Skip to comments.3-drug combination stabilizes new onset of type-2 diabetes
Posted on 07/02/2013 5:34:19 PM PDT by neverdem
A new study shows patients newly diagnosed with type-2 diabetes fare better when they are given a 3-drug combination compared to conventional therapy with one anti-diabetic medication.
The finding that comes from researchers at University of Texas Health Science Center at San Antonio was presented June 22 at the 73rd Scientific Sessions of the American Diabetes Association in Chicago.
Ralph DeFronzo, M.D., chief of the Diabetes Division in the School of Medicine at The University of Texas Health Science Center at San Antonio presented findings from a two-year study that included 134 participants at the University Health System's Texas Diabetes Institute.
The 3 drug combination given in the study included consists of metformin, pioglitazone - a newer class of medication for type 2 diabetes - and exenatide, which is a glucagon-like peptide or GLP-1 agonist. An example is the drug Byetta.
Usual treatment is to start patients with new onset of diabetes on the drug metformin; then add a drug in the sulfonylurea class that stimulates release of insulin from the pancreas and next insulin, based on response to blood sugar control.
Examples of sulfonylurea drugs include Glucatrol, Amaryl, Diabeta and Micronase. In addition to helping the beta cells in the pancreas produce more insulin the anti-diabetic drugs help the bodys cells use insulin more efficiently.
DeFronzo explains the 3-drugs used in the study for diabetes helped preserve beta cells in the pancreas.
Each has a different target that corrects two deficits associated with type-2 diabetes the bodys inability to respond better to the hormone insulin and decreased insulin production from beta cells in the pancreas.
The goal of the therapy the researchers say was to prevent weight gain that happens easily with other anti-diabetic drugs, keep hemoglobin A1c (HbA1c) levels normal that in turn prevents complications of blindness, kidney and blood vessel disease and prevent blood sugar levels from fluctuating.
DeFronzo reported the triple therapy for diabetes:
The 3 medications studied for new onset type-2 diabetes may not be right for every patient because of side effects that should be discussed with your doctor or pharmacist. "These drugs are not cures, but patients are basically normal while taking them," Dr. DeFronzo said in a press release.
By not mentioning pioglitazone and exenatide, the UPI story led me to believe that the three drugs used in the test were metformin, a sulfonylurea and insulin injections.
FReepmail me if you want on or off the diabetes ping list.
Suit filed for Pancreatic Cancer By Use of Byetta, Januvia and Janumet
NEW YORK, June 14, 2013 /NEWS.GNOM.ES/ The law firm of Rheingold, Valet, Rheingold, McCartney & Giuffra LLP has just commenced what is believed to be the first suit in New York for the development of pancreatic cancer in the user of two common anti-diabetic drugs, Byetta and Janumet (also known as Januvia). The suit, by Staten Island resident Robert Cataletto, was filed on June 14, 2013 Cataletto v. Amylin Pharmaceuticals, LLC, et al., E.D.N.Y. CV 13-3411.
Mr. Cataletto received prescriptions from the doctor attending to his adult diabetes condition in the period from 2009 to 2012 for Byetta and Janumet. Byetta, manufactured by Merck, Inc., has been on the market since 2005 and is known as a glucagen-like peptide. It treats diabetes by preventing a build- up of sugar in the body.
Junuvia is made by Amylin Pharmaceuticals LLC, a company recently bought by Bristol Myers Squibb Co. First marketed in 2007, it in the category of a dipeptidyl-peptidase-4 drug, which also reduces blood glucose levels. When combined with an older drug, metformin, the drug is known as Janumet. The broader category for the drugs involved in this law suit is known as incretins.
The complaint which was just filed alleges that the manufacturers of both of these products were alerted starting in 2010 that there was an increased incidence of pancreatic cancer in users of these drugs as compared to diabetics treated with the older, more proven forms of treatment. The notice also came from the German Medical Association and a petition by Public Citizen, a non-profit health group in Washington.
