Triple star system clue to gravity


Millisecond pulsar, left foreground, is orbited by a hot white dwarf star, centre, both of which are orbited by another, more-distant and cooler white dwarf, top right.
The pulsar (L) is orbited by a hot white dwarf star (C) both of which are orbited by a cooler, distant white dwarf (R)

Astronomers have discovered a unique triple star system which could reveal the true nature of gravity.

They found a pulsar with two white dwarfs all packed in a space smaller than Earth’s orbit of the Sun.

The trio’s unusually close orbits allow precise measurements of gravity and could resolve difficulties with Einstein’s theories.

The results appear in Nature journal and will be presented at the 223rd American Astronomical Society meeting.

“This triple system gives us a natural cosmic laboratory far better than anything found before for learning exactly how such three-body systems work and potentially for detecting problems with general relativity that physicists expect to see under extreme conditions,” said Scott Ransom of the US National Radio Astronomy Observatory (NRAO) in Charlottesville, VA.

“This is a fascinating system in many ways, including what must have been a completely crazy formation history, and we have much work to do to fully understand it.”

Pulsars emit lighthouse-like beams of radio waves that rapidly sweep through space as the stars spin on their axes.

They are formed after a supernova collapses a burnt-out star to a dense, highly magnetised ball of neutrons.

Using the Green Bank Telescope, the astronomers discovered a pulsar 4,200 light-years from Earth, spinning nearly 366 times per second.

Such rapidly-spinning bodies are called millisecond pulsars – and are used by astronomers as precision tools for studying gravitational effects and other phenomena.

Subsequent observations showed the pulsar is in a close orbit with a white dwarf star, and that pair is in orbit with another, more-distant white dwarf.

Green Bank radio telescope, West Virginia
Green Bank is 100m wide – the world’s largest fully steerable radio telescope

Three-body systems are keenly studied because they allow competing theories of gravity to be tested.

But until now the only known triple system containing a millisecond pulsar was one with a planet as the outer companion, causing only weak gravitational interactions.

“This is the first millisecond pulsar found in such a system, and we immediately recognised that it provides us a tremendous opportunity to study the effects and nature of gravity,” Prof Ransom said.

“The gravitational perturbations imposed on each member of this system by the others are incredibly pure and strong.”

By precisely timing the arrival of the pulses, the scientists were able to calculate the geometry of the system and the masses of the stars.

The pulsar’s inner white-dwarf companion has an orbital period of less than two days, while the outer dwarf has a period of almost a year.

The system gives the scientists the best opportunity yet to look for violations of the equivalence principle described by Einstein – which states that the effect of gravity on a body does not depend on the nature or internal structure of that body.

This was famously illustrated by Galileo’s dropping of two balls of different weights from the Leaning Tower of Pisa, and Apollo 15 Commander Dave Scott’s dropping of a hammer and a falcon feather while standing on the Moon in 1971.

Rather than drifting to the ground, the feather plummeted, falling as fast as the hammer. Without air resistance to slow the feather, both objects hit the lunar dust at the same time.

“While Einstein’s theory of general relativity has so far been confirmed by every experiment, it is not compatible with quantum theory,” said Prof Ransom.

“Because of that, physicists expect that it will break down under extreme conditions.”

High-precision timing of the pulsar’s “lighthouse” flashes will let astronomers hunt for deviations in the equivalence principle at a sensitivity several orders of magnitude greater than ever before, said astronomer Prof Ingrid Stairs of the University of British Columbia.

“Finding a deviation would indicate a breakdown of general relativity and point us toward a new, correct theory of gravity,” she said.

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Always Tired? Take This Daily to Help Drench Your Body With Energy.


Story at-a-glance

  • Ubiquinol serves an essential function in creating cellular energy. As such it may help reduce the rate of aging, and benefit multiple health problems, from general fatigue to chronic health problems
  • Every comparative study on CoQ10 (the conventional oxidized form) and ubiquinol (the reduced, or electron-rich form) has confirmed that ubiquinol is more bioavailable than CoQ10, which makes it the most effective and least costly alternative of the two
  • A number of studies have shown that ubiquinol is absorbed and metabolized in exactly the same way as ubiquinol from a food source, making it an ideal supplement to optimize your health.
  • Dr. Barry focuses on clinical research development and collaboration and on the development of the technical, business and commercial translation of products and technology.

