I can't remember a time when I didn't worry about my dad's diabetes. My father, Carl Payne, 67, was diagnosed with type 2 diabetes nearly 40 years ago, and despite continuous treatment since then, his blood glucose, or blood sugar, was always too high whenever doctors checked his A1C levels. That changed about a year ago, when he discovered how counting carbohydrates helps to control his blood sugar. That realization came as he was undergoing training to get fitted for a medical device called an insulin pump.

My dad, who has had to take regular insulin injections since the mid-1980s, said he remembers being sent to a diabetes education class in 1970, when he was first diagnosed. At that time, carb counting wasn't as heavily recommended as it is now. After he started counting carbs last year, he discovered what diabetes experts have long known: The more carbs you eat, the higher your blood sugar reading is, and the more you need insulin. My dad recently had his A1C level checked again, and the doctor said it was much improved.

The American Academy of Pediatrics caused a brouhaha last year when it said that kids as young as 8 should be put on statin drugs if diet and exercise don't work to lower high cholesterol levels. Many of its own members wondered whether it was wise to put children on drugs that they'd have to stay on for several decades in the absence of pediatric studies showing that this approach is safe and effective at preventing future heart attacks. A new study, which may calm those worries, shows that fewer than 1 percent of American children ages 12 to 17 actually need these drugs anyway.

We've heard the message: HIV is spreading rapidly, so the onus is on us to protect ourselves from getting infected in the first place. Still, even though HIV has been in the news quite a bit recently—especially since National Black HIV-AIDS Awareness Day on February 7—there are still clues that not everyone is listening. A Centers for Disease Control and Prevention survey recently found that some gay and bisexual young black men admit to having risky sex. But there's also been encouraging news from basic research, including the potential that HIV might someday be eradicated via stem cell transplant.

The CDC's February 6 "Morbidity and Mortality Weekly Report" gave the results of a small survey of young gay and bisexual black men living in Jackson, Miss., who were asked questions about the level of safety of their sexual activity. Jackson was selected because a sexually transmitted disease clinic there had reported a spike in HIV diagnoses among black men who had sex with men. Twenty of 29 survey respondents said they'd had unprotected anal intercourse during the 12 months prior to testing positive for HIV—and only three had thought themselves "likely" or "very likely" to get HIV in their lifetimes.

Last week, I blogged about an article in the Pediatrics journal written by vaccine expert Paul Offit and received a slew of heated comments both defending and attacking Offit's criticism of doctors who take a flexible approach to vaccinations. Vaccines are certainly a heated issue among parents and doctors alike: Witness the mass protests currently going on against a New Jersey law that takes effect this week mandating that preschoolers be vaccinated against the flu before they're allowed to return from winter break to their nursery school or day-care center.

Many of the commenters were concerned about Offit's conflict of interest; he is the co-inventor of the RotaTeq vaccine against rotavirus. Pediatrician Lawrence Rosen, who serves on the complementary medicine advisory board for the American Academy of Pediatrics (publisher of Pediatrics), sent me an E-mail commending me on my blog and included a letter he sent to the journal criticizing the AAP for "discouraging honest and open dialogue about one of the most important public health issues of our times" in not handling flexible vaccination as a debate that has two sides.

The last day of 2008 means more than the dawn of a new year for asthmatics. For those told to carry albuterol inhalers with them to use in the event of an asthma attack, it's also the last day that the chlorofluorocarbon, or CFC, inhalers that they'd long been accustomed to can legally be sold in the United States. CFCs are harmful to the environment, so they are being replaced in inhalers with environmentally friendlier hydrofluoroalkane, or HFA. Unfortunately, the new, eco-sensitive inhalers are not yet available in generic form.

