This blog tracks updates to the Blood Sugar 101 Web site.


Monday, May 9, 2016

A Large Epidemiological Study Confirms Actos/Bladder Cancer Link


Page Changed:Actos and Avandia: Dangerous Diabetes Drugs
Text Updated: Actos Is Proven to be Associated with A Higher Rate of Bladder Cancer
On Sept 17, 2010, the FDA announced that it was conducting a safety review of Actos, because prelimnary (5 year) results from a 10 year study found "...there was an increased risk of bladder cancer in patients with the longest exposure to Actos and in those with the highest cumulative dose of the drug.

In June of 2011 the FDA confirmed FDA confirmed that there was a heightened risk of bladder cancer with Actos. Years later, in May of 2016 a study published in the high impact British Medical Journal, which studied the records of 145,806 patients again concluded that "Piaglitazone [Actos] is associted with an increased risk of bladder cancer." This association was only true for Actos, not Avandia, suggesting something about the drug itself, not the class of drugs, was at fault.

Pioglitazone use and risk of bladder cancer: population based cohort study. Marco Tuccori, et al.
BMJ 2016; 352 doi: http://dx.doi.org/10.1136/bmj.i1541. However, doctors can still prescribe Actos.

Friday, April 22, 2016

FDA Warns Onglyza and Nesina Raise Risk of Heart Failure Confirming Earlier Study

Page Changed: DPP-4 Inhibitors Januvia, Onglyza, Trajenta, Combiglyze, Janumet, and Jentadueto


Added Text:

In April of 2016 After another year of dallying around, during which unknown numbers of patients were probably injured by this drug and a new one in the same class, Nesina, the FDA issued a safety alert stating,
An FDA safety review has found that type 2 diabetes medicines containing saxagliptin and alogliptin may increase the risk of heart failure, particularly in patients who already have heart or kidney disease. As a result, FDA is adding new warnings to the drug labels about this safety issue.
However, in line with the FDA's policy of putting the business interests of the companies it regulates ahead of the interests of the people who take these drugs, the FDA's recommendation to doctors was merely,
Health care professionals should consider discontinuing medications containing saxagliptin and alogliptin in patients who develop heart failure and monitor their diabetes control.
This is shameful! Why should any doctor wait until a patient taking a suspect drug has already developed heart failure--a condition that usually limits their life expectancy to a few years--before taking them off it. There are multiple studies confirming that these drugs appear to be promoting the developement of heart failure.You can read the FDA's safety alert noting the label change HERE
If you are prescribed any of these drugs, remember that few busy doctors are able keep up with changes to the labels of all the drugs they prescribe. And as the FDA allows these suspect drugs to be sold, they will continue to be prescribed. This kind of FDA response is in line with its policy of putting the business interests of the drug companies it is supposed to regulate above those of drug users. 

Metformin Protects Diabetic Women with Cancer Better than Other Anti-diabetic drugs

Page Changed: Metformin

Text added:

A second large epidemiological study, which examined data from the Women's Health Initiative, found that though women with diabetes had a higher rate of cancer than the general population, "Metformin users, particularly long-term users, may be at lower risk of developing certain cancers and dying from cancer, compared to users of other anti-diabetes medications." That study is found here:

Diabetes, metformin and incidence of and death from invasive cancer in postmenopausal women: Results from the women's health initiative. Zhihong Gong et al., International Journal of Cancer, Volume 138, Issue 8, pages 1915–1927, 15 April 2016

Saturday, November 14, 2015

New Page: The Real Symptoms of Diabetes

Page added: The Real Symptoms of Type 2 Diabetes

 Contrary to what you might read elsewhere, the actual symptoms that most people with Type 2 diabetes experience right before they are given a diabetes diagnosis are not increased thirst, a continual need to urinate, and unexplained weight loss.

These symptoms are typical of Type 1 diabetes. And they also occur in people with Type 2 Diabetes when their beta cells have become so damaged by years of exposure to very high blood sugars that they no longer can secrete any insulin. But nowadays most people are diagnosed with diabetes early enough that they have not experienced this kind of diabetic damage.

Neither do many people who are fully diabetic have several other diabetic symptoms you see listed on the American Diabetes Association's web site: slow healing of cuts and bruises, and pain and tingling in their hands and feet. These symptoms also are associated with long-standing diabetes, as they are the result of diabetic nerve damage, a diabetic complication that typically takes years to develop.

People with diabetes may experience three symptoms also listed on the ADA's list of diabetic symptoms in the months or year before diagnosis: blurry vision, extreme tiredness, and feeling very hungry though eating sufficient food. But so do many other people who don't have diabetes, since these symptoms can be produced by thyroid problems, allergies, or coming down with the flu. So these symptoms alone are not enough to suggest that a person has diabetes. Though if you do experience relentless hunger, which often produces the obesity so many doctors incorrectly believe causes diabetes, it is a very good idea to ask your doctor to test your blood sugar to ensure that in your case this relentless hunger is not a true symptom of diabetes or prediabetes.

That said, however, the most common symptom most people with Type 2 Diabetes experience is none at all! 