    Dr. Barry earned his bachelor’s degree in biology from Boston College; his Ph.D. in chemistry/biochemistry from the University of Maryland; postdoctoral research in Biological Chemistry and Molecular Pharmacology at Harvard Medical School; and was a staff researcher in neuropathology at Harvard Medical School.

    He is an active member of numerous professional associations including the American Chemical Society and the American Association for the Advancement of Science.

    What’s the Difference Between Ubiquinol and CoQ10?

    There is a good reason why CoQ10 is one of the most popular supplements sold today. Largely because it is a highly effective metabolic agent and when people use it they tend to notice an improvement, especially in their energy levels.

    Ubiquinol is the reduced, electron-rich form of coenzyme Q10. Although it was well known within research circles since the late 1950’s, it wasn’t introduced commercially until about 2006. Ubiquinol is highly unstable, and therefore not suitable to be put into pill or capsule form. That all changed once a company finally developed the appropriate technology to stabilize ubiquinol.

    “The thing with ubiquinol is, because it’s electron rich, it’s called ‘reduced, this is a chemical term that means it has a couple extra electrons… [which makes it] unstable in light and air. In other words, it will oxidize,” Dr. Barry says.

    Conventional CoQ10 (also known as ubiquinone) is in essence oxidized CoQ10; it is “electron deficient.” Why does this electron deficiency make CoQ10 a less preferable alternative compared to the more electron-rich ubiquinol? And why do you need either of these substances in the first place?

    Dr. Barry explains:

    “In terms of the molecular structure… when we are talking about oxidized and reduced coenzyme Q10, It’s the same molecule; either with, or without, those two extra electrons.

    The fundamental importance of ubiquinol and coenzyme Q10 is metabolic energy… It’s an essential component of the electron transport chain in the mitochondria facilitating the generation of ATP. The mitochondria are responsible for production of around 95 percent of the ATP you produce in your body, and CoQ10 is an essential component of that.

    … Ubiquinol has two extra electrons. Because it has those two extra electrons and can donate them, it is a very strong lipid soluble antioxidant… Strong enough to help regenerate vitamin E and vitamin C [in your body]… Those are the two main functions [of CoQ10 in either form]. There are other functions, such as gene expression… [and] cell signaling as well. [But] the two main functions is cellular energy and cellular protection.”

    When trying to tease out the real difference between ubiquinol and CoQ10, it can help to compare them to two other antioxidants: vitamin E and vitamin C. In essence, taking CoQ10 is like taking oxidized vitamin C or E—something that would not be recommended—so why wouldn’t you take un-oxidized ubiquinol?

    “The vitamin C and vitamin E that you buy is the reduced form,” Dr. Barry explains. “After it acts as an antioxidant in your body it becomes oxidized. No one would ever sell oxidized vitamin C or would ever sell oxidized vitamin E. Nor would you want to buy it. If you took your vitamin C pill and put it out on the counter today, tomorrow morning it would be brown. It would be oxidized. “

    More Reasons Why Ubiquinol is the Better Alternative

    According to Dr. Barry, every single publication on ubiquinol to date has shown that the bioavailability is higher with ubiquinol when compared to CoQ10, in some cases the difference is very small, while in others it is a large difference. Even though the per mg dose costs more, it is FAR more cost effective than conventional CoQ10 as much less is needed to achieve the same or better result. The increased absorption rate means you only need to take about one-third the amount of ubiquinol compared to CoQ10. In general, ubiquinol is therefore about two-thirds cheaper than a CoQ10 supplement, and you get greater benefits. However all of this depends upon your age and state of health.

    Interestingly, although it’s a lipid (fat) soluble antioxidant, which typically means it’s more difficult to absorb, ubiquinol is ‘peculiar’ in that its rate of absorption appears to be based on your body’s metabolic demand—which is great. Meaning, if you’re healthy, you absorb less, and when you’re ill, or struggle with chronic disease, your body will absorb more. Its absorption rate is basically self-adjusting so it becomes very difficult to take too much.

    That said, since it is lipid-soluble, you do need to take it with a meal – or if not with a meal then with a teaspoon of peanut butter or olive oil to ensure optimal bioavailability and absorption.

    When it comes to safety, the two versions are virtually identical. The reduced form, ubiquinol, has the same safety profile as conventional coenzyme Q10, which is extremely safe. There are no known side effects or drug-drug interactions, and both have been shown safe even in large dosages.

