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

Entries Tagged as 'Diabetes Medication'

Who Reverses Diabetes with Bariatric Surgery

July 23rd, 2012 · 4 Comments

People who have diabetes and are severely overweight are deciding more and more often that bariatric surgery is just the thing for them. Although it is expensive and like any surgery it can have complications, the amount of weight that they lose is usually dramatic and their diabetes often completely disappears.

Some people, including a couple of my friends, have had wonderful results from bariatric surgery. But not everybody benefits.

If you are morbidly obese, I’m sure that you have considering bariatric surgery. But how can you tell what the chances are that it will work for you?

A study presented yesterday at the annual meeting of the American Society for Metabolic and Bariatric Surgery can help you decide. Richard A. Perugini, M.D., a bariatric surgeon at the University of Massachusetts Medical Center in Worcester, was the lead study author and presented the findings of his team at the annual meeting. The abstract of the study, “Predictors for Remission of Type 2 Diabetes Mellitus Following Roux En Y Gastric Bypass,” is online.

Graphic of a Roux-en-Y gastric bypass connection
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Posted in: Diabetes Medication

Metformin Forever

May 30th, 2012 · 66 Comments

Metformin controls the insulin resistance of people who have type 2 diabetes so well that, if possible, all of us should be taking it. That’s what Roderic Crist, M.D., told me at the annual convention of the American Society of Bariatric Physicians in Denver this weekend. Dr. Crist specializes in family medicine in Cape Girardeau, Missouri.

“Not everybody can take every drug,” he added, when I followed up our conversation by calling him at his office after he returned home. “But most of the time people can take metformin if they take it carefully.”

Doctors increasingly prescribe it not only for type 2 diabetes but also for insulin resistance, polycystic ovary syndrome, and non-alcoholic fatty liver disease.

Roughly one-third of Dr. Crist’s patients have diabetes. Well over half, if not two-thirds of the people he sees are insulin resistant.

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Bydureon Approved Today

February 28th, 2012 · No Comments

Today we have the biggest diabetes drug news in 90 years. The U.S. Food and Drug Administration finally approved Bydureon, extended release exenatide.

Now people with type 2 diabetes can take just one shot a week. This single weekly injection will help millions of us manage our diabetes better.

We already know that Bydureon has a significant side effect. Weight loss.

We know that because Bydureon is the extended release version of Byetta, which millions of people have already successfully used to manage their diabetes and reduce their weight. I was one of them.

I used Byetta from February 6, 2006 until December 5, 2007. That’s 22 months.

When I started my twice-daily injections of Byetta my A1C was already pretty good, 6.2. But I was able to reduce my level to 5.3 before I stopped taking it.

That alone would have been enough to make me happy. But what Byetta did to my weight changed my life. The day that I started taking it I weighed 312 pounds and my waist was 58 inches. Twenty-two months later my weight was down to 168 pounds. Unfortunately, I can’t find what my waist measurement was at that time.

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No Diabetes Supplement like Noni

January 13th, 2012 · 6 Comments

When the captain of the skiff who took me snorkeling off South Water Caye, an island of Belize in the Caribbean Sea on Thanksgiving Day, told me about the benefits to people with diabetes of a local fruit, I listened. While I was theoretically on vacation, I always think about my diabetes and how I can help other people who have this disease.

The captain, Ismael Usher, said that his grandmother had diabetes and managed it by drinking the juice of the noni tree. After we got back to the island, he picked a noni fruit from a tree there and gave it to me.

I Study the Fruit of the Noni Tree after Snorkeling
Noni was new to me, so I ate it. It didn’t taste good. But I expected that after trying several other traditional remedies, like bitter melon and gymnema sylvestra.

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Diabetes Without Drugs

October 11th, 2011 · 21 Comments

All drugs have side effects, some worse than others. Yet one of the cornerstones of diabetes management along with diet, weight control, and exercise, is to take insulin or one of the many diabetes medications that our doctors routinely prescribe.

People with type 1 diabetes have no choice. They have to take insulin. But the great majority of us have type 2 and mostly take one or two or even three different pills for our condition.

Some of these pills are clearly safer than others. For example, none of us take Rezulin any more, now that it killed at least 63 people. That was a dozen years ago so I wouldn’t be surprised if you forgot about Rezulin or never heard of it, but half a million of us were using it when the U.S. Food and Drug Administration recalled it.

Six years later Avandia became even bigger than Rezulin, earning GlaxoSmithKline $2.5 billion that year. Not so many of us take Avandia now that studies show that it raises the risk of heart attack by 43 percent.

Recently, yet another diabetes drug, Actos, seems to be life-threatening. Already banned in parts of Europe because it may cause bladder cancer, the FDA says that doctors should be cautious when telling us to take Actos. “The benefits of blood sugar control with pioglitazone,” it says, “should be weighed against the unknown risks for cancer recurrence.”

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Medicine Once a Month

August 12th, 2011 · No Comments

How would you like to manage your diabetes by taking your medicine just once a month?

You can’t do that yet. But that prospect is on the horizon.

While I seldom write about news that we can’t use at the moment, I think that this is such big news that many of you will want to know about it right now.

Only once before (if my memory serves me) have I ever written about a diabetes medicine that the U.S. Food and Drug Administration had not yet approved. That was in 2002 when I wrote about something then called Exendin-4 in my article “The Monster Drug.”

That monster drug, renamed exenatide — made from the venom of Gila monsters — became Byetta after the FDA approved it in 2005 as the first of a new class of drugs, GLP-1 agonists. Byetta became a monstrously successful medication for people with diabetes, including this writer. Full disclosure: I own some shares of stock in Amylin Inc., the company that developed Byetta.

