DSMA Blog Carnival: DSMA, DCCT & the Most Awesome Thing I've Done In Spite of Diabetes

During February 2011, the Diabetes Social Media Advocacy (DSMA) group began what what they are calling the monthly "DSMA Blog Carnival", something that will continue in the future with a variety of different topics. Essentially, it's a chance to explore a recent DSMA question in more than 140 characters (Twitter messages are limited to 140 characters each for my readers who may not be intimately familiar with that particular social network). This month's topic is "The most awesome thing I have done in spite of diabetes is _____ (fill in the blank)"

At first, I wasn't sure I wanted to even try this topic.

It's not that I haven't done awesome things in spite of diabetes. Quite the opposite: for me, the challenge was how to limit my conversation to a single thing. Then it occurred to me: the most awesome thing I have done in spite of type 1 diabetes has been to live my life -- seriously, and so far, it's been a great one!

My sentiments echo at least one other d-blogger I follow Mike Durbin at MyDiabeticHeart.com (see HERE for his post). I concur that ranking things is not something I can easily do, but my reasons are a bit different than his. For example, by my calculations, I have now spent approximately 83% of my life-to-date with type 1 diabetes. The other 17% is pretty much a footnote from my perspective, and as time passes, what few memories I do have about life before diabetes become even more vague (barring a few explicit memories on the subject, like my kicking the pediatrician who gave me the news I had type 1 diabetes and throwing what was probably the worst tantrum I had ever thrown as a kid).

When I was diagnosed at age 7 in 1976 (you can do the math to figure out my age), the outlook was sort of hazy. Medicine was just on the verge of a greater understanding of diabetes -- not that they're even close to completing their work yet, but at the time, the medical profession still had many rudimentary questions that simply hadn't been answered yet. Just a few years earlier, in 1973, for example, the the U.S. had officially "standardized" insulin sold for human use in the U.S. to U-100 (100 units per milliliter); prior to that date, insulin was sold in a variety of potencies and my parents actually had to specify at the pharmacy they wanted U-100 or the phamacist might give you the wrong potency. Today, I don't think many patients with diabetes are even aware different potencies can even exist, which explains how some patients can accidentally overdose when a stupid pharmacy clerk hands them a vial of U-500 insulin accidentally. Also, the following year, in 1974 to be precise, researchers had only just confirmed that type 1 diabetes was, in fact, an autoimmune disease that has just as much (if not more) in common with multiple sclerosis and psoriasis as it does with type 2 diabtes which is a metabolic disorder.

It wasn't until 1983 that the much-ballyhooed Diabetes control and complications trial (DCCT) would even kick off, and while that study was acknowledged to be a well-designed, landmark study, contrary to widely-held perception, it was NOT a perfect, flawless research study. For example, the DCCT is generally believed to have tracked 1,441 randomly selected diabetic participants for a period of 10 years. That's exactly what we've been taught to believe. However, as my friend Deb Butterfield poignantly once
WROTE:

"The truth is that the study [DCCT] began in 1983 with only 278 participants, the first two years were devoted to planning and feasibility studies and the DCCT's full cohort of 1,441 participants was not achieved until 1989, only four years before the study ended. Of the original 278 participants, 8 [which equates to 2.9% of the cohort] dropped out and 11 [which equates to 3.9% of the cohort] died. Those sad statistics were caused in large part by severe hypoglycemia. But then the study designers made changes to the eligibility criteria for the full-scale trial to exclude anyone with this very common short-term complication of diabetes. This exclusion raises fundamental questions about the randomness of this selection process."

Another flaw: although the DCCT authors observed a far greater increase in hypoglycemia than there were reductions in eye, kidney, and nerve damage, the authors miraculously failed to note this except in a footnote to their study conclusions. Was that just an oversight, or was that omission by design? It really makes me wonder.

Beyond that, the (DCCT) study authors noted that they were unable to show any reduction in cardiovascular morbidity and mortality without longer-term follow-up, hence the need for the NIH/NIDDK follow-up study called the Epidemiology of Diabetes Interventions and Complications (EDIC) study. However, even those conclusions had limitations. Most notable (in my opinion) was the so-called "Quality of Life" measure (see HERE for a copy of those questions and the statistical summary, too). One glaring omission was the absence of a single reference to COST of treatment in their Quality of Life measurements. Nowhere in that survey is a single question about how much of the participants' monthly disposable income went towards paying co-pays and/or deductibles required by insurance, nor was there any reference to the amount of a participant's free time was spent on hold with insurance companies trying to get approvals or appeal for prescribed treatments, getting coverage for prescriptions that might not be on their insurance company's formulary, or finding a doctor or nurse educator who is on the insurer's "preferred" provider list, etc.