    Even better, a number of studies have demonstrated that CoQ10 is absorbed and metabolized in exactly the same way as CoQ10 from a food source. And according to Dr. Barry, you’d have to consume close to three pounds of sardines a day to get the recommended dose of CoQ10. (Dark leafy green vegetables and organ meats are also CoQ10-rich sources.)

    As for dosage, studies indicate that ubiquinol is ideally taken chronically, meaning every day for extended periods of time. Studies show that if you currently do not take any Q10 then taking 200 to 300 milligrams a day, (preferably divided and taken twice a day) to start plasma levels plateau after about two to three weeks, you can then cut that down to a 100 mg/day maintenance dose. If you’re acutely or chronically ill, you can keep taking the larger dosage.

    Can Ubiquinol Slow Down the Aging Process?

    One of the most dramatic benefits of ubiquinol lies in its potential to slow down the aging process. There’s compelling evidence indicating this, which was instrumental in convincing me of its clinical benefits, and motivating me to start taking ubiquinol personally.

    One powerful example of ubiquinol’s anti-aging effects was an early mouse study, performed by researchers at a major medical center in Japan. Specially-bred mice that age very rapidly were used to test CoQ10 and ubiquinol against a control group that did not receive supplementation. At the end of the study, when the mice were the equivalent age of 90 to 100 in human years, the differences between the control group and the ubiquinol groups were quite dramatic.

    While the control mice were near death, the ubiquinol mice ran around like teenage mice, and the only difference during their entire lifespan was taking ubiquinol.

    “What we found is that, in just about every study that has been conducted with ubiquinol (and each one is necessarily a direct comparison to coenzyme Q10), there is a very dramatic metabolic and physiological effect seen with ubiquinol that you don’t necessarily see with conventional coenzyme Q10. That study convinced me that there was something different going on with ubiquinol. It also convinced Kaneka,” Dr. Barry says.

    “… [Kaneka] realized that there is something very profound going on here. There is a very dramatic difference between the two… That’s when we knew we really had a tiger by the tail. We were looking at something that’s very different from conventional coenzyme Q10. Again, that’s been reflected in almost every study since, either to a slight degree in some cases or to a very dramatic degree in every publication since then.”

    Needless to say, this may have profound implications for humans as well.

    Now, we know that ubiquinol plays a vital role in ATP production—which is the basic fuel for every cell in your body; without this most basic cellular energy production you die. Your body does produce ubiquinol naturally, in fact it is the predominant form in most healthy cells, tissues and organs, but as you age, not only does this conversion become less efficient; your cellular energy (ATP) production also diminishes. And that’s when you start seeing chronic and acute disease associated with aging and the aging process itself.

    “Without the efficient production of ATP (energy produced in your mitochondria) in each cell in your body, that [age-related] deterioration is even faster,” Dr. Barry explains.

    “As we age we produce less CoQ10 and more importantly the efficiency of conversion to the reduced ubiquinol form diminishes hence we become more susceptible to the deleterious effects of aging; much more susceptible to acute and chronic disease. So it’s very important to keep those energy levels up. It doesn’t even have to be acute or chronic disease… Fatigue is one of the top five complaints by adults in the U.S… There is a reason for that and there is a connection with ubiquinol in terms of energy production.

    … In the mitochondria, there is a thing called the electron transport system. What happens in the transfer of electrons, in that electron transport chain is fundamental to ATP production in every mitochondria in every cell in our body. Ubiquinol is an essential component in the electron transport chain and If ubiquinol is not there… you don’t get the ATP production.

    So it’s not that it’s this intangible thing that may or may not work, that you may or may not need, it’s absolutely critical. You do produce it in your body… but that [natural production] diminishes as you age. Importantly, [if] the conversion of oxidized coenzyme Q10 to reduced ubiquinol in your body [is] not efficient, then you’ll have problems.”

    Other Diseases that May Benefit from Ubiquinol

    Another area where ubiquinol is a crucial supplement is for those taking statins to lower their cholesterol. Statin drugs are very effective in reducing cholesterol levels but not very selective. Statins inhibit a key enzyme (HMG-CoA Reductase) that also share a common metabolic pathway with CoQ10 production. Therefore statins also reduce your body’s ability to produce CoQ10 and therefore ubiquinol, and once your body gets depleted, you’re putting your heart health at great risk. Remember, ubiquinol is absolutely vital for optimal energy production within each cell, and your heart is one of the most energy demanding organs in your body. Since statins diminishes your ubiquinol, these drugs also promote premature aging throughout your entire body…

    But ubiquinol isn’t just for those taking statins or those wanting to prolong life in general. Against diseases such as Huntington’s and Parkinson’s in particular, CoQ10/ubiquinol has been found to slow progression of the disease. Research over the years has also looked into its benefits for diseases such as:

    Alzheimer’s disease Huntington’s disease Periodontal disease
    Parkinson’s disease ALS Renal disease

    More Information

    To learn more about ubiquinol and CoQ10, there are independent sites that offer good information, such aswww.ubiquinol.org where you can learn more.

