Invokana is the newest diabetes drug to hit the market and uses an innovative mechanism to help control blood sugar for type 2 diabetes. Invokana, produced by Janssen Pharmaceuticals, will make a splash in the market as this is the first drug of its kind.
The statistic for this drug that I’m most interested in is the reduction in A1C percentage. Hemoglobin A1C is the percent of glucose that is bound to red blood cells. It also gives a three-month big picture of the patient’s control of their blood sugar. The higher the number the higher the person’s daily blood sugars will be; the goal is to be under seven percent. Trials have shown that Invokana has lowered A1C percent by approximately 1 percent over 26 weeks with a 300 mg dose and a 0.77 percent decrease with a 100 mg dosage. A one-percent reduction is approximately a decrease of 14 points on an average daily blood glucose reading. Lower blood sugars overall will prevent complications which can include blindness, renal failure and amputations.
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Last year I participated in the Saratoga Springs Tour de Cure, an annual bike ride that is held nationwide to raise money for the American Diabetes Association. One of the most inspiring things about the Tour are the Red Riders, individuals who live and ride with diabetes. To better explain what the Red Rider program is and about her own aspirations, I had the pleasure of interviewing the founder of the Red Rider program, Mari Ruddy!
She runs the daily business and management of TeamWILD, a program that teaches adults how to live with diabetes through exercise. She also coaches and speaks at ADA Tour de Cure rides. Mari’s working on a book that will no doubt highlight the success of the Red Riders, the health battles she’s personally fought and won, and offer guidance and insight for diabetics to truly live.
Tell me about the Red Rider program.
I’m the founder of the Red Riders, who are cyclists with diabetes. I also started the first Team Red. Now all 90 Tour de Cure rides have Red Riders and a Team Red. The first year there were 111 Red Riders. This summer, 2013, there will be [more than] 7,000 Red Riders in the US. In 2012, all the Red Riders together raised $3.9 million. The goal in 2013 is [for] the Red Riders [to] collectively raise $4.5 million. The Tour itself raised more than $26 million in 2012. These numbers are very exciting.
How much money does “your” Tour raise?
My “home” Tour for the past seven years was the one in Colorado. Now that I’ve moved back to my home state, I consider the Tour de Cure Twin Cities in Minnesota my home ride! We intend to raise $1 million this year at the Minnesota Tour.
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When I was told that there could be another type of diabetes all I could do was cringe. With the rate at which diagnosis of type 2 is rising, adding one more type to mix is an overwhelming thought.
Type 3 diabetes was first discovered in 2005. A study from Brown University has linked that eating too much sugar has an effect on brain function. Insulin resistance means that circulating insulin is not being used the way it should to get glucose into cells. If the brain does not receive the energy and nourishment it needs, it begins to deteriorate, and those deteriorating brain cells can result in confusion and memory loss. Over the long term, more permanent memory loss could progress to Alzheimer’s disease.
The nutrition recommendations to help prevent type 3 diabetes are the same as they are for type 2, which include eating sugar in moderation, managing your weight, and eating smaller portion sizes. More studies will need to be conducted to confirm that type 3 diabetes is a separate form of diabetes versus a complication of type 2 diabetes.
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Lorcaserin was approved by the FDA on June 27 and will be sold as the brand name Belviq. Produced by Arena Pharmaceuticals out of San Diego, California, it is indicated for the treatment of obesity in addition to a reduced-calorie diet and exercise. Upon that approval news, I was quoted in an article on SheKnows.com saying “This is a sad attempt by the FDA to thwart the obesity epidemic,” and I stand by my comment.
I also mentioned in that statement that we need a plan to solve the problem, so here goes.
A Vision for Ending Obesity
I just read this fantastic book by Dr. Francine Kaufman called Diabesity: The obesity-diabetes epidemic that threatens America– and what we must do to stop it. This women is an inspiration to females in the medical profession like myself and to diabetics all over the world. She’s specializes in pediatric endocrinology, which is the treatment of children with hormone conditions, particularly diabetes. What she’s found in her years of practice is a growing trend of youth developing type 2 diabetes. This was once previously called adult onset diabetes, but this is now not the case. The vast over-consumption of food beyond what our bodies actually need to function and the sedentary lifestyles that we now lead has caused our children to develop this devastating illness. I feel this is why the FDA is approving diet drugs when initially they were rejected due to side effect concerns.
The cost of medical care for diabetics is astronomical and with people developing it at earlier ages this will only exacerbate the problem. Part of the Affordable Health Care Act is a $13 billion fund with a committee developed to focus on prevention of diseases. This is where medical practice needs to move toward prevention and away from treatment.
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There are mixed reviews about the recent approval of lorcaserin (Belviq) and its new availability as a prescription weight loss drug. Obesity has become an epidemic in the United States and across the world and the maker of lorcaserin, Arena Pharmaceuticals, will market this drug as a supplement to drug and exercise to help patients reach their weight loss goals faster. Every drug has side effects and I felt it was important to look closer at some of the possible reactions.
Lorcaserin activates the serotonin 2C receptor which helps you eat less and feel full sooner. Previous weight loss drugs activated the 2B receptor and caused damage to heart valves. Cardiovascular health will be monitored once this hits the market to ensure no damage to the heart valves occur, as there were concerns about this in trials. In October 2010, lorcaserin was rejected by the FDA due to a cancer signal being detected. It caused mammary tumors in rats, which the makers believe is related to the animal themselves and should not have the same effect in human subjects (although prolactin levels can become increased in humans leading to breast development in men and lactation in women).
Multiple studies had patients with and without diabetes treated long term for one to two years with nearly 8,000 patients participating. Those who were randomized with lorcaserin along with diet and exercise counseling lost 3 to to 3.7 percent more weight. The drug should be discontinued if the patient does not lose at least five percent of their body weight in the first twelve weeks.
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