Eat for your gut type

I love this name. I have to give credit to Soraya Petroff, specialty sales representative with Eli Lilly.
This concept refers to research showing that it is the bacteria in your gut, not your blood type or personal genetics, that has the greatest influence on how different foods effect you.
You can find out what foods are more likely to work well with you or fight with you by having your gut biome DNA tested. The results will reveal the foods optimal to your health.
If you want to get this done, got to www.daytwo.com   I hope to have a discount code soon for you so you don't have to pay full price.
I am fascinated with my analysis.  Fat content, protein content a portion size play a big role in the score of a food. the food is scored 1 to 10 with 10 being the best on my blood sugar, meaning it will raise my blood sugar the least. A 1 score is the worst, meaning it will raise my blood sugar the most. fore example, both brown and white rice served plain are 1.5 and 1.4 respectively. So much for the brown rice theory being good for me. But if I prepare the brown rice as risotto with mushrooms, this recipe adds cream and cheese which adds fat and protein. Now the score goes up to 7.6.  The calories go up so I have to watch the portion size. This needs to be kept as a side dish, not an entree. a 4 oz serving is recommended. Another example, I was looking at spaghetti carbonara. Scores ranged from 3 to 7. Why such a wide range? The one with 3 was a 12 oz serving, the one with 7 was a 3.5 oz serving. Simple math. Keep it a side dish, not an entree.

New year and the office changes

New face at the front desk: Lauren Bony, who you may know as my medical assistant, is filling in at the front desk for an indefinite time. She did this for a brief bit a couple years ago and it's taking her a moment to get used to it again. Please be patient as we get back up to speed. Since I don't have her as my MA I now have to do more myself and it's taking a little longer for everything to get done, but it is getting done.
Please pass this on to any of my patients so they all know what's going on.

More bad news about pot and T1 diabetes

Study finds higher risk of diabetic ketoacidosis in pot users.

I love my daily diabetes updates- look what I found!

Study shows efficacy of mDiabetes app in reducing A1C levels

A study in Diabetes Care showed that type 2 diabetes patients who used mDiabetes, a smartphone-based app with an individualized diabetes management algorithm, significantly improved their A1C levels and had more significant A1C reductions below the 7.0% threshold after 24 weeks, compared with those who used a paper logbook. South Korean researchers recruited 172 patients, ages 19 to 80, and found that 31.1% of those in the mDiabetes group experienced a drop in A1C levels below 7.0% without experiencing hypoglycemia, compared with 17.1% among those in the logbook group.

What to do about your basal insulin

You've tried them all; Lantus, Basaglar, Levemir, Tresiba, Toujeo. Either they don't meet your needs or they cause side effects. What is next? An insulin pump! this is by far the most predictable delivery of basal insulin. You get a fine trickle of short acting insulin for 24 hours. The new pumps by Medtronic and Tandem are very high tech. If you want to get in to that I am more than happy to support you. If you want simple insulin delivery then go with the Omnipod. Few buttons to push, no tubing and if you order now you will get the DASH upgrade free when it ships next year.
Diabetes only gets more difficult with age. Modern technology makes it easier.

Is stress shortening your life?

Everybody experiences stressors. How this affects you health and longevity depends on how you respond to stress.  Do a Google search on "does stress shorten your lifespan" and you find an abundance of articles and research demonstrating the relationship between stress response and lifespan.

There is an abundance of resources to help you better respond to stress.  Many are free ans simple to do. But, similar to eating healthy and exercising, they are often forgotten or dismissed.  How you prioritize your health is reflected in what you do to stay healthy.

There is a more thorough approach to stress management called resilience training.  Resilience is the concept of dealing with stress in a positive and healthy way that allows you to bounce back better than you were before the stressor.  You know that muscles get stronger by using them to their maximum. In the same way you can get mentally and emotionally stronger by using stress as mental weight lifting. The challenge is to engage these mental exercises regularly, just as you should be doing with physical exercise.

The methods utilized in resilience training are quick, simple and have been shown to be clinically effective. Pick up a training book on Amazon, find a few exercises that fit with your schedule and personality, and DO IT.

I am planning to offer a resilience training workshop in February 2019. My current plan is to have a 60-90 minute session once weekly for 4 weeks. Start time would be 5:15 pm.  Attendees are expected to purchase the workbook and read the introductory chapter prior to the first class.  I haven't determined the fee yet, or if it will be billable to insurance. I will keep you posted via this blog and my office Facebook page.

Give me the placebo!

But don't tell me I'm getting it. If I know then it won't work.
I was looking at data on a recently-approved medication for migraine prevention. For $600 a month I can reduce my average migraine from 8 per month to 4 per month. The cost-free, side-effect free placebo reduced migraine days from 8 per month to 6 per month. If the placebo doesn't' work I can always switch to the real medication.
The power of placebo is real. Clinical trials routinely include a placebo group. The response rate to the placebo varies depending on what condition is being treated. The 'side effects' on placebo are also interesting, further demonstrating what the power of the mind can do.
I think that the power of placebo frightens off a lot of 'alternative practices' from doing any science to demonstrate safety and efficacy. What if they discover that the recent fad of (insert name of fad) is no more beneficial than placebo?  On the other hand, if I don't know that it's a placebo it might work for me!
Dr. George Lundberg has some excellent articles  that discuss the placebo effect. In 1998 he and Dr. Phil Fontanarosa wrote:
There is no "alternative medicine." There is only medicine:
Medicine that has been tested and found to be safe and effective. Use it; pay for it.
And, medicine that has been tested and found to be unsafe or ineffective. Don't use it; don't pay for it.
And, medicine for which there is some plausible reason to believe that it might be safe and effective. Test it and then place it into one of the other two categories.
This approach sounds simple. It also can be threatening to the multi-billion dollar industry of nutritional supplements. Try it and see if it works? Look back on the comment 'there is some plausible reason...". If it's cheap and harmless it might be worth a try. The likelihood of success depends on your susceptibility to he placebo effect.
There are plenty of trials for a variety of nonprescription therapies showing various benefits and failures. It's not always easy to find these reports. You need to know how to navigate PubMed and Google Scholar and know how to stratify the validity of the studies. As examples, there have been clinical trials for migraine headache using coenzyme Q10, riboflavin and melatonin. The studies weren't sufficiently large enough to garner the attention of the American Headache Society but the data supports at least giving it a try. On the other hand, herbal treatments purported to be useful for headache, including ginger, wood betony, feverfew and vervain, have no actual data. They have the support of history and urban legend. I have no idea what the effectiveness is above placebo.
I recommend the following articles by Dr. Lundberg to round out the discussion:
Accidental genius of homeopathy
Therapeutic (non) touch.