I was diagnosed with type 2 diabetes in 2000. I'd been "borderline" for a number of years. I also have rheumatoid arthritis (since age 26, now 65), however, that is under control with prednisone (3 mg. per day) and Remicade. I also have Graves Disease. We went to Europe in 2000 and I asked my Endocrinologist for extra prednisone (as I was afraid of my arthritis acting up). He gave me a large dose - 20 mg - for a few days and I tapered off for the three weeks we were in Europe. Long story short - when I got back a friend of mine who is also diabetic offered to check my blood sugar. My reading was 245. I immediately went back to the doctor and he confirmed that I was indeed diabetic. We tried Metformin but due to a peptic ulcer (that comes and goes) I can't take it for very long. I am 5'2 and weight 193. I can't seem to lose weight and attribute it to my prednisone, glupizide and actos. What can I do? I have been taking half a capsule of Metformin, but my stomach is acting up again. Doctor doesn't seem very concerned. Help!!. Thanks. (Can't remember password).
Have you considered trying insulin and a low carb diet? I could no longer take metformin as it damaged my kidneys - which they said was unusual. I was disapointed as I was afraid of insulin. It was the best thing I did. I have lost weight (25 pounds) and still need to lose more. Thanks to David my eyes are better. I followed his recommendation to take pycnogenol when I was treated for diabetic retinopathy about a year ago. I had been on a low carb dietfor a year when I had lazer treatment. I continued the low carb diet, took lutein and pycnogenol and other vitamins. I went to see the specialist again last month. He said "I don't believe this. Your eyes are better, this never happens." I reported to my diabetis doctor who specializes is low carb diets and she said that I am the third patient who has healed their eyes. She said it is due to diet and the vitamins I am taking. Mary
Dear Glorianna and Mary,
I second Mary's recommendation. In fact, I realized after posting my reply to you that I should have written about the advantages of a very low-carb diet that at least at first could well include insulin injections.
And, Mary, thank you for letting me know that you were able to reverse your retinopathy with Pycnogenol. I am so pleased!
Plus, a week or two ago the PR firm that represents the British company, Horphag Research, that has the patent on Pycnogenol sent me the press release and in fact the full-text of a new study. I almost wrote about it here, but had second thoughts because one of the authors of the study works for Horphag.
But, here for your information are the key paragraphs from the press release:
"A recent study published in the Journal of Ocular Pharmacology and Therapeutics reveals Pycnogenol® (pic-noj-en-all), an antioxidant plant extract from the bark of the French maritime pine tree, can improve microcirculation, retinal edema and visual acuity in the early stages of diabetic retinopathy.
“Previous research has shown that Pycnogenol® may reduce the progressing advanced stages of diabetic retinopathy,” said Dr. Robert Steigerwalt, a lead researcher of the study. “While previous studies focused on the latent stages of diabetic retinopathy, the aim of this new study was to show the protective effects of Pycnogenol® in the early stages of this growing diabetic complication.”
The randomized controlled study, conducted by G D’Annunzio University in Italy, investigated a total of 46 diabetic patients over a period of three months. The Pycnogenol® treatment group consisted of 24 patients, with 22 patients placed in a placebo treatment group. Each of the patients had been previously diagnosed with diabetes for at least four years prior to participating in the study and their blood glucose was well controlled by diet and oral anti-diabetic medication. Patients had early stage retinopathy characterized by capillaries in the eye leaking fluid into the retina causing swellings. At this stage only minor bleedings into the retina occur and damage to light-sensing cells may still remain largely reversible.
Subjects were treated with three 50 mg Pycnogenol® tablets (total 150 mg. of Pycnogenol®) or placebo tablets in the morning after breakfast over a period of three months. Following treatment with Pycnogenol®, the major positive observation of this study was visual improvement, which was subjectively perceived by 18 out of 24 patients in the Pycnogenol® group. Testing of visual acuity using the Snellen Chart (the standard eye chart used by eye care professionals to measure visual acuity) showed a significant improvement from baseline 14/20 to 17/20 after two months of treatment with Pycnogenol®. There were no improvements found in the control group.
