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3-drug combination stabilizes new onset of type-2 diabetes
eMaxHealth ^ | June 25, 2013 | Kathleen Blanchard RN

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 body’s 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 body’s 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.”


TOPICS: Culture/Society; News/Current Events
KEYWORDS: diabetes; exenatide; metformin; pioglitazone; type2diabetes
UPI's version: Three medications for type 2 diabetes may be more effective

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.

1 posted on 07/02/2013 5:34:19 PM PDT by neverdem
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Comment #2 Removed by Moderator

To: austinmark; FreedomCalls; IslandJeff; JRochelle; MarMema; Txsleuth; Newtoidaho; texas booster; ...
Fat Cells Feel the Cold, Burn Calories for Heat

FReepmail me if you want on or off the diabetes ping list.

3 posted on 07/02/2013 5:41:03 PM PDT by neverdem (Register pressure cookers! /s)
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To: neverdem

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 pancreatitis—inflammation of the pancreas gland—in 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. 

Complete article:

http://news.gnom.es/pr/suit-filed-for-pancreatic-cancer-by-use-of-byetta-januvia-and-janumet


4 posted on 07/02/2013 5:41:30 PM PDT by Jyotishi (Seeking the truth, a fact at a time.)
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To: FlingWingFlyer

IMHO, you’re on the wrong thread.


5 posted on 07/02/2013 5:42:35 PM PDT by neverdem (Register pressure cookers! /s)
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To: neverdem

You’re right. Sorry! Something is going crazy here. I posted on another thread and the post just disappeared. Weird.


6 posted on 07/02/2013 5:46:51 PM PDT by FlingWingFlyer (Former member of the GOP useful idiot voter base.)
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To: neverdem

What are the three drugs? This is very confusingly written.


7 posted on 07/02/2013 5:47:25 PM PDT by CJ Wolf
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To: theKid51; Apple Blossom

ping


8 posted on 07/02/2013 5:48:44 PM PDT by bmwcyle (People who do not study history are destine to believe really ignorant statements.)
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To: neverdem
I've been prescribed Metformin and told to lose weight.When I lost a lot of weight a few years back I was taken off Metformin because my A1c was back to normal.Then I gained weight again (bad hip,couldn't exercise) and was put back on Metformin.My weight is way down again (new hip,easy to exercise) so I hope to be taken off of it again.
9 posted on 07/02/2013 5:49:05 PM PDT by Gay State Conservative (The Civil Servants Are No Longer Servants...Or Civil.)
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To: Jyotishi

Thanks for the link.


10 posted on 07/02/2013 5:49:20 PM PDT by neverdem (Register pressure cookers! /s)
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To: neverdem
Pioglitazone (Actos) has numerous side effects and is expensive as hell. It's made by Takeda, a Japanese pharmaceutical company. When I finally got my doctor to take me off it 18 months ago, they were charging $9/dose to uninsured users.
11 posted on 07/02/2013 6:02:33 PM PDT by lentulusgracchus
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To: CJ Wolf
What are the three drugs? This is very confusingly written.

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.

12 posted on 07/02/2013 6:05:12 PM PDT by neverdem (Register pressure cookers! /s)
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Will it be covered under Obamacare?


13 posted on 07/02/2013 6:07:06 PM PDT by Rio
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To: neverdem

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.


14 posted on 07/02/2013 6:21:49 PM PDT by aMorePerfectUnion ( “The more corrupt the state, the more numerous the laws.” - Tacitus)
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To: neverdem

Please add me. Thanks Diabetes


15 posted on 07/02/2013 6:41:49 PM PDT by Rannug ("God has given it to me, let him who touches it beware.")
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To: lentulusgracchus
You sound like a type 2, at least. Not all type II diabetics are the same, but with high blood pressure, and some other criteria, you may have Syndrome X, also known as metabolic syndrome. Diets restricted in carbohydrate intake have benefited many type 2 diabetcs and those with metabolic syndrome.

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.

Psyllium helps fight type 2 diabetes mellitus

16 posted on 07/02/2013 6:42:13 PM PDT by neverdem (Register pressure cookers! /s)
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To: neverdem

I’ve been taking metformin + Byetta for 4 years now, A1C has remained in the high 5’s.


17 posted on 07/02/2013 6:45:35 PM PDT by Some Fat Guy in L.A. (Still bitterly clinging to rational thought despite it's unfashionability)
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To: Some Fat Guy in L.A.

Metformin kills my gut. Is there anything anybody can recommend to get through this?


18 posted on 07/02/2013 8:01:14 PM PDT by LeonardFMason
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To: LeonardFMason
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.

19 posted on 07/02/2013 10:08:09 PM PDT by neverdem (Register pressure cookers! /s)
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To: lentulusgracchus

I forgot to mention that your doc needs to be informed before you try my suggestions.


20 posted on 07/02/2013 10:20:21 PM PDT by neverdem (Register pressure cookers! /s)
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To: neverdem

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.


21 posted on 07/02/2013 10:52:42 PM PDT by Pining_4_TX (All those who were appointed to eternal life believed. Acts 13:48)
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To: Pining_4_TX
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.

22 posted on 07/03/2013 12:35:03 AM PDT by neverdem (Register pressure cookers! /s)
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To: neverdem

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.”


23 posted on 07/03/2013 2:56:39 PM PDT by Pining_4_TX (All those who were appointed to eternal life believed. Acts 13:48)
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To: LeonardFMason
Metformin kills my gut.

Mine too at first but I got used to it - took a couple of months.

24 posted on 07/03/2013 6:07:22 PM PDT by Some Fat Guy in L.A. (Still bitterly clinging to rational thought despite it's unfashionability)
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To: neverdem

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:

http://www.vitamindcouncil.org/about-vitamin-d/vitamin-d-and-other-vitamins-and-minerals/

After reviewing the info with my team of Doctors I added 4 of the supplements to my daily diet.

Results:
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.


25 posted on 07/04/2013 12:58:12 PM PDT by Petruchio (Democrats are like Slinkies... Not good for anything, but it's fun pushing 'em down the stairs.)
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