Can Food Affect Your Mood?


It’s widely known that your mood can trigger food cravings, cause you to overeat or kill your appetite entirely. But the opposite also holds true in that the food you eat can make or break your mood.

This is apparent not only in the minutes after you’ve eaten but also over time, as your diet helps to shape your mental health from the inside out.

Story at-a-glance

  • Individual food choices may make a difference in how you feel mentally and emotionally from day to day
  • Mood-boosting foods include dark chocolate, purple berries, coffee, bananas, omega-3 fats and turmeric (curcumin)
  • Foods linked to poor mood include sugar, wheat (gluten) and processed foods
  • A whole-food-based diet, including fermented foods to optimize your gut flora, will support positive mood and mental health

Food Affects Mood

How Does Food Impact Your Mood?

I simply cannot overstate the importance of your food choices when it comes to your mental health. In a very real sense, you have TWO brains—one in your head, and one in your gut—both of which are created from the same tissue during fetal development.

These two systems are connected via your vagus nerve, the tenth cranial nerve that runs from your brain stem down to your abdomen. It is now well established that the vagus nerve is the primary route your gut bacteria use to transmit information to your brain.

Maintaining optimal gut health is therefore paramount when trying to address your mental state. In this regard, the modern “Western” diet has several things working against it:

    • Genetically modified foods can significantly alter your gut flora, thereby promoting pathogens while decimating the beneficial microbes necessary for optimal mental and physical health.
    • Glyphosate—the most widely used herbicide on food crops in the world with nearly 1 BILLION pounds applied every year—has been shown to cause both nutritional deficiencies, especially minerals (which are critical for brain function and mood control), and systemic toxicity.

Moreover, recent cell research has found that it is so toxic it exhibits carcinogenicity in the nearly unbelievable parts-per-trillion concentration range.

    • High-fructose diets also feed pathogens in your gut, allowing them to overtake beneficial bacteria. Furthermore, sugar suppresses activity of a key growth hormone in your brain called brain-derived neurotrophic factor (BDNF). BDNF levels are critically low in both depression and schizophrenia.

Sugar consumption also triggers a cascade of chemical reactions in your body that promote chronic inflammation. In the long term, inflammation disrupts the normal functioning of your immune system and wreaks havoc on your brain.

Last but not least, sugar (particularly fructose) and grains contribute to insulin and leptin resistance and impaired signaling, which also play a significant role in your mental health.

  • Artificial food ingredients, the artificial sweetener aspartame in particular, can wreak havoc with your brain function. Both depression and panic attacks are known potential side effects of aspartame consumption. Other additives, such as artificial colorings, are also known to impact mood.

In the big picture, nourishing your gut health is therefore essential to maintaining a positive mood – and I’ll discuss how to do this shortly. However, even individual food choices may make a difference in how you feel mentally and emotionally from day to day …

7 Foods to Enhance Your Mood

Eating the foods that follow may be a simple way to boost your spirits, as each is known to have a positive impact on mood.

1. Dark Chocolate

If you’re one of these individuals who gets a nice mood boost whenever you sink your teeth into a bar of pure, unadulterated chocolate, it is not happenstance.

There’s actually a chemical reason called anandamide, a neurotransmitter produced in the brain that temporarily blocks feelings of pain and depression. It’s a derivative of the Sanskrit word “bliss,” and one of the great things about chocolate is that it not only produces this compound, it also contains other chemicals that prolongs the “feel-good” aspects of anandamide. Chocolate has even been referred to as “the new anti-anxiety drug.”

One study in the Journal of Psychopharmacology also revealed that drinking an antioxidant-rich chocolate drink equal to about 1.5 ounces of dark chocolate daily felt calmer than those who did not.

2. Protein

A high-quality source of protein – like organic eggs, a piece of Gouda cheese or a handful of almonds – helps to keep your blood sugar levels steady for enhanced energy and mood.