Hmmmm, so apparently money is no object when it comes to diabetes treatment, and indeed, it probably wasn't for the DCCT/EDIC participants. Most of their treatment was paid for ... by you and me as U.S. taxpayers thanks to the NIH/NIDDK paying for that research. It's really no surprise that 96% of the cohort invited to participate chose to do so; participating meant they never had to deal with private insurance companies to get the care they were prescribed whereas they would have had to deal with all of B.S. than if they did not participate. In effect, the NIH/NIDDK coerced the participants to stay in the study by freeing them from the all of the usual crap you and I have to deal with to get our basic treatments covered. From my perspective, that measure (money & time spent to get prescribed treatments) should always play a significantly larger role in the so-called "Quality of Life" measures rather than how enjoyable a participant's sex life is, but alas, that was not the case in the DCCT/EDIC. That's a pretty big flaw in the applicability towards real-life patients, yet doctors must be reminded of these issues by patients, whose first question about a treatment is typically whether it is on their formulary.

Finally, there is also at least some scientific evidence that both cardiovascular disease and neuropathy have an autoimmune basis as well, meaning regardless of how good or bad your glycemic control may be, some nerve damage and cardiovascular disease might occur regardless. Even the criticisms of the original conclusion on cardiovascular disease, specifically that the population studied in the DCCT was relatively young (the age range of participants was 13–39 years), and therefore their likelihood of having a significant cardiovascular event during the follow-up period was low cannot explain away the autoimmunity question (for those of you dying to know what the study was, view HERE, or HERE for one on the topic of autoimmune neuropathy). Furthermore, although the DCCT authors observed a far greater increase in hypoglycemia than there was reduction in eye, kidney, and nerve damage, somehow, miraculously, they failed to note this in the DCCT conclusions except in the tiny footnotes!

That's not terribly comforting, except that for people who might be chastised for their failure to adequately manage their diabetes might still have something they can throw back at their doctors for some "complications" that were previously presumed to be due exclusively to glycemic management. Unfortunately, that's also little more a consolation prize, and too often, people will make snarky comments at the funeral home that if "so-and-so had just managed his/her diabetes better, he/she wouldn't be dead right now". I guess these people missed Emily Post's long-running newspaper colum on Etiquette (some readers may even ask "Who is Emily Post?", but should know that her daughters now run an etiquette website at http://www.emilypost.com/)

The follow-up EDIC study was supposed to answer the questions on cardiovascular disease, and did to some extent, but the notable take-away they did NOT publish was the fact that intensive glycemic control alone failed to prevent all cases of cardiovascular disease, suggesting that there's a bit more to preventing this complication than glycemic control alone.

But today's post was not meant to raise questions about the DCCT conclusions; rather it was to celebrate the fact that I have pretty much done everything I've wanted to in spite of diabetes.

If there's anything I might like to do but couldn't in spite of diabetes, it's that I might like to work as a contract employee (who can set their own rate, hours, etc.) but cannot do thanks to the inability to get healthcare insurance at any price in the United States thanks to diabetes being a preexisting condition. While the recent healthcare law may make that a possibility in some states, that won't happen until 2014, so it may still be a possibility for me in a few years, just not at the moment. But I can live with that provided some dumb-@$$ politicians don't decide to try to dismantle the law since they had 20 years to do something about this problem, yet chose not to even address it until a rival political party did it first, and they did not like the outcome. They had over 20 years to address this issue, but preferred to ignore it until over a year after it became law.

Anyway, maybe I can add some interesting perspective to the next DSMA Carnival topic for March 2011!

From the Archives: "Schoolhouse Rock vs. Public Schoolhouse Rock"

Every Friday, I get an e-mail from SiteMeter.com which provides me with some stats on the total number of visits to my blog, the average number of visits per day, the average length of a visit this week, the number of visitors today, the number of visits this week, the number of page views, the number of page views per visit this week and a host of other data. Among the other items are what I find most interesting: referral data and domain names from where these visitors arrived at my site. Sometimes, when time permits, I'll look at where my viewers are coming from, what search terms they used to find my blog on a search engine or other site, etc. I even know what kind of computer (PC or Mac) and broswer (Internet Explorer, Mozilla Firefox, Google Chrome, Apple Safari, etc.) they're using.

