I found this remarkable graphic on a web site devoted to investment strategies. The article it illustrates pointed out that investors could earn excellent returns their entire lives by investing in these companies because their products saturate the world.
The graphic shows you how many brands these 10 companies control. I bet you thought many of them were separate companies.
When you realize how fully junk food is controlled by a few companies, you have to ask yourself how much money these super-sized international corporations pour into making sure that the public never learns the price they pay for loading up on the crap they sell.
Here's the graphic:
http://static.cdn-seekingalpha.com/uploads/2013/5/13/912334-13684252689472475-Tim-McAleenan-Jr-_origin.jpg
May 15, 2013
May 4, 2013
May Diabetes News Snippet Post
News items of interest to people with diabetes that come up during May 2013 will be posted in the comment section of this post. Click on "comments" Feel free to comment or point out items that you feel need discussion.
All the April news snippets have now been collected and posted here:
http://diabetesupdate.blogspot.com/2013/05/diabetes-news-items-posted-during-april.html
May 1, 2013
Diabetes News Items Posted During April
Here are all the Diabetes-related news items that were posted during April.
April 21, 2013
When You Cut Carbs, Don't Raise Phosphate Levels
Recently I've been reading up on the role of phosphates in heart disease, and what I am learning has some troubling implications for people who eat low carb diets.
I already knew that people who have been diagnosed with kidney disease must avoid phosphates, as they can further damage the kideny's filtration units. I'd also discovered, and blogged about, the fact that and a person's lifetime intake of the phosphates present in brown-colored sodas, both diet and regular, have been found to correlate with their likelihood of developing kidney disease. (Details HERE)
But until recently, I had not realized that blood levels of phosphate that fall within the upper part of the supposedly normal range range on lab tests correlate with a higher likelihood of developing the calcified arteries that represent heart disease.
This is true even in populations of young, supposedly healthy people.
There are many studies linking phosphate consumption to poorer health outcomes. But most striking was this study published by researchers involved in the Framingham Offspring Study. They followed 3,015 young, healthy people for 15 years found that those with higher levels of phosphorus in their blood at the beginning of the study were more likely to have greater amounts of calcification in their arteries at the end of the study.
The researchers conclude, "... higher serum phosphorus levels, even within the normal range, may be a risk factor for coronary artery atherosclerosis in healthy young adults."
So where do these high levels of blood phosphorus come from? The answer is complex. Phosphorus is a normal part of the human diet. We need it for our bones and to regulate various physiological processes. Phosphorus occurs naturally in meat and many other foods we eat, which is where we get them. But it is likely that the damagingly high levels of phosphorus that make their way into our bloodstream and damage our arteries are not coming from the meats and dairy we consume, but from surprisingly large amount of phosphorus-containing additives--usually phosphates--that are added to processed foods as a flavoring agent or preservative.
Added phosphates are found in many processed and restaurant foods. They are added to brown-colored sodas like Coke and Pepsi, and increasingly often to bottled ice tea. You will also find phosphates in most cold cuts, processed cheeses, and all rotisserie meats, including the ones sold as "all natural." There is phosphate added to half and half. They may even be found in supplements.
Phosphates are found in many of the meats you buy from the Meat department at your supermarket. Whole and parted out turkeys and many chickens have labels that tell you they have been "enhanced" with solutions supposedly added to improve flavor. These solutions almost always contain sodium phosphate. (You can see a discussion of these enhanced meats HERE.) Phosphates are likely to be in prepackaged hamburger, but they may also be in pork products that were cut by the butcher. The only way to find out is to ask the butcher if the pork was enhanced with a solution.
While food labels may list phosphates in the list of ingredients there is no requirement that manufacturers list them, so phosphates are often omitted from labels. (Details HERE) Even worse, even when phosphate appear on a label, you have no idea how much phosphorus has been added. So unlike the situation with sodium, you can't track your phosphorus intake and keep it to a safe level. For that matter, it isn't even clear what the safe level is.
People with kidney disease are told to keep their phosphorus levels between 800 to 1,000 mg/day, though of course, doing this is virtually impossible since it is unknown how much phosphorus is in the many prepared foods they eat. But at least their blood phosphorus levels are measured, so they have some hint as to how they are doing.