3. Bananas

Bananas contain dopamine, a natural reward chemical that boosts your mood. They’re also rich in B vitamins, including vitamin B6, which help to soothe your nervous system, and magnesium, another nutrient associated with positive mood. Just be careful to limit them if you have insulin/leptin resistance.

4. Coffee

Coffee appears to affect a number of neurotransmitters related to mood control, so drinking a morning cup could have an effect on your general sense of wellbeing. Research has also shown that coffee triggers a mechanism in your brain that releases BDNF, which activates your brain stem cells to convert into new neurons, thereby improving your brain health.  Interestingly enough, research also suggests that low BDNF levels may play a significant role in depression, and that increasing neurogenesis has an antidepressant effect!

5. Turmeric (Curcumin)

Curcumin, the pigment that gives the spice turmeric its yellow-orange color, is thought to be the primary component responsible for many of its medicinal effects. Among them, curcumin has neuroprotective properties and may enhance mood and possibly help with depression.

6. Purple Berries

Anthocyanins are the pigments that give berries like blueberries and blackberries their deep color. These antioxidants aid your brain in the production of dopamine, a chemical that is critical to coordination, memory function and your mood.

7. Animal-Based Omega-3 Fats

Found in salmon or supplement form, such as krill oil, the omega-3 fats EPA and DHA play a role in your emotional well-being. One study in Brain Behavior and Immunity showed a dramatic 20 percent reduction in anxiety among medical students taking omega-3, while past research has shown omega-3 fats work just as well as antidepressantsin preventing the signs of depression, but without any of the side effects.

3 Mood-Busting Foods to Avoid

Just as foods can uplift your mood, they can also quickly bring it down. Here are the top three foods that can trigger a poor mood.

1. Sugar

Sugar can lead to fluctuations in blood sugar, which can bring on mood swings, but its role in poor mood actually goes much deeper than that. Entire books have been written on this topic, such as William Duffy’s book, Sugar Blues. There are at least three potential mechanisms through which refined sugar intake could exert a toxic effect on your mood and mental health:

  • Sugar (particularly fructose) and grains contribute to insulin and leptin resistance and impaired signaling, which play a significant role in your mental health
  • Sugar suppresses activity of BDNF, which promotes the health of your brain neurons. BDNF levels are critically low in both depression and schizophrenia, which animal models suggest might actually be causative
  • Sugar consumption also triggers a cascade of chemical reactions in your body that promote chronic inflammation. In the long term, inflammation disrupts the normal functioning of your immune system, which is linked to a greater risk of depression

2. Gluten

Gluten, a protein found in grains such as wheat, rye and barley, may negatively impact mood and brain health. In fact, a number of studies indicate that wheat can have a detrimental effect on mood, promoting depression and even more serious mental health problems such as schizophrenia. One mechanism that can help explain the mysterious connection between wheat and mental health problems is the fact that wheat inhibits production of serotonin.

Neurotransmitters like serotonin can be found not just in your brain, but also in your gut. In fact, the greatest concentration of serotonin, which is involved in mood control, depression and aggression, is found in your intestines, not your brain! Wheat in particular has also been implicated in psychiatric problems, from depression to schizophrenia, due to an array of brain-disruptive opioid peptides, and wheat germ lectin (WGA), which preliminary research indicates has neurotoxic activity.

3. Processed Foods

The list of potentially mood-busting ingredients in processed foods is a long one. Aside from sugar and gluten, they may also contain trans fats, artificial colors, monosodium glutamate (MSG), artificial sweeteners and other synthetic ingredients linked to irritability and poor mood.

Nourishing Your Gut Flora May Boost Your Mood and Protect Your Mental Health

As explained by Dr. Natasha Campbell-McBride, a medical doctor with a postgraduate degree in neurology, toxicity in your gut can flow throughout your body and into your brain, where it can cause symptoms of poor mood, autism, ADHD, depression, schizophrenia and a whole host of other mental and behavioral disorders. With this in mind, it should be crystal clear that nourishing your gut flora is extremely important to support a positive mood. To do so, I recommend the following strategies:

  • Avoid sugar and processed, refined foods in your diet. If you need help doing this, read through my nutrition plan for a simple, whole-food-based diet. There is simply no question that eliminating refined sugars is the most powerful intervention the average person can make to improve their gut flora.
  • Eat traditionally fermented, unpasteurized foods. Fermented foods are the best route to optimal digestive health, as long as you eat the traditionally made, unpasteurized versions. Ideally, you want to eat a variety of fermented foods to maximize the variety of bacteria you’re consuming. Healthy choices include:
    • Fermented vegetables
    • Lassi (an Indian yoghurt drink, traditionally enjoyed before dinner)
    • Fermented milk, such as kefir
    • Natto (fermented soy)
  • Take a high-quality probiotic supplement. Although I’m not a major proponent of taking many supplements (as I believe the majority of your nutrients need to come from food), probiotics is an exception if you don’t eat fermented foods on a regular basis. Research has shown that certain probiotics may help alleviate anxiety by modulating the vagal pathways within the gut-brain, affecting GABA levels, and lowering the stress-induced hormone corticosterone.