Best regards,
David
Mary,
Thank you for your post. I was under the impression that if you get on insulin you'll never get off. My sister, who is also diabetic, is on insulin and she has gained a lot of weight since starting it, although I don't think she follows a particular diet. I'm not adversed to giving myself shots, I do already for my arthritis, but I certainly don't want to gain any more weight. My endocrinologist is no longer affiliated with my insurance, so right now I'm under the care of my Internal Medicine doc. I trust her but I started taking Metformin again under her recommenation. She knows my history of peptic ulcers, so I wonder....In the meantime I am trying to start a diet and the battle goes on, even if I don't seem to be winning the war. Another thing, I've noticed my eyes getting worse, even though I had an exam about six months ago, so that's my next thing to address. The information on pycnogenol is interesting and helpful should I need it. Take care and Happy Holidays.
I am on metformin and have thought about taking insulin-
however several people I know, all have gained weight after
starting on insulin. They all follow a strict discipline of taking doses of specific amount of insulin, several times a day. They do so, no matter what they eat, what their BGs are at the time or how much exercise they get. I am not a doctor and have never taken insulin. But it seems to me as if they all they take much more insulin than they need-leading to the weight gain. I don't understand why people won't tailor their insulin intake specific to their individual need. Why not just take a minimum amount of fast acting insulin after a meal- simply to replace the second phase action of the pancreas insulin release which is totalling lacking in people with TYPE2?
I have been taking pycnogenol for over a year and plan on taking it the rest of my life. I have not had any side affects. However, your milage may vary so I would take special care when you try it. I only start a new vitamin or medication solo. That is I never take more than one new treatment at a time and watch how my body responds. Bronwyn
Dear Bronwyn,
Making one change at a time is the best procedure! I say that even though I am often guilty of being so much in a hurry to get better that I change everything. That's what I did when I got severe headaches this past March. It worked -- but now I don't know WHAT worked.
Best regards,
David
David, grateful thanks for this column you write and research..I learn more herethan anywhere else about Diabetes and treatments..Bless you!
I wrote to you once before about retinal edema.
I was diagnosed in 2005 as diabetic...I actually think I was borderline...not totallydiabetic.
I was put on 5mg metformin immediately...and believe it contributed to my retinal edema.
I lost 40 pounds in 3 months...due to diet discipline and metformin ...I am now normal weight for height and age...
My eyes were great before taking the Metformin medication...20/20 vision
I mentioned the increasingly blurred eyes to my doctor and asked if there was a connection to the Metformin...as it occurred an hour after taking the pill...I was told ...no!... it was probably my diabetes..
But I now believe that blood sugars that are too low as aresult of Metformin greatly and adversely affect the vision.
Correct dosage is vital in this instance.
The dosage was then reduced to half a tablet...a day
then a 1/4 tablet a day
then none...
I discovered that by taking metformin over a two year period ...often reduced my Blood sugars to below 4.)0 and that feeling was awful..weakness, fatigue, disorientation and an inability to think clearly ....as well as severe leg cramps ... finally we realised that I was better off managing with diet and exercise... I can be stronglydisiplined about diet...my aic test results are 6.0
I actually feel my best (as in normal) when I am between 6.5 and 7.5...and since all ondividuals are different it may be a good idea fr non diabetics to have sugars monitored to keep a record of what is normal Blood Sugar number for them...especially if diabetes runs in the family..
I think diet and exercise should be THE first method of treatment in controlling early signs of possible diabetes....especially if Blood sugar numbers are not really high..Like 10/12
I have also realized that it takes more than 48 hours to clear the body of foods like a whole grain bagel and light cream cheese...even if one fasts.... before a Blood sugar test...
After 5 years I understand more about my body and how it works....
I have had Kenalog injections for retinal edema...and also laser treatments the side effects were cataracts.. that operation has been done...Kenalog works for me... every 4 months I need another needle.. Voila! Clear vision...
.My Optthamologist then decided I should have Victerectomy in right eye... to avoid the every 4 month Kenalog needle...
I did have it and am scheduled to have left eye done Feb 1st...I am hesitating and may cancel as it is my best eye...and I am a artist...do you think Pyconogenol would help me at all..?
This is indeed along winded explamation of my condition in order to ask about Pyconogenol
thanks
J
Dear J,
Thank you. And I wish that I could give you a straight answer about Pyconogenol. It does look promising. But all of the studies that I know of have been co-authored by someone or other from the company that has the patent on it. So of course I am suspicious of conflict of interest.
Still, the stuff isn't too expensive. You can't want for real proof. I know that if I were in your shoes I would risk the few dollars to buy it.
Best regards for a healthy and happy new year,
David
David's right ... you probably meant first phase insulin which is currently (if not well) replaced with Apidra, Humalog or Novolog. But they aren't fast enough for rapidly digesting carbs - or corrections in my opinion.
