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Diabetes Developments - A blog on latest developments in diabetes by David Mendosa

Entries Tagged as 'Medication'

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The Safety of Diabetes Drugs

April 6th, 2014 · No Comments

A possible connection between one of our newest and most important classes of diabetes drugs and pancreatic cancer has frightened many of us. But people with diabetes can now breathe easier.

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The United States Food and Drug Administration and its European counterpart just released their joint findings concluding that these drugs, which include Byetta, Victoza, Bydureon, and Januvia, have “no compelling evidence of an increased risk of pancreatitis or pancreatic cancer.” The full-text of this report, “Pancreatic Safety of Incretin-Based Drugs — FDA and EMA Assessment,” is available free online in one of our most prestigious medical journals, The New England Journal of Medicine.

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Posted in: Medication

Why We Take Which Diabetes Drug

March 22nd, 2014 · 2 Comments

Although I have managed my diabetes by eating low-carb ever since 2007 and enthusiastically recommend it to anyone who has diabetes, I certainly recognize its limitations and the importance of diabetes drugs.

Low-carbing isn’t easy. The transition from fueling our bodies with carbs to one of burning fat can challenge us in seven ways as I wrote here last month. Even then, when we get through the transition period, many people find that sticking with it can take too much discipline, particularly when family members all too willingly share their bagels and bread.

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Posted in: Medication

Dangers of Sulfonylureas for Diabetes

October 28th, 2013 · No Comments

If you doctor started you on one of the sulfonylureas to manage your diabetes, you may be significantly more likely to die early than if you take metformin. Research presented on Wednesday showed that among more than 92,000 people in the United Kingdom with type 2 diabetes those who took only sulfonylureas were 58 percent more likely to die from any cause than those who took only metformin.

The research is in an abstract, “Association between first-line monotherapy with sulfonylurea versus metformin and risk of all-cause mortality,” presented at the annual meeting of the European Association for the Study of Diabetes in Barcelona, Spain. The findings are preliminary because they haven’t been published in a peer-reviewed journal. And since the findings come from an observational study, the higher risk of death might be that doctors prescribed a sulfonylurea to sicker people. Another concern might be that Bristol-Myers Squibb, which sells Glucophage, a brand of metformin, provided financial support for the study.

Lots of us still take one of the sulfonylureas, which was the first oral drugs to help us manage type 2 diabetes. For more than half a century we have been using them — a class of drugs that includes Amaryl (glimepiride), Glucotrol XL (glipizide), and glyburide.

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Posted in: Medication

Safety of Diabetes Drugs

September 13th, 2013 · 3 Comments

Two studies published in professional journals this year have cast renewed doubt about the safety of one of our most important class of diabetes drugs. But the leading regulatory agencies both in Europe and the U.S. seem to think that those studies are flawed.

We call this class of drugs incretin-based or GLP-1 agonists. They include Byetta, Victoza, and Bydureon.

The most recent investigation of this class of drugs came out last month in the American Diabetes Association’s journal Diabetes Care. Dr. Peter Butler of UCLA is the lead author of “A Critical Analysis of the Clinical Use of Incretin-Based Therapies.” It was prompted by a study conducted by Dr. Sonal Singh and colleagues at the Johns Hopkins University School of Medicine, “Glucagonlike Peptide 1–Based Therapies and Risk of Hospitalization for Acute Pancreatitis in Type 2 Diabetes Mellitus.” That article appeared in JAMA, and both are available online.

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Posted in: Medication

Diabetes Supplements are Drugs Too

August 25th, 2013 · No Comments

Many people with diabetes use supplements to help them manage their blood sugar. They use everything from bitter melon and gymnema sylvestre to cinnamon and fenugreek to help them control their diabetes. And now to judge from the many emails I get, berberine has become the big hope.

Most people who take supplements for blood sugar control do that because they worry about the side effects of prescription medication. The problem is that they imagine that their supplement of choice doesn’t have any side effects.

Any medication that does anything for us also has side effects. Some are obvious, but many others don’t show up until lots of people have used them for years. Then it is too late for the early adopters.

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Posted in: Medication

How We Defeated Obesity and Diabetes

August 22nd, 2013 · No Comments

The biggest challenge in managing our diabetes is controlling our weight. But fortunately we have three roads that will take us there.

Cheryl, who is my friend and colleague at HealthCentral, traveled one of these roads. I have traveled the other two. Each of them have been a great trip.

A couple of weeks Cheryl wrote “How I Defeated Obesity and Diabetes” for the obesity area of HealthCentral. Gastric bypass surgery is the road that worked for her.

Since Cheryl knew that I had defeated obesity via other means, she asked me to round out the picture with my experience. Our intention is to provide a comprehensive roadmap of the three ways that we know from our own experience that will work for controlling obesity.

Cheryl has written many posts for HealthCentral about surgical ways to manage weight. I have also written a couple of posts here, more recently at http://www.healthcentral.com/diabetes/c/17/154007/reverses-bariatric/.

I once considered surgery to manage my weight. But instead I took the  other two routes that are available to those of us who have diabetes.

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Posted in: Medication

Using Marijuana to Manage Diabetes

June 30th, 2013 · 4 Comments

When I stopped smoking marijuana, I got diabetes instead. Maybe the timing was just a coincidence, but a new study indicates marijuana and diabetes may be connected.