But phosphorus levels are not tested as part of the standard suite of blood tests given to people with diabetes, so we have no way of knowing how high our blood phosphorus levels might be. Unfortunately, if you are eating a low carb diet, they may be higher than you realize.
When you eat out, you are almost guaranteed to be eating phosphates. Assume it is in all the chicken you order. But the phosphates aren't just in the meat. McDonald's nutritional information (an oxymoron?) discloses that there are phosphates not only in all their chicken offerings--often two or three different kinds of phosphates--but also in their American Cheese, bacon, bacon bits, and Buttermilk Ranch Sauce.
But at least McDonalds is honest enough to provide a complete listing of their ingredients online. Many fast food companies do not. Instead, they only provide the information required to be on the nutritional label, which does NOT disclose the presence or quantity of phosphates.
So what is a person to do?
Phosphates may be posing a huge problem for all people with diabetes, firstly because so many people with Type 2 already have early kidney disease at the time they are diagnosed, and secondly because so many foods we consider safe to eat because they don't raise blood sugar when we eat them may contain phosphates that can damage our vascular systems over time.
Here are some steps you can take to limit the damage. The most important is this:
READ LABELS!
Once you become aware that phosphates are something you want to avoid, you may be shocked at how common they are in many foods that you have been thinking of as healthy.
After you become aware that our food supply is full of these questionable additives you can do the following:
1. Avoid drinking brown-colored diet sodas and bottled iced teas. Coke, Pepsi and Dr. Pepper usually contain phosphates.
2. Read the labels on everything you buy and if you have a choice, buy the version that doesn't list phosphates. (Though that doesn't guarantee you aren't getting some.)
3. Avoid or limit consumption of rotisserie meats, chicken or other meats with added solutions. If you must eat them, keep them as occasional indulgences.
4. Don't eat meat from fast food restaurants. (There are plenty of other reasons to avoid them, a main one being the presence of MSG and hidden forms of MSG which increase hunger and promote fat gain.)
5. Buy your poultry from health food markets that do not add enhancing solutions. Don't assume their products don't contain phosphates. Ask to speak to the manager and ask if their meats have been treated with solutions of any type. Many foods containing phosphates are marketed with labels calling them, "All Natural."
6. Eat only unprocessed cheeses--cheddar rather than American cheese, for example.
7. Read the labels on all cold cuts and bacon you buy. Don't buy the ones with phosphates--though unfortunately, you can't be entirely sure that omission from the label means omission from the food.
It is likely that as more of the health-conscious baby boom generation develops kidney disease as they age, more public attention will be focused on this problem and pressure will be brought on food companies and supermarkets to either omit phosphates from their foods or label the phosphate content in meaningful ways. I sure hope so.
But until recently, I had not realized that blood levels of phosphate that fall within the upper part of the supposedly normal range range on lab tests correlate with a higher likelihood of developing the calcified arteries that represent heart disease.
This is true even in populations of young, supposedly healthy people.
There are many studies linking phosphate consumption to poorer health outcomes. But most striking was this study published by researchers involved in the Framingham Offspring Study. They followed 3,015 young, healthy people for 15 years found that those with higher levels of phosphorus in their blood at the beginning of the study were more likely to have greater amounts of calcification in their arteries at the end of the study.
The researchers conclude, "... higher serum phosphorus levels, even within the normal range, may be a risk factor for coronary artery atherosclerosis in healthy young adults."
So where do these high levels of blood phosphorus come from? The answer is complex. Phosphorus is a normal part of the human diet. We need it for our bones and to regulate various physiological processes. Phosphorus occurs naturally in meat and many other foods we eat, which is where we get them. But it is likely that the damagingly high levels of phosphorus that make their way into our bloodstream and damage our arteries are not coming from the meats and dairy we consume, but from surprisingly large amount of phosphorus-containing additives--usually phosphates--that are added to processed foods as a flavoring agent or preservative.
Added phosphates are found in many processed and restaurant foods. They are added to brown-colored sodas like Coke and Pepsi, and increasingly often to bottled ice tea. You will also find phosphates in most cold cuts, processed cheeses, and all rotisserie meats, including the ones sold as "all natural." There is phosphate added to half and half. They may even be found in supplements.
