A year ago the U.S. Food and Drug Administration approved a new drug to treat type 2 diabetes. But few of us ever heard of it. Until now. Studies presented at the annual convention of the American Association of Clinical Endocrinologists in Houston on Friday finally caught our attention. The senior...
Welcoming Welchol
5/20/09 8:22pm
High LDL is not part of the metabolic syndrome. Low HDL is.
5/21/09 3:42pm
well, it more likely is:
http://www.americanheart.org/presenter.jhtml?identifier=4756
perhaps your emphasis is to imply that low HDL is associated with increased morbidity/mortality than high LDL, but that point would be subsumed by the double whammy of concurrent high LDL/low HDL which is precisely why this metabolic syndrome is so dangerous
5/21/09 5:50pm
My emphases was that the official description of Metabolic syndrome includes low HDL, but does not include high LDL. Metabolic syndrome has official criteria to what it includes, and high LDL is not one of them. Having a pattern of small LDL particles usually is seen in people who have metabolic syndrome, but it also is not officially the criteria for the diagnosis.
6/ 1/09 10:04pm
In case anyone is searching for additional information on the drug, note that it is colesevelam, not colesevemal.
I haven't seen the drug used much in Arizona (where I live), particularly not for diabetes. This might be related to 1) it adds a layer complexity since it cannot be used for diabetes as a single agent, and 2) it interferes with absorption of many other drugs. Many people with diabetes are taking mutliple drugs.
Statins are the market-leaders for cholesterol lowering because there are data that they reduce cardiovascular disease and death rates, not just lower cholesterol levels. Welchol can't make that claim.
-Steve Parker, M.D.
-http://diabeticmediterraneandiet.com
6/ 1/09 10:50pm
6/ 2/09 11:18am
Thank you, David, for bringing this drug to my attention. I try hard to stay up to date, but hadn't heard of this one, or had forgotten about it.
By my count, we now have 10 classes of drugs to treat type 2 DM. When I started my medical career over two decades ago we only had three.
I appreciate all you do for people with diabetes.
-Steve
6/ 2/09 11:54am
Dear Dr. Parker,
Ten is my count too, and I list, describe, and link them at http://www.mendosa.com/drugs.htm
In the U.S. before 1995 when the FDA finally approved metformin, the only classes of drugs that we had to control our diabetes were insulin and the sulfonylureas. And in at least one respect both of them made it HARDER for us to control our diabetess because they cause us to gain weight.
Best regards,
David
3/30/11 8:21pm
"Statins are the market-leaders for cholesterol lowering because there are data that they reduce cardiovascular disease and death rates, not just lower cholesterol levels."
drs say the above all the time to patients but none of the statins i took claimed this ..in fact the drug manufacturer's literature claim was exactly this..." blank statin has been shown to lower HDL cholesterol but has NOT been shown to decrease moridity ( death ) from heart attack or stroke".
6/16/09 5:01pm
The side effects of this drug appear to be minimized. I am intolerant of statin drugs, so my Doctor suggested Welchol. I was supposed to start with 2 capsules twice a day. Wanting to be cautious, I started with 1 capsule twice a day. After five days I have such severe muscle pain and overall body weakness that I stopped taking the drug. It makes me wonder how many Doctors would recommend Welchol if they were in this kind of pain?
Mayumi
7/ 9/09 4:13pm
My dr. just prescribed Welchol because I am also intolerant of statin drugs. He said that Welchol has almost no side effects. I will err on the cautious side myself, but am disappointed that you had muscle pain and/or weakness with this drug also.................it makes me not want to start it, but I will give it a try.
You're right - I wonder how many physicians would endure the horrible muscle pain that a lot of patients experience on statins. Incredibly, I was told at first to take a Motrin every day..............like that would help! Good luck in your search for a remedy that will help you.
10/23/09 11:53pm
3/30/11 8:52pm
i just wanted to say that i took several statin drugs was started on them while in the hospital with a stroke. I was on a high blood pressure drug with HCT, plus zocor statin plus plavix blood thinnner. I came out of the hospital with impacted feces ( extreme constipation) which caused an anal fissure that lasted for 18 months...severe daily pain and it ruined my social life. On top of that i was weak, couldn't walk across the room without my heart pounding. I started walking i couldn't get around a block had to cling to trees to get back home. i lost 15 lbs 5 days in the hospital.
Being overweight i had started on a low fat low carb low calorie diet...after 9 months eating this restricted diet, i had gained th 15 lbs back.
Lucky for me i developed a growth on one eyelid and i went to an eye specialist for remove. Always up to that year had perfect eye exams. This time they said i had blepharitis, borderline glaucoma, the beginning of cataracts, and bleeding in the retina! The eye dr asked if I am diabetic I said no but i'm on blood thinners..he said to call the prescribing dr. I did a cardiologist and he said to stop taking the plavix immediately/ Discontinued after 6 weeks went back to eye dr, said the bleeds were gone so i felt it was the plavix.
