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

John Dodson’s Diabetes Journey

January 10th, 2013 · 8 Comments

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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.

John is now 79 and finally retired this year. Between 1978 and 1999 he was the pastor of the Los Altos United Methodist Church near San Jose, California. He was greatly loved there, as is apparent when reading a book, Pastor John’s World, that one of his parishioners wrote. Between 1999 and early this year he was a consultant to his church, including assignments as interim pastor in Aptos, California, and Anchorage, Alaska, where I visited him three years ago and had the opportunity to see his dynamic performance.

Before Byetta, John was much less active and had a big problem with his weight. He had weighed 250 pounds then; he weighs 161 now.

But Dr. Joe and his nurse practitioner, Penelope Mays, also taught John about the importance of diet and exercise. “It was not a part of what we did when we had diabetes,” he says. “Dr. Joe has a more comprehensive approach; he looks at everything we do.”

Penelope had such a level of commitment that she introduced John to hiking. “She is so committed to helping her patients with diabetes that she took me hiking on her day off. I checked my blood sugar before we started the hike and after we ended it. It was down 30 points, and that proved to me that hiking makes a difference. So I made hiking a part of my life.”

The New York Times featured John’s success on Byetta in an article about him in 2006. He used it for at least three years, but eventually it stopped working for him in spite of his trying everything he could think of.

“I did a lot of experimenting,” he says. “I put it together with Symlin. Dr. Joe didn’t think it would do much good, but it actually did help me lose more weight.” Byetta is approved for two shots a day — before breakfast and dinner — but John also experimented with taking another shot before lunch, even though his insurance didn’t cover it.

I asked him whether he meant that it stopped controlling his blood sugar or his weight.

“In terms of my weight,” he replied. “It certainly helped, but not like it originally did.” His A1C levels recently have ranged between 5.8 to 6.1.

So to help him control his weight, when a newer drug in the same GLP-1 class became available, John switched to it. Victoza (liraglutide) came on the market in February 2010, and soon after that, John started taking it. This newer drug requires only one shot per day. But eventually Victoza too stopped helping him control his weight.

But the same company that introduced Byetta in 2005 introduced an extended release version of it early this year. Unlike Byetta, which requires two shots per day, this extended release version, Bydureon, does its thing in one shot per week. Mixing the drug with the extended release powder can be tricky, he says, so now his wife Vicky reads the instructions to him page-by-page.

On January 27, 2012, I wrote here that the FDA had approved Bydureon and emailed John about it. “I saw that, and bam! I jumped on it right away,” he told me a few days ago. So John must be one of the few people who have used all three of the new GLP-1 drugs.

Like when he started Byetta, he was the first person in his county to use Bydureon. “I wanted to keep that record.”

How is Bydureon working for you? I asked John. “It’s working wonderfully for me: it is reassurring, so steady, so constant. They have an amazing support system behind Bydureon. It is a fantastic drug and makes me feel like I am tremendously served. It has basically saved my life.”

This is a mirror of one of my articles that was originally published on Health Central.

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Posted in: Diabetes Medication, People With Diabetes

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8 responses so far ↓

  • 1 Stalina Dsouza // Jan 21, 2013 at 3:54 am

    My husband was just diagnosed with diabetes II, he is in complete denial. How do I get him with the program?

  • 2 David Mendosa // Jan 21, 2013 at 4:37 am

    Dear Stalina,

    I recently wrote on precisely your question. What you can do is in this article:

    http://www.mendosa.com/blog/?p=1400

    Namaste,

    David

  • 3 Melissa Mitchell // Jan 23, 2013 at 11:37 pm

    I’m 37 and I was diagnosed with Type 2 diabetes 12 years ago. My control has fluctuated over the years, but during a several year struggle with Depression and Anxiety (BiPolar2), it was abysmal.
    6 months ago I had an epiphany and realised how much damage I was doing to my body, and that I really would die young if I didn’t fix it.

    So 6 months in I’ve got my A1C down to normal. I’ve gone from massive amounts of Novorapid (I don’t know what it’s called outside of Australia) to none at all. I still take Lantus at night (but less) and Metformin.

