Three new studies point out the dangers in our diabetes drugs

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RobertIA Posted: Sun, Apr 19 2009 11:22 PM

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I was not looking for this news!  Now I am wondering what is safe?  I urge everyone to read the following link:

http://www.healthcentral.com/diabetes/c/17/67852/diabetes-dangers

Makes things interesting!

Added - Apparently you will have to copy and paste to use the link.  Bob

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whalen replied on Mon, Apr 20 2009 8:39 AM

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Dear Robert,

Interesting article.  I went on insulin several years ago, mostly because I did not trust the drugs.  It enables me to control the glucose even when my diet is less than perfect.  I do keep a tight rein on the carbohydrates and do not use insulin as an excuse for eating anything I want.

I do take some drugs for high blood pressure but they are generic and have been around a long time.

It's hard to know what to do.  Just muddle on as best we can, I guess.  I am all for education.

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Ron AKA replied on Mon, Apr 20 2009 2:51 PM

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I would not take that article by David Mendosa too seriously. First, while he made his name by being an early adopter of low glycemic foods, I don't think he has any real qualifications to describe him as an expert -- beyond being just another diabetic like the rest of us. In fact I find it a bit disappointing to see that he has gone on the low carb diet bandwagon. I would suggest he wrote the article to promote that view. Some comments:

1. Alzheimer's is associated with diabetes, so will you be better off taking medication or not? Not at all clear, but good possibility without medication you will be dealing with a lot of other diabetes complications besides Alzheimer's. Also study is only based on rat study.

2. Similar with macular edema, it is associated with diabetes, so what if you don't take meds?

3. The dangers of hypos are well known, and obviously anyone treating diabetes wants to avoid them. This does not mean it is also good to be high all the time.

The thing to keep in mind about medications is that while they have some (usually very rare) side effects, the alternative is almost certain complications that are much worse. There is no risk free alternative once you have diabetes. Low carb diets mean high fat and protein. Most do not get cholesterol under control with that type of diet, and CVD is the most common complication of diabetes.

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Ron AKA replied on Mon, Apr 20 2009 2:56 PM

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RobertIA:

Added - Apparently you will have to copy and paste to use the link.  Bob

It is a bit tricky to paste links here. The best way is to type the name of the link, highlight it by dragging, then click on the chain icon. You paste the link address in the first box, and then select open in new window from the second box, and there is no need to fill in the third box for title.

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nomorecarbs replied on Mon, Apr 20 2009 7:24 PM

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I'm sure David Mendosa lost RonAKA with this quote,

" I know from my own experience that a very low-carb diet combined with regular exercise is both the safest and the most effective way to control my blood glucose level."

Hey, this is what I've been saying all along.  Why take drugs and risk hypoglycemic episodes and drug side effects, when you can normalize blood sugars with diet and exercise alone?  What is more of a fad, a low carb diet for diabetes similar to that practiced a century ago, or the high refined carbohydrate modern diet, never followed by anybody in the world more than a couple of generations ago?  Yes, pharmaceuticals can help you lower your blood sugars for a while.  You may be more vulnerable to hypoglycemia, so now, even normal blood sugars will scare the bejeebers out of you.  Ultimately, you will be given new combinations of drugs to deal with the progressivity of your diabetes.

Diabetes is a disorder of carbohydrate metabolism.  Why so many insist on basing their diets on carbohydrates is a mystery to me.  When people like Mendosa mention that, it would seem to be obvious that they are right on.  Not so. 

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Ron AKA replied on Mon, Apr 20 2009 7:56 PM

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nomorecarbs:

I'm sure David Mendosa lost RonAKA with this quote,

" I know from my own experience that a very low-carb diet combined with regular exercise is both the safest and the most effective way to control my blood glucose level."

No he did not loose me at all, but perhaps I lost you with this statement about Mendosa and his agenda:

"I would not take that article by David Mendosa too seriously. First, while he made his name by being an early adopter of low glycemic foods, I don't think he has any real qualifications to describe him as an expert -- beyond being just another diabetic like the rest of us. In fact I find it a bit disappointing to see that he has gone on the low carb diet bandwagon. I would suggest he wrote the article to promote that view."