Sometimes, I get details I DON'T really need but is still interesting; for example, I know that a viewer from somewhere around Kelowna, British Columbia (that's in Canada for my geographically-challenged readers) visited a POST I did last March about the artificial pancreas being featured on the TV show "The Doctors" and they clicked on the photo I included on that post of the soap-opera star looking Dr. Stork in his "The Bachelor" days (circa 2006) as well as in his scrubs for "The Doctors" today, perhaps to download the photo or have a look at it enlarged. Someone else in or around Washington, DC looked at the same post (making me wonder if they saw it someplace else, or read about it online someplace), but they did not click on the photo, but they did stay on the page for 12 minutes and 57 seconds, probably to watch the full clips that I included in the post; they exited on "The Doctors" website, perhaps to see if there was anything else there of interest.

Generally, I suspect that the visits from places like Russia, China and Taiwan and other places that do not even use the Roman alphabet are highly likely to be spammers and I'm always curious where they come from, but since I don't publish my contact info. online (which is by design), I really don't get an excessive amount of spam. I also have the ability to check domain names where people are viewing my site from, so I can see when someone is visiting me from a computer at a big pharma company, I know it. Ditto for medical device companies. I get a few of hits from Bagsværd, Denmark, so I know at least a few people at Novo Nordisk and/or their employees are watching what I'm doing, but they may not have realized that I KNOW when they're watching, and what posts they are visiting! In the U.S., working from home via VPN access seems to be fairly common, so I may not know when a drug company person is viewing my site as they work from home, but the analytics aren't too bad for my purposes. Mobile access to my site is less clear, but most of the traffic is not from Smart Phones anyway.

Sometimes I view the link(s) that brought people to my blog, and recently, someone else from Washington DC (I guess it could be the same viewer) actually viewed my archives from October 2007 (visit HERE, or select from the archives drop-down window in the right margin of my blog and select by date from there). From there, I found a post I found without any broken links (the comment is a different story), working videos, etc. that I posted back on October 2007 which still brought a smile to my face when I looked at it again today. Hence my post for today!

The original post can be found HERE, but I simply copied the content and am re-sharing it again today. Have a look:


Schoolhouse Rock vs. Public Schoolhouse Rock

Today's post is a bit out of character for me (George Simmons of The B.A.D. Blog is better known for his weekly YouTube postings), but perhaps when you have a look, you may see my logic here.

Last night, I was watching the news and there was another story about yet another local school district trying to introduce "healthier" snack options by replacing sodas with (and the logic escapes me here) juice, which often contains as many calories and as much sugar as the so-called unhealthy beverages they are supposed to be replacing.

Bottled water IS healthier, but replacing sodas with juices that are often loaded with high-fructose corn syrup and other crap make the newly chosen beverages no better than the sodas which have been banned by many school districts across the country. I'm sorry, but if you're going to making these moves in the name of health, make sure we aren't just villanizing soda, then replacing it with another form of junk food with a nicer label. In addition, the food included in many public school lunches is equally bad (if not worse), yet entirely sanctioned by the USDA and the FDA. Shame on us! A better bet is to pack our kid's lunches ourselves!

Like many kids who grew up in the 1970's, I tend to view Schoolhouse Rock! cartoons with a sense of nostalgia. As Wikipedia notes, these educational cartoon shorts have become cultural icons, so much that they have been parodied on other television shows, including the likes of Saturday Night Live, MadTV and The Simpsons. It is for that reason I thought it might be appropriate to include clips from the original, followed by MadTV's parody, "Public School House Rock" to make my point. Watch them and see if you agree.

First, the original:
Followed by the MadTV version:

Doctors Sue USDA Over Dietary Guidelines, Accusations of Protecting U.S. Agribusiness

At the end of January 2011, the U.S. Department of Agriculture (USDA) and the U.S. Department of Health and Human Services (HHS) released new Dietary Guidelines for Americans (referred to herein as "DGA"), see HERE for those guidelines. The USDA and HHS have jointly published the DGA for Americans every 5 years since 1980. Naturally, there were some headlines about the new guidelines, notably that Americans should eat fewer calories and reduce their sodium consumption. The DGA recommend that healthy adults should limit sodium intake to 2,300 mg per day while individuals with high blood pressure should consume no more than 1,500 mg per day.

