Page Changed: Onglyza, Kombiglyze, Tradjenta -- Just like Januvia but Worse
Added the following:
Onglyza is now being being marketed as Kombiglyze, a pill that combines Onglyza and Metformin. Easily swayed doctors are therefore prescribing to newly diagnosed patients only the very expensive combo pill instead of the extremely cheap generic Metformin pill. Don't let your doctor prescribe this combo drug.
And added this:
As of Summer 2011 there is yet another FDA-approved DPP-4 inhibitor drug available that is very similar to Onglyza. It is named Tradjenta. Based on its prescribing information, which you can read HERE, it it shares with Onglyza the characteristics that it makes very little change in blood sugar, costs a fortune, and causes the same significant immune-system related side effects--most notably the permanent sinus headache/runny nose that is a result of DPP-4 inhibition in the sinues--as well as raising the risk of pancreatitis.
In patients whose A1cs averaged 8.1% and whose fasting blood sugar averaged 178.4 mg/dl Trajenta lowered A1c to a still dangerous average 7.5% and lowered the fasting blood sugar to a rampantly damaging average of 165.1 mg/dl.
You can lower your blood sugar far more just by following the advice you'll find HERE.I have heard from hundreds of people who have done just that without any drugs except generic metformin--or no drugs at all.
Chances are there will soon be a metformin-Trajenta combo drug. Avoid it. If you feel that despite the risks you want to take a DPP-4 inhibitor Januvia appears to be the one that lowers blood sugar the best, though it doesn't do all that good a job of it and will end up giving you significant side effects.
Friday, June 24, 2011
Thursday, June 16, 2011
Actos Associated with Higher Bladder Cancer Risk & FDA Administers Avandia Wrist Slap
Page Changed: Actos and Avandia Dangerous Diabetes Drugs
Added the following text:
In June of 2011 the FDA confirmed that there was a heightened risk of bladder cancer with Actos.
FDA Drug Safety Communication: Update to ongoing safety review of Actos (pioglitazone) and increased risk of bladder cancer
FDA Imposes Tight Restrictions on Avandia Prescribing
In May of 2011 the FDA tightened the restrictions on prescribing Avandia but they did not take it off the market, and doctors can and do still prescribe it. The new restrictions state that patients who are now taking the drug will have to sign an informed consent statement acknowledging that they understand all the risks before they will be allowed to refill their prescriptions and that new patients will not be able to receive the drug unless their doctors certify that they are unable to control their blood sugar levels with other therapies and that medical problems preclude them from taking Avandia's primary competitor, Actos.
As you can see, this means nothing. Doctors who prescribe Avandia will keep on prescribing it. The FDA is not likely to take either of these dangerous drugs off the market until weeks before their patents expire. They are just too profitable.
Avandia (rosiglitazone): REMS - Risk of Cardiovascular Events includes Avandia, Avandamet, and Avandaryl
Added the following text:
In June of 2011 the FDA confirmed that there was a heightened risk of bladder cancer with Actos.
FDA Drug Safety Communication: Update to ongoing safety review of Actos (pioglitazone) and increased risk of bladder cancer
FDA Imposes Tight Restrictions on Avandia Prescribing
In May of 2011 the FDA tightened the restrictions on prescribing Avandia but they did not take it off the market, and doctors can and do still prescribe it. The new restrictions state that patients who are now taking the drug will have to sign an informed consent statement acknowledging that they understand all the risks before they will be allowed to refill their prescriptions and that new patients will not be able to receive the drug unless their doctors certify that they are unable to control their blood sugar levels with other therapies and that medical problems preclude them from taking Avandia's primary competitor, Actos.
As you can see, this means nothing. Doctors who prescribe Avandia will keep on prescribing it. The FDA is not likely to take either of these dangerous drugs off the market until weeks before their patents expire. They are just too profitable.