What I find is that diabetics who choose to follow non-conventional treatment programs end up spending a lot of time and effort trying to justify why they are going against the advice of all the professionals (their doctor, their endo, ADA, CDA, AACE, Heart and Stroke Associations, etc....). Often they seem to take this a step further to the evangelical level. My suspicion is that the reason for this is to try and justify away the bad feelings brought on by cognitive dissonance. Those who follow the advice of their doctors and the other professional bodies who are true experts in the field, do not share this burden of guilt.

Mendosa is no expert, and I my guess is that he is just doing these blogs to try and ease his guilt.

Just my thoughts,

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jen1229 replied on Mon, Apr 20 2009 10:16 PM

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It's not often that I agree with Ron, but this time I do.  He said waht I wnated to only more eloquently.

Diabetes is a progressive disease.  Most (not all, but most) people will eventually progress from diet control, to meds and possibly insulin.  I try to explain this to people when they tell me that they are resistant to taking meds for diabetes.  It's kind of silly in a way.  People take drugs for cholesterol, when they may not be mediacally necessary, yet they won't take medicine when they have a known chronic disease.

I also disagree with NOMORECARBS in that diabetes is not a disease of carbohydrate metabolism.  It is a disease of insulin production or the lack thereof.  If the body made enough insulin, or used it properly, then carbohydrate metabolism would not be a problem. 

I have now lost 36.8 pounds and my levemir (Long acting) insulin has gone down from 68 units to 50.  I am reducing every five pounds as long as it still continues to work.  So far so good.  BMI has gone from 64 to 57.

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nomorecarbs replied on Mon, Apr 20 2009 11:23 PM

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Mendosa is not an expert because he is not a doctor nor has a PhD?  Well, there are medical doctors and PhDs who do advocate low carb diets for diabetes, but of course they are not experts, in Ron's mind, but quacks.

As for diabetes not being a disease of carbohydrate metabolism, here is Roche's breakdown of metabolic disorders:

"

Examples are:

• diabetes (disordered carbohydrate metabolism)
• dyslipidaemia (disordered fat metabolism)
• anaemia (shortage of red blood cells or low haemoglobin) and other renal diseases
• osteoporosis (loss of bone minerals)."

http://www.roche.com/research_and_development/r_d_overview/pharmaceuticals/r_d_metabolism.htm

As for the need for medications and progressivity of disease, time will tell.  I've had diabetes for about 26 years, and am 63.  How long would diabetics following this very low carb regimen have to live with normal blood sugars for one to conclude that diabetes need not necessarily be progressive?  I have followed a low carb diet for 8 years, and see no trend of worsening blood sugars nor am I experiencing any complications.  Will that be true in ten years time, twenty years time?  I'm hopeful and confident, but, obviously, can't prove it to doubters.

Like Mendosa, I am looking at my personal experience as an important source of information.  Given a choice between believing that diabetes is going to progressively destroy my life, versus believing that diabetes can be managed and will not destroy my life, I find it, an easy choice.  My blood sugars are lower than the great majority of people taking medications, so what is it that the medications are going to spare me from?  So, perhaps, it is a leap of faith to believe that diabetes can be controlled so well that complications can be avoided, but studies of low carb diets haven't yet given me any reason to doubt my faith, and my personal experience seems consonant with this belief.

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RobertIA replied on Tue, Apr 21 2009 2:40 PM

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Thank goodness for free speech!  First, it's a shame when one person has to degrade another.  While I will admit that I do not worship at anyone's feet, when I disagree with something or someone I try to maintain an open mind and to ask why.

So Ron, Why?  I don't know your past history with Mr. Mendosa.  I have my own disagreements with him, but I will continue to respect his position, his thoughts, and right to say them.  If I had as many years dealing with diabetes and the experiences he has had, being asked to research, write, and speak - I think he has earned the respect of enough people to be labeled by others as a lay expert.  This is how I heard him introduced several years ago for a speech.  Before I had diabetes.

Just because I disagree with people who should be experts because of formal education, and passing an exam, does not mean that their school education is any less (or more) valuable that the education received in life.  Sometimes, I would even have to say based on their demeaner and behavior, maybe much less valuable.

Just because a carpenter is an expert with a hammer, does not mean that he has to have a formal education in carpentry, belong to a union, or earn a excessively high income. 