During the January 31, 2011 news conference when the new dietary guidelines were released, USDA Secretary Tom Vilsack said "We know today the average American probably consumes 3,400 milligrams of sodium, so this is a fairly significant effort on our part and it must be reflected in the decisions that food-processing companies, in particular, make over time so folk don't necessarily reject out of hand these guidelines because the taste is so fundamentally different."

Still, one has to wonder how long THAT will actually take?

Reducing sodium consumption is a tad more complex than asking Americans to stop using their salt shakers. The U.S. food industry has promised for decades that it was doing all it could to reduce sodium content, yet the average American's sodium consumption has increased dramatically over over the years. That's mostly because the sodium content is already far too high before Americans even open their packages of prepared foods, and/or their restaurant meals and/or take-out foods. The sad reality is that it's really not American consumers, but the U.S. food industry that's so hopelessly (helplessly?) addicted to sodium. That's who has to change their food pyramid, but we shouldn't hold our breath waiting for any radical changes from them anytime soon short of U.S. lawmakers mandating it.

Beyond the salt issue, the DGA also recommended that Americans eat less overall for the first time ever, which was perhaps the most radical change in the guidelines. Still, a study recently published (in the February 15, 2011 edition) in the International Journal of Obesity found that most parents and older children noticed calorie counts posted in New York City fast-food restaurants (as mandated by the New York City Department of Health and Mental Hygiene, but since copied by a number of other counties and/or states across the U.S.), but having access to that information prominently did not seem to stop them from ordering their favorite burgers and fries. It seems that by the time consumers have entered the restaurant, they've already decided what their meal (or the meal for their child) is going to be. It is not known whether adults behave in the same way, however, since the study did not examine that population.

Most of this is more rhetoric of the sort we've been hearing for years now. But what else is being done about it? For example, healthclubs in New York cost (at a minimum) $60/month, require ongoing memberships and many have so-called "joining" fees. A more cost-effective alternative might be to utilize city parks and recreational facilities, but thanks to tight budgets that exist in most municipalities around the country today, hours are being cut at most of these facilities, thereby limiting access even further. True, simple things like taking a walk around the block remain free, but what we're talking about here is removing major impediments to better health, and the budget cuts at parks and recreation departments are often the first to be implemented. Is it any wonder why the Lancet rightfully called the obesity and type 2 diabetes "epidemic" a public health humiliation? (see HERE and HERE for more detail)

All of that is pretty much old news, but certainly none of it is groundreaking news. But last week, there was some groundbreaking news on the U.S. DGA that hardly any media outlets and/or diabetes bloggers even caught.

Doctors Group Sues USDA for Conflicts-of-Interest Over New Dietary Guidelines for Americans

On February 15, 2011, the Physicians Committee for Responsible Medicine (PCRM), a Washington-based nonprofit organization that is dedicated to preventive medicine and promoting a vegan diet actually sued the U.S. Departments of Agriculture and Health and Human Services, claiming that both agencies (particularly the USDA) have too many conflicts-of-interest to issue clear and science-based dietary guidelines. (see the press release HERE, or the news story HERE)

The organization cites the government's "conflicts-of-interest and arbitrary and capricious behavior in developing nutrition advice that was supposed [emphasis mine] to help Americans fight record obesity levels."

The group claims the main issue is that the new dietary guidelines' use what they call biochemical terms, such as "saturated fat" and "cholesterol" instead of specific food terms such as "meat" and/or "cheese," a deliberate omission that can be traced to the USDA's close ties to U.S. food processing and restaurant industries, including fast-food companies such as McDonald's. Their lawsuit demands a complete rewrite of sections of the DGA that use such technical terms which the group claims is to avoid mentioning the specific risks of meat and dairy products. The lawsuit also raises concerns over the Dietary Guidelines Advisory Committee members that have ties to the food processing and restaurant industries, including a member who served on an advisory council for McDonald's Corp.

"While the Guidelines do acknowledge the healthfulness of plant-based diets, they also employ confusing euphemisms like 'solid fats' to avoid being clear about the health risks posed by meat and dairy products," PCRM nutrition education director Susan Levin, M.S., R.D. said in the organization's press release (noted above).

"Americans need straightforward health advice, not bureaucratic mumbo jumbo designed to protect agribusiness."

