April 6, 2013

Another Reason to Consider Insulin

Outside of one type 2 diabetes oral medication, I am happier than even to be on insulin and not oral medications. More of them are showing nasty side effects and creating other potential health problems. Sulfonylureas are suspected of causing heart problems. Avandia has been pulled from the market and Actos is a problem for bladder cancer. Thiazolidinediones (glitazones) is their class of oral medications. Now the oral class of DPP-4 inhibitors or Januvia is on the block for being a cause of irregular growth of cells in the pancreas. These may cause cancerous tumors.  Even if I have thought good about Byetta, this is also now an injection to be cautious about.

This leaves only three classes of oral medication, plus a new class just approved, but with much more testing required by the FDA. Janssen Pharmaceutical’s new type 2 diabetes treatment, Invokana (canagliflozin); Invokana is the first in a new class of medications called sodium glucose co-transporter 2 (SGLT2) inhibitors to be approved in the United States. There are several types of trials required before all restrictions are lifted. From my reading, I would be very hesitant to consider the new oral medication. Others agree and have expressed this as well.

The three classes presently considered safe, but causing minimal concerns include Biguanides (Metformin), Alpha-glucosidase inhibitors (Glyset, Precose), and Glitinides (Meglitinides) (Prandin).

Never stop taking any medication you are taking; however, it would be wise to talk with your doctor and see if a change needs to be made. Do not forget to investigate insulin as there are very few side effects and what you need to be concerned about is hypoglycemia. The informal group is happy that so many of us are on insulin and the three on oral medications are asking many questions about insulin now. We have suggested that since two are on metformin and one is on a sulfonylurea that they now get too upset. We are talking to them about insulin however.

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