Type II diabetes and avandia

[dumpster56]

Diabetes drug side effect reports triple - Yahoo! News

This is the american way, instead of losing the weight and exercising people run to some make believe wonder drug.

Some wonder drug.

Gives ya a heart attack.

[ERD50]

NewGuy - is there any sky at all left within a 100 mile radius of your home?


This is pretty simple and common:

A) Some people need medication.

B) Medications *ALL* have side effects.

C) As we learn about the risk/rewards, we can make informed choices.

Yes, people should eat well and exercise.

Did you ever take an aspirin in your lifetime? Did you know that the list of side effects is so long that it would probably not pass FDA regs if introduced today?

Hey, let's not do *anything* because it *might* hurt us?

People get hurt exercising. People choke on granola.

Chill.

-ERD50

PS: Has it ever occurred to you to post a topic in such a way as to encourage meaningful debate rather than ' AHHH- I HATE THIS AND I NEED TO RANT ABOUT IT AND THE SKY IS FALLING AGAIN, AND SINCE PEOPLE GOT TIRED OF ME TELLING THEM HOW MUCH I HATE OUR CURRENT LEADERS I'LL FIND SOMETHING ELSE TO ATTACK!!!!"

How about - Hmmm, there are some reports of serious side effects on this med, including heart attacks. Anyone have details on the risk/reward, are there better alternatives, etc....

Just a thought.

[pfpelican]

I have type II diabetes, exercise more than most and eat few carbs, as directed by a dietitian, and I still need meds. One of those I take is akin to avandia...and my doctor says it's ok for me. Seems to be working, but I do need meds in addition to my excessive diet and above-normal exercise. Not weight-associated (I'm skinny) but hereditary. Must be nice to be genetically healthy and need nothing, like newguy. Nice, but not realistic. BTW...my diabetes didn't show up till I was 60. Too bad youth is wasted on the young.

[Rich_by_the_Bay]

Quote:

Originally Posted by pfpelican I have type II diabetes, exercise more than most and eat few carbs, as directed by a dietitian, and I still need meds. One of those I take is akin to avandia...and my doctor says it's ok for me. Seems to be working, but I do need meds in addition to my excessive diet and above-normal exercise. Not weight-associated (I'm skinny) but hereditary. Must be nice to be genetically healthy and need nothing, like newguy. Nice, but not realistic. BTW...my diabetes didn't show up till I was 60. Too bad youth is wasted on the young.

Points are very well taken.

This "blame the patient" mentality is very misguided and frankly just scientifically wrong in the vast majority of situations. I think it's driven by money ("why should I pay for their problem").

Small consolation, but I've seen many such people change their minds in a big hurry when they get sick.

[haha]

New Guy isn't a villain- as I remember he himself takes meds for hypertension. He runs more in a week than any racehorse in America, and he still needs meds. If he had diabetes genes he might need meds for that too.

I would like to say that I enjoy his posts. Some may be over the top, but has anyone noticed that blandness in spreading around here?

At least I find that I read his posts.

I thought that escaping boredom and forced niceness was why y'all decamped from corporate/academic/professional Amerika?

Ha

[Rich_by_the_Bay]

Quote:

Originally Posted by haha New Guy isn't a villain- as I remember he himself takes meds for hypertension. He runs more in a week than any racehorse in America, and he still needs meds. If he had diabetes genes he might need meds for that too. I would like to say that I enjoy his posts. Some may be over the top, but has anyone noticed that blandness in spreading around here?

Ha, do you feel that disagreeing with someone's perspective is the same as villifying them? Not sure I follow.

ERD50, Pfpelican, and I independently expressed disagreement with blaming someone for their illnesses. On re-reading those posts, I still can't find the "villain" thing you seem to be sensitized to. Spirited, perhaps, but not villifying and certainly not "bland."

I wouldn't blame newguy for his hypertension, and I'm glad he is taking care of himself. Sometimes s%#t just happens, which gets back to the original dissenting point of view: don't blame the patient.

Sorry if I've misunderstood your points.

[haha]

Quote:

Originally Posted by Rich_in_Tampa Ha, do you feel that disagreeing with someone's perspective is the same as villifying them? Not sure I follow.

Quote:

Originally Posted by Rich_in_Tampa ERD50, Pfpelican, and I independently expressed disagreement with blaming someone for their illnesses. On re-reading those posts, I still can't find the "villain" thing you seem to be sensitized to. Spirited, perhaps, but not villifying and certainly not "bland." I wouldn't blame newguy for his hypertension, and I'm glad he is taking care of himself. Sometimes s%#t just happens, which gets back to the original dissenting point of view: don't blame the patient. Sorry if I've misunderstood your points.

You have.

I think you are getting a bit sensitive. Since you were not named or quoted, nor was anyone else, it appears that all I did was to express support for New Guy, and say that I at least thought his posts were interesting, not only but partly because he isn't oh so totally pink panties nice.

To say that "So and so is not a villain" is not the same or even close to saying to others- "Stop vilifying so and so".

I don't want to pick out people. I think they should post whatever they want to post. However, someone did bother to tell New Guy how he might better express his feelings about Avandia, fat and diabetes in the way that this poster felt was more appropriate.

