Use Lantus – Be Ready to Change in 2017

Sometimes I’m amazed at how oblivious some people in this world can be. Actually, I should say it really doesn’t amaze me given this is the world of diabetes, which is full of clueless opinions. I mention this after some conversations on the nature of the insulin market. Yes, people are beginning to wake up to the fact (yes, those damn pesky facts again), that insulins have become a commodity. This is particularly true with long-acting insulins, of which there are now 5, one being a biosimilar.

Lilly has the biosimilar, Basaglar,which is winning the war that counts: formulary position. Lantus, the current leader, isn’t just losing the war, it’s losing by a mile. Starting next year, when formulary changes go into full effect, Basaglar will become the long-acting insulin of choice. Not because it’s any better than Lantus — it isn’t. It’s the same as Lantus, only cheaper — which is exactly the point.

Still, many seem to believe there will be pushback from physicians. Why would they switch any patient from Lantus to Basaglar, especially when Lantus works so well? First, as much as I hate to state the obvious, it really won’t be left up to the physician. It will be the payor and formulary position that wins, not the opinion of the physician. Think about the discussion a physician would have with a Lantus-using patient after these formulary changes take place.

“Mr./Ms. Patient, you know I would like to keep you on Lantus. It’s been a great drug that has worked very well for you. Now I could keep you on Lantus, but there is a slight problem: your insurance company no longer covers Lantus. You can stay on Lantus, but I must warn you that it’s going to cost you where it hurts most: in your wallet. Your alternative is to go on this new insulin called Basaglar, which is basically the same as Lantus and is covered by your insurance.

Now I know what you’re thinking: should you trust this new insulin, is it really the same as Lantus? Let me assure you that you have nothing to worry about, for two reasons. First, according to all the studies I have read, Basaglar works just as well as Lantus. Second, Basaglar is not made by some no-name company you have never heard of; it’s made by Eli Lilly, a company with a long and distinguished history in diabetes.

Now I want to say that I am not happy about the changes made by your insurance company, although I am not surprised by their decision. So, the choice, as always, is up to you. You can stay on Lantus and pay more — likely a lot more. Or you can switch to Basaglar and pay what you were paying before. You tell me.

This type of discussion is about to happen in physician offices in 2017; likely sooner, as we’re pretty sure insurance companies have been informing patients about the upcoming changes in formulary. Changes which they will support so that the patient feels comfortable switching from a drug that works very well to one they have never heard of. In the end, patients will accept these changes, as at the end of the day this isn’t about whether Basaglar is as good as Lantus: this is about money. While there may be some who will pay a premium for Lantus, the majority will not.

Try Walking after Eating

If you have type 2 diabetes, walking can be very helpful for you as a way to lower your blood glucose level. When is the best time to go for a walk to gain the benefit of walking?

According to a recent study, a short walk after eating may help lower blood glucose levels more than exercising at other times of the day. A measurement of blood glucose called postprandial glycemia, which has been linked with heart disease risk, averaged 12 percent lower when study participants took a walk after eating, compared with those who exercised at other times. The largest drop in postprandial glycemia, 22 percent, was achieved by walking after dinner, the study authors found.

"If you have type 2 diabetes, there is a guideline to be active for at least 150 minutes a week," said study author Andrew Reynolds, a researcher at the University of Otago, in New Zealand. But, he added, "the benefits we observed due to physical activity after meals suggest that current guidelines should be amended to specify after-meal activity, particularly when meals contain a substantial amount of carbohydrates," he said. "Consider walking after you eat as part of your daily routine," he added.

However, one U.S. diabetes specialist offered a caveat on that advice. Exercise is indeed part of good management and care for those with type 2 diabetes, said Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City. But, he urged caution about the benefits of exercising right after meals.

Because heart disease is common among those with type 2 diabetes, "we need to be careful in encouraging exercise after a meal, as the demands on the heart increase with meals," he explained. "This is especially important in people with heart disease, as diversion of blood from the coronary or carotid arteries to the gut is not always best for these patients." The study findings were published Oct. 17 in the journal Diabetologia.

In the study, Reynolds and colleagues had 41 people with type 2 diabetes walk a total of 150 minutes a week. In the first phase of the study, participants walked for 30 minutes daily whenever they wanted. In the second phase, 30 days after the first phase, participants were told to take a 10-minute walk no later than five minutes after each meal. During both phases, blood glucose was monitored. Walking after meals lowered blood glucose levels more effectively among the participants, the study found.

Improvements in controlling blood glucose with exercise have been shown by many trials, Zonszein noted, but exercise and good lifestyle are often not enough. "In type 2 diabetes, a combination of good lifestyles and proper medications is important for successful outcomes," he said.

