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February Newsletter


By David Mendosa

Last Update: August 21, 2002

People with type 2 diabetes will soon have another way to control their blood glucose.

‘We are looking at a revolution…’

Hot News in Diabetes
The Food and Drug Administration just told pharmaceutical giant Novartis that it could market Starlix (nateglinide) in the United States.

Your doctor will be able to prescribe it as your only diabetes medicine or together with Glucophage (metformin). The company says it will have it available here "early in 2001."

Starlix is not just another oral hypoglycemic agent. It is the first of an entirely new class of drugs. Made from an amino acid called D-phenylalanine, Starlix will be marketed as the first "smart drug" for diabetes. It's to be taken immediately before each meal.

Like several other drugs, Starlix reduces blood glucose levels after meals. Precose, Glyset, and Prandin do this too, but perhaps not as wisely. What's smart about Starlix is that it works by stimulating rapid, short-acting insulin secretion—and then stops working when it's no longer needed to bring down glucose levels. This means that there is little risk of it causing hypoglycemia (low blood glucose).

"Beta cells normally secrete more insulin when you eat," says Harvard endocrinologist Arturo Rolla, "literally the moment you put the first bite in your mouth." It is this first phase insulin release that acts as the body's first defense against high glucose levels after meals. In type 2 diabetes the loss of this first phase insulin can mean hours of high blood glucose levels. Starlix promises to help us correct that problem.

Lifestyle Improvement Tip
Nothing can improve the lifestyle of people with diabetes more than bringing down blood glucose levels with diet, exercise, and drugs like Starlix. But because of when many of us do our fingerstick tests, we might not have any idea how high our levels are.

Many people with type 2 diabetes think they are doing fine if they do a fasting blood glucose test once a day. They aren't.

While being consistent in timing the test makes trend interpretation easier, our fasting levels are always lower than after eating. Two hours after beginning a meal is generally when the blood glucose levels of people with diabetes are the highest. Some foods will have much greater impact on blood glucose levels than others—but there's no way of knowing that unless you test.

"We are looking at a revolution in home monitoring of blood glucose," says endocrinologist Arturo Rolla. The new emphasis, he says, is going to be on testing after a meal. "I've already been doing this for four to five years."

Testing after meals is important, agrees William Biggs, an endocrinologist practicing in Amarillo, Texas. "We have been training everybody to monitor their blood sugars before meals and usually we are thrilled to get two or three readings a day, even if none of them are taking after meals. We are going to have to get a whole new mindset getting people to realize how important it is to do some testing after a meal."

Related Web Site Reviews
A new nutrition web site,,, specializes in comprehensive articles about nutrition, diet, and food by experts in the field. Its article on:

Vitamin E is as good a primer on the different types of vitamin E as you will find anywhere.

You can find many more studies about diabetes and vitamin E by using the Web's newest and best search engine, Google. Searching well over 1 billion Web pages, Google is not only the largest but also probably the fastest search engine. But even more important is Google's unique technology, called PageRank. Google's results are listed in the order of how many links other sites have to that site. It also weights more heavily links on pages that many other pages link. In practice this means that what you are looking for is usually at or near the top of Google's results.

"Smart Drugs: Are We Ready for Them?" by David Mendosa appeared in the September 2000 issue of Diabetes Wellness Letter, while Novartis was awaiting FDA approval of Starlix. The article is online at

This article was originally written for the LXN Corp. Web site.

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