Likewise, although I didn't say anything about how you or anyone else should express himself, other than that I enjoy interesting more than not interesting, how come you felt you had to address me? To the point of telling me how I should employ the word bland?

OK by me- what is bland to me is not bland to you. I am mildly surprised you are gripped by this level of granularity.

Ha

[dumpster56]

I was talking about the drug. Man it really is getting blah around here. Bottom line type II diabetes has exploded here in the country with high school kids begin diagnosed with it! Sorry BUT the vast numbers are because people eat such junk and do not exercise. In addition the drugs that are being fast tracked by the FDA are well suspect. Look I am not one to pass judgement, I do sound like it sometimes, but gang this is just a forum. sometimes I throw stuff out there for a response! Its called brainstorming. Again many don't want to hear what I have to say Ala Mr Nords. Because he feels I bring nothing positive to the forum. Well that is his right so I am on his ignore list.

An Ignore list! A guy who was smart enough to be a submariner, wants nothing to do with another fellow early retired guy. Really because I don't follow what he feels is what is best for the forum.

Public forums, this is not I understand however understand that I do not go over any lines. I do not bad mouth anyone I do however speak with frankness that I guess is a bit much for some.

Fat and diabetes, look at the stats, it is really what causes it. Most do not have a gene that makes them get it. Its the McDonalds, The pizzas the beer, the pasta the wine the cookies and cakes and bagels on and on and on. The junk food.

Then we all want a drug to make it get better!

[pfpelican]

Quote:

Originally Posted by newguy888 Fat and diabetes, look at the stats, it is really what causes it.

Wow!

My doctor will sure be glad to hear that.

I have high blood pressure too. Wanna take a shot at what causes that?

Wow !

[FIRE'd@51]

Quote:

Originally Posted by newguy888 Fat and diabetes, look at the stats, it is really what causes it. Most do not have a gene that makes them get it. Its the McDonalds, The pizzas the beer, the pasta the wine the cookies and cakes and bagels on and on and on. The junk food.

I don't think this is correct. From what I have read on the subject, being fat does not cause diabetes. A lot of fat people never get diabetes, and about 10% of type II's are not overweight. If you have the gene for diabetes, being overweight can accelerate its onset, because being overweight can cause insulin resistance which over time causes beta cells to wear out. If you don't have the gene, your pancreas continues to produce larger amounts of insulin to overcome the resistance, but the beta cells don't wear out, so you don't become diabetic.

[pfpelican]

Mark’s Daily Apple » Blog Archive » The Definitive Guide to Insulin, Blood Sugar & Type 2 Diabetes (and you’ll understand it)

[haha]

Quote:

Originally Posted by FIRE'd@51 I don't think this is correct. From what I have read on the subject, being fat does not cause diabetes. A lot of fat people never get diabetes, and about 10% of type II's are not overweight. If you have the gene for diabetes, being overweight can accelerate its onset, because being overweight can cause insulin resistance which over time causes beta cells to wear out. If you don't have the gene, your pancreas continues to produce larger amounts of insulin to overcome the resistance, but the beta cells don't wear out, so you don't become diabetic.

Your explanation is likely correct. Still, from a public health perspective what is changing is the incidence of obesity in society, not the incidence of the gene. (Ignoring for a moment possible genetic differences between Europeans and non-European immigrants)

You summary says a lot- 10% of type 2s are not overweight- which means that 90% are. Also type 2 is getting more and more common in teenagers and even younger children. It used to be that type 2 diabetes was uncommon earlier than the mid thirties at the earliest. Again the gene distribution isn't changing, our physical and social habits are.

Ha

[Rich_by_the_Bay]

A little over 80% of type 2 (adult onset) diabetes is associated with obesity. Fat cells cause resistance to insulin, so the more fat cells the more insulin required to bring down the blood sugar. There is a strong genetic component, so you often inherit "potential diabetes" which under certain conditions will make its appearance and under others will not be manifest. While most are therefore obese, there are a lot of people who have type 2 diabetes despite a good weight, good diet, and decent exercise programs.

Unlike juvenile diabetes where not enough insulin is produced, in adults usually there is a normal amount of insulin produced, but it either arrives too late for the meal at hand, or is met by resistance in the cells of the body (fat cells and others). Exercise exerts an insulin-like effect.

Avandia is worrisome, and I never adopted it widely due to concerns years ago in the earlier drugs of that class (liver failure). There are almost always alternatives to this drug and while things are being sorted out more definitively, I've gently encouraged most of my patients to switch over at a convenient time. For some who are doing extremely well they may choose to stay on it, but they need to know the state of the situation.

[TromboneAl]

Whether right or wrong (or partially right/wrong), I understand NewGuy's frustration with a world where more and more people are obese, and many people get no exercise.

[Rich_by_the_Bay]

Quote:

Originally Posted by TromboneAl Whether right or wrong (or partially right/wrong), I understand NewGuy's frustration with a world where more and more people are obese, and many people get no exercise.

Me, too. What to do about it is the hard part.