There have been similar reports of a sharp increase in pancreatitisinflammation of the pancreas glandin users of these same drugs. The complaint alleges that pancreatitis may be a forerunner of pancreatic cancer. Pancreatic cancer is among the deadliest of all cancers, for which there are no satisfactory treatments.
IMHO, you’re on the wrong thread.
You’re right. Sorry! Something is going crazy here. I posted on another thread and the post just disappeared. Weird.
What are the three drugs? This is very confusingly written.
Thanks for the link.
From the eMaxHealth article: "The 3 drug combination given in the study included consists of metformin, pioglitazone - a newer class of medication for type 2 diabetes - and exenatide, which is a glucagon-like peptide or GLP-1 agonist. An example is the drug Byetta."
They gave generic names until the end when they wrote the trade name Byetta. Glucophage and Actos are trade names of metformin and pioglitazone, respectively.
Will it be covered under Obamacare?
Type II is caused by a disturbance in the cell wall - most often related to consumption of man-altered fats... instead of high quality fats.
Please add me. Thanks Diabetes
If you enter Volek JS, Feinman RD into PubMed's query box, then you'll do an authors' search on two writers who have written 11 articles showing the benefit of carbohydrate restriction. Scan the abstracts, at least. Many are FReebies.
Try a carbohydrate restricted diet, exercise ad libitum and psyllium.
Comparison of the Atkins, Zone, Ornish, and LEARN Diets for Change in Weight and Related Risk Factors Among Overweight Premenopausal Women The A TO Z Weight Loss Study: A Randomized Trial I didn't pick the sample, but check the abstract, at least.
I’ve been taking metformin + Byetta for 4 years now, A1C has remained in the high 5’s.
Metformin kills my gut. Is there anything anybody can recommend to get through this?
Talk to your doc about reducing the dose of metformin and reducing your carbohydrate intake or using psyllium or both. Check the links in comment# 16.
I forgot to mention that your doc needs to be informed before you try my suggestions.
The results show that the drugs reduce the numbers. They do not show that this results in a reduction in long-term complications, which is what is really important.
Doctors and the FDA are starting to question this approach. The studies necessary to show meaningful results from taking these drugs would have to last decades. Obviously, the drug companies prefer the current system where they just have to show that the surrogate markers of the disease, the numbers, improve.
When you consider that every drug has side effects, and that the more drugs you take, the greater the risk, it would make sense to proceed with caution.
While I'm inclined to look for adverse drug reactions, they are usually dose related. They are probably starting this 3-drug combination with the lowest dose of each drug because hypoglycemia is a definite fear.
I've seen a low dose multiple drug approach recommended for high blood pressure also to avoid adverse drug reactions.
I believe in treating patients, not numbers, but if you have bad outcomes, and the patient's numbers are really bad, and the doc didn't try to correct those numbers, the doc might get sued for malpractice.
The fear of lawsuits and a lack of alternatives is precisely why Americans are taking too many prescription drugs.
The combination of lowering the threshhold for what is considered to be bad and the aging population means that it won’t be long before 90% of us are considered to be sick with something, and thus in need of pills.
I highly recommend the book Rethinking Aging: Growing Old and Living Well in an Overtreated Society by Nortin Hadler, MD. I personally know of a number of people who were harmed by too many tests, pills, and/or surgeries. Doctors have forgotten the beginning of their oath, “First, do no harm.”
Mine too at first but I got used to it - took a couple of months.
My T2-D was out of control. When I started chemo for cancer my Insulin use went from insane to outrageous. Someone sent me the following link:
After reviewing the info with my team of Doctors I added 4 of the supplements to my daily diet.
My Fasting BS with 150IU Levemir 2X/Day was 275 - 300.
Now my Fasting BS with NO added Insulin is 140 - 160.
Note: My BS still goes sky high during Chemo infusion weeks because of the steroids, but that is expected. I am working with my Doctors to recalculate my Insulin dosing for both steroid and non-steroid days..
YMMV. Talk to your DR. FIRST.