In a second study in the same issue of the journal, British researchers analyzed the findings of 23 studies on the relationship between physical activity and incidence of type 2 diabetes. In all, these studies included more than 1.2 million people. Among these participants, more than 82,000 developed type 2 diabetes, the researchers reported.

The researchers found that those who exercised at least 150 minutes a week had a 26 percent lower risk of developing type 2 diabetes. The results also suggested that exercising more than the recommended 150 minutes had even greater benefits in reducing the risk of diabetes, cutting it by more than half.

The British team was led by Andrea Smith, who's with the Health Behavior Research Center at University College London.

Many Sue Big Pharma Over Statins

As we are seeing, Americans are starting to wake up to the Cholesterol Myth and the Statin Drug scam, and those injured by these drugs are seeking damages in litigation at a very fast pace here in 2014, in spite of the mainstream media blackout due to intimidation from Big Pharma.

The $100 billion dollar cholesterol-lowering statin drug industry is under attack, as thousands of Americans are filing lawsuits against the manufacturers of cholesterol-lowering drugs such as Lipitor. Research continues to confirm just how dangerous these drugs are, with yet another study published recently linking increased statin drug use to type 2 diabetes.

Since the study was published by the American Diabetes Association, these known risks to cholesterol-lowering drugs can no longer be denied or defended, and the lawsuits are pouring in at a rapid pace. Most of the lawsuits at this point are from women who have suffered with diabetes as a result of taking cholesterol-lowering drugs, but lawsuits over breast cancer, Alzheimer’s, liver damage, and others may soon follow now that it is generally known how dangerous these drugs are.

This information regarding a tsunami of lawsuits against cholesterol drug manufacturers has yet to be widely published by the mainstream media, however. To find out the magnitude of the lawsuits being filed against statin drug manufacturers, we turn to law firms who are reaping the fruit of litigation against Big Pharma.

According to statistics supplied by various law firms, there were 464 claims filed against Lipitor as of April 15, 2014, which increased to 703 by May 15, and then to 846 by June 16. By mid-July 2014, over 959 claims have been filed for damages due to Lipitor alone, and that increased in August to 1162. There are also many claims currently filed against Crestor, the next nearest competitor to Lipitor, and undoubtedly other similar drugs now sold under generic labels. These lawsuits now number well over 1,200, and are increasing at a rapid pace.

Lipitor is by far the most profitable drug in the history of mankind among all pharmaceutical products, let alone being the most profitable cholesterol drug before its patent expired at the end of 2011. Sales to date from this one particular cholesterol-lowering statin drug have exceeded $140 billion.

Lipitor benefited from the change in marketing laws in 1997 that allowed pharmaceutical companies in the U.S. to advertise their products directly to consumers. Pfizer convinced an entire generation of Americans that they needed a pill to lower their cholesterol in order to prevent heart disease, in what will go down as one of the most brilliant and unethical marketing schemes of all time.

After Lipitor’s patent expired at the end of 2011, the FDA issued its first warnings against statin drugs, which includes: liver injury, memory loss, diabetes, and muscle damage. Soon after issuing these warnings, the lawsuits started trickling in. Today, with more and more studies being published linking statin drug use to various side effects, those lawsuits have become a tidal wave, even though you are not likely to hear about this in the mainstream media.

Big Pharma fights back – they do not want you to know cholesterol drugs are worthless and dangerous. As is often the case when learning about the criminal activities of Big Pharma, much of the research is conducted outside of the U.S. The above referenced study published recently by the American Diabetes Association, for example, was conducted in Italy.

Since the patent on Lipitor has expired, pharmaceutical companies have been searching for the next big blockbuster cholesterol drug to bring in profits as Lipitor did. One of these newer cholesterol-lowering drugs is U.S.-made Zetia by Merck. Alberto Donzelli, head of education, appropriateness, and evidence-based medicine at Milan’s public health authority in Italy, has issued warnings about the dangers of this drug, and advised doctors in Italy not to prescribe it. Merck responded with two cease-and-desist orders and the threat of suing Donzelli. Donzelli backed down, but Merck has received a lot of public pressure in Europe since the story was picked up by the British Medical Journal. It was also reported in the Wall Street Journal here in the U.S. When doctors and medical professionals oppose Big Pharma, they put their careers and sometimes their lives on the line.

