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


Thursday, March 26, 2015

Cipro and Other Common Antibiotics can Cause Permanent Neuropathy and Hypos

Page Changed: Neuropathy
Text Added:

Certain Commonly Prescribed Antibiotics Can Also Cause Neuropathy So Avoid Them

The fluoroquinolone family of antibiotics, which includes  ciprofloxacin (Cipro), gemifloxacin (Factive), levofloxacin (Levaquin), moxifloxacin (Avelox), norfloxacin (Noroxin), and ofloxacin (Floxin) have been found to cause a form of neuropathy which can be irreversible. These drugs can also cause hypoglycemia in people with diabetes. They are commonly prescribed for urinary tract infections, but there are other drugs that are a better choice for poeple with diabetes. If you are battling with neuropathy, ask your doctor to prescribe one of the other, safer, drugs.

Diabetes Self-Management:Nerve Damage and Fluoroquinolone Antibiotics.

Tuesday, March 24, 2015

Early Reports on Afrezza Lead to Cautious Optimism

Page Changed: Inhaled Insulin - Afrezza
Added:

Early reports posted on diabetes social media sites are encouraging. Most of those reporting are people with Type 1. They report being able to tolerate a higher dose than the corresponding amount of injected insulin they usually use. Most are finding they need to use correction doses after meals because of Afrezza's very short activity curve. They are also finding that they need to adjust their basal insulin after a week or so on Afrezza. For some it works extremely well. However, others are reporting that it is possible to experience hypos while using Afrezza, contrary to claims of some investors who have also been posting to diabetes social media. There aren't enough people with advanced Type 2 using it yet to determine how it will work for its target market--people with Type 2 who have put off using insulin out of a fear of needles.

Because it is inhaled, Afrezza can not be taken by people who have lung problems or by smokers. Because the long-term impact of exposing lung tissue to a growth-promoting hormone is unknown, the FDA insisted on much longer, more rigorous testing for Afrezza. I had originally thought that the testing for Afrezza had gone on longer than that for Exubera, which did eventually appear to cause some excess lung cancer, but that does not appear to be true, so a certain amount of caution would be advisable. I would personally be willing to give it a try, but I would not use it for every meal. If you do experience prolonged bouts of coughing after using it that don't go away after a week it's probably a good idea to avoid it.

For now there is no reason for people who are comfortable using fast acting injected insulin who are getting great control with it to switch to Afrezza. But for people who have been putting off moving to meal-time insulin out of a fear of needles, and for those who don't have the necessary skill to work out insulin/carb ratios and carefully dose injected insulin to the carbs in their food, and who are having too many hypo, Afrezza may be very helpful. If your doctor does prescribe it, be sure that he or she follows the instructions on the Prescribing Information and sends you for a lung function test before you start Afrezza and then follows up with one six months later. Also make sure that he gives you enough to cover snacks and occasional corrections at the dose you will need. A single box may not be enough. Most people reporting on early experiences with Afrezza are using two or even three boxes.

If that activity curve really works out that way in real life and for people with Type 2 diabetes, and the drug turns out to be safe over the longer term, Afrezza might provide a way for people who were just diagnosed with Type 2 to normalize their blood sugar because it restores their lost first phase insulin.

Tuesday, February 3, 2015

Herbal Supplements taken to the lab: No herbs, wrong herbs, and unlabelled wheat and beans

Page Changed: Text added:Worthless or Dangerous Supplements

Text Added:

In February 2015, The Washington Post (owned by the same Jeff Bezos whose company, Amazon, sells thousands of supplements) reported on what happened when the New York State Attorney General sent store-bought herbal supplements purchased at Target, Walmart, Walgreens, and GNC to the lab. As the paper explains,
The tests were conducted using a process called DNA barcoding, which identifies individual ingredients through a kind of “genetic fingerprinting.” The investigators tested 24 products claiming to be seven different types of herb — echinacea, garlic, gingko biloba, ginseng, saw palmetto, St. John’s wort and valerian root. All but five of the products contained DNA that was either unrecognizable or from a plant other than what the product claimed to be.
Additionally, five of the 24 contained wheat and two contained beans without identifying them on the labels — both substances are known to cause allergic reactions.
 You can read the entire article HERE.

