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

Entries Tagged as 'Medication'

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Good Drugs, Bad Drugs

January 21st, 2010 · 3 Comments

We know that the only person who can tell us what to eat and exercise is ourself. But most of us need a third leg of diabetes control — one or more of the prescription drugs — and we usually leave that decision up to our doctor.

Often this is a big mistake. Many of our doctors are too set in their ways. The problem is simply that doctors too are human.

Older doctors have practiced most of their lives with a Hobson’s choice of one oral diabetes drug. In 1957 the first sulfonylureas became available by prescription in the United States. Not until about 40 years later did the Food and Drug Administration approve a second diabetes drug, metformin.

Until we could get metformin, we did have the opportunity to take insulin instead of a sulfonylurea. And we had a lot of different sulfonylureas to choose from, making it appear that our choice was greater that it really was. Brand names include Amaryl, Glucotrol XL, Diaßeta, Glynase, Micronase, as well as Dymelor, Diabinese, Orinase, and Tolinase. Combination drugs like Metaglip, Glucovance, Avandaryl, and Duetact also are part sulfonylurea. [Read more →]

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Posted in: Medication

The Big Ds: Diabetes, Depression, and the D Vitamin

January 8th, 2010 · 9 Comments

Since alliteration helps us to remember connections, we’re lucky that diabetes, depression, and the D vitamin all start with the same letter. We aren’t lucky that diabetes and depression are so closely connected, as I wrote in my essay on “Diabetes and Depression” here a year ago. But we’re in luck that vitamin D might treat both conditions, killing two birds with one stone, as our less technologically powerful ancestors used to say.

“About 70 percent of the population of the United States has insufficient levels of vitamin D,” says Adrian Gombart, a principal investigator with the Linus Pauling Institute at Oregon State University. “This is a critical issue as we learn more about the many roles it may play in fighting infection, balancing your immune response, helping to address autoimmune problems, and even preventing heart disease.”

People with diabetes may have even lower levels of vitamin D, according to a review last year in The Diabetes Educator. People at risk of diabetes and the metabolic syndrome (or syndrome x) also have low vitamin D levels.

Recent research found that 19 percent of people with type 2 diabetes probably suffer from major depression and an additional two-thirds of us have at least some depressive symptoms. People with diabetes are twice as likely to be depressed as other people.
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Posted in: Medication

The Case for More Vitamin D

December 28th, 2009 · 4 Comments

Are you suspicious of snake oil claims that something will treat a whole lot of health problems? I sure am.

The newest entry on the snake oil scene would seem to be vitamin D. I’ve lost track of all that this vitamin is supposedly good for — everything from building strong bones to protecting us from strokes and heart failure to reducing our risk of cancer and on to helping us regulate our immune system and control inflammation, our blood pressure, and even our blood glucose. Recently, some people are even recommending it for respiratory problems ranging from the common cold to the H1N1 (swine) flu virus.

If even half of this is true, vitamin D must be the biggest health discovery since aspirin. But so far we have only a few generally accepted uses of vitamin D.

We’ve known since the early 1920s that vitamin D cures rickets and other diseases that soften our bones, including osteomalacia and osteoporosis. The U.S. Food and Drug Administration in 1994 approved a vitamin D preparation to treat psoriasis. [Read more →]

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Posted in: Medication

Why Glucose Tabs are Better

June 15th, 2009 · 2 Comments

This weekend my friend Mark and I drove about 120 miles from our homes in Boulder to Leadville in Central Colorado. Mark is a member of the diabetes support group that meets monthly at my apartment, and we are both avid hikers and nature photographers.

On Friday as we set off on the Turquoise Lake trail near Leadville, Mark checked his blood glucose. It was about 75 mg/dl so he ate a chocolate bar that he had in his pack.

“I figure that as long as I have to eat something to raise my level, I may as well eat something that tastes good,” he commented.

Maybe my body language showed my disagreement. So he asked me why I didn’t like his solution. [Read more →]

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Posted in: Medication, Testing

Welcoming Welchol

May 20th, 2009 · 7 Comments

A year ago the U.S. Food and Drug Administration approved a new drug to treat type 2 diabetes. But few of us ever heard of it.

Until now. Studies presented at the annual convention of the American Association of Clinical Endocrinologists in Houston on Friday finally caught our attention.

The senior author of one of those studies spoke at length with me at the convention. Yehuda Handelsman, an endocrinologist in private practice in Tarzana, California, led a 16-week multi-center international study comparing how well Welchol (colesevelam HCl), Avandia, and Januvia did. In the study they randomized 169 people to evaluate the effects of these three oral diabetes medications on glycemic control and lipid profiles when added to metformin.
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Posted in: Medication

The Vitamin D Window

May 18th, 2009 · 7 Comments

When he examined the young lifeguard, he saw that almost every square inch of her body was well tanned. She had been wearing practically nothing when she worked at the beach.

Neil Binkley, M.D., told me about his patient because she had the highest physiologic level of vitamin D in her system of anyone he ever saw. Her level was 80 ng/ml.

I had to look up the word “physiologic” to make sure what Dr. Binkley meant. Physiologic in the sense that he’s using it is “something that is normal, neither due to anything pathologic nor significant in terms of causing illness,” according to a medical dictionary.
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Posted in: Medication

Choosing Exercise or Antioxidants

May 13th, 2009 · 8 Comments

Based on what I’ve read recently, some of which I have reported here, I’ve grown more and more wary of the wisdom of taking supplements. Few of the them seem to help.

And now comes a new study indicating that the two most common supplements can actually work against us. Those supplements are vitamins C and E.

It seems that we have a choice of exercising or taking large doses of those supplements. We know that exercise has lots of good effects like increasing our sensitivity to insulin, which is of great importance to all of us with diabetes.
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Posted in: Exercise, Medication

Diabetes Drug Dangers

April 19th, 2009 · 8 Comments

A single research report that found risks in one of the medications that we take to control our diabetes would warrant our attention. But when three separate studies find serious side effects from all our major drugs, the time is right for us to reconsider how we control our blood glucose levels.

Most of us think of our diabetes drugs, diet, and exercise as the three basic ways we do that. But drugs come first. Maybe they should come last, at least for all of us with type 2 diabetes, who unlike type 1s have a choice.

Since March 10, studies have called into question the side effects of metformin, the glitazones, insulin, and the sulfonylureas.
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Posted in: Medication

Comparing Insulins for Type 2s

April 5th, 2009 · 4 Comments

Some of our doctors don’t help us when they use insulin as a threat: “Unless you reduce your blood glucose, I am going to have to put you on insulin.”

So it’s no surprise that many of us who have type 2 diabetes think we have failed when our doctors prescribe it. This comes from thinking of injecting insulin as a last resort.

It isn’t. More and more of us are now starting to take insulin as soon as our doctors have diagnosed our type 2 diabetes. Probably half of the men in my diabetes support group started taking insulin as a first choice.
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Posted in: Medication

Avoiding Flu Vaccine Toxicity

December 14th, 2008 · 10 Comments

When I recommended here a month ago that we all get vaccinated against influenza this year, I had no idea how much controversy it would stir up. Some of the concerns are legitimate, but we have alternatives. Other concerns stem from irresponsible rants on the Internet that I’ve traced back to a totally discredited South Carolina doctor.

My article here last month jumped the gun. I knew that the flu authorities at the U.S. Centers for Disease Control and Prevention (CDC) wanted to talk with me so that I could help get the word out. But since CDC and the Health Central Network weren’t able to work out the arrangement in time, I wrote then because the flu season was already upon us.
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Posted in: Medication