Phosphates are found in many of the meats you buy from the Meat department at your supermarket. Whole and parted out turkeys and many chickens have labels that tell you they have been "enhanced" with solutions supposedly added to improve flavor. These solutions almost always contain sodium phosphate. (You can see a discussion of these enhanced meats HERE.) Phosphates are likely to be in prepackaged hamburger, but they may also be in pork products that were cut by the butcher. The only way to find out is to ask the butcher if the pork was enhanced with a solution.
While food labels may list phosphates in the list of ingredients there is no requirement that manufacturers list them, so phosphates are often omitted from labels. (Details HERE) Even worse, even when phosphate appear on a label, you have no idea how much phosphorus has been added. So unlike the situation with sodium, you can't track your phosphorus intake and keep it to a safe level. For that matter, it isn't even clear what the safe level is.
People with kidney disease are told to keep their phosphorus levels between 800 to 1,000 mg/day, though of course, doing this is virtually impossible since it is unknown how much phosphorus is in the many prepared foods they eat. But at least their blood phosphorus levels are measured, so they have some hint as to how they are doing.
But phosphorus levels are not tested as part of the standard suite of blood tests given to people with diabetes, so we have no way of knowing how high our blood phosphorus levels might be. Unfortunately, if you are eating a low carb diet, they may be higher than you realize.
When you eat out, you are almost guaranteed to be eating phosphates. Assume it is in all the chicken you order. But the phosphates aren't just in the meat. McDonald's nutritional information (an oxymoron?) discloses that there are phosphates not only in all their chicken offerings--often two or three different kinds of phosphates--but also in their American Cheese, bacon, bacon bits, and Buttermilk Ranch Sauce.
But at least McDonalds is honest enough to provide a complete listing of their ingredients online. Many fast food companies do not. Instead, they only provide the information required to be on the nutritional label, which does NOT disclose the presence or quantity of phosphates.
So what is a person to do?
Phosphates may be posing a huge problem for all people with diabetes, firstly because so many people with Type 2 already have early kidney disease at the time they are diagnosed, and secondly because so many foods we consider safe to eat because they don't raise blood sugar when we eat them may contain phosphates that can damage our vascular systems over time.
Here are some steps you can take to limit the damage. The most important is this:
READ LABELS!
Once you become aware that phosphates are something you want to avoid, you may be shocked at how common they are in many foods that you have been thinking of as healthy.
After you become aware that our food supply is full of these questionable additives you can do the following:
1. Avoid drinking brown-colored diet sodas and bottled iced teas. Coke, Pepsi and Dr. Pepper usually contain phosphates.
2. Read the labels on everything you buy and if you have a choice, buy the version that doesn't list phosphates. (Though that doesn't guarantee you aren't getting some.)
3. Avoid or limit consumption of rotisserie meats, chicken or other meats with added solutions. If you must eat them, keep them as occasional indulgences.
4. Don't eat meat from fast food restaurants. (There are plenty of other reasons to avoid them, a main one being the presence of MSG and hidden forms of MSG which increase hunger and promote fat gain.)
5. Buy your poultry from health food markets that do not add enhancing solutions. Don't assume their products don't contain phosphates. Ask to speak to the manager and ask if their meats have been treated with solutions of any type. Many foods containing phosphates are marketed with labels calling them, "All Natural."
6. Eat only unprocessed cheeses--cheddar rather than American cheese, for example.
7. Read the labels on all cold cuts and bacon you buy. Don't buy the ones with phosphates--though unfortunately, you can't be entirely sure that omission from the label means omission from the food.
It is likely that as more of the health-conscious baby boom generation develops kidney disease as they age, more public attention will be focused on this problem and pressure will be brought on food companies and supermarkets to either omit phosphates from their foods or label the phosphate content in meaningful ways. I sure hope so.
March 31, 2013
FDA Approves a Highly Questionable New Diabetes Drug, Invokana
The FDA just gave its approval to the first drug in a new class of diabetes drugs, Johnson & Johnson's canagliflozin, which will be marketed in the U.S. as Invokana.