When people take Byetta they inject it before breakfast and before dinner. That twice-a-day coverage isn’t quite as convenient as the second GLP-1 agonist, Victoza.

But when and if the FDA approves an extended release form of Byetta called Bydureon, taking it just once a week will be even more convenient.

Today’s news is about an even longer lasting form of exenatide. This is the biggest news announced at the 71st Scientific Sessions of the American Diabetes Association.

The ADA’s annual meeting is always the biggest diabetes gathering in the world. This year more than 17,500 people, including 14,000 scientists, physicians, and other health care professionals — plus a few regular people and some journalists like me — are meeting in San Diego, California, from June 24 to June 28.

The amount of information presented is staggering. I am making my way through more than 2,000 abstracts and more than 1,600 posters. But they seem to save the biggest news for what they call “Late-Breaking Posters,” some 131 in all. These posters got posted today.

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Posted in: Diabetes Medication

Comparing Type II Diabetes Pills: Metformin and the Insulin Secretagogues

May 17th, 2011 · 4 Comments

When people with type 2 diabetes could take a pill instead of insulin to help us control our diabetes, smiles must have appeared on many faces. The pill was tolbutamide, and in the mid-1950s it became the first of the sulfonylurea class of drugs.

But that was more than half a century ago. Meanwhile, we now have choices of pills we can use. In fact, we now have nine other classes of oral diabetes medication plus several combinations.

The sulfonylureas force the beta cells in the pancreas to pump out the insulin that our body makes there. That’s why we call these drugs insulin secretagogues. For years many of us have been concerned that they will eventually burn out whatever beta cells we have left.

About a dozen years ago I voiced this suspicion to Edward S. Horton, who was then the director of clinical research at the Joslin Diabetes Center in Boston. In reply he told me that we have no evidence for this belief.

“You are not whipping the beta cells to death,” he said. “There is evidence that the beta cells do fail gradually over time. But there is no evidence that drugs hasten the process. I know that it is a popular conception that people have, but it is not true.”

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Medical Marijuana for Diabetes

February 2nd, 2011 · 4 Comments

Here is a copy of a letter — with the author’s name and other identifying information redacted out — about anecdotal evidence that medical marijuana might help some complications of diabetes.

The person who wrote me has a better memory than I do. I don’t remember corresponding with him before, but he remembers that when I used marijuana I was addicted to it. It got to where I had to be high all my waking hours. My correspondent is also quite correct in writing that I would not be a good candidate for medical marijuana, except as a last resort.

The jist of what he wrote follows:

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Posted in: Diabetes Complications, Diabetes Medication, Psychosocial

Meeting the tiniBoy Lancet Inventor in Korea

November 30th, 2010 · 1 Comment

Stanley Kim is a practicing physician in Southern California who recently invented the smallest and painless lancets for testing our blood glucose. I wrote about this invention here this August.

At that time Dr. Kim and I hadn’t met. I interviewed him on the phone from my home office in Colorado.

We had to travel all the way to South Korea to meet in person. We are in Busan, Korea’s second largest city with about 3.6 million residents. Specifically, we are both attending the International Diabetes Federation’s Western Pacific Region Congress along with about 3,000 other people who work with diabetes. This congress is taking place in Busan Exhibition and Convention Center (BEXCO) in the most modern part of the city near Haeundae, the most famous and frequented beach in all of South Korea.

As modern as Korea is — particularly in this part of the country — it is naturally quite different from what I normally experience in Colorado. But for Dr. Kim, Busan is quite familiar. He grew up in Busan and has a condo here.

Until I mentioned the meeting during the course of the interview for the article I wrote here in August, Dr. Kim didn’t know that it was happening in his hometown this year. He then arranged to attend the meeting. And at the last minute the conference organizers approved his poster presentation for the tiniBoy lancets. [Read more →]

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Test Strips and Meters from South Korea

November 30th, 2010 · No Comments

Greetings from the bottom of my heart and the top of Seoul. I am writing you from South Korea where I am for two weeks at the invitation of one of the largest blood glucose meter and test strip manufacturers in the world.

People from i-SENS Inc., a company headquartered in Seoul that designs and manufacturers blood glucose monitoring systems, asked me to visit them this fall. In fact, they originally invited me to come last October. But I had to postpone my visit because I had an emergency operation for twisted small intestines at the beginning of that month, and my surgeon said I couldn’t travel.
For the first few days of my trip I am staying on the top floor of a hotel in the Seongbuk district of Seoul, near the company’s headquarters. With 24.5 million inhabitants Seoul is the world’s second largest metropolitan areas in population (after Tokyo and ahead of Mexico City, New York City, and Mumbai, in that order). Seoul has been Korea’s capital for more than 600 years.
On Friday I left Seoul for the day to visit the new factory that i-SENS built in Wonju city four years ago to make test strips for its blood glucose meters. I went with my friend and hostess, Margaret Leesong. The i-SENS director of international business relations, Margaret visited me in Boulder a couple of years ago, when we had a great hike together in the foothills of the Rockies.

Margaret lived in the States from 1973 to 1978 and then again from 1988 to 1996, when she moved to Australia, remaining there until 2005. After her college years at Seoul National University, she earned a Ph.D. in biophysics from Purdue University in Indiana and then an LLB (law degree) from the University of Sydney. She speaks flawless English.
When Margaret met me at the hotel on Friday morning, we took a taxi to the bus station, where we took a two-hour ride to Wonju, a much smaller city of about 300,000 people in northeastern Korea. From there a staff member who helped us as driver and tour guide from the company picked us up and took us to the factory.

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