Now, adopting a vegan diet is viewed as a bit extreme, even for a fair number of vegetarians who believe that a vegetarian diet can and should be lacto-ovo (including dairy products and eggs), not only for health reasons, but also for dietary flavor and variety. Notably, a 1999 meta-analysis of 5 studies comparing vegetarian and non-vegetarian mortality rates in Western countries actually found that the mortality rate due to ischemic heart disease was actually 34% lower among lacto-ovo vegetarians (vegetarians who eat dairy products and eggs) and pescetarians (those who eat fish but no other meat) than it was for vegans. But regardless of your opinion on vegan diets, there is no denying that vegetarians are generally healthier than carnivores according to most research that have compared the two groups. But the group's lawsuit was a first to challenge the new U.S. DGA, and the committee who helped assemble the new dietary guidelines.

Outcome to Be Decided in Court

The outcome of the lawsuit will be decided in the courts, but if even if it proves unsuccessful, the group has raised yet another issue of conflicts-of-interest among government agencies that are supposed to be free of outside influences when making their decisions. Stay tuned to the PCRM's website for the outcome!

Dollars for Docs: "Would You Be A 'Thought Leader' for us?"

Short of outright bribery, doctors view the practice as helping patients, while critics (as you might imagine) view the practice rather differently.

Back in October 2010, the non-profit newsroom Propublica introduced a database called "DOLLARS FOR DOCS" of payments made to thousands of U.S. doctors so now you can easily find out some of the money drug and biotech companies are paying them. The reality is that this is the first public database that consolidates disclosures that the courts demanded from just eight (8) drug companies (specifically Eli Lilly & Co., GlaxoSmithKline, AstraZeneca, Pfizer, Merck, Johnson & Johnson, and Cephalon, and a few tidbits from Novartis — whose sales collectively make up about a third of the market) covering $257.8 million in payouts to over 17,000 doctors since 2009. Initially, the database contained data for only 7 companies, but some data from Novartis was added after the launch of the database went public, hence the count is now up to 8. Of note is the fact that these payments were mostly for speaking engagements, consulting and various other duties. They now have a widget for the Dollars for Doctors database, which I have included HERE:

Typically, this money has been the medical profession's dirty little secret.

The medical profession has happily accepted money from drug, biotech and medical device companies for years as "thought leaders" (more on that below) without anyone other than the IRS knowing about it and most doctors vehemently deny these payments represent any "conflict-of-interest" although a growing body of evidence seems to suggest otherwise.

As "Diabetes Update" blogger Jenny Ruhl eloquently WROTE in her post (one of the few diabetes bloggers who even wrote about it) on this subject "These payment revelations were forced (emphasis mine) out of the companies, after they lost lawsuits that proved these companies had broken the law with how they marketed their drugs."

The disclosures come as medical institutions and lawmakers are working to try and rein in potential conflicts-of-interest, curbing these type payouts, we need to keep in mind that numerous other drug and biotech companies still fail to disclose this information because they haven't been caught breaking the law (that doesn't mean they aren't paying docs to speak about their products, only that the courts haven't forced them to disclose it).

The good news is that under the new U.S. healthcare law, starting in 2013, ALL drug/biotech/medical device companies selling products in the United States will be required to disclose this data in a public database to be operated by the U.S. Department of Health and Human Services. Let's just call the Propublica "Dollars for Docs" database a sneak peak at what we're likely to see much more of in the next few years!

I cannot hope to do adequate justice to this topic other than to say that I was not surprised that the endocrinology and metabolism field actually received far more money than I had expected to see. We all know that the neurology field and psychology has seen widespread abuse, but perhaps the biggest surprise in the diabetes medical business was that the leading recipients of payments weren't the names you might expect, but what could best be described as ordinary doctors not known for their frequent medical journal submissions or anything else who have managed to collect an EXTRAordinary amount of money from the drug industry.

NPR did a very interesting story about this which you can read about at the link below, although for convenience, I have included the audio for the story right HERE. It is only a few minutes in length, but I think quite objective reporting on the subject:



The practice of using money for elaborate vacations for doctors consisting of golf trips to Pebble Beach, or weekends at luxurious South Beach or Scottsdale resorts largely disappeared in 2002 when the drug industry trade-group known as PhRMA (which stands for the Pharmaceutical Research and Manufacturers of America) changed it's member policies on what was rapidly becoming a legislator concern in Congress. The organization banned the lavish vacations, dinners and miscellaneous trinkets such as pens and notepads that remain in my doctors' offices to this day. But as NPR reporter eloquently indicates:

"The practice of trying to influence doctors with money hasn't disappeared, it's shifted."