I learned later the statins cause cataracts! I began taking a homeopathic Similisan for Cataracts over the counter...it's been over 5 years and the eye drs haven't mentioned cataracts again, the cataract formula also helps the dry eye
I also was put on the combo statin with zettia vytorin which got my cholesterol numbers to PERFECTION. However, I my body felt like i was dying. The dr would not believe that statins were causing my muscle weakness fatigue etc. He said they just do NOT do that. So i got rid of him and got another dr after he yelled at me in his office.
The new dr after tests announced "you have permanent kidney damage from your high blood pressure". I said i have been extremely ill with a week of flu then a stomach virus, could dehydration caused this..she said no...the symtom i was having for a few days was very little urine. At that time i was a coffee only drinker. She wanted me to go to a kidney special ist* in their group in another office..instead i did change drs again b/c she did not like my asking questions. She told me look i have 7 minutes to talk to you, figure out what's wrong with you and write a prescription so i can only take care of ONE PROBLEM per visit.
I changed drs again and i stopped taking all statins. The new drs put me on well chol. It gave me severe constipation but i started taking NOW calcium magnesium tabs before bed. As long as I did that i was aok. Plus i had started drinking 64 ounces of water daily. ALL my liver function and kidney function tests were as normal as they could be right smack in the middle of the range. They have been normal for 5 years now. So the dr who said i had permanent kidney damage from HIGH BLOOD pressure was also WRONG as well as the dr who said statins do NOT cause muscle weakness fatigue. STatins have been shown to cause congestive heart failure. Bad stuff. I'm 60 yo and i ask myself BEFORE STATINS, what did people do?
I've been on the well chol almost 2years now. I have gained weight 15 lbs the first year but my mother died and i felt the weight gain was due to depression. Still in a depression, many heel pains which i pinpointed was caused by athletic shoes so started wearing backless shoes...rarely have horrible heel pain. REcently it's been terrible back pain another period of stress ( legal mess )
One thing from all these drs they do not like to do thyroid tests....most do only a TSH useless if there's thyroiditis. One dr said my thyroid was hypothyroid but he did not prescribe anything. Anothe said "you're high normal ". The last drs said your thyroid is "low normal" . I said may i ask you what that means? She said you should have good metabolism. I said how is it i go from slow thyroid to fast thyroid yet I am still overweight? The last drs took the most thyroid tests but saw no reason to do any thyroid antibodies tests, which if elevated ould indicate some autoimmunie thyroid. An eye dr told me my eye showed signs of Graves Disease. When i was in 20s to 30s my normal temperature was 99 to 101. Now it is 94 to 96.
It's exhausting trying to find a drs that can and will treat the entire body.
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indeed, Joslin has been lobbying for quite some time for expanding use of bile acid sequestrants as an ancillary treatment for DM- there is actually another independent benefit from BAS in DM, but i forgot the mechanism! :(- my only beef with this post is the claim that metformin does not cause wt. loss, therefore categorizing it along with Januvia- metformin does, in fact, cause wt. loss, via decreased appetite, and lipolysis via decreased insulin levels:
http://content.nejm.org/cgi/content/abstract/333/9/550
Dear Frankenduf,
I also thought that metformin could cause a little weight loss. But I quoted Dr. Handelsman to the contrary. In any case, the effect is minimal.
Best regards,
David
metformin did NOT lead to either appetite or wgt loss for me but to increase of both. nor did it help control BG but did cause extreme gastric distress and insufferable fatigue. I will never touch it again.
It's my understanding that metformin alone won't make the pounds melt off with no effort, but it can help you lose weight if you're also doing diet and exercise. I know someone who had been trying to lose weight for years, with no success. She was finally Dx'd with type 2 and given metformin and was then able to lose 60 pounds and is now normal weight. However, she continues a very strict diet and walks or runs for an hour every day.
She said she simply couldn't lose without the metformin.
To me this is similar to David's weight loss on Byetta. It helped, but he probably wouldn't have lost the weight if he'd spent his days on a lounge chair watching football games and drinking beer.
I know someone else who says that without metformin, she'll pack on pounds when she eats carbs.
Of course, both of these examples are annecdotal.
I'm sure Dr. Handelsman has a reason for his conclusions. But his interview was arranged by the drug company that is selling Wellchol, and one should evaluate his comments in that light.
I took another bile acid sequestrant a long time ago, and it caused severe constipation. I now have diverticulosis and wonder if the BAS was a contributor to that, so I tend to run in the other direction when someone suggests a BAS. However, Welchol isn't supposed to have this effect.
Allison Goldfine, who wrote the introduction to my T2 book, had an article on Welchol here.