New York Times: FDA Approves a New Diabetes Drug From J.&J. (May require subscription)
Reuters: U.S. FDA approves Johnson & Johnson diabetes drug, canagliflozin
This class of drugs, the sodium-glucose co-transporter-2 (SGLT2) inhibitors, lowers blood sugar by blocking reabsorption of glucose by the kidney and increasing its excretion in urine. The manufacturer also claims that it causes weight loss--always a potent selling point for a diabetes drug.
As is the case with all new diabetes drugs, now that the drug is approved, drug company flacks will start saturation bombing family physicians with materials that make it sound like they should put every patient with Type 2 on this wonderful, new drug, which is priced at $8.77 a pill or $263.10 for a monthly supply.
They shouldn't.
The committee of "experts" who reviewed this drug were ambivalent about it because the company's own, [most likely, statistically manipulated], clinical study of patients at especially high risk of cardiovascular disease showed that within the first 30 days, 13 patients taking canagliflozin suffered a major cardiovascular event [mainly strokes and some heart attacks] compared with just one patient taking a placebo. After that, the imbalance was reversed, though the drug then caused a slight increase in LDL cholesterol.
However, as the New York Times report notes, " F.D.A. spokeswoman said Friday that the significance of those findings was unclear, and the label of the drug includes no warnings about heart attacks or strokes."
That means that busy family physicians who are conscientious enough to review the FDA Prescribing Information will have no idea that they may exposing some of their previously stable patients with Type 2 Diabetes to life-altering strokes and heart attacks that will either kill them or ruin their quality of life.
One third of the experts in the FDA committee who reviewed the research J&J provided about Invokana advised against approving this drug (5 out of 15). They also expressed concern that this drug might be more dangerous for people with kidney disease--which of course, describes a lot of people with Type 2 Diabetes who have followed conventional medical advice.
A very similar drug that operates on the same pathways, dapagliflozin, was rejected by the FDA on safety grounds, which make it all the more important to worry about the safety of this one.
Johnson & Johnson's current management has shown itself criminally unconcerned with the fate of those who buy its most toxic products, as was demonstrated by the fact that the company continued to market their metal-on-metal replacement joints long after people inside the company knew that a high number of them were failing within a very few years after surgical implantation, exposing users to the risks of more major surgery and the possibility of joint deterioration that could permanently limit mobility and lead to life long pain and disability. (Details HERE)
With this kind of corporate culture, it is not impossible that J&J insiders might have tweaked the studies used to approve its drug to make them look better than those that led to the rejection of dapagliflozin.
We have learned from the history of the Incretin drugs that when members of a class can't be approved for a long time due to disturbing findings in approval testing, the members of the class that are approved often turn out to have the same effects when given to more patients.
But you can be sure that now that this money-making new drug is officially on the market, J&J will do all it can to keep the public from learning about the true toll it exerts on those who take it.
And of course, as we have now learned from every new expensive diabetes drug released in the past 20 years, the rest of the side effects of this new class of drugs won't begin to become evident until millions of prescriptions have been sold and hundreds of thousands of people suffered whatever else it is that it does to the body, because no approval testing exposes people to a new drug long enough for those effects to become clear. (And many of the effects would require microscopic studies of the tissues of people taking the drugs which are never required for approval.)
Other Side Effects
Yeast Infections
Unmentioned in any of the news stories about this new drug is the fact, mentioned in Invokana's Prescribing Information, that it causes serious yeast infections in women and uncircumcised men. This makes sense since sugary urine promotes the over-growth of yeast. One in ten of those who took the drug experienced this side effect. One in twenty who took it experienced urinary tract infections.
Decreased Kidney Function
The Prescribing Information states: "INVOKANA increases serum creatinine and decreases eGFR [glomerular filtration rate.]" It also raises the risk of dangerous low blood pressure and hyperalkemia (high potassium levels) especially in people taking blood pressure medication. (Hyperalkemia can lead to heart rhythm abnormalities. Older people, particularly those over 75 are those most likely to have the most severe kidney-based reactions to the drug.
