Diabetes drug side effects are also a classic case of what happens when doctors focus on changing the numbers (e.g., glucose, insulin) without paying attention to the big picture. Over and over again, diabetes drug studies show that while the drug controls the numbers, the patients taking it have an increased risk of heart disease and death, and those who survive tend to have a poor quality of life. Controlling diabetes numbers in a patient who continues to eat poorly and not exercise is an exercise in futility and failing health.
Giving a prediabetic patient drugs without directly helping him or her make lifestyle changes should be considered malpractice. Any physician or health organization that doesn’t vigorously, consistently, and insistently work with a diabetic patient to lose weight (without weight loss drugs, preferably), eat healthy foods, and exercise is not in the business of healing—they are in the business of pushing drugs. Diabetes drugs should never, ever be a substitute for a healthy lifestyle.
Are Prescription Drugs Causing Your Low Blood Sugar?
If you are diabetic or your blood sugar is unstable, and you are suffering from hypoglycemia or hyperglycemia, you should be aware of those substances that can lower your blood sugar:
But the truth is, in the end it’s up to you. Your physician and health care organization have many patients and limited time, and they can’t force you to do anything. Only you can make the changes necessary to avoid the lifetime of ill health created by diabetes. If you get on diabetes drugs and stay on them without addressing the underlying causes of the diabetes, the disease will inevitably progress, with its serious side effects. The only way to avoid the progression of diabetes is to bring the body back into balance.
In countries where people eat a diet low in fat and sugar and high in whole foods such as unrefined grains and fresh fruits and vegetables, diabetes is almost nonexistent. When people from these countries move to the United States, their diabetes risk skyrockets. Tragically, as “nutrition-free” Western processed and fast foods are introduced to third-world countries, their rates of diabetes are rapidly rising.
The government’s Agency for Healthcare Research and Quality (AHRQ) estimates that if Americans don’t change their ways, roughly 86 percent of those ages 18 and older may be overweight or obese by 2030. The cost of caring for this sickly population will approach a trillion dollars annually, or one out of every six health care dollars.
CAUTION!
If you have diabetes, notify your physician if any of the following occurs:
• Hyperglycemia: excessive thirst or urination
• Hypoglycemia: fatigue, excessive hunger, profuse sweating, or numbness in the extremities
• Miscellaneous: fever, sore throat, rash, or unusual bruising or bleeding
• Severe stomach pain
Diabetes Drugs
Examples of Alpha-Glucosidase Inhibitors
Acarbose (Precose)
Miglitol (Glyset)
This is a relatively new type of diabetes drug that works by blocking enzymes that normally break down carbohydrates. This drug can cause unpleasant stomach and digestive problems such as cramps, gas, and diarrhea, and can make existing intestinal problems worse.
What Does It Do in Your Body? Slows the digestion of carbohydrates in the small intestine, which reduces the amount of glucose (sugar) that is released into the blood after eating.
What Is It Prescribed For? Lowering blood sugar levels. This drug is intended to be supplemental therapy to diet and exercise.
What Are the Possible Side Effects? The most common side effects occur in the digestive system, including abdominal pain, diarrhea, and gas.
These drugs can impair kidney function and have caused cancerous kidney tumors in rats. They can cause hypoglycemia, or low blood sugar levels, so if you’re taking it, be sure to have a readily available source of dextrose on hand to counteract hypoglycemia.
CAUTION!
Think Twice About Taking This Drug If . . .
• You have kidney problems of any kind.
• You have serious intestinal problems.
• You are exposed to stress such as fever, trauma, infection, or surgery.
What Are the Interactions with Food? Take this drug orally with the first bite of your main meal.
What Nutrients Does It Throw out of Balance or Interact With? Vitamin B12.
What Else to Take If You Take This Drug. A supplement of vitamin B12, sublingually.
