Inhaled Insulin (“Exubera”) This new product which is manufactured by both Pfizer and Nektar Theraputics has been approved for distribution in both Europe and the USA. It will be packaged as powder in a 1-mg and 3-mg blisters which the patient will empty into an eyeglass case-size container to be inhaled. Exubera has been approved for both type 1s and type 2s, and will address mainly the postprandial (meal-related) hyperglycemia. Active or previous (past 6 months) smokers, or anyone with a pulmonary (lung) condition will be discouraged from using this modality. When compared with the newer fast-absorbing insulin, Exubera had comparable activity profile. Many patients with type 2 diabetes who have an elevated HbA1c but a normal fasting glucose level, will benefit from Exubera before or right after eating. In type 2s, the ability to secrete insulin from the pancreas is constantly on the decline, making Exubera a good alternative. Type 1s, on the other hand, need more accuracy of dosing, and typically need treatment for many years. Current long-term clinical experience with this agent is limited to only 7 years. Time alone will tell if longer use of Exubera will be safe.   Xylitol This is a natural sweet-tasting substance found in fruits such as raspberries. It has 1/3 the calories and has been approved by the FDA as a food-additive. Interestingly, it has been found to interfere with some oral bacteria that are responsible for cavities. In studies around the world, it has been found that chewing xylitol-sweetened gum was associated with a 30%-60% reduction in cavities. Other studies found that chewing gum with 7 to 10 grams a day of xylitol for 5 weeks reduced bacteria by 10-fold. Overdoing it with 30 to 40 grams a day of xylitol may cause gas, intestinal cramping and diarrhea.
RED GRAPEFRUIT In patients with coronary heart disease who did not respond to statins (Zocor) for lowering the cholesterol levels, red grapefruit seemed to be much more potent in lowering triglyceride levels than either a plain grapefruit, or no grapefruit at all. The star ruby grapefruit has a yellow peel with a red blush and an intensely red pulp. It is very sweet, and has few or no seeds. For the diabetics – please check your sugar, and for all – please enjoy! **Please note, grapefruit and grapefruit juice may interact with some popular medications like Lipitor and Procardia. The interaction could lead to potentially dangerous effects. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.
HYBRID DIABETES “Hybrid Diabetes”. More children are presenting with a new form of diabetes that can be characterized as “hybrid”, since it has characteristics of both types. These children may have the antibodies found in type 1, and also may be obese and therefore have insulin resistance. One could hypothesize, that since obesity is so prevalent, it could act as an accelerator for those individuals who are destined to develop antibodies. Neither condition is advantageous, both together are definitely a bad mistake…
GASTRIC BANDING FOR OBESE ADOLESCENTS Gastric Banding for Obese Adolescents. There are approximately 11 million obese children in the US. Many of them go on to develop the many complications that are attributed to this condition, not the least of which is diabetes. All complications may be averted by significant weight loss, which quiet often is very difficult to achieve. The LAP-BAND device is an adjustable gastric banding device which is introduced laparoscopically, during a procedure that takes about 55 minutes. The advantage versus the gastric-bypass surgery procedure is, of course, the option of removing the band at any time. Given the fact that we still know very little about normal body-energy-control, a procedure such as this one is reasonable. Agents such as Byetta, however, may change all of this in the very near future.
GLUCOSE METERS FOR THE VISUALLY IMPAIRED Glucose Meters for the Visually Impaired. More than 3 million diabetics in the US are visually impaired. A new meter which says out load the glucose value is coming shortly to the marketplace. It’s called the SesoCard Plus, and it has many good features. It’s small, and it requires a very small drop of blood – 0.5 microliter, and it gives the result in 5 seconds. It has a large visual display, and stores 500 tests results in its memory. It should be coming in September of this year, and will be of great help to those who have poor vision.
VITA-BETIC SUPPLEMENT FOR DIABETICS The Litvin Centers for Diabetes is now offering Vita-Betic sugar-free multivitamins designed with diabetic nutrition in mind. Persons with diabetes need to safeguard their health. Vita-Betic is a multivitamin which in addition to all the standard/essential vitamins has other ingredients which have been found to be beneficial to the typical diabetic patient. Vita-Betic is specially formulated with essential Chromium and Vanadium which are helpful in improving insulin action and various herbs which promote anti-oxident activity. Many multi-vitamins contain sugar and do not include all the nutrients that may be valuable for a diabetic's nutritional needs. Vita-Betic was specially made with the diabetic in mind, it supplies vitamins, minerals, and nutrients that are essential for people with diabetes to achieve their optimum health. This is a special offer at a reduced cost. For more information, click here.
FREE DIABETES SUPPLIES FOR MEDICARE PATIENTS ---------- WWW.DIABETES-DOCTOR.COM We recently added a new area to our web site called "Diabetes Supplies." Patients with Medicare coverage may be eligible to receive FREE DIABETES SUPPLIES through the LCD (Litvin Centers for Diabetes). We offer FREE Shipping anywhere in the U.S. and the convenience of no paperwork to process. To find out if you qualify, call or Enroll today and our professional staff will contact you.
Waist Circumference is a Strong Predictor to Heart Disease In a study coming out of the Cooper Institute in Dallas data from 33,000 men was collected between 1979, and 2003. In this group, a 5-cm increase in waist circumference was associated with a 17% increase in cardiovascular mortality (death). This is a very simple parameter to follow, and should be taken seriously by every individual at risk for heart problems (that means all diabetics).
Office News Podiatrist On Board. We have a new podiatrist! Dr. Michael Rosenblum has been a podiatrist for many years, and has extensive experience in taking care of diabetics. He has joined our center as of March 2006, and will have weekly sessions at both of our locations. In addition to giving on-going care, Dr. Rosenblum will also be able to fit you with diabetic shoes. Please inquire with our receptionist when you can be scheduled.

Fort Lee Office Hours	West Orange Office Hours
Day From To Mon 8:30 am 5:30 pm Tue 8:30 am 5:30 pm Wed CLOSED CLOSED Thu 8:30 am 5:30 pm Fri 9:00 am 1:00 pm Sat CLOSED CLOSED Sun CLOSED CLOSED	Day From To Mon CLOSED CLOSED Tue* 9:00 am 3:00 pm Wed 9:30 am 5:00 pm Thu CLOSED CLOSED Fri 9:30 am 4:30 pm Sat CLOSED CLOSED Sun CLOSED CLOSED *Dr. Litvin is in every other Tuesday of the month.
Fort Lee Address 158 Linwood Plaza Fort Lee, NJ 07024 201-461-0585	West Orange Address 622 Eagle Rock Avenue West Orange, NJ 07052 973-736-1221

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