I made the trip to my pharmacy about two weeks ago to pick up my prescription for HFA albuterol inhalers. Like other asthmatics, I was dismayed by the cost: a $30 copay for two inhalers under my insurance (which paid $43.72 toward the cost). In the past, my copay had been just $10 for each pair of generic albuterol inhalers containing CFCs. The Food and Drug Administration has approved the following HFA inhalers: ProAir HFA Inhalation Aerosol, Proventil HFA Inhalation Aerosol, and Ventolin HFA Inhalation Aerosol; also, another HFA inhaler that contains levalbuterol, a medication similar to albuterol, is sold as Xopenex HFA Inhalation Aerosol.

The American Academy of Pediatrics rolled out its new immunization schedule for kids in its latest issue of the journal Pediatrics , released today. The big change for this year is a new recommendation for an annual flu vaccine for all kids ages 6 months to 18 years—which follows the new guidelines of the Centers for Disease Control and Prevention.

Along with this policy statement and numerous research papers, the journal contains a "special article" that quite frankly shocked me for its one-sided treatment of a very important issue with regard to vaccinations. The article is an attack on doctors who take a flexible approach to vaccinations, working with parents who, say, don't want their 2-month-old to get vaccinated against eight different diseases at once, which is what's recommended on the AAP schedule.

As a 30-something, I hereby resolve to sleep more in 2009. And published today in the Journal of the American Medical Association is a well-timed finding to motivate my New Year's resolution: Longer sleep duration for people in their 30s and 40s may decrease the risk of coronary artery calcification, a predictor of atherosclerosis and heart disease. In fact, the study showed that one extra hour each night lowered the estimated odds of having such gunk in the vasculature by 33 percent. According to the study authors, getting that extra hour brings a benefit, cardiovascularly speaking, similar to that of lowering systolic blood pressure (the top number in the blood pressure ratio) by 17 points.

Diane Lauderdale, study director and associate professor of health studies at the University of Chicago, noted that the results need to be replicated by further research. But she says the 30s and 40s are "a time when many people start on a trajectory leading to coronary disease risk." Certainly, that's not how I think of myself at age 32. Subjects' coronary calcification was found in the study by imaging tests (not typically given to this age group) and considered subclinical, meaning not yet developed into full-blown disease.

Often hailed as "wonder drugs" for their ability to lower cholesterol and reduce heart attack risk, statins actually don't work that well in about 20 percent of users. Turns out, these people may have certain genetic mutations that lower the drugs' effectiveness, according to a new study from Duke University Medical Center. Those who carry a specific mutation in the ABCA1 gene, which is responsible for cholesterol transport into and out of cells, had a 24 percent decline in their "bad" LDL cholesterol levels after going on a low-dose statin compared with a 32 percent reduction in those who didn't carry the gene mutation.

These folks might need to switch to a more powerful statin, study author Deepak Voora tells me. Or perhaps they might want to try combining a statin with a cholesterol-lowering fibrate drug. A new one, called TriLipix, was approved yesterday.

When it comes to vaccinating kids in developing countries, immunization rates have long lagged behind those in the United States—which means a significant number of children are still dying from infectious diseases. Efforts by the World Health Organization, UNICEF, and others have dramatically improved immunizations against such diseases as diphtheria, tetanus, and pertussis, but the increase in vaccination rates may have been greatly exaggerated. Foreign governments—which get paid $20 for each child vaccinated against DTP by a global alliance of health organizations—may be overestimating how well they get the job done, according to a study published today in the journal Lancet.

University of Washington researchers funded by the Bill & Melinda Gates Foundation (which is a member of the alliance) discovered from household surveys that about 7.4 million children were vaccinated against DTP in 51 countries from 1999 to 2006. The countries, though, reported vaccinating 13.9 million. That indicates they received overpayments to the tune of $140 million.

The news out today warns that more than half of adults have no intention of getting a flu shot. It's based on a Rand survey of 4,000 U.S. adults that shows the following:

• Fifty-three percent of all adults surveyed have no intention of getting the flu vaccine this year, while 17 percent say they haven't yet but will at some point.
• Seventy percent of healthy adults under age 50 have no intention of being vaccinated, while 16 percent say they will at some point but haven't yet.