Effect on Blood Sugar
A low dose of the drug (100 mg) lowered A1c on average .79% (i.e. from 8.0% to 7.21%. The high dose (300 mg) lowered A1c, on average .94%. In contrast, the impact of plain metformin on blood sugar, according to the Glucophage prescribing information (available HERE) is to lower blood sugar 1.4% over 29 weeks. However, when Invokana was combined with metformin, the combination only lowered A1c .79% for the low dose and .94% for the high dose--no different than when Invokana was taken alone and less than what is achieved with a proper amount of cheap generic metformin.
On average, the low dose lowered fasting blood sugar from 173 mg/dl to 155 mg/dl--a level high enough to ensure the development of all the classic diabetic complications. The high dose lowered fasting blood sugar from an average of 173 mg/dl to 138 mg/dl.
Very significantly, the Prescribing Information does NOT report the effect of this drug on post-meal blood sugars when taken alone. It only reports its effect on post-meal blood sugars when taken with metformin, where it lowers blood sugar by the same amount that metformin alone would lower it. In short, Invokana does not appear to have any significant effect on post-meal blood sugars and has no effect, overall that couldn't be achieved by taking cheap, generic metformin.
Even when Invokana was combined with metformin, the combined impact on post-meal blood sugars was unimpressive. The average blood sugar of the untreated people in this study two hours after eating was between 258 mg/dl and 262 mg/dl--a level guaranteed to produce heart disease and other classic diabetic complications. When Invokana was taken along with metformin, their average 2 hour post-meal blood sugar was still 205 mg/dl to 210 mg/dl, a level still high enough to cause heart disease and all the classic diabetic complications.
This makes it clear Invokana offers no significant benefit to people with Type 2 diabetes. We know from several research studies that post-meal blood sugars over 155 mg/dl promote the development of heart disease. (Details HERE)
You can find everything that J&J will let the public know about Invokana here: Invokana Prescribing Information
Say "No" to Brand New Diabetes Drugs!
If your doctor tries to put you on this drug, say no. Wait ten years, and search the literature then to see what scientists have found out about its real effects on patients before you try it.
If you can't control your blood sugar using standard therapies the safest approach is this:
1. Try the dietary strategy described on this page: How to Lower Your Blood Sugar
2. If that doesn't lower your blood sugar to a healthy level, ask your doctor about starting metformin ER. Make sure you end up with a clinically effective dose which for most people is at least 1500 mg a day. The ER form is kinder to the stomach.
3. If you don't respond to metformin, ask your doctor to prescribe long-acting insulin, which should lower your fasting blood sugar. Read up on how to set the dose so that it is most effective.
4. If that isn't enough, ask your doctor to prescribe fast acting insulin to cover the carbs in your meals. Read up to learn how to set the dose, as most family doctors don't have the resources to give Type 2s the proper training in using this kind of insulin. (Don't use mixtures of fast and slow insulin (70/30 mixes) as they almost always make it extremely hard to get good control of blood sugar.)
These are the safe, long-tested strategies that provides the best reward for the smallest amount of risk in people with Type 2 diabetes.
New York Times: FDA Approves a New Diabetes Drug From J.&J. (May require subscription)
Reuters: U.S. FDA approves Johnson & Johnson diabetes drug, canagliflozin
This class of drugs, the sodium-glucose co-transporter-2 (SGLT2) inhibitors, lowers blood sugar by blocking reabsorption of glucose by the kidney and increasing its excretion in urine. The manufacturer also claims that it causes weight loss--always a potent selling point for a diabetes drug.
As is the case with all new diabetes drugs, now that the drug is approved, drug company flacks will start saturation bombing family physicians with materials that make it sound like they should put every patient with Type 2 on this wonderful, new drug, which is priced at $8.77 a pill or $263.10 for a monthly supply.
They shouldn't.
The committee of "experts" who reviewed this drug were ambivalent about it because the company's own, [most likely, statistically manipulated], clinical study of patients at especially high risk of cardiovascular disease showed that within the first 30 days, 13 patients taking canagliflozin suffered a major cardiovascular event [mainly strokes and some heart attacks] compared with just one patient taking a placebo. After that, the imbalance was reversed, though the drug then caused a slight increase in LDL cholesterol.
However, as the New York Times report notes, " F.D.A. spokeswoman said Friday that the significance of those findings was unclear, and the label of the drug includes no warnings about heart attacks or strokes."