    But I’ve lost 20kgs (44lbs) and have started an exercise program. It’s slow going as I have several painful chronic conditions. But my entire life is changing. And while my Doctor is supporting me {he has been so encouraging}, the fact that I’ve taken charge of this has made me prouder of myself than I’ve ever been in my life.

    Anyway. I wanted to share that with someone who gets it. :) And I feel confident that you DO.
    Your website is new for me – I’ve been on here an hour or so now. But it’s bookmarked and I feel like you are going to be so helpful to me, {I don’t mean that I am going to bother you}. This is a fantastic resource.

  • 4 David Mendosa // Jan 24, 2013 at 6:25 am

    Dear Melissa,

    I get it! In fact, I got on the same train with you, so to speak, when I began to lose weight starting in 2005. That made all the difference in my life too.

    Namaste,

    David

  • 5 Ralph Webb // Jan 24, 2013 at 11:19 am

    Dear David:

    First and foremost thank you for this site. I have been coming here for several years and I am on your email list. As I mentioned in a post I recently made on a low carb forum, you and your site share common sense knowledge that anyone with diabetes can find invaluable. I know I do.

    I too used Byetta when it first came out but it really didn’t work for me in either weight loss or blood glucose numbers and I was one of those who suffered from its side effects of stomach upset. When Victoza came out I went on it and had great results with blood glucose numbers but little effect on my weight.

    In December of 2010 I started a low carb diet, as described by Dr. Richard Bernstein’s in his book “The Diabetes Solution” and my life changed in ways I never expected. It was at this time I also found your site. When I read you were controlling your diabetes with diet and exercise alone I knew what my new goal was going to be.

    It took me exactly one year and eleven months to the day to go from a daily injection, 1.8mg, of Victoza and 2000mg of metformin to being completely off all medications. It was my doctor who kept saying, “You know you don’t need to take those meds any more.”

    My weight went from 215lbs to 165lbs the first year and I have maintained that weight ever since. My A1c went from 6.1 – 6.2 to 5.1 – 5.2 and my morning fasting numbers went from an average of 115 – 120 to 85 – 90. I went from no exercise at all to 3 miles a day on a treadmill at a fast walk pace and 4 days a week working with weights. The change has been dramatic.

    Being 63 years old and having several other serious medical conditions I know there are limitations I have but I have found I can stretch their boundaries farther than I ever thought possible.

    I read all of your articles and have used your archive of older articles many times. You provide a great service and I can’t thank you enough both for your work and showing us what can be done when you have a plan and the determination to accomplish it. Thank you again and I look forward to your future work.

    Ralph Webb

  • 6 David Mendosa // Jan 25, 2013 at 11:19 am

    Dear Ralph,

    Thank you for your message. Your journey can help inspire others that they can succeed at managing their diabetes as you have.

    Namaste,

    David

  • 7 pat // Apr 1, 2013 at 6:37 pm

    David: I have recently been diagnosed w/D2 and have been reading your entire website with great interest. The information you share is so diverse and very helpful in assisting my developing understanding of the complexities of this condition; I have really appreciated it. Today I was looking up information on coconut and almond flours; as a by-product of that search I came across a Dr. Oz video about a natural supplement derived from a plant related to tamarind and mangosteen; it is called garenja cambogia and the active component is hydroxycitric acid. It is alleged to reduce absorption of carbohydrates, reduce glucose resistance, improve blood lipid profiles, increase metabolism of visceral fat, etc., etc. Allegedly a “miracle” product w/few negative side effects. I have by nature a rather skeptical response to such claims but do try to maintain an open mind. Have you examined the literature on this hydroxycitric acid, have you ever used it, have your docs heard of it, and if so, what has been your assessment of the claims being made for it? Thanks for your consideration of my question.

  • 8 David Mendosa // Apr 1, 2013 at 6:45 pm

    Dear Pat,

    I am perhaps even more skeptical than you are. No, I am not familiar with this product. In fact, Dr. Oz is notorious for promoting many untested products as the cure for everything. Some may well work, but I’m not going to take a chance until I see several studies about them.

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