Wednesday, January 28, 2015

Afrezza, Super fast-acting inhaled insulin now on Sale. Afrezza page added to Blood Sugar 101

Page added:

 Text added:

Afrezza A New Extremely Fast-Acting Inhaled Insulin



Afrezza became available in pharmacies on January 26, 2015. It is being covered at a non-preferred tier by quite a few insurers and should be coming to more within the next year. Afrezza is a brand new inhaled insulin. Readers who have followed my blog know that I was very negative on the first inhaled insulin, Exubera. That was because it was extremely hard to dose and did not appear to be as good as injected insulin.

I have been following the Afrezza story for about a year, and am cautiously hopeful that, unlike Exubera, Afrezza will be a much more useful product.

That isn't just because it's inhaled rather than injected. That's a nice feature that will appeal to the many people with Type 2 who really need insulin but won't start it out of misguided fear of needles. Insulin needles are painless when prescribed correctly. So this is not a good reason to avoid insulin. But people do. We all know far too many people who fit that category. Many end up on dialysis or with amputations.

So Afrezza will be good for needlephobes. But what really excites me about Afrezza is its activity curve. It is different from all the existing injected insulins and does something that no other drug does. To understand what that is, you need to understand how our bodies normally produce insulin, in two distinct phases. You can read more about this HERE. All the current injected insulins replace second phase insulin production. They take about an hour to start working and several more to exit the body. But Afrezza appears to replace first phase insulin production which just happens to be the part of insulin production that disappears first. People diagnosed with Type 2 diabetes have usually lost all their first phase insulin production while retaining a lot of their second phase capability.

This means it might be an excellent drug for people recently diagnosed and one that is much safer than the drugs like Januvia or Victoza many are being put into at that time, whose dangers I have discussed elsewhere.

One major problem with injected insulin is that it takes a long time to exit the body. This means that you can still have insulin working a couple hours after you have finished digesting your meal. This can cause hypos and makes doctors dose fast-acting insulin very conservatively. They don't give you enough to really cover your meal because of the fear that the lingering insulin will cause lows. But because Afrezza leaves the body much more quickly, you may be able to take a larger dose that will lower your blood sugar post-meal much better, knowing it will be gone right after it lowered your blood sugar.

The above is based on the claim made by the drug company that makes Afrezza and it is supported by activity curve graph published in the prescribing information which you can see in the graph to the right:


Lispro, which is what Afrezza is being compared to here, is Humalog.

Afrezza comes in cartridges that you put into the small inhaler, inhale, and throw away. The inhaler does not need to be cleaned. Every two weeks you throw out the inhaler and use the second one that comes with the cartridges.

The doses come in cartridges sold in increments of 4 units. Because of the fast way Afrezza operates, it may be possible to use a significantly larger dose than you would use if you were injecting a slower fast-acting insulin. The prescribing information makes it sound like 4 units would be appropriate for anyone using up to 4 units of injected insulin. Whether this is true we will only know after we hear from people who report their results.

What makes me feel that I can trust the company that makes Afrezza, MannKind Corp, is that it was founded and largely funded by Al Mann, an engineering genius whose other companies developed the first modern insulin pump (which he sold to Medtronic), the artificial cochlea, and whose latest company has developed a functional artificial retina. Mann is 89 years old and has put more than 10 years into getting Afrezza to market. He understands insulin better than most, having developed the pump, so when he says that Afrezza duplicates first phase insulin, and backs that claim with a billion dollars of his own money, I listen.

Because it is inhaled, Afrezza can not be taken by people who have lung problems or by smokers. It has, however, been tested for safety over a much longer time period than most drugs. This is because Exubera, a completely different formulation, did seem to cause lung cancer. So the FDA insisted on much longer, more rigorous testing for Afrezza.

For now there is no reason for people who are comfortable using fast acting injected insulin who are getting great control with it to switch to Afrezza. But for people who have been putting off moving to meal-time insulin out of a fear of needles, and for those who don't have the necessary skill to work out insulin/carb ratios and carefully dose injected insulin to the carbs in their food, and who are having too many hypo, Afrezza may be very helpful.

And if that activity curve really works out that way in real life, Afrezza might provide a way for people who were just diagnosed with Type 2, who by restoring their lost first phase insulin might be able to totally normalize their blood sugar.

If you do try Afrezza, please let me know how it works for you. Use the email link found on the CONTACT tab at the top of this page and title your email "Afrezza report."

Monday, January 12, 2015

Updated 5% Club Page with Reports from 2014

Page changed: The 5% Club They Normalized Their Diabetic Blood Sugar and So Can You!

Updated some outdated links. 