Avandia (rosiglitazone): REMS - Risk of Cardiovascular Events includes Avandia, Avandamet, and Avandaryl
Saturday, May 28, 2011
Glycated LDL May Explain LInk of A1c to Heart Disease Risk
Page changed: A1c and High Post Meal Blood Sugars Predict Heart Attack
Added this text:
The study is Glycation of LDL by Methylglyoxal Increases Arterial Atherogenicity: A Possible Contributor to Increased Risk of Cardiovascular Disease in Diabetes. Naila Rabbani et al. Diabetes. Published online before print May 26, 2011, doi: 10.2337/db11-0085
You can read a good explanation of what this study means here:
Science Daily: Super-Sticky 'Ultra-Bad' Cholesterol Revealed in People at High Risk of Heart Disease
In brief the finding is this: LDL becomes dangerous when it becomes glycated--i.e. when sugar molecules become bonded to it. When that happens it is more likely to stick to the artery walls. It is very likely given the correlation between heart attack and A1c that LDL becomes dangerously glycated at a rate that corresponds to the rate at which hemoglobin becomes glycosylated--which is what the A1c measures. (Glycosylation is permanent glycation.)
===
Also deleted suggestion to get a CRP test as recent research suggests it is not a good predictor of the value of statins in people who don't already have significant heart disease.
Added this text:
Glycated LDL May Be The Culprit
An intriguing study published in May, 2011 may explain both why measuring cholesterol gives such confusing correlations with heart disease and why the A1c predicts it so much better.The study is Glycation of LDL by Methylglyoxal Increases Arterial Atherogenicity: A Possible Contributor to Increased Risk of Cardiovascular Disease in Diabetes. Naila Rabbani et al. Diabetes. Published online before print May 26, 2011, doi: 10.2337/db11-0085
You can read a good explanation of what this study means here:
Science Daily: Super-Sticky 'Ultra-Bad' Cholesterol Revealed in People at High Risk of Heart Disease
In brief the finding is this: LDL becomes dangerous when it becomes glycated--i.e. when sugar molecules become bonded to it. When that happens it is more likely to stick to the artery walls. It is very likely given the correlation between heart attack and A1c that LDL becomes dangerously glycated at a rate that corresponds to the rate at which hemoglobin becomes glycosylated--which is what the A1c measures. (Glycosylation is permanent glycation.)
===
Also deleted suggestion to get a CRP test as recent research suggests it is not a good predictor of the value of statins in people who don't already have significant heart disease.
Tuesday, April 12, 2011
Huge Long-Term Study: Glibenclimide, Glipizide, Glimipiride, and Tolbutamide Associated with Increased Risk of Death and Heart Attack.
Page Changed Amaryl, Glyburide, Prandin, Starlix: Drugs that Stimulate Insulin Secretion
Added this text:
Then in 2011, a study analyzed the health records of "All Danish residents >20 years, initiating single-agent I[nsulin] S[ecretogogues, ie. Sulfs and glinides] or metformin between 1997 and 2006 were followed for up to 9 years (median 3.3 years)." It found the following drugs were as safe as Metformin: Prandin (repaglinide), and Diamicron (gliclazide, not sold in the U.S.).
All the other sulfonylurea drugs raised the risk of death, whether or not people had had a heart attack before taking them. The study concludes:
Added this text:
Then in 2011, a study analyzed the health records of "All Danish residents >20 years, initiating single-agent I[nsulin] S[ecretogogues, ie. Sulfs and glinides] or metformin between 1997 and 2006 were followed for up to 9 years (median 3.3 years)." It found the following drugs were as safe as Metformin: Prandin (repaglinide), and Diamicron (gliclazide, not sold in the U.S.).
All the other sulfonylurea drugs raised the risk of death, whether or not people had had a heart attack before taking them. The study concludes:
Monotherapy with the most used I[nsulin]S[ecretagogues]s, including glimepiride, glibenclamide, glipizide, and tolbutamide, seems to be associated with increased mortality and cardiovascular risk compared with metformin. Gliclazide and repaglinide appear to be associated with a lower risk than other I[nsulin]S[ecretagogues]s.Mortality and cardiovascular risk associated with different insulin secretagogues compared with metformin in type 2 diabetes, with or without a previous myocardial infarction: a nationwide study. Tina Ken Schramm et al. Eur Heart J (2011) doi: 10.1093/eurheartj/ehr077
Friday, April 8, 2011
Statin effectiveness doess not correlate with CRP in people at very high risk of heart attack
Page changed: A1c and Post-Meal Blood Sugars Predict Heart Attack
Added the following reference to this new study to the discussion of the relationship of CRP and statin effectiveness.
A larger analysis published in 2011 in the Lancet seems to contradict this finding because it found statins prevented a significant number of cardiovascular events regardless of CRP level.
