by Gary Pepper, M.D. Chances are, if you have diabetes you have heard about a new class of drugs to treat high blood sugar (glucose). The first of these new medications to gain FDA approval in the U.S., in 2013, is Invokana manufactured and promoted by Janssen Pharmaceuticals and Johnson & Johnson. In the last year and a half the number of these drugs known as SGLT2 inhibitors, has multiplied faster than tribbles to include Farxiga, Xigduo, Jardiance and Invokamet. Prescriptions for these medications are also showing explosive growth, increasing 300% since January 2014. A recent forecast by Express Scripts calls for this one class of drugs to be responsible for about a 20% increase in the yearly cost of prescriptions per all members per year for the next 3 years . The explanation behind the eager adoption and dissemination of this brand new class of medications may eventually serve as a tragic lesson for diabetic patients and for the medical community in general. (more…)
A few days ago I was concluding a visit with a patient with thyroid disease, while her diabetic husband, also my patient, looked on. They are a pleasant older couple I have known for years, who are devotedly helping each other stay healthy. As they were leaving the exam room the wife apologetically turned the subject to her husband mentioning he was having almost daily â€œepisodesâ€ of weakness and confusion. “I hadnâ€™t changed his diabetic medication recently so why should his blood sugar be an problem now”, I thought. A number of other unpleasant possibilities immediately occurred to me. I inquired about signs of a possible stroke or heart condition. If these other angles were unproductive I faced the choice of sending him to the hospital for an evaluation. We quickly ran through a routine systems review. He had lost 10 lbs in the past month, the wife mentioned. â€œOh, no, cancerâ€ , was my first thought. His wife explained that as a New Yearâ€™s resolution he enrolled in a commercial weight loss program for diabetics. With relief, I knew we had the explanation of his disturbing new symptoms.
Most of my diabetic patients are on medication since they are unable to maintain good glucose control with diet and exercise only. If they succeed however, in achieving weight loss then the diabetes medication must be reduced to prevent undesirable hypoglycemia (low blood sugar). Hypoglycemia is potentially dangerous because the brain cannot function properly resulting in abnormal behavior, loss of muscle control and even unconsciousness. Imagine this occurring while behind the wheel? Down here in Florida this is all too common.
Many commercial weight loss programs have started targeting Type 2 diabetics (adult onset) with their TV ads. These programs are generally administered by people without any medical background. They cannot advise medication changes (not that you would want them to) without breaking the law by practicing medicine without a license. The result, as with my patient, is the development of potentially serious complications of hypoglycemia.
In a previous blog https://metabolism.com/2010/10/17/injured-diabetic-diet , I worried that this type of problem could develop with commercial weight loss programs. I didnâ€™t expect to see evidence of it so soon and in my own exam room. If my patientâ€™s wife didnâ€™t stop and mention his new symptoms at the last moment that day, I imagine a far worse outcome for her husband was possible.
The HCG diet has created a great deal of controversy among experts and the people who have tried it. Cami posts these words of warning about the HCG diet based on her own and her husband’s experience.
What Dr. Simeons book does not tell you is that there is a good chance your hair will fall out aproximately three months after completing the 500 calorie phase of the diet. He also doesnâ€™t mention that the shock to your system can cause adrenal fatigue, and hypothyroidism if you were already prone to these conditions.
My husband and I both went on the hCG diet and both lost the weight we had been hanging onto for years. I followed the diet perfectly, but as soon as the hCG stopped, the weight began coming back on, FAST! I had to do a steak day every other day, my blood sugar plummeted and I began to feel awful! I suffered fatigue, dry skin, dry mouth, no energy, no libido, and my muscles and joints began to hurt. The carb and sugar cravings were so intense I felt like a drug addict. I gained all the weight back plus 13 lbs. in three months, then the hair began to fall. My doctor was shocked and completely surprised. His only theory is that the usual dose wasnâ€™t enough for me and I triggered a starvation response which affected my thyroid and adrenals. Together we are going to support adrenal health, then begin t3 therapy in an effort to repair my thyroid. My husband on the other hand, feel great! He has been able to keep off the weight, add some muscle and is happy and energetic every day. hCG does work, but if you have any health problems related in any way to the hypothalmus, I would consider taking the weight off very slowly to avoid starvation response.
The mission of the The Thyroid Project is to encourage sharing of information and experience between the public and the medical community about the treatment of hypothyroidism (low thyroid function). For at least the past few decades there is a growing awareness of â€œsomething missingâ€ in the way suffers of hypothyroidism are treated for their disease.
Too many patients, as documented in an on-line study of 12,000 individuals conducted by the American Thyroid Association published in June 2018, (https://doi.org/10.1089/thy.2017.0681) , complain of persistent symptoms of hypothyroidism despite what their doctors believe is successful treatment with levothyroxine (brands include Synthroid, Unithroid, Tirosent, Levoxl). We believe something needs to be done to resolve this conflict between patients and their doctors.
Discover the impact of AI on the spread of medical information! Dr. Gary M. Pepper examines the risks of relying on AI summaries from potentially tainted sources, highlighting a controversial NEJM study on testosterone treatment. Learn why it’s crucial to keep public medical data clean and what this means for the future of health information.
Metformin has been the mainstay of diabetes treatment for 50 years with an impressive array of success stories in terms of effectiveness and affordability. On top of this, recent research points to the unexpected potential of metformin for the ability to reduce the risk of dementia and cancer and may even slow the aging process. So why is this drug so under-rated? Our review at metabolism.com digs into these intriguing questions.
Without effective intervention the early stage of type 2 diabetes known as prediabetes carries a high risk of progressing to outright diabetes. Metabolism.com provides an up-to-date summary of recommendations from national authorities, for preventing and possibly reversing this life long affliction