I have heard from quite a few people who were diagnosed with blood sugars well over 400 mg/dl (22 mmol/L) who had no idea anything was wrong until their doctor came in waving a lab test result sheet in their face.

The reason for this is that doctors are becoming better at diagnosing people with diabetes before they have had it for the many years it takes for diabetes to cause the severe damage to the pancreas and nerves that results in the first two groups of symptoms listed above. So people are getting diagnosed with diabetes long before they develop the symptoms of long-standing diabetic complications.

But that said, there are a few conditions that are not considered by most doctors to be symptoms of diabetes that often are.

The Lesser Known Symptoms of Early Diabetes

  1. Recurrent Urinary Tract and Genital Yeast infections.
    When you are diabetic, your body will eliminate the excess glucose from your blood by diverting it into your urine. Bacteria and yeast thrive on this urinary glucose. Though you may temporarily wipe them out with medications, they are likely to come right back, since there are always more yeast and bacteria in the environment to create new infections.

  2. Carpal Tunnel Syndrome.
    Studies have shown that Carpal tunnel syndrome often occurs as much as a decade before a person is diagnosed with diabetes, and that it may be predictive of it. Other tendon problems, like Tarsal Tunnel Syndrome and Frozen Shoulder (Adhesive Capsulitis) may also point to the presence of undiagnosed diabetes.

  3. Ruptured Vertebral Discs.
    While the evidence for this as a diabetic complication is less compelling than it is for the previously mentioned symptom, there is also some evidence that discs may rupture after years of exposure to higher than normal blood sugars. Apparently this exposure may make disc material become "crispy" and hence more likely to rupture. (Details HERE. Spinal stenosis has also been found to be associated with diabetes. (Details HERE. So if you have a family in which relatives have both diabetes and serious back troubles, a diagnosis of degenerative disc disease should motivate you to ask your doctor to check out your blood sugar.

  4. Sleepiness Shortly After Eating a Lot of Starch and Sugar.
    If your blood sugars are rising extremely high after you eat a high carbohydrate meal or dessert and then dropping down swiftly, you may often feel the sudden onset of exhaustion as your blood sugars drop. This symptom points to a very early diabetic state, however. If you don't take steps to lower your blood sugar when it is rising and falling this way, eventually it will just stay high and you will no longer experience the rapid drop that is so enervating.



If you develop any of these conditions, ask your doctor to include an A1c test and a fasting glucose test with your next lab test. If the tests come back normal, it doesn't hurt to test your blood sugar with a blood sugar meter at home as described HERE to make sure you aren't experiencing diabetic blood sugars after eating, since the tests doctors order often miss that kind of diabetic blood sugar. If you see post-meal blood sugars that are firmly in the diabetic range ask your doctor to order a Glucose Tolerance Test with readings taken 1 and 2 hours after consuming the glucose, as this is the test that can diagnose diabetes that only shows up after meals.

Is It Really Diabetes?

An surprising proportion of the email I receive from people who visit this site comes from people who by no stretch of the imagination have diabetes, though they do have a lot of painful, persistent, and at time bizarre symptoms that their doctors haven't been able to diagnose.

Many of these people are hoping that they do have diabetes, because they are so desperate to find some cause for their symptoms that can be treated and and give them relief. But before you assume that a symptom you are experiencing is due to undiagnosed diabetes use the technique described HERE to test your blood sugar. If you aren't seeing readings in the diabetic range, you don't have diabetes and you will not be able to convince any doctor to the contrary.

If you discover that you have blood sugars in the prediabetic range, or if your blood sugars are only in the diabetic range after eating, a condition that does not show up on most of the tests that doctors order, you can still do a lot on your own to lower those blood sugars back to a safe level. You'll find instructions on this page:

How to Lower Your Blood Sugar

Follow these instructions and bring your blood sugars down to a safe, normal range and you need never experience any of the symptoms of diabetes. Even if you have actually had diabetes.

Thursday, October 15, 2015

Afrezza Page Rewritten to Embody User Experience Since Product Release

Page Changed: Inhaled Insulin Please visit the link above to read the newly revised text, much of which has been changed from the previous version posted shortly after the drug was released.

Wednesday, October 14, 2015

New Page: The Real Symptoms of Diabetes

New Page added: The Real Symptoms of Diabetes

Text added:

Contrary to what you might read elsewhere, the actual symptoms that most people with Type 2 diabetes experience right before they are given a diabetes diagnosis are not increased thirst, a continual need to urinate, and unexplained weight loss.

These symptoms are typical of Type 1 diabetes. And they also occur in people with Type 2 Diabetes when their beta cells have become so damaged by years of exposure to very high blood sugars that they no longer can secrete any insulin. But nowadays most people are diagnosed with diabetes early enough that they have not experienced this kind of diabetic damage.

Neither do many people who are fully diabetic have several other diabetic symptoms you see listed on the American Diabetes Association's web site: slow healing of cuts and bruises, and pain and tingling in their hands and feet. These symptoms also are associated with long-standing diabetes, as they are the result of diabetic nerve damage, a diabetic complication that typically takes years to develop.