Today, the free pens and post-it pads with the drugs' names may very well be history, but there is still one, almost foolproof way to accomplish the task of getting a doctor to speak on behalf of a drug being sold by the drug sales rep: asking them to become what is known euphemistically as a "thought leader". When doctors speak about a treatment, their prescriptions for that brand of drug tends to increase, too.

Equally interesting was the following VIDEO from PBS:

One thing you might try doing is searching for your own endocrinologist's name in the ProPublica database; you could be surprised!

Introducing The NEW "Scott's Web Log"

New Year, New Design, New URL

For my inaugural blog post for 2011, I was planning to implement some big changes, consistent with some of the other big announcements made by my fellow diabetes bloggers recently, including Scott K. Johnson, Amy Tenderich and several others within the diabetes blogging community, including my friend Hannah McDonald (a.k.a. "Dorkabetic") who is reportedly still working on some of her own blog refinements, but she tells us they are coming soon. Another blogger I follow, Alex O'Meara, who authored the book "Chasing Medical Miracles: The Promise and Perils of Clinical Trials" and is himself what could best be called a "former" type 1 (he had an islet transplant a few years ago which made him insulin-independent, at least for the time-being) has also recently updated his blog (see HERE), too, so I seem to be in pretty good company. But my timing wasn't exactly right on the New Year, but a bit later. Still, I guess it's an advantage to being the only one on this date to announce my big changes.

My blog news was pre-empted by the news of my longtime pet's passing last month (see HERE) which I'm still dealing with, but the blog stuff has helped to divert my attention to more pleasant thoughts. In spite of my being quiet on the blogging front, I was actually working through some issues behind-the-scenes that have been in the works for a while.

Today, as you can see (except possibly if you're reading this from an RSS reader, in which case I really encourage you to click on the actual link to this blog post so you can actually SEE the changes I'm referring to) I join the others by introducing some of the biggest changes I've here at Scott's Web Log since I first launched this blog in the fall of 2005. Although my Twitter feed has already been updated with the new design mascot, I have remained active on that social network throughout my blog's makeover. (I can talk a bit about Twitter later, but first the announcement.)

A New Year, A New Look, and A New Domain Name

There's nothing like kicking off a new year with some long-awaited changes all at once! For the 2011 new year, I have finally decided to give my own blog presence a much-needed design face-lift, and for my faithful readers, that may take some time getting used to (with the basic green template being gone after 6 long years of the same), but rest assured, the content you come here for will continue!

The now-retired design for "Scott's Web Log"

Aside from the obvious visual changes, I should also point out that I now have my own domain name, too. I've finally taken the plunge and am officially using the "sstrumello.com" domain name, so my blog address will henceforth be found at the following URL:

http://blog.sstrumello.com/

Apparently, my move comes just as some geeks are predicting that the internet could run out of addresses soon (see HERE and HERE for more on that prediction). I don't worry too much about that stuff, although a shortage of the popular .com domains could plausibly be tapped out before too long, but I can say that "sstrumello.com" domain has already been assigned -- to me! I have little doubt those issues will be resolved somehow before it reaches crisis mode, but back to my main issue: While the old domain "sstrumello.blogger.com" should still work for the immediate future, but if I should ever I decide to switch blog hosts down the road, I strongly recommend that you update your bookmarks and/or update your RSS feeds to the new, http://blog.sstrumello.com/ address so you'll be sure to capture all of my future posts, research into cure-related stuff, scrutiny of the business of diabetes, regulatory issues we need to be aware of, groundbreaking interviews, industry research, etc. regardless of which company I decide to have host my blog in the future.

I realize that some of this is might be radical news for my loyal readers (and I would note that I've decided to adopt the same new theme with my Twitter avatar, at least for the time-being) http://twitter.com/sstrumello, although I may not keep the "3D Man" (the template's name) avatar on Twitter forever, it will be there for the next few weeks at least to introduce my new visual "brand".

About the New Design

I actually selected this new design template about a year ago and believe it or not, I've actually owned the sstrumello.com domain name for even longer, but wasn't really using it. I wanted to make some refinements to the new design template (changing the fonts, adjusting the size of the publishing area, etc.) before I went "live" with it. I also had some setting changes that I needed to implement with my domain name registrar and with Google's Blogger as my host before I implemented all this stuff. Being someone who is pretty steady in my ways, I also had some concerns that my old blog posts would not necessarily continue working with their old URLs, but after some trial-and-error on my part, it seems to be a non-issue (but please let me know if you uncover anything).

