ADA news: Byetta gets better

Byetta will soon be available as a once-weekly injection. The study presented revealed more weight loss and better improvement in hgb A1c compared to twice daily Byetta. The people who inititally took twice daily Byetta were switched over to the weekly dose and they also experienced further weight loss and further improvement with hemoglobin A1c. The weekly dose initially caused some itching and irritation at the injection site but this side effect goes away over time. There's no projected date for weekly yetta to be available.

Lessons from the American Diabetes Association

Three big studies announced results this year. Each was designed to determine if aggressive blood sugar control would reduce the risk of having a heart attack in people with type 2 diabetes. This is an important question since most people with T2DM will die of a heart attack or stroke at a younger age than people without diabetes. Aggressive control meant blood sugars under 100 mg/dl and hemoglobin A1c under 6.5%

The tightly controlled groups fared no better than the groups whose A1c was 7.5-8% for the frequency of heart attack, stroke or death from any cause. There was some indication that people who had diabetes for less than 7 years or who had healthy hearts to begin with were less likely to have a heart event if their A1c was under 7%

It was fairly evident that lower blood pressures and lower cholesterol definitely reduced risk of heart disease regardless of level of diabetes control. The results were so hot off the press the researchers did not have time to analyse if lower A1c helped to prevent or stop progression of eye, kidney and nerve damage.

More in the next few days.

headlines: Cinical Endocrinology News

I finally got a chance to look at the May 2008 issue of
Clinical Endocrinology News
Here are some interesting headlines:
Weight Loss After Bariatric Surgery Lowers Bone Density page 14
Yoga Not Found to Improve Bone Mineral Density page 17
Teens With Bedroom TV's Haver Poorer Diets, Are Less Active page 22
Please comment if you want more discussion on any of these articles.

American Diabetes Association Scientific Meeting

June 6-10 2008 in San Francisco, CA. I'll be there to learn the latest in diabetes care and related topics including prevention and management of complications. Eye disease, kidney disease, nerve damage and heart disease can run rampant in people with diabetes and I will do what I can to prevent, arrest and if possible reverse these complications. I will be posting my findings here soon.

diabetic neuropathy and benfotiamine

Your feet burn, tingle, itch and there's nothing you can see on your feet or shoes causing it. Sometimes it's a stbbing or shooting pain. This is the start of diabetic neuropathy , damage to nerves. The link leads you to the National Institutes of Health/National Medical Library and offers a more complete description of various forms of diabetic neuropathy .

There are many treatments for neuropathy; cheap generic medications, expensive brand medications, IV insulin and Anodyne therapy to name most of them. Most prescription medications have impressive side effect profiles although many patients will have no side effects and many others find the pain relief to be worth putting up with side effects. One treatment that gets little recognition is Benfotiamine, a nonprescription thiamine derivative effective in treating diabetic neuropathy. I can summarize all the research as follows: it's about as effective as any prescription medication with far fewer side effects and no interactions with other medications. It treats the actual cause of the neuropathy rather than simply treating symptoms. Benfotiamine 150 mg, 2 capsules twice daily can frequently reduce symptoms of neuropathy. The link will connect you to a retailer that also has all the research posted at his web site. I have no business relationship with this company.

Keep in mind that any treatment for neuropathy is only a treatment and not a cure.

Metabolic Activation Therapy

This treatment was first developed by Dr. Tom Aoki and has been available at his center in Sacramento CA since 1986. A number of people in Reno NV seemed to be appropriate candidates for this treatment but Sacramento was too far away for the weekly treatments. Endocrine Associates began offering this treatment in Reno March 2002. The results confirm the findings published on this therapy.

The most notable benefit is how kidney failure slows down. Some patients note that they can feel hypoglycemia more easily. Some note an improvement in neuropathy. Some have reported that their retinopathy (eye disease) has stabilized.

The treatment is a once-weekly, 6-hour process. An IV is started and a specially-programmed pump delivers pulses of insulin. The patients eat carbohydrates to prevent hypoglycemia. Finger stick blood sugars are tested every 30 minutes. Every hour a 2-3 minute breathing test is performed to see how well the person is using the carbohydrates (respiratory quotient).

This treatment does not replace insulin therapy but is in addition to multiple daily injections or insulin pump therapy.

For more details and a list of publications on metabolic activation therapy see the Aoki Diabetes Research Institute website. Information is also available at Metabolic Industries and Advanced Diabetes Treatment Centers. If you think you would benefit from MAT ask your physician for a referral to Endocrine Associates.

Basics of diabetes care and other endocrine conditions

Rather than repeating what has been published in print and on the internet I will provide links to web sites that I have found to be useful and reliable. I am starting off with a very short list and will be adding more as I can.

American Diabetes Association:
http://www.diabetes.org/

American Association of Clinical Endocrinologists:
http://www.aace.com/