Bob

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Ron AKA replied on Tue, Apr 21 2009 6:02 PM

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Bob, I am not intending to degrade anyone. I just think Mendosa is wrong to suggest diabetics should not be taking the medications that their doctors have prescribed for them. Further I don't believe he is qualified to make such suggestions. I do not know the person, but exchanged some e-mail with him several years ago. He clearly is knowledgeable in the area of glycemic index and glycemic load. It is kind of a shame that he seems to have abandoned the idea of eating low glycemic index carbs in favour of avoiding carbs. Low glycemic carbs tend to be very heart healthy.

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RobertIA replied on Tue, Apr 21 2009 6:59 PM

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Well - Ron

You have nailed the one place that you and I agree on.  However, even though Mr. Mendosa and I disagree, on the point of what doctors prescribed, I do understand his reasoning.  People with diabetes need to be aware that their doctors can be in error.  I am seeing more and more of this - Doctors who do not understand diabetes and put the blame on the patients.  Other doctors threaten patients with insulin.   Thus, I will not take his position as he states it, but will ask many if they are sure that the doctor has prescribed the best for them.  And now with many of the studies also pointing this out, I am more sure than ever that the patients need to make themselves even more knowledgeable about what they are taking.  Some people seem wedded to what the doctor prescribed and may not realize that maybe they aren't on the medicine that is best for them.  The following link has been much of my guide in my own research.  There are many pages and much information - I suggest bookmarking - to read as you have time.

http://patients.about.com/od/internethehealthresources/a/persadvicesites.htm

And for all that Mr. Mendosa has done to further the cause of diabetes education, I will disagree with him in private and not in an open forum.  If people would read his writings with an open mind, they will learn that he has and is doing much to bring standards into the public for education.  Like his discussion on what is normal for A1c levels.  The following link is an excellent example:

http://www.mendosa.com/blog/?p=366

I urge you to read this as we have had much discussion about A1c - not that anyone was wrong, but for further verification and education.

Mr Mendosa has taught me to read what the drug company publicly states about their meds and then go to an independent drug guide and read about the side effects, contraindications, and further information.  Then I come to the internet and read what I can find.  Often, there is information which would tell me that the Doctor is in error or not prescribing the best medicine for me.  The last leg of my research takes me to the pharmacist and pharmacy guides.  Then I make up my mind.  I have had the pharmacist even suggest alternate meds and have me read about them as well.  Because the pharmacist knows the reading I do, I probably get more information that the average patient.

Bob

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nomorecarbs replied on Tue, Apr 21 2009 10:05 PM

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Bob,

I don't see a problem with disagreeing with anyone on an open forum, that would appear to be the point of a forum, the free exchange of ideas and information.  And, in effect, you have already expressed where you disagree with Mr. Mendosa.  On the other hand, not surprisingly, I agree with Mr. Mendosa on the medications for type II diabetics.  I believe far more diabetics could control their diabetes with diet and exercise than actually do, and in part, it's because their doctors really don't encourage them to, and probably don't believe they can.  Doctors primarily write prescriptions.  If dietary advice is to be given, they will probably farm that out to a CDE.  Could the doctors or the CDEs be wrong?  Of course, they are human.

Whether one chooses to rely solely on their professional diabetes team, or engage in their own research, the end result of their treatment of diabetes is borne solely by the diabetic, not the doctor, not the CDE.  I'd have more respect for the medical establishment if I saw signs of improvement in treatment.   We are doing more of the same, and getting the same results.  Americans have reduced their intake of animal fats, grocery store shelves are full of 'low fat' foods.  More people are becoming obese and more are becoming diabetic.  Diabetics, by and large,  continue to have unsatisfactory blood sugar control, and progressively worsen.  Someone once defined insanity as doing the same things as before, but expecting different results.  That sounds like diabetes medical care to me.  I think Mendosa does a good job in discussing these different ideas, I'm on his email list.  I don't always agree with him, but find a lot of interesting material on his site.

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Saluki777 replied on Wed, Apr 22 2009 10:46 PM

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Well said.  I wish I could cut out more carbs, but sadly, I love them too much!  My numbers sure would be better.