That means that busy family physicians who are conscientious enough to review the FDA Prescribing Information will have no idea that they may exposing some of their previously stable patients with Type 2 Diabetes to life-altering strokes and heart attacks that will either kill them or ruin their quality of life.
One third of the experts in the FDA committee who reviewed the research J&J provided about Invokana advised against approving this drug (5 out of 15). They also expressed concern that this drug might be more dangerous for people with kidney disease--which of course, describes a lot of people with Type 2 Diabetes who have followed conventional medical advice.
A very similar drug that operates on the same pathways, dapagliflozin, was rejected by the FDA on safety grounds, which make it all the more important to worry about the safety of this one.
Johnson & Johnson's current management has shown itself criminally unconcerned with the fate of those who buy its most toxic products, as was demonstrated by the fact that the company continued to market their metal-on-metal replacement joints long after people inside the company knew that a high number of them were failing within a very few years after surgical implantation, exposing users to the risks of more major surgery and the possibility of joint deterioration that could permanently limit mobility and lead to life long pain and disability. (Details HERE)
With this kind of corporate culture, it is not impossible that J&J insiders might have tweaked the studies used to approve its drug to make them look better than those that led to the rejection of dapagliflozin.
We have learned from the history of the Incretin drugs that when members of a class can't be approved for a long time due to disturbing findings in approval testing, the members of the class that are approved often turn out to have the same effects when given to more patients.
But you can be sure that now that this money-making new drug is officially on the market, J&J will do all it can to keep the public from learning about the true toll it exerts on those who take it.
And of course, as we have now learned from every new expensive diabetes drug released in the past 20 years, the rest of the side effects of this new class of drugs won't begin to become evident until millions of prescriptions have been sold and hundreds of thousands of people suffered whatever else it is that it does to the body, because no approval testing exposes people to a new drug long enough for those effects to become clear. (And many of the effects would require microscopic studies of the tissues of people taking the drugs which are never required for approval.)
Other Side Effects
Yeast Infections
Unmentioned in any of the news stories about this new drug is the fact, mentioned in Invokana's Prescribing Information, that it causes serious yeast infections in women and uncircumcised men. This makes sense since sugary urine promotes the over-growth of yeast. One in ten of those who took the drug experienced this side effect. One in twenty who took it experienced urinary tract infections.
Decreased Kidney Function
The Prescribing Information states: "INVOKANA increases serum creatinine and decreases eGFR [glomerular filtration rate.]" It also raises the risk of dangerous low blood pressure and hyperalkemia (high potassium levels) especially in people taking blood pressure medication. (Hyperalkemia can lead to heart rhythm abnormalities. Older people, particularly those over 75 are those most likely to have the most severe kidney-based reactions to the drug.
Effect on Blood Sugar
A low dose of the drug (100 mg) lowered A1c on average .79% (i.e. from 8.0% to 7.21%. The high dose (300 mg) lowered A1c, on average .94%. In contrast, the impact of plain metformin on blood sugar, according to the Glucophage prescribing information (available HERE) is to lower blood sugar 1.4% over 29 weeks. However, when Invokana was combined with metformin, the combination only lowered A1c .79% for the low dose and .94% for the high dose--no different than when Invokana was taken alone and less than what is achieved with a proper amount of cheap generic metformin.
On average, the low dose lowered fasting blood sugar from 173 mg/dl to 155 mg/dl--a level high enough to ensure the development of all the classic diabetic complications. The high dose lowered fasting blood sugar from an average of 173 mg/dl to 138 mg/dl.
Very significantly, the Prescribing Information does NOT report the effect of this drug on post-meal blood sugars when taken alone. It only reports its effect on post-meal blood sugars when taken with metformin, where it lowers blood sugar by the same amount that metformin alone would lower it. In short, Invokana does not appear to have any significant effect on post-meal blood sugars and has no effect, overall that couldn't be achieved by taking cheap, generic metformin.
Even when Invokana was combined with metformin, the combined impact on post-meal blood sugars was unimpressive. The average blood sugar of the untreated people in this study two hours after eating was between 258 mg/dl and 262 mg/dl--a level guaranteed to produce heart disease and other classic diabetic complications. When Invokana was taken along with metformin, their average 2 hour post-meal blood sugar was still 205 mg/dl to 210 mg/dl, a level still high enough to cause heart disease and all the classic diabetic complications.
