The Southern Side of the Endocrine System: Pancreas Part II – A front porch chat about Type II Diabetes medications
One of the most frustrating (recurring) experiences in my pharmacy career is watching the slow motion “arson” crime scene that is Type II Diabetes, and not being able to carve out the time (within the crazy busy demands of a pharmacist’s job) to properly educate those who desired a way out. I loved my pharmacy clients, and it’s never pleasant watching the decline of someone you care about, especially when the decline was, in most cases, 100% preventable.
Here are a few facts to chew on:
Type II Diabetes is a lifestyle disease, yet many (dare I say most) clients did not alter their eating habits or increase exercise in an effort to change the outcome of their diagnosis. Perhaps they just didn’t know…. or didn’t care. Either way, the evidence was in their grocery shopping carts as they picked up their prescriptions! Diabetic medications tend to give a false sense of security…. “If I just take my medication, I can still eat what I want.” It doesn’t work that way! …. While blood glucose may appear to stay marginally managed, insulin producing pancreatic cells continue to die off and free radicals are produced at a crazy rate causing even more inflammation…. THE VERY THING THAT ADDS GASOLINE TO THE DIABETES FIRE AND DESTRUCTION within the body.
Type II Diabetes is a multibillion dollar industry with the clear winners being Big Pharma and the Medical Industrial Complex….NOT the patient (despite this being a completely overcomeable disorder) . Type II diabetes is a $237 BILLION (and rising!) annual jackpot to these entities. Thinking about it a little differently…… it would be a huge loss financially to the industry if people actually recovered from their unwell ways and became healthy again.
Once someone gets started on the slippery slope of Type II diabetic medication use, it’s often very difficult to find a prescriber who will spend the time to help their patient backwalk out of Type II diabetes. Many doctors now work for corporations, and like pharmacists who do the same, they have daily quotas to meet. That means dialogue is typically limited to just a few minutes before the next patient/client must be seen. I suspect it is a rare conversation that a doctor says…. “You can reverse this now with some effort. Would you like to know how?” At least that would give the patient the opportunity to make a choice to alter their trajectory in a positive way, instead of believing they were on an unstoppable path of disease with no way out.
The side effects of blood glucose lowering medications are responsible for over 100,000 ER visits in the US per year (not counting the other visits related to diabetes aggravated cardiovascular disease, high blood pressure, kidney damage, vision problems, gastroparesis, strokes, neuropathy, foot ulcers, dementia, hard to treat infections, and more).
It’s not uncommon to have a conversation with a Type II diabetic where I hear something that goes like this: “I can’t afford to eat healthy or use any supplements outside of what my insurance will pay for.” While this may be their belief, it’s certainly not true. People diagnosed with diabetes spend (on average) $16,752.00 per year OUT OF POCKET for medical expenses, which is much much higher than modifying diet and lifestyle habits! Besides, can you put an actual price tag on health? I will always maintain that where there is a will, there’s a way!
While all of the medications commonly used in Type II Diabetes are prone to side effects, a little known fact is that many of them actually make the health situation of a diabetic worse instead of better.
Did that last point startle you? Let me explain.
Type II diabetes is a completely different beast than Type I. Type I is only treatable with injected insulin, while Type II has many oral medications which are typically used as a first line of treatment. If lifestyle changes and diet are not addressed in the process, there is a high likelihood that the ultimate result will be destruction of the beta cells of the pancreas and insulin will eventually be added.
Unlike Type I diabetes, with Type II, the pancreatic beta cells ARE churning out insulin like crazy….. at least in the early years of Type II. The cells are just not able to recognize and utilize it because their sensitivity has been deadened by chronic and caustic glucose overload. Typically, there are many “early years” in the story of the average Type II diabetic. If the pancreatic cells haven’t burned themselves out yet, there is a significant opportunity for full recovery. (Labwork would reveal if this is the case…. more on that later.)
Medications such as Metformin, Glyburide, Glipizide, Glimepiride, Rosiglitazone and Pioglitazone all carry the ability for causing deficiencies of coQ10, folate, vitamin B12, and significant damage to the gut microbiome. You hopefully know by now, that if the gut ain’t happy, the rest of the body is in for a rocky ride.
When those deficiencies gain speed, brain fog, depression, neuropathy, muscle cramping, liver damage, digestive issues, yeast infections, fatigue, high blood pressure, and increased risk for cardiovascular disease start showing up for the (not so fun) party. Each one of these symptoms is at risk for being medicated unless your favorite health professional has the wherewithal to get you on supplements to mediate those deficiency risks.
Additionally, these medications don’t just magically change sugar into something friendlier to the body. They instead turn the excess sugar into fat, making it harder to lose weight, padding the liver with fat (fatty liver disease), and contributing to inflammation along the way.
What if insulin shots have already entered into the picture? I have met Type II diabetic patients who have been able to reverse their need for insulin with diet, exercise, and close supervision of a trusted health professional, so it is most assuredly doable unless countless years have already gone by and it is determined by your (willing to help) health professional that too much damage has been done. Long term lantus (probably one of the most commonly used insulins in use today) carries an increased risk of cancer, and it does not play well with pre-existing kidney or liver disease. That’s interesting, because someone with Type II diabetes who has “graduated” to insulin will have already developed fatty liver disease and compromised kidneys because of the sugar load. This is akin to giving an arsonist a book of matches.
Injectables Byetta and Victoza do help improve insulin sensitivity, but at the risk of thyroid cancer (Victoza), GI issues, dizziness, hair loss, weakness, drug induced pancreatitis, kidney damage, gastroparesis, serious infections, anemia, and weight gain. The literature on this class of drugs states that these medications are to be used as an adjunct to diet modification and exercise and with those two will come weight loss. Unfortunately, that often gets lost in translation, and people instead gain weight instead of losing weight as they mentally give the medication the responsibility of doing the work while lifestyle habits remain unchanged.
Drugs such as Januvia, Janumet, and Onglyza are used to drop HbA1c (a 3 month panoramic view of blood sugar levels) by 1-2% of the current HbA1c. For example, if you have a high HbA1c of 8, this would suggest that these medications may drop your HbA1c to 7.84…. A whopping total of 0.16 points. A concerted effort to change diet and exercise habits would drop that number much lower AND wouldn’t give the added “gift” of an increased risk of pancreatic and thyroid cancers, pancreatitis, generalized inflammation, skin reactions, runny nose or congestion, upset stomach, or dangerous lack of urine production.
In December 2008, well known New England Journal of Medicine published what is now known as the “ACCORD” study, which showed that the more aggressive the attempt to control Type II Diabetes pharmacologically, the greater the risk of death to the Type II patient.
Is it worth the risk to manage Type II diabetes simply by taking a pill instead of addressing the root cause? I am in no way implying that anyone should cold turkey stop taking their medication. Heavens no! Diabetic meds are very serious medications and you’ll want to have a chat with your prescribing professional about what your personal desires are.
This is a tough topic, and it makes me uncomfortable addressing it, because I know that it may make many of you uncomfortable too. We can’t dance around this topic though, because the truth is what we need in health and wellcare….and after all, there IS good news!
Not every disease and dysfunction has a relatively simple and inexpensive repair process like Type II diabetes does. Diet, exercise, adequate nutritional supplementation when deficiencies are identified, and partnering with a knowledgeable professional or two to help you along the way will improve both your quality and quantity of life! I can just about guarantee that.
Next up? Tips and tricks to both avoid and shed the Type II diagnosis.