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.
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.
The annual convention of the American Association of Clinical Endocrinologists — those medical specialists who treat diabetes — is underway in Houston. I’m covering the event for The Health Central Network.
The convention took over the George R. Brown Convention Center in the downtown of America’s fourth largest city. The convention center is so big that after Hurricane Katrina 7,000 refugees lived here.
In the mob of today’s convention you might imagine my surprise that the first person I made eye contact with asked if I was David Mendosa. The person who asked was Sarah Senn, who I had sent several photos for an article that she wrote about me. But we had never previously met in person.
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.
Earlier studies that I reviewed here indicated that when we take our food in liquid form rather than in a solid one, we consume more calories that day. And now a big new study shows that when we cut back on the amount of liquid calories that we consume, we do lose weight.
But, unlike the earlier studies, the new one finds only one liquid culprit: sugar-sweetened beverages. No other type of beverage is associated with a change in weight.
This is good news for people with diabetes. More than 85 percent of us are overweight or obese, according to a survey by the U.S. Centers for Disease Control and Prevention.
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.