This makes it clear Invokana offers no significant benefit to people with Type 2 diabetes. We know from several research studies that post-meal blood sugars over 155 mg/dl promote the development of heart disease. (Details HERE)
You can find everything that J&J will let the public know about Invokana here: Invokana Prescribing Information
Say "No" to Brand New Diabetes Drugs!
If your doctor tries to put you on this drug, say no. Wait ten years, and search the literature then to see what scientists have found out about its real effects on patients before you try it.
If you can't control your blood sugar using standard therapies the safest approach is this:
1. Try the dietary strategy described on this page: How to Lower Your Blood Sugar
2. If that doesn't lower your blood sugar to a healthy level, ask your doctor about starting metformin ER. Make sure you end up with a clinically effective dose which for most people is at least 1500 mg a day. The ER form is kinder to the stomach.
3. If you don't respond to metformin, ask your doctor to prescribe long-acting insulin, which should lower your fasting blood sugar. Read up on how to set the dose so that it is most effective.
4. If that isn't enough, ask your doctor to prescribe fast acting insulin to cover the carbs in your meals. Read up to learn how to set the dose, as most family doctors don't have the resources to give Type 2s the proper training in using this kind of insulin. (Don't use mixtures of fast and slow insulin (70/30 mixes) as they almost always make it extremely hard to get good control of blood sugar.)
These are the safe, long-tested strategies that provides the best reward for the smallest amount of risk in people with Type 2 diabetes.
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India's Supreme Court says drug companies can't continue the patents on old drugs by making trivial changes to them, making it possible for the world's poor to afford generic versions of many drugs otherwise priced beyond their reach.
If only the U.S. had a similarly enlightened policy. But here the companies can extend the patents by doing things like combining an old drug with another drug and calling it a new drug, or selling an extended release form.
India rejects Novartis drug patent
Heart disease is found in significant amounts in prehistoric mummies including those living "paleo" pre-agricultural lifestyles.
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)60598-X/abstract.
It probably has something to do with changes to calcium metabolism that occurred during our evolution in conjunction with some other, highly beneficial development.
Yet another blow to the idea that ancient people lived in some kind of metabolic paradise ruined by the development of agriculture. Note the average age of death of the mummies. "Paleo" people were lucky to live into their 50s.
There are "as many as 4,000 predatory journals today, at least 25 percent of the total number of open-access journals." They will publish anything, as long as the author pays a hefty fee.
Many of these vanity journals are where you find the studies that claim that supplements are effective for a wide selection of incurable and chronic diseases.
http://www.nytimes.com/2013/04/08/health/for-scientists-an-exploding-world-of-pseudo-academia.html
The research says that eating meat leads to people having more carnitine and some bacteria that break it down in their guts. However, the conclusion you read in the headlines, that this causes heart disease is based entirely on rodent research>.
Since the mice who developed heart disease when fed diets rich in carnitine have not evolved over millions of years to eat meat-rich diets it is scientifically irresponsible to claim this means that dietary carnitine causes heart disease in humans.
But because it is an article of religious belief that eating meat is bad, this research is getting front page treatment.
Washington Post Fat and Cholesterol Aren't Only Heart Dangers of Red Meatl
Most family doctors prescribe new, heavily marketed drugs with no idea of their dangerous side effects. That's why you need to check out diabetes drugs on bloodsugar101.com before you take them.
Science Daily: Doctors Not Informed of Harmful Effects of Medicines During Sales Visits
Belly fat is associated with a higher risk of kidney disease. Though this mystifies the experts, the explanation is almost certainly that people with supposedly "normal" blood sugars can have blood sugars high enough to damage the kidneys.
Diagnosing diabetes with the current standard allows people to be told they have "normal" blood sugars when their sugars rise into the 200s 1 hour after the start of a glucose tolerance test as long as they drop under 240 mg/dl by the 2nd hour.