Between 1972 and 1984 I was a heavy marijuana user. But I wasn’t heavy. In fact, in 1972 under the influence of marijuana I was able for the first time to manage my weight while becoming much more active. Then, I became an editor of a business magazine where I sat on my butt for long working hours every day, stopped using pot, and gained back all the weight I had lost under the influence of that illegal drug.

I was addicted to marijuana. Stopping was one of the hardest things I ever did, but as my cough got worse over the years I knew that I had to stop to save my health.

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Posted in: Medication

Why People with Diabetes Need to Avoid Statins

June 23rd, 2013 · 2 Comments

Those of us who have diabetes have enough to be concerned about for me to be writing here about all those things that don’t help us. You won’t find me writing about any of those many supplements and miracle cures that won’t do anything for you except separate yourself from your money. You don’t need me to tell you that if it sounds too good to be true, it probably is.

Have you noticed that whenever you encounter a problem, the act of dealing with that problem can create more problems, unless you are especially careful? Those of us who have diabetes need to be especially careful of the drugs that our doctors prescribe, because any drug carries with it unwanted side effects.

Even the type of drug that more Americans and people around the world take has a long list of side effects. Statins, a class of drugs that lower low-density lipoprotein cholesterol (LDL), are commonly prescribed to people with diabetes and pre-diabetes when our lifestyle changes don’t achieve the LDL targets that our doctors like.

About 32 million Americans take a statin. One-fourth of us 45 and over do. One of the statins, Lipitor, is the all-time biggest selling prescription medicine in the history of the world with sales of more than $130 billion.

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Posted in: Complications, Medication

John Dodson’s Diabetes Journey

January 10th, 2013 · 8 Comments

At first John Dodson wasn’t a good diabetes patient, he says. For the first 10 years after he learned that he had type 2 diabetes in 1985, he thought that managing his diabetes was up to his doctor.

“I tried to do what he said, but of course I failed,” he told me. “My blood sugar was generally between 150 and 250, so I had an awfully hard time.”

The doctor that he saw at that time was a general practitioner. That doctor prescribed the only oral drug we had at that time for diabetes, one of the a sulfonylureas called glyburide. Later he switched to an endocrinologist, who gave John an unpleasant wake-up call.

“That doctor told me that there was nothing he could do for me and that after five years I would be on dialysis,” John recalls. “I walked out of that office thinking that this is not going to be my future.”

So he switched right away to another endocrinologist, Dr. Joe Prendergast. He is one of this country’s leading endocrinologists and a pioneer in many areas. I have known him since 1999 when I wrote about his telemedicine practice in an article that I wrote for the American Diabetes Association’s website.

“The very day that I saw Dr. Joe,” John remembers, “he said, John, I think I’ve got something that will help you.” That was in June 2005. A diabetes medication in a new class of drugs called GLP-1 agonists, Byetta (exenatide), had just become available. John became the first person in the county to take Byetta.


John Dodson near Moss Landing, California,  in February 2008

Byetta was what connected John and me. We started corresponding in early 2006 when he wrote me about my about my post here, “Stalking Byetta.” His encouragement for me to start taking Byetta even if I couldn’t work out my insurance coverage did a lot to get me started a few days later. Since that time John became my role model and ultimately my best friend, and we have visited each other often.

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Posted in: Medication, People

The Trouble with Steroids

November 16th, 2012 · No Comments

An outbreak of fungal meningitis has killed five people who took tainted steroid injections for back pain. And 42 more in seven states are sick, according to the Centers for Disease Control and Prevention. Most of them are in Tennessee, but others are in Virginia, Michigan, Indiana, Maryland, Florida, and North Carolina.

But what connection does this bad news have to those of us who have diabetes?

The connection is that we already had other reasons to avoid steroid injections when we can. Steroids can cause our blood sugar levels to skyrocket. They can make us ravenously hungry and lead to our gaining weight.

Prednisone is one of the most commonly prescribed steroids. It is a corticosteroid, not one of the anabolic steroids that bodybuilders use. Our doctors prescribe prednisone because it can reduce or relieve severe inflammation. At the same time steroids have profound effects on all of our body.

These side effects can be serious. One friend of mine joined the diabetes support group that I started because he had severe back pain, took the prednisone that relieved it, and ended up with type 2 diabetes.
Prednisone and other steroids are powerful drugs that really work. Unfortunately, they can come with very high costs. It matters a lot how much you take and for how long.
When we take any powerful drug like prednisone we have to work with our doctors to make the choices that can minimize the side effects so that we get the benefits with the least possible risk. Be in charge of your body.

These side effects can be serious. One friend of mine joined the diabetes support group that I started because he had severe back pain, took the prednisone that relieved it, and ended up with type 2 diabetes.

Prednisone and other steroids are powerful drugs that really work. Unfortunately, they can come with very high costs. It matters a lot how much you take and for how long.

When we take any powerful drug like prednisone we have to work with our doctors to make the choices that can minimize the side effects so that we get the benefits with the least possible risk. Be in charge of your body.

This is a mirror of one of my articles that Health Central published. You can navigate to that site to find my most recent articles.

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Posted in: Medication