The fact that cholesterol is not responsible for heart disease, and that cholesterol-lowering drugs provide no statistical advantages to prolonging life by reducing heart attacks, has been widely reported for many years now by those of us in the alternative health media. One mainstream media source in Australia, however, decided to air a documentary on the Cholesterol Myth and “Cholesterol Drug Wars”. The show featured Dr. Mary Anne Demasi and interviewed several doctors and health officials who dared to tell the truth regarding the cholesterol drug scam. It was broadcast by ABC Australia in late 2013, under vigorous protests from the pharmaceutical industry. The videos were eventually removed from their website, and the network issued a statement retracting their endorsement of the show.

Please read the full article here, as there is much more that is revealed about the actions of Big Pharma.

Diabetes, Reading Food Labels – Part 2

Nutrients - "% Daily Value" shows how much a serving of that food gives you for each key nutrient listed. These daily goals are set by the government, based on current nutrition recommendations. The percentages are based on a 2,000-calorie/day diet, which would be right for an average- or large-size man who gets little exercise. Women or seniors with diabetes, or people trying to lose weight, need fewer calories.

If your daily calorie intake isn't 2,000, you may need to do a little math. Some nutrient goals change with the number of daily calories. Some, including sodium and calcium, are based on things like your age, sex, or health, not the number of calories you eat. Talk to your doctor or your diabetes educator about how to adjust the % Daily Values on labels for your diet.

In general, when it comes to fat, saturated fat, cholesterol, and sodium, choose foods with a low % Daily Value. For total carbohydrates, dietary fiber, and vitamins and minerals, try to reach your daily target for each nutrient.

Ingredients - Every product should list all the ingredients in it. They're in order from the largest to smallest amount, by weight. This means a food is made up of the heaviest amount of the first ingredient and the least amount of the last ingredient.

Label Claims - Some food labels make claims such as "low cholesterol" or "low fat." A manufacturer can only use these words if a food meets strict government definitions:

LABEL CLAIM	DEFINITION (per standard serving size)
Fat-free* or sugar-free	Less than 0.5 gram (g) of fat or sugar
Low fat	3 g of fat or less
Reduced fat or reduced sugar	At least 25% less fat or sugar than the regular product.
Cholesterol free	Less than 2 milligrams (mg) cholesterol and 2 g or less of saturated fat
Reduced cholesterol	At least 25% less cholesterol and 2 g or less of saturated fat
Calorie free	Less than 5 calories
Low calorie	40 calories or less
Light or lite	1/3 fewer calories or 50% less fat

Other important terms found on food labels have to do with the amount of salt or sodium. Remember that 1 teaspoon has 2,000 mg.

LABEL CLAIM	DEFINITION
Sodium-free or salt-free	Less than 5 mg per serving
Very low sodium	35 mg or less of sodium per serving
Low sodium	140 mg or less of sodium per serving
Low sodium meal	140 mg or less of sodium per 3 1/2-ounce meal
Reduced or less sodium	At least 25% less sodium than the regular version
Light in sodium	50% less sodium than the regular version
Unsalted or no salt added	No salt added to the product during processing

Part 2 of 2 parts

Diabetes, Reading Food Labels – Part 1

In addition to understanding labels, be sure to read the 'Nutrients' section. This section can hide some nutritional surprises occasionally that will make you avoid the food.

Food labels can help you make better decisions about what you eat and how you manage your diabetes. While I know many people do not believe this because of the number of carbs they consume, this is truer than many are willing to admit.

Just about every packaged food made in the U.S. has a "Nutrition Facts" label that gives a serving size and other nutritional information. It has measurements of fat, cholesterol, sodium, carbohydrates, protein, vitamins, and minerals for a typical amount of that food. This information can make it easier for you to choose foods that will fit into your meal plan and help control your blood sugar, cholesterol, blood pressure, and weight.

Here's an example of a Nutrition Facts label. Find out more about its parts below.

Serving Size - A serving size is a standard measurement based on the amount of food people typically have at one time. The size of the serving determines the amounts listed on the label. It helps you figure how many calories and nutrients are in your food on your plate.

Pay attention to that serving size, including the number of servings in the package, and compare it to how much you're actually eating. Don't confuse portion size with serving size. A portion is what you choose to eat -- and there are no standard measures for this.

For example, if a slice of bread is a serving size and you eat a sandwich with two slices of bread, you've had two servings of bread in your one portion, so you'll have to double all the nutritional numbers like calories and carbs. If a package has four servings and you eat the whole thing (like a bag of crunchy snacks), you get 4 times the calories, fat, and everything else listed on the label.

Calories and Calories From Fat - Calories measure energy, so this number tells you how much energy you get from one serving. (Remember, you'll need to adjust this if your portion is different from the serving size on the label.) This part of the label also tells you how much of that energy comes from the fat in a serving.

Part 1 of 2 parts