Plus, high insulin levels raise blood pressure, which also damages kidneys.
http://health.usnews.com/health-news/news/articles/2013/04/11/belly-fat-may-be-tied-to-kidney-damage
A review of diabetes research as reported by the newsletter EndocrinologyToday reveals that "...funding sources included industry (50.9%), NIH (7.5%) or other, with most being single-center trials of other sponsorship (37.7%) or industry-funded multicenter studies (27.4%). Only 1.4% of trials listed primary outcomes that included mortality or clinically significant cardiovascular complications, according to data."
In addition, "30.8% excluded patients aged older than 65 years and the majority excluded patients aged older than 75 years,"
The majority of studies intended to change outcomes were drug studies. They broke down into studies of "drugs (63.1%) and behavioral (11.7%)... Additionally, most trials were designed to enroll fewer than 500 (91.1%) or 100 (58.6%) patients, with mean completion periods of 1.8 years."
In short, most of the studies we have are very short, small, studies sponsored by drug and device companies meant to promote the use of their products which give no clue as to the impact of these drugs on the many people older than 65 who form the bulk of the diabetes patient community.
The report concludes that "recently registered diabetes trials may not adequately address issues needed to inform evidence-based practice. " In short, we don't know squat about what works in the most important diabetic populations over long periods of time.
But your busy, overworked doctor is unlikely to be aware of any of this and will prescribe whatever drugs look good in the studies the drug reps tout.
The study can be found here:
http://link.springer.com/article/10.1007/s00125-013-2890-4
Portion size trumps portion size training. Big portions make aware people overeat..
http://www.sciencedaily.com/releases/2013/04/130416102316.htm
RLL,
I deleted your post as it was not fair use. It was a review of a book propounding a speculative theory that did not look to me as if it was based on a real understanding of the underlying science, but was twisting it to fit the current fashion in the more hand waving branch of biology.
The review can be read here:
http://www.sciencebasedmedicine.org/index.php/doves-diplomats-and-diabetes/#more-25640
..to add to the last post there is not an iota of proof that as falsely claimed restoring truly normal blood sugars won't prevent diabetic complications. Following mediocre, drug-company promoted medical standards that do not lower blood sugar safely or effectively won't prevent them, but I hear from too many people doing extremely well who are healthy because they achieve normal sugars without the unsafe drugs.
I will write a longer defense of why the book could be significant later.
Nano particles in cosmetics etc are another cause of diabetes.
http://www.sciencedaily.com/releases/2013/04/130418162138.htm
This article might interest you: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3580884/ It interests me because my husband has autonomic system failure from other causes (multiple system atrophy)
Pem,
Thanks! That article is very interesting indeed. It is Diabetic cardiac autonomic neuropathy, inflammation and cardiovascular disease. Aaron I Vinik, et al., J Diabetes Investig. 2013 January; 4(1): 4–18.
Dr. Bernstein has been writing about the impact of autonomic neuropathy on people with diabetes since the 1990s. Good to see that someone else has picked up on it.
Most important takeaway for people with diabetes: Autonomic neuropathy begins at blood sugars in the prediabetic range.
This is another reason why diagnosing diabetes at far lower blood sugars than doctors use could save lives. Keep your blood sugar under 140 mg/dl at all times and you can slowly reverse neuropathies of all kinds.
Several people have emailed me wondering why I didn't comment on the item that has been in the news about a newly discovered hormone that supposedly; causes the regrowth of the pancreas. This is being reported as if it was a breakthrough that held out the promise of a cure for diabetes.
Here's what I have been replying to these queries:
I had seen this report, but since it is a) rodent research and b) very, very far from having any practical applications for people with diabetes now, I have refrained from commenting on it.
It's one thing to get cells growing, it's another thing to get them growing properly. The evidence emerging about the impact of the GLP-1 drugs on pancreatic cell growth stands as a warning. Yes, these drugs seem to grow a lot of new cells, but they are not secreting properly and they appear to be growing invasively and causing tumors.
There is a continual flow of this kind of research, which is always hailed as the Next Big Thing that will cure diabetes. Often it "cures" mouse models of diabetes that are, like 99% of the mouse models completely different conditions than human diabetes. You never hear another word about most of them.
So I concentrate on things with practical applications or implications for people dealing with diabetes now.