People with diabetes do experience three symptoms also listed on the ADA's list of diabetic symptoms in the months or year before diagnosis: blurry vision, extreme tiredness, and feeling very hungry though eating sufficient food. But so do many other people who don't have diabetes, since these symptoms can be produced by thyroid problems, allergies, or coming down with the flu. So these symptoms alone are not enough to suggest that a person has diabetes. Though if you do experience relentless hunger, which often produces the obesity so many doctors incorrectly believe causes diabetes, it is a very good idea to ask your doctor to test your blood sugar to ensure that in your case this relentless hunger is not a true symptom of diabetes or prediabetes.

That said, however, the most common symptom most people with Type 2 Diabetes experience is none at all! I have heard from quite a few people who were diagnosed with blood sugars well over 400 mg/dl (22 mmol/L) who had no idea anything was wrong until their doctor came in waving a lab test result sheet in their face.

The reason for this is that doctors are becoming better at diagnosing people with diabetes before they have had it for the many years it takes for diabetes to cause the severe damage to the pancreas and nerves that results in the first two groups of symptoms listed above. So people are getting diagnosed with diabetes long before they develop the symptoms of long-standing diabetic complications.

But that said, there are a few conditions that are not considered by most doctors to be symptoms of diabetes that often are.


The Lesser Known Symptoms of Early Diabetes

  1. Recurrent Urinary Tract and Genital Yeast infections.
    When you are diabetic, your body will eliminate the excess glucose from your blood by diverting it into your urine. Bacteria and yeast thrive on this urinary glucose. Though you may temporarily wipe them out with medications, they are likely to come right back, since there are always more yeast and bacteria in the environment to create new infections.




  2. Carpal Tunnel Syndrome.
    Studies have shown that Carpal tunnel syndrome often occurs as much as a decade before a person is diagnosed with diabetes, and that it may be predictive of it. Other tendon problems, like Tarsal Tunnel Syndrome and Frozen Shoulder (Adhesive Capsulitis) may also point to the presence of undiagnosed diabetes.




  3. Ruptured Vertebral Discs.
    While the evidence for this as a diabetic complication is less compelling than it is for the previously mentioned symptom, there is also some evidence that discs may rupture after years of exposure to higher than normal blood sugars. Apparently this exposure may make disc material become "crispy" and hence more likely to rupture. (Details HERE. Spinal stenosis has also been found to be associated with diabetes. (Details HERE. So if you have a family in which relatives have both diabetes and serious back troubles, a diagnosis of degenerative disc disease should motivate you to ask your doctor to check out your blood sugar.




  4. Sleepiness Shortly After Eating a Lot of Starch and Sugar.
    If your blood sugars are rising extremely high after you eat a high carbohydrate meal or dessert and then dropping down swiftly, you may often feel the sudden onset of exhaustion as your blood sugars drop. This symptom points to a very early diabetic state, however. If you don't take steps to lower your blood sugar when it is rising and falling this way, eventually it will just stay high and you will no longer experience the rapid drop that is so enervating.


  5. If you develop any of these conditions, ask your doctor to include an A1c test and a fasting glucose test with your next lab test. If the tests come back normal, it doesn't hurt to test your blood sugar with a blood sugar meter at home as described HERE to make sure you aren't experiencing diabetic blood sugars after eating, since the tests doctors order often miss that kind of diabetic blood sugar. If you see post-meal blood sugars that are firmly in the diabetic range ask your doctor to order a Glucose Tolerance Test with readings taken 1 and 2 hours after consuming the glucose, as this is the test that can diagnose diabetes that only shows up after meals.

    Is It Really Diabetes?
    An surprising proportion of the email I receive from people who visit this site comes from people who by no stretch of the imagination have diabetes, though they do have a lot of painful, persistent, and at time bizarre symptoms that their doctors haven't been able to diagnose.

    Many of these people are hoping that they do have diabetes, because they are so desperate to find some cause for their symptoms that can be treated and and give them relief. But before you assume that a symptom you are experiencing is due to undiagnosed diabetes use the technique described HERE to test your blood sugar. If you aren't seeing readings in the diabetic range, you don't have diabetes and you will not be able to convince any doctor to the contrary.

    If you discover that you have blood sugars in the prediabetic range, or if your blood sugars are only in the diabetic range after eating, a condition that does not show up on most of the tests that doctors order, you can still do a lot on your own to lower those blood sugars back to a safe level. You'll find instructions on this page:

    How to Lower Your Blood Sugar

    Follow these instructions and bring your blood sugars down to a safe, normal range and you need never experience any of the symptoms of diabetes. Even if you have actually had diabetes.

    Tuesday, September 29, 2015

    Added Link to Blog Post Examining Tresiba Label

    Page Changed: Insulin for Type 2 Diabetes

    Added the following:
    Tresiba, a longer acting insulin was approved in late September of 2015. Basaglar, a biosimilar version of Lantus will not be sold in the U.S. until 2017,
    You can learn more about the new basal insulins in these blog posts which go into the properties of each extensively:
    Toujeo, a More Concentrated Version of Lantus
    The Newly Approved Basal Insulin Tresiba's Label is Disappointing.