To sum up, foods have an immense impact on both your body and your brain, and eating whole foods as described in mynutrition plan is the best way to support your mental and physical health. Whether you need a quick pick-me-up or you’ve been struggling with poor mood for a while, the best place to start to turn your mood around is likely not in your medicine cabinet but right in your pantry or refrigerator.

Attitude adjustment: Not just for patients.


Endocrine Today, December 2013

“I’m so tired of having my sugars high all the time. I’m tired of feeling like this. If it’s going to help me, I’m willing to try insulin.”

Mr. D, my 41-year-old patient, told me this during a recent clinic visit, and I felt a small sense of hope, mixed with a substantial amount of surprise. Hope, because he had reached the point of “I’ve had it, and I’m going to do something about this!” He was motivated and ready — this is where change starts. Surprised, since each time before, he had adamantly declined adding another agent, let alone insulin.

He had just obtained his latest labs: his HbA1c was 11.1%, triglycerides 2,220 mg/dL, and blood pressure 152 mm Hg/107 mm Hg. But, even more critically from his vantage point, he felt equally out of balance in other areas of his life, too. He’s struggling to make ends meet despite working a full-time job at his own business, 7 days a week, 10 to 15 hours a day. He has been having difficulties with his ex-wife and his teenage daughter. He’s also battling depression.

Mr. D. shifted his attitude. I hope that he continues to sustain this new-found motivation, especially during the inevitable bumps along the road, when challenges or obstacles pop up, and he could veer off his new, more hopeful path. But I asked myself, “Should we change ours as well?”

 

third-year medical student was working with me that day, and I thought then, as I do now, “What a great teachable moment.” While the patient was the teacher, the medical student wasn’t the only learner that day.

How, then, do we help our patients? Here are three keys that could assist us in changing our mindsets:

1. We should move beyond “non-compliance.”

You know the feeling: You see the name of your next patient, and you cringe a bit. This is a patient who has been “lost to follow-up” for a year, but when s/he does return, despite having the same poor glycemic control, doesn’t bring in their log book, and declines your recommendations. Rather than labeling patients as “non-compliant,” consider what Steven V. Edelman, MD, has emphasized: “There’s no one who doesn’t want to have a long and healthy life. But many patients with diabetes still need to realize they’re managing their diabetes for themselves, not their doctor[s].”

2. Draw upon your team.

Practices are increasingly calling upon the expertise of a multidisciplinary team of health care professionals — certified diabetes educators, dietitians, pharmacists, health coaches, podiatrists, and more — to facilitate patients’ care. Whether during individual appointments with these providers, or group classes, these members of your team are invaluable resources to help inform, as well as inspire, your patients. One of my colleagues just recently started a 7-week workshop involving these team members, but with the emphasis on having the patients take the lead in goal-setting, and learning from each other, rather than merely hearing lectures.

3. Celebrate the small successes, and remember those who’ve made progress.

We’re so used to the negative in medicine: an “unremarkable exam,” “the patient complains of …,” “patients not meeting goals for glycemic control.” But what about those patients who are trying and those who are making steady progress? Or those who are starting to commit to change, like Mr. D.? We should acknowledge the patients who are taking action.

I hope that, in keeping with this season, which among other things is a time for reflection, we all rekindle our commitment to be ready for our patients when they’re ready.

For more information:
  • Greenberg R. The Blog. Diabetes dynamo: Dr. Steven Edelman makes a personal quest America’s health intervention. Huffington Post. Aug. 25, 2010. Available at:www.huffingtonpost.com/riva-greenberg/diabetes-dynamo-dr-steven_b_692825.html. Accessed Nov. 25, 2013.
  • Edward C. Chao, DO, is assistant clinical professor of medicine at University of California, San Diego, and staff physician at VA Medical Center, San Diego.