Examples of Insulin
Insulin injection (Insulin, Humulin R)
Insulin injection, concentrated (Concentrated Regular)
Insulin zinc suspension, extended ultralente (Humulin U Ultralente)
Insulin zinc suspension, lente (Humulin L)
Isophane insulin suspension and insulin injection (Humulin 70/30, Humulin 50/50)
Isophane insulin suspension NPH (Novolin N)
Insulin glargine (Lantus)
Insulin aspartate (Novolog, Novolog Mix 70/30)
Adult-onset diabetes is usually a disease of excess sugar in the bloodstream and an impaired ability to use the hormone insulin to carry the sugar out of the blood and into the cells. In rare cases, it may be caused by the inability of the pancreas to make insulin. At one time, insulin was thought to be the savior of diabetics: simply inject it into the body to replace what isn’t there. But diabetes is always more complicated than a pancreas that doesn’t make insulin.
Most people with type 2 diabetes actually make plenty of insulin but have insulin resistance, a condition where their cells are resistant to using it. But the pancreas keeps getting the message that there isn’t enough insulin and keeps producing it. Excess insulin causes its own problems, including high blood pressure and poor cholesterol levels (low HDL and high LDL), increasing the risk of complications as the disease progresses. This is why it is so important that even insulin-dependent diabetics reduce their need for insulin as much as possible through good management of blood sugar levels using diet, supplements, and exercise.
What Does It Do in the Body? Insulin is taken to replace the insulin that should be produced by the pancreas but is not produced at all or is not produced sufficiently. Insulin regulates blood sugar levels in the body.
What Is It Prescribed For? People who cannot survive without prescribed insulin for blood sugar regulation, which is mostly type 1 diabetics.
What Are the Possible Side Effects? Allergic reactions such as rashes, shortness of breath, fast pulse, sweating, a drop in blood pressure resulting in dizziness or light-headedness, as well as insulin shock.
If insulin is injected, redness, swelling, and itching at the site can occur. Open sores at the site of injection can occur. Also, if injections happen at the same site several times, fat may accumulate at the site and inhibit insulin absorption.
CAUTION!
Think Twice About Taking This Drug If . . .
You have an insulin resistance or allergy. There is almost never a reason to prescribe insulin to a type 2 diabetic. Be sure your physician has a good reason if this is the case.
What Are the Interactions with Food? Coffee decreases the amount of insulin and length of time it is in your system.
What Nutrients Does It Throw out of Balance or Interact With? Blood sugar, vitamin B12.
What Else to Take If You Take This Drug. Supplement of sublingual vitamin B12.
Examples of Sulfonylurea Drugs
Acetohexamide (Dymelor)
Chlorpropamide (Diabinese)
Glimepiride (Amaryl)
Glipizide (Glucotrol)
Glyburide (Micronase, Glynase PresTab, DiaBeta)
Tolazamide (Tolinase)
Tolbutamide (Orinase)
These oral drugs (taken by mouth) lower the amount of sugar in the bloodstream by stimulating the pancreas to make more insulin. They decrease the liver’s production of glucose, a simple sugar, and they make cells more sensitive to insulin, improving the uptake of insulin and sugar for energy. The downside of these drugs is that they increas
e the risk of dying of heart disease, one of the most common side effects of diabetes, and they tend to cause weight gain, one of the causes of diabetes! They can also cause hypoglycemia (low blood sugar) by removing too much sugar.
Less serious but frequent side effects are digestive upsets such as nausea, vomiting, heartburn, gas, diarrhea, and constipation.
What Do They Do in the Body? Lower blood glucose.
What Are They Prescribed For? Non-insulin-dependent diabetes mellitus (also called adult-onset or maturity-onset diabetes, ketosis-resistant diabetes, and type 2 diabetes). In addition, they are sometimes prescribed as temporary adjuncts to insulin therapy to improve diabetic control.
What Are the Possible Side Effects? Digestive-system reactions are common. They include nausea, heartburn, and diarrhea. These drugs can suppress the immune system and cause anemia, liver and kidney impairment, and jaundice.
