What's the difference between God and doctors?  Seven year old Erika Watkins can tell you.

Monica Wynn was born in Plymouth, England in 1919, and diagnosed with diabetes in 1927. She remembers weekly visits by a doctor who drew blood from a vein, and reported the sugar results on his next visit – the following week. She also remembers that “some people didn’t like the idea of their children mixing with me sometimes,” as a diabetic child.

Francis Andrews recounts being carried ¼ mile by his brother, who put him into a bed at a hospital in Cheltenham at the beginning of the war in 1939. He speaks of “enormous” needles, the soluble insulin he first used, and the hypo troubles brought about by transitioning to protamine zinc insulin before eventually using globin insulin. He also remembers Benedict’s solution and urine in test tubes boiled over a spirit lamp, and the messes caused by the occasional shattering of those rapidly heated tubes becoming “a sort of rather unpopular event in the household.”

John Browning tells of an “extraordinarily brave” nurse who allowed him to practice his first injections on her in 1957.

These are but a few of the 50 diabetics whose stories are recorded as text and audio interviews at Diabetes Stories – Personal Tales of Diabetes Through the Decades. The Oxford Centre for Diabetes, Endocrinology & Metabolism hosts the recordings “as a contribution to the history of medicine.” I found the discussions of diabetes care from years ago to be fascinating, and the unmistakable instances of British understatement are most entertaining.

Sometimes we feel inundated with complexities, overburdened, and stressed to extremes, and not without good reason. But these histories can help restore a little perspective, particularly when subjects such as WWII air raids, and digging out from beneath the rubble, arise.

Here's a piece on breath analysis testing for hyperglycemia.  It seems that a correlation exists between exhaled methyl nitrate gas and blood sugar, and is discernable without poking holes in the skin.  Is it another step toward accurate, non-invasive glucose testing?

When you get your A1c results, your endocrinologist may also give you an average blood sugar number from a reference chart in the exam room. It helps “translate” the glycosylated hemoglobin figure into something more meaningful, and it’s easy for us to deal with the same apples that our meters produce than the oranges of an A1c percent. As set from the DCCT trials, presently an A1c of 6% correlates to an average blood sugar of 135mg/dl, and 7% equates to 170mg/dl.

Recently, a study of almost 500 Type 1, Type 2, and non-diabetics in Europe, Africa, and North America set out using continuous blood glucose monitoring and finger sticking over a four month period to establish with increased accuracy the correlation between blood sugar values and a newly established A1c standard from the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC.) Apparently, the findings exceeded expectations for accuracy, and officials who conducted the study are preparing to report their findings sometime around the end of the year.

The new IFCC reference number for A1c tests is calibrated in mmol/mol, and can be converted mathematically to mg/dl. In the study, accuracy levels exceeded 90% between the average glucose levels from CGMS/finger sticks and the new A1c test standards.

This all means that our A1c results in the future (hopefully not too long after the study results are published) can be given to us with a more accurate average blood sugar number. So when your endo refers to his A1c--mg/dl chart, you may want ask if it’s up to date with the new IFCC reference numbers.

Remember that commode you got your keester glued to right before your dx?

C’mon, sure you do. Bob Dougherty does.

And his endo says it gave him diabetes.

See for yourself.

Last Friday, NancyTW and I visited Epcot Center at Walt Disney World in Orlando, Florida. For her, it was the first time there, and my first time back since about 1987. We had reservations for dinner at the French restaurant, and found it to be among the most enjoyable dining experiences we have ever had. It was also among the most expensive, but worth every last cent.

About twenty years ago, as I walked the World Showcase at Epcot, a street entertainer in ‘France’ spontaneously performed a perfect pantomime impersonation of me taking a picture with the Nikon I was holding. A moment later, he was making humorous and emotional contact with other visitors, all through facial expressions and body language, without ever uttering a word. He juggled wooden clubs and other props, and his black striped shirt combined with his white make-up to provide me with exceptional opportunities for extraordinary photos of a man silently proficient at putting smiles on peoples’ faces, all on the fly.

In the years since then, I have wondered many times how well the performer would have mimicked me had I sat on a bench and tested my blood sugar.

On Saturday evening, we attended a performance of La Nouba by Cirque du Soleil at Downtown Disney. Similar to the mime of two decades ago, the 90 minute program featured dozens of clowns, mimes, and performers entertaining their audience with feats of incredible dexterity, and humor-filled stories and antics, all without the use of words.

So with memories of a mime from twenty years past, a marvelous experience in the finest French cuisine, and an awe-inspiring acrobatic performance to remember, I have to note the sad coincidence that famed French pantomime Marcel Marceau passed away in Paris this weekend. It is an admirable quality to bring laughter and joy into peoples’ hearts, and even more so when done in silence.

You may be noticing some new and aggressive advertisements on the tube, radio, and the web, that push the importance of knowing your A1c. The ads are a campaign recently created by The Ad Council. For those unfamiliar with this group, it is the biggest PSA outfit in the country, and some very recognizable slogans have come from them in the past, such as “A Mind Is A Terrible Thing To Waste,” and “Friends Don’t Let Friends Drive Drunk.”

The ads are intended to alarm people as to the insidious complications of diabetes that can often be dealt with effectively with enough lead time and proper blood sugar control. Obviously, knowing your A1c gives you an advantage toward reducing the risk of complications by allowing you to intelligently craft a game plan to keep your sugars in line.

Don’t expect any sugar coating, for lack of a better term, to the ads when you see them. The Ad Council is pushing the cold facts of heart disease and stroke right in our faces.

I say, Good For Them!

If you’re diabetic and reading this post, such a campaign may be preaching to the choir. But last week, I wrote about those diabetics who don’t pay close enough attention to their control, and often suffer terrible consequences as a result. The Ad Council is putting these folks right in the crosshairs, and interested diabetics are able to call 1-877-TEST-A1C (1-877-837-8212) or visit www.diabetesA1C.org for more information.