Why don't doctors prescribe it? Why do they prefer to instill the fear of god of insulin in people? Good question. It's an argument I've had my times with my endo. I've been insulin dependent since i was 12 and the Joslin didn't scare the bejesus out of us back then. Why do they do it now with the most useful, safest, least side effect filled "solution" to the matter.
I was worried too about weight gain and was also afraid of the injections. I started insulin last March and have lost 60 lbs by writing down everything I ate, counting carbs, diet and exercise. The injections are not painful and not a problem. My internist had tried to convince me for the last 2 years to take them. I need to lose about 20 more lbs for my BMI. Once you get on a planned diet and exercise program it is pretty easy; however the holidays have been hard. I have slipped up on both diet and exercise and it is hard to get back. I am a compulsive person and really need to leave carbs alone as much as possible! I have felt so much better physically and mentally. It is worth getting on a good routine!! Good luck.
Nan
Though I control my insulin resistance with diet and exercise for the most part , my doctor had tried to put my on Avandia in the beginning, and I said no. Shortly after, the drug he had resommended was linked with heart problems. I am staying natural, while my own insulin still works, but I would be happy when the spray Insulin like generex Oral-lyn, or Oral Insulin comes out, so I could occasionally give in to my PMS cravings, without extraordinary guilt, and higher postprandials. Thanks for your article.
Great translation of the risk in English for those who don't have access to or can't stand the thought of reading the medical journal stuff.
For the record - I am sooo not a proponent of these meds: burnout potential, hyperinsulinemia, hypoglycemia, (further) insulin resistance etc. And they don't work long-term since patients aren't resolving the cause; they are most likely treating the symptoms. Never a good idea in my mind. But I'm a silly goose type 1 who has no fear of insulin injections.
Happy New Year, David.
Doris Dickson
Is Starlix part of the bad drugs?
I've been on Starlix for three years. It lowered my post-prandial numbers less and less and I gained back a lot of the weight that I had lost while I ate the same low carb diet and kept up with my execise routine. Very frustrating! I will discuss with my doc at the next visit and try to get off it.
Anyone else had weight gain with Starlix? Thanks
Because there was no control group, the correletion does not demonstrate a causal relationship. There is no baseline data so NO conclusion can be responsibly drawn about risk vs benefit.
Since the leading "cause" of death of ALL people is cardiac failure, this study only affirms that a person with one chronic illness, diabetes, has a statistically larger probability of dying that someone without. That statistic alone cannot be used to make a rational treatment decision.
These studies may satisfy intellectual curiousity, but tend to look at the results in a negative manner. They never ask "How is life expectancy improved by using a particular drug vs NOT taking anything?"
This is an endemic failure of the medical "research" that is psonsoered by the pharmaceutical industry, which seldom if ever does studies to establish the relative efficacy of drug treatments. This pseudo-scientific work is what identifies them as incompetent, if not unethical charletons.
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I also had to cite England's National Health Institute to my doctor for a study that said beta blockers would no longer be the BP treatment of first choice for the whole country due to studies finding they could bring on stroke and diabetes in those at risk (like me!). Her first response was a bizarre---all drugs have side effects! The day I was diagnosed with The D, I threw my beta blocker and my statin in the garbage as I stormed out of her office, bought a BP monitor and set out to get things under control myself, which I have done.
I have also found that European and sometimes Australian research is waaay ahead of us on the use of herbs and supplements.
Thanks, as usual for you helpfu, supportive columns.....Judith in Portland
Judith,
I'd love to hear more about diabetes research regarding herbs and supplements... do you have any decent info or links to share?
Hi Boulder Friend (love your town!). Sorry I have to make this sketchy, my mother just had a stroke and I am a little scattered. I began this research back in '96 when I was diagnosed with fibromyalgia and then adapted that thread in my life for diabetes. The easiest thing is to google the condition or herb you want to figure out and look specifically for European sources/government studies. So, for instance, you would find that Germany and much of Scandinavia regularly prescribes hawthorne in support of other meds for various types of heart problems.
My favorite concise website for general, reliable info on herbs, as well as ordering, is right here in the lush Willamette Valley: Mountain Rose Herbs. Teas, Supplements, Supplies, history and interactions of everything they sell, plus links to reputable websites for research sources.
I'd be happy to answer any specific questions you have. And I'm wishing you well!.....Judith