Added:

Note: After the newsgroup succumbed to robot-spam, I received many more such reports from readers of the site and my books who emailed me, but because most of them repeated the experiences described by newsgroup participants, I stopped updating this page. Now, in response to request from site visitors for more recent stories, I have started off this section with extracts from reports I received from visitors to this site and readers of my books during 2014, This should reassure you that people who follow the strategies I recommend continue to report these very exciting results.

Reports from Members of the 5% Club


  2007 Dx'd at 358 bg fasting and a 10.3 HbA1c.  I got into the 5% club within the first 18 months keeping only metformin. I have had only one in 6's since (6.2), and my last test a week ago was my lowest at 5.5.  I do shoot [insulin] now (4 yrs) to give my remaining betas a rest plus basal because I could not get the fasting down on my own. I"m usually 5.7-  5.9 hba1c.
  --Bill 1/7/2015



October 2011 I was sent by ambulance to ER.  EMT could not read my BG. All their meter showed was "HI". Not uncommon for DKA you might be thinking, but the meter they used topped at 900.  Needless to say they started IV insulin immediately.  When I got to the ER they took a reading; "HI" again.  Talk about panic.  Their meter topped at 1500!  It was so high they couldn't even measure an A1c. 

So fast forward to now.  How am I doing?  Well I don't take any medications, I eat very low carb, and rarely see a meter reading over 110- typically under 100 at any time. 

A1c has been in the 4.8-5.2 range for over two years now.  Which I will take as a 5.0 and chalk the 0.2 variance to lab error.  Not too shabby!
--David 12/20/2014


I sent you an email a couple years ago to thank you for helping me turn around my Type II and get it under control.
 
I am 53 years old and yesterday I had a doctor’s appointment and A1C was 5.9.

--W. 12/19/2014


I started to apply your principles and my results are going very fast, with no medication. ... The principles work....2014
October 23 — lab FBG 217, a1c 9.4

November 10 — FBG 125, lab a1c 8.5

November 20 - FBG 105, home a1c 7.8

Today, November 21 — FBG 95
--Inez 11/21/2014


I was diagnosed Type 2 ,3 and a half months ago at 49 with a A1C of 12 % and a fasting sugar of 18.8. I was told by the Doctors to take metformin 'if my kidneys were not damaged already' and that I would be on insulin in a few years.They told me it was extremely difficult to lower your A1C even with drugs.My feet  were becoming numb and my eyes were bad as well as all the other symptoms,I had them all and I had been in denial.

After the shock of the diagnosis and what the Doctors said I thought I was finished,a short painful life probably with my feet amputated all because I had got fat.I was nearly having panic attacks but I started reading everything I could , diabetes books and sites on the internet including yours and I started feeling more positive.

I refused the metformin (maybe it was unwise with those numbers) and started a low carb diet with non starchy vegetables,I took supplements like co-enzyme 10 and alpha lipoic acid,I did alot of exercise both aerobics and weights,and tested my blood sugar regularly. I was very strict and motivated and I lost about 33 lbs in that time but the most amazing thing was my blood was tested the other day and my A1C was 5.8%.I knew it had dropped on my meter but was amazed that my A1C dropped so much so quickly. I had to ask the Doctor for the result,there was no acknowledgement from him and they want to retest me,probably can't believe you can do that so quickly with no medication,
--Yvonne 8/28/2014


I have now completed my first year since diagnosis. My A1c at diagnosis was 7.7. Three months later it was 5.2 and has remained at 5.2 ever since.
Your advice and my solid health care coverage (two full plans from two employers), which means I can test, baby, test have been the keys to my success.

I have lost 112 lbs, without really trying and am gently slowing down.

--Fred 7/28/2014


I am a 70 year old woman who got the diagnosis of diabetes early in May this year.  My doctor wanted me to try to handle it with diet and exercise.  I went to the dietician to receive nutritional instruction.  She but me I a diet of 75 grams of carbohydrates for each meal 3 times a day along with some routine literature, and told me not to test more than twice a day.  Needless to say I did not really reduce my blood glucose dramatically even though I cut down my carb intake below her recommendations.  I was becoming somewhat depressed.