We can't legislate it away; education is not highly effective; insurance incentives or surcharges are probably not practical and certainly unproven. While Medicare gets hit hard, social security might actually benefit fiscally (early deaths). Medical breakthroughs, like pancreatic islet cell transplants, are only partially successfull, limited in availability, obscenely expensive, and have dangerous immunosuppressive maintenance meds.

Then again, we have seen heart attack rates go down, AIDs restrained significantly in developed countries, and other examples of seemingly hopeless health problems tamed one way or another.

[FIRE'd@51]

If you read the link pfpelican posted, it seems that the FDA recommendation to eat 300 gm (1200 calories) of carbs per day may be part of the problem. For years the medical profession has been telling us to watch our fat intake. Perhaps it's the carb intake that we should be watching. I believe that there is mounting evidence that reducing carbs also leads to lower lipid levels, as well as weight reduction.

With regard to the increase in type II diabetes diagnoses, I suspect a good portion of that has come from lowering the fasting blood glucose level by which one is classified as having diabetes. About 10 years ago it was reduced to 126 mg/dl. I think prior to that it was 140 or higher. Additionally, there is the classification of pre-diabetes for those with fasting blood glucose levels between 100-126. I would suspect that this has triggered more folks to have a more definitive test for diabetes such as an oral glucose test, resulting in more diagnoses of the disease. In other words, I am saying that perhaps many more folks had diabetes years ago, but were not diagnosed as such because their fasting blood glucose was not above the then higher diabetic threshold. Today those folks would be considered diabetic. And who knows how many of the folks that died from heart disease in the past were really diabetic by today's standards, but were considered non-diabetic back then.

[ERD50]

Quote:

Originally Posted by FIRE'd@51 If you read the link pfpelican posted, it seems that the FDA recommendation to eat 300 gm (1200 calories) of carbs per day may be part of the problem. For years the medical profession has been telling us to watch our fat intake. Perhaps it's the carb intake that we should be watching. I believe that there is mounting evidence that reducing carbs also leads to lower lipid levels, as well as weight reduction.

I wouldn't be so quick to blame carbohydrates:

Diet Basics, Nutrition, Weight Loss, and Cooking with Marty Gallagher (with refs)

Quote:

They ignore the fact that the healthiest populations in the modern world consume high-carbohydrate diets. People in Okinawa eat a high-carbohydrate (55%) diet, and have rates of heart disease, cancer, senility, and diabetes that fall among the world's lowest. Okinawa also has the world's highest proportion of disability-free centenarians.

-ERD50

[dumpster56]

Did you see supersize me?

The guy ate the McDonalds stuff for a month. You saw what happened. It has nothing to do with carbs the increase in Diabetes, It has to do with the massive amounts of foods refined that we eat these days. Go ahead take a count of how many calories you eat in a day. You will be amazed. I ate almost 3800 calories yesterday! Now I have run almost 80 miles this week but those 3800 calories were so darn eary to consume. Heck 500 came from 3 beers!!

[Cattusbabe]

Quote:

Originally Posted by FIRE'd@51 I don't think this is correct. From what I have read on the subject, being fat does not cause diabetes. A lot of fat people never get diabetes, and about 10% of type II's are not overweight. If you have the gene for diabetes, being overweight can accelerate its onset, because being overweight can cause insulin resistance which over time causes beta cells to wear out. If you don't have the gene, your pancreas continues to produce larger amounts of insulin to overcome the resistance, but the beta cells don't wear out, so you don't become diabetic.

Ah the voice of reason. You nailed it. DH has Type II. It is genetic. He is also slightly overweight. He takes meds and I am relearning how and what to cook. We are also -gulp- exercising. Me I'm a a-hum "big girl" however Blood sugars and A1C are with normal range. No hypertension no nothing. It is just the luck of the draw.

Having said all of that I have a question. Is this discussion really about DM or a veiled way of fat bashing? Fat people are the one group people feel comfortable making fun of and lecturing about their lack of discipline and morals.

[Cattusbabe]

Quote:

Originally Posted by FIRE'd@51 If you read the link pfpelican posted, it seems that the FDA recommendation to eat 300 gm (1200 calories) of carbs per day may be part of the problem. For years the medical profession has been telling us to watch our fat intake. Perhaps it's the carb intake that we should be watching. I believe that there is mounting evidence that reducing carbs also leads to lower lipid levels, as well as weight reduction. With regard to the increase in type II diabetes diagnoses, I suspect a good portion of that has come from lowering the fasting blood glucose level by which one is classified as having diabetes. About 10 years ago it was reduced to 126 mg/dl. I think prior to that it was 140 or higher. Additionally, there is the classification of pre-diabetes for those with fasting blood glucose levels between 100-126. I would suspect that this has triggered more folks to have a more definitive test for diabetes such as an oral glucose test, resulting in more diagnoses of the disease. In other words, I am saying that perhaps many more folks had diabetes years ago, but were not diagnosed as such because their fasting blood glucose was not above the then higher diabetic threshold. Today those folks would be considered diabetic. And who knows how many of the folks that died from heart disease in the past were really diabetic by today's standards, but were considered non-diabetic back then.

Quite right. Great post.