The effectiveness of these drugs decreases over time, eventually resulting in a complete failure of the drug to control glucose—yet another reason to control your blood sugar with diet, exercise, and supplements!
Flushing of the face when taken with alcohol may occur, as can water retention—particularly if you have congestive heart failure or liver cirrhosis. These drugs can also cause weakness, ringing in the ears, fatigue, dizziness, and headache.
CAUTION!
Think Twice About Taking These Drugs If . . .
• You have diabetes complicated with a high count of ketones.
• You are diabetic and pregnant.
• You have heart problems. Diabetic patients using this drug were two-and-a-half times more likely to die from cardiovascular problems.
• You have liver or kidney problems.
• You are elderly, debilitated, or malnourished.
• Your adrenal or pituitary glands are not operating sufficiently.
What Are the Interactions with Food? Food delays absorption of these drugs by about 40 minutes. These drugs are more effective if you take them 30 minutes before eating food.
Do not drink alcohol with these drugs—particularly chlorpropamide and tolbutamide. Symptoms of this interaction can be dizziness, weakness, mental confusion, collapse, and coma.
What Nutrients Do They Throw out of Balance or Interact With? These drugs lower levels of vitamin B12.
What Else to Take If You Take These Drugs. Sublingual vitamin B12.
Miscellaneous Diabetes Drugs
Metformin (Glucophage)
Metformin is an oral diabetes drug that lowers blood sugar by suppressing glucose production in the liver and increasing the sensitivity of cells to insulin. Unlike the sulfonylurea drugs, it does not stimulate the production of insulin, so there is less chance of hypoglycemia, and it tends to cause weight loss, not weight gain. Like all of the oral diabetes drugs, digestive discomfort is a common side effect. It can also impair kidney and liver function and shouldn’t be used by people who use alcohol excessively.
What Does It Do in the Body? It decreases liver glucose (sugar) production, decreases intestinal absorption of glucose, and increases uptake and use of glucose.
What Is It Prescribed For? To lower blood glucose levels in patients with non-insulin- dependent diabetes.
What Are the Possible Side Effects? Low blood sugar if you don’t eat enough calories, if you exercise strenuously and don’t supplement with additional caloric intake, if you drink alcohol, or if you take another glucose-lowering drug with metformin.
Digestive problems can occur with this drug, including diarrhea, nausea, vomiting, abdominal bloating, gas, and loss of appetite.
Lactic acidosis is a rare but serious metabolic complication where too much of the drug accumulates in the body. It is fatal in 50 percent of the cases. It usually happens in people with kidney impairment.
This drug can increase your chances of dying from cardiovascular problems by two and a half times.
CAUTION!
Think Twice About Taking This Drug If . . .
• You have kidney disease or dysfunction.
• You have cardiovascular problems.
• You have inadequate vitamin B12 or calcium intake.
What Nutrients Does It Throw out of Balance or Interact With? Vitamin B12.
What Else to Take If You Take This Drug. Sublingual vitamin B12.
Rosiglitazone maleate (Avandia)
Pioglitazone HCl (Actos)
These drugs were approved in 1999. Both belong to a class of antidiabetes drugs called thiazolidinediones and are usually taken with sulfonylureas, insulin, or metformin. They can also be used without other diabetes drugs.
What Do They Do in the Body? They lower blood glucose by increasing insulin sensitivity. They decrease the production of sugars by the liver and enhance the action of insulin, helping it move more glucose out of the bloodstream and into the cells. They do not increase insulin secretion from the pancreas.
What Are They Prescribed For? The treatment of type 2 diabetes.
What Are the Possible Side Effects? In May 2007, the New England Journal of Medicine reported that an analysis of dozens of studies on Avandia (Avandamet or Avandaryl when mixed with other diabetes drugs) showed that taking the drug significantly increased the risk of heart attack and death. Around the same time, the FDA issued a “safety alert” based on the same research. In December 2007, the Journal of the American Medical Association released the results of a large study showing that older patients treated with thiazolidinediones (Avandia and Actos) had a 60 percent increased risk of congestive heart failure, a 40 percent increased risk of heart attack, and a 29 percent increased risk of death. Those are huge increased risks! Finally, in February 2008, the FDA issued a black-box warning about the risks of using these drugs, but still didn’t remove them from the market.
