! And to what end?

The writer, named Joseph Pierandozzi, starts off by stating that “bodily functions” — including diabetes — are far from first-date topics. Yet after only a few dates, he admits, he and his new girlfriend were discussing other sensitive topics such as attitudes towards religion, and “the politics of eating.” How does a PWD have dinner with someone, while discussing eating habits no less, without letting on that they’re dependent on insulin and that food presents intense challenges to their day-today well-being?

It seems that our hero was quite practiced at the art of D-ception: “I employed my usual spy techniques, carrying only necessary equipment with me on dates (a single syringe and a bottle of insulin hidden in a jacket pocket until I could sneak off to the bathroom), and as we spent more time together, I began testing my glucose levels less often to keep Kristin from seeing my hard-to-conceal glucose meter.”

He talks about perfecting these “diabetic spy games” throughout his 10 or so years of dating. So now I understand the ‘how’ of keeping something as core to your life as type 1 diabetes secret. Sounds exhausting to me! But what bothers me most is the ‘why.’

Let’s face it, secrets are a protection mechanism. People generally keep them in order to protect themselves or someone else. If you’re hiding a medical condition from another person, it’s tough to make the argument that you’re doing it for them. What? You don’t want them to be sad? Not likely. More likely you don’t want them to be “turned off” by you, either disgusted by or frightened of your condition. Because this might lead to their rejection of you.

While I realize that, “Hi! I have type 1 diabetes” isn’t a great pick-up line in a bar, I also can’t imagine sneaking around to test my BG in secret, on date after date. I get it when Joseph says “I refuse to be defined by my diabetes,” but at the same time, it is a big, glaring, day-to-day, minute-by-minute component of your life when you’re dependent on insulin. The way I see it, the longer you put off revealing your condition to someone you care about, the bigger the risk you’re actually taking, because:

• A bigger “deal-breaker” than having a medical condition might very well be keeping the secret for so long. “Didn’t you trust me to handle this well?”

• Sneaking around to hide something like this? You might as well wear a sign on your shirt that says “Insecure.” (Besides, the very act of “living a lie” like this can make you feel like a fraud.)

• If you don’t tell, chances are the secret will slip out some other way — like through a remark made by someone else, or when you’ve passed out on the floor at some party.

• And don’t get me started on the dangers of experiencing a severe hypo when you’re with someone who doesn’t event know you have diabetes (!)

According to psychologist and author Dr. Dale Atkins (no relation to the diet guru), “People keep secrets because they expect to benefit from doing so, but these benefits come at a considerable price that often outweighs the advantages.”

What’s more, she says, “We often exaggerate in our minds how people will respond.” People are often less ruffled and more supportive than we might expect.

But hey, maybe I’m the wrong person to judge the decision to keep your health issues hidden, since I’m just so exceedingly “out there” with mine. (The oversharing generation?)

So on the subject of medical secrets, I’d love to know: What do you all think? Come on, spill the beans…