I found your site and it became crystal clear what I needed to do.  I bought a scale.  I reduced my carb intake to low amounts, tested rigorously, and have worked up to 40 minute work outs every day.  I am testing under 120 an hour after every meal and now some mornings I am under 100 even though my count goes up during the night. 
--Christine 5/25/2014


About 3 months ago I went to my doctor thinking that I must be doing
great!  I eliminated most meat from my diet, and stuck to a fish,
vegetable, fruit, and grain diet.  My A1c was higher than before at
7.4.  My doctor told me to avoid all sugars and come back in 3 months
for another A1c test.  I came across your site which gave more details
on how to eat right and get my blood sugar under control.  I eat mostly
grass fed or organic meats, vegetables, and raw seeds and nuts.  My A1c
result is now 5.7 on today's visit to my doctor.  It would have been
lower, had I not had the 2 jelly filled doughnuts three weeks ago...
--Tom 5/22/2014


I emailed you about 1-1/2 years ago, all excited about losing a bunch of weight and getting my blood sugar under control. You congratulated me, and put me in my place a bit by telling me that if I made it 3 years, that would really be considered a success.

Well, as of January 22, it has been 3 years.  I have kept off the 120plus pounds lost, my A1C is 5.1, and I'm still working out every day. I have even been able to stop taking Metformin with no adverse results. Thank you again for your encouragement and research. It has been invaluable.

--Craig 2/11/2014


I'm a rocket scientist (seriously... ) who REALLY had problems with what my diabetes-diet-councilor was telling me.... Heck, I learned about the krebs cycle in high-school.... Heck, I taught high-school biology just after the Army & none of my STUDENTS would buy that banana-juice I was being fed...You provided understandable & useful information... my A1c is down from 9.7 to 5.7 on just metformin, glipizide, and a diet worked out with your TEST,TEST,TEST method

--Scott 1/08/2014


Note: Because of space constraints, I have omitted the many reports I have received between 2014 and 2007 when I stopped updating this web page as there were already more reports than most people wanted to read.

Saturday, November 1, 2014

New SGLT2 combo drugs approved, and more side effects discovered

Page Changed: SGLT2 Inhibitors, Farxiga, Invokana, Jardiance. Questionable New Drugs

Added this text:
p >These sodium-glucose co-transporter-2 (SGLT-2) inhibitors lower blood sugar by blocking reabsorption of glucose by the kidney and increasing its excretion in urine. However, recent findings suggest tht though these drugs ramp up excretion of glucose, they also ramp up production of glucose by stimulating the secretion of glucagon. More about that can be read HERE

and

The Diabetes.co.uk web site describing this class of drugs also says that in the studies used for approving the drug there were more cases of liver failure, breast and bladder cancer, though the effect was not strong enough to block approval of the drug. Added mention of Invokamet and Xigduo, combination forms of these drugs with metformin.

Monday, October 27, 2014

Changes to the "What is a Normal Blood Sugar" page

Page Changed: What is a Normal Blood Sugar

Added this text:

What is an Abnormally Low Blood Sugar?
Blood sugars under 70 mg/dl (3.9 mmol/L) are considered to be hypoglycemic and should be avoided.
If you are not on insulin or a drug that causes your pancreas to secrete insulin, a blood sugar 5 to 10 mg/dl slightly below this range, while it might be uncomfortable, is not dangerous unless there is evidence that it is continuing to drop. This is because home blood sugar meters often read lower than lab values, so a reading in that very slightly lower range might actually be normal.
However, if you are using insulin or a drug that causes your body to secrete insulin (described HERE you must err on the side of caution and keep your blood sugar well over 70 mg/dl (3.9 mmol/L).
This is because home meters may also read higher than your actual blood sugar so your 70 mg/dl reading may actually be 62 mg/dl. Even more importantly, the insulin or oral drug that has lowered your blood sugar to this level may still be working to lower your blood sugar even more. So if you don't treat a reading near 70 mg/dl, it may go on to drop to a dangerouly low level.

-----------------------

Added this section:

Normal Blood Sugars in Pregnancy

Because the blood volume increases greatly during pregnancy, diluting blood sugar, normal blood sugar concentrations for pregnant women are lower than those for everyone else.

Based on current research, normal pregnant women's blood sugar falls into this range:
Fasting: 70.9 ± 7.8 mg/dl (3.94 mmol/L ± .43)
One Hour Post Meal: 108.9 ± 12.9 mg/dl (6.05 ± .72 mmol/L)
Two Hours Post Meal: 99.3 ±10.2 mg/dl (5.52 ± .57 mmol/L )


Pregant women with diabetes should strive for these blood sugars:
Fasting: 79 mg/dl (4.4 mmol/L)
One Hour After Meals: 122 mg/dl (6.8 mmol/L)
Two Hours After Meals: 110 m/gdl (6.1 mmol/L)

You can learn about the studies that established these values HERE