This is a classic case where a drug effectively changes the numbers, lowering insulin and glucose levels, but has a good chance of killing the patient in the process—“the treatment worked, but the patient died.”
Here is an adapted excerpt from Avandia’s “Medication Guide”:
Avandia can cause serious side effects, including:
New or Worse Heart Failure
• Avandia can cause your body to keep extra fluid (fluid retention), which leads to swelling (edema) and weight gain. Extra body fluid can make some heart problems worse or lead to heart failure. Heart failure means your heart does not pump blood well enough.
• If you have severe heart failure, you cannot start on Avandia.
• If you have heart failure with symptoms (such as shortness of breath or swelling), even if these symptoms are not severe, Avandia may not be right for you.
Other side effects of Avandia may include edema (fluid retention), breathing problems, weight gain, fatigue, and other types of heart problems.
The FDA has issued a warning that older women who take Avandia or Actos are at a significantly higher risk of fracturing a bone.
Other side effects of these drugs can include accidental injury, anemia, back pain, diarrhea, edema, weight gain caused by edema, macular (eye) edema, fractures, fatigue, high blood sugar, low blood sugar (rosiglitazone), aggravated diabetes, muscle pain, throat irritation, tooth disorders (pioglitazone), headache, sinusitis, and upper respiratory tract infection (rosiglitazone and pioglitazone).
CAUTION!
Think Twice About Taking These Drugs If . . .
• You have liver disease. These drugs are similar to troglitazone (Rezulin), the diabetes drug that caused multiple cases of liver failure and was pulled from the market.
• You are premenopausal and have not been ovulating. These drugs, when given to women who are insulin resistant, can cause ovulation to resume, and pregnancy can result.
Ultimately, given all of these hazards, we’re not sure why a physician would prescribe these drugs at all.
Exenatide (Byetta)
Byetta is a fairly new injectable diabetes drug that has the potential to take the place of insulin for
type 2 diabetics because it doesn’t tend to lower blood sugar excessively the way insulin can and because it promotes weight loss in most people who take it. Is it a magic bullet? No such luck. Side effects are listed later in this section, and remember, drugs tend to look a lot better in the first few years they are released, because long-term side effects haven’t yet emerged. This may turn out to be a useful drug, but at this time you should consider yourself a guinea pig if you’re taking it.
What Does It Do in the Body? It behaves much like human glucagon-like peptide-1 (GLP-1), which plays a role in regulating glucose metabolism and insulin secretion by stimulating insulin secretion in the pancreas and lowering blood glucose. It also suppresses the release of glucagon, which blocks the liver’s ability to convert fat to sugar and can also reduce liver fat content.
What Is It Prescribed For? Byetta is prescribed for the treatment of type 2 diabetes, usually in combination with other drugs such as metformin.
What Are the Possible Side Effects? Here’s the bad news: after Byetta had been on the market about three years, the FDA began to get reports of sudden and severe pancreatitis in patients taking it, resulting in serious illness and a handful of deaths. Severe abdominal pain and vomiting can be symptoms of acute pancreatitis.
In rodent testing, Byetta appeared to be associated with benign tumors of the thyroid.
This drug may make kidney disease worse.
This drug is not recommended for people with gastrointestinal disease. In the drug trials, 57 percent of those taking it experienced nausea, 17 percent experienced vomiting, and 8.5 percent experienced diarrhea. Those are extremely high percentages. Reportedly these side effects improve over time. Other side effects can include rash, flatulence, loss of appetite, sour stomach, belching, heartburn, indigestion, dizziness, headache, and feeling jittery. Patients taking Byetta had more episodes of hypoglycemia than those taking metformin or a sulfonylurea drug.
Prescription Alternatives Page 44