C-reactive protein concentration and the vascular benefits of statin therapy: an analysis of 20 536 patients in the Heart Protection Study. Heart Protection Study Collaborative Group. The Lancet Volume 377, Issue 9764, Pages 469 - 476, 5 February 2011 doi:10.1016/S0140-6736(10)62174-5
However, that is not quite what the study really showed, because all the participants in that study were at high risk of heart attack. The earlier study, in contrast, was a study of people who did not have a higher than normal risk of heart attack.
No one argues that statins don't help people who are at very high risk of heart attack--but it is a mistake to include people with diabetes who have been in excellent control for years and maintain A1cs below 6% in that group. The Lancet study treated people with a diabetes diagnosis as "high risk" but in the UK people with diabetes are considered to be in "excellent control" if they have A1cs approaching 8% and those wishing to achieve tighter control receive little support, no medication, and often no test strips.
Added the following reference to this new study to the discussion of the relationship of CRP and statin effectiveness.
A larger analysis published in 2011 in the Lancet seems to contradict this finding because it found statins prevented a significant number of cardiovascular events regardless of CRP level.
C-reactive protein concentration and the vascular benefits of statin therapy: an analysis of 20 536 patients in the Heart Protection Study. Heart Protection Study Collaborative Group. The Lancet Volume 377, Issue 9764, Pages 469 - 476, 5 February 2011 doi:10.1016/S0140-6736(10)62174-5
However, that is not quite what the study really showed, because all the participants in that study were at high risk of heart attack. The earlier study, in contrast, was a study of people who did not have a higher than normal risk of heart attack.
No one argues that statins don't help people who are at very high risk of heart attack--but it is a mistake to include people with diabetes who have been in excellent control for years and maintain A1cs below 6% in that group. The Lancet study treated people with a diabetes diagnosis as "high risk" but in the UK people with diabetes are considered to be in "excellent control" if they have A1cs approaching 8% and those wishing to achieve tighter control receive little support, no medication, and often no test strips.
Wednesday, April 6, 2011
Metformin reduces the invasiveness of endometrial cancer cells by 25%
Page Changed: Metformin.
Added this text:
A study conducted in women with PCOS published in 2011 found that six months of treatment with metformin decreased the invasiveness of endometrial cancer cells by 25% compared to the activity of the same cells in women with PCOS who had not taken metformin. The design of this study makes it more likely that it is the drug itself, not correlated factors, that explain the anti-cancer effect of metformin.
Metformin Treatment Exerts Antiinvasive and Antimetastatic Effects in Human Endometrial Carcinoma Cells. Journal of Clinical Endocrinology & Metabolism , 2010; 96 (3): 808 DOI: 10.1210/jc.2010-1803
Added this text:
A study conducted in women with PCOS published in 2011 found that six months of treatment with metformin decreased the invasiveness of endometrial cancer cells by 25% compared to the activity of the same cells in women with PCOS who had not taken metformin. The design of this study makes it more likely that it is the drug itself, not correlated factors, that explain the anti-cancer effect of metformin.
Metformin Treatment Exerts Antiinvasive and Antimetastatic Effects in Human Endometrial Carcinoma Cells. Journal of Clinical Endocrinology & Metabolism , 2010; 96 (3): 808 DOI: 10.1210/jc.2010-1803
Thursday, March 17, 2011
10 Year Study Reveals BG Levels that Lead to Retinopathy
Page changed: Research Connecting Blood Sugar Levels with Organ Damage
Added this new study:
The French DESIR study of people diagnosed with pre-diabetes confirmed what the studies cited above have found. Subjects who developed retinopathy over a 9 year period had an average fasting blood sugar of 130 mg/dl and an average A1c of 6.4%. Those who did not develop retinopathy over this period had an average fasting blood sugar of 108 mg/dl and an average A1c of 5.7%.
Added this new study:
The French DESIR study of people diagnosed with pre-diabetes confirmed what the studies cited above have found. Subjects who developed retinopathy over a 9 year period had an average fasting blood sugar of 130 mg/dl and an average A1c of 6.4%. Those who did not develop retinopathy over this period had an average fasting blood sugar of 108 mg/dl and an average A1c of 5.7%.
Hemoglobin A1c and Fasting Plasma Glucose Levels as Predictors of Retinopathy at 10 Years: The French DESIR Study. Massin P. et al. Arch Ophthalmol.2011 Feb;129(2):188-195.
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