At the time I selected this design, I didn't really have to search too hard for a design I really liked (they now they have so many more desgins -- many of which are celebrities -- and this one is now really buried among them). Even better: this design was a FREE design template (the reason it's free is because at the top of the page in the original design templete, there were links to the designer's web page, which enables them to continue offering some cool designs without charging for them, and also the graphic has their tiny logo on it, although I'm actually hosting the image myself, just in case the image should disappear from their site in the future. I felt that the selection of this particular template was consistent with my basic focus on the business of science/medicine as a basic focus, as well as my Bionic fascination (see HERE and HERE), which this fit in very well with. By the way, pretty unrelated, except the 1970's TV show "The Six Million Dollar Man" is now available on DVD (see HERE), which follows the DVD release of The Bionic Woman.

As for the design modifications that I wanted, my goal was to keep the column widths the same as they were with my old template, make some margin adjustments, and continue using the same font family that was in the old blog template, just in a different color. But my skills in this stuff is what could best be called "basic" (I say enough to be dangerous, but not enough to know how to do what I really want/need) so I needed some assistance to make the kind of modifications I felt were needed. I reached out to fellow d-blogger Chris Bishop, whose blog names and presence has changed a few times over the years, but he's got the graphic design and web programming skillset that I so badly needed.

For those of you who haven't met Chris personally, he was perhaps most humorously captured in this YouTube video by Scott K. Johnson at last year's CWD FFL conference. When Chris isn't suffering from narcoleptic attacks (as he was in this presentation), I can honestly say that his graphic design skills are pretty awesome (his numerous tattoos are evidence of that, not to mention the comic-like images he did for a few of us in his old blog), and he did a really great job helping me tweak with my new blog template (which I noted actually came from the pYzam.com website, which has lots of free blog templates, although not all are for Blogger specifically). Chris was able to help me with modifying the margins, column widths, fonts, fitting video images in, etc., taking far less time than I would be able to accomplish by myself, so my thanks to Chris on his help with all this stuff!

Next On The Agenda ... Thoughts on the JDRF Capital Chapter Research Summit

This past weekend (on January 29, 2011), I attended the JDRF Capital Chapter's Research Summit that was held just outside Washington, D.C. at the Bethesda (Maryland) North Marriott Hotel & Conference Center, although this was really Ginger Viera's relatively new home turf. I also got to meet a few other diabetes bloggers I hadn't met previously, including Miriam Tucker + @MiriamETucker and Ann Bartlett which was awesome!

One of the chapter's event organizers had invited me to attend this event, and in spite of SmartCells' (which was recently acquired by Merck) Todd Zion having to cancel at the last minute, they had a really great agenda, and also earned a phenomenal turnout for this event. I plan on speaking with the organizers and getting some additional information about what was involved in planning this event, what to do, what to avoid, potential pitfalls .... all that stuff. My goal is to share this information with others who might be interested in doing something similar with their local JDRF chapters. Ideally, I'd like to see a number of these events nationwide, but the JDRF isn't quite there -- yet -- so I am happy to share anything I can in order to help others who want to do something like this in their areas.

I think I'll Pass on the Guest Bloggers ... For Now

while many people in the Diabetes Online Community (the "D-OC") of bloggers have been doing "guest posts" and/or posting stuff on other people's diabetes blogs, I'm not a huge fan of doing that. My reasoning: if I wanted to read something written by someone other than the person who started the blog, I could just as easily visit those people's blogs. I just don't think many people go to Scott's Web Log to read content written by Kelly, George, Kerri, Allison or whoever else is guest blogging -- that's just my impression, and maybe I'm way off-base, but I just don't see guest blogging as an imperative that I need to pursue at this point in time. Personally, I'd find it much more interesting if people shared a list of bloggers they follow and provide the rationale for why they follow those particular blogs than read guest posts. Because of this, you may have noticed that I haven't really featured any "guest posts" here, because my feeling about that is "really, what's the point"? I won't say I'll "never" do it, but I'm also not actively recruiting guest bloggers right now!

In the interim, I'd love to get your comments on the new design for Scott's Web Log and what you think of it, so please feel free to leave comments (and take my poll HERE)!