Drugs and More Drugs
Diabetes presents a unique opportunity for diabetic drug therapies.
Diabetes is elevated blood glucose. That glucose comes from the food you eat.
A person has been eating so much carbohydrate for so long that they finally became diabetic.
Once they do, nobody ever tells them that they can stop eating carbohydrates completely.
The requirement for dietary carbohydrates in humans is ZERO. Not one gram ever.
You do not have to eat any carbohydrates. That’s right. NONE.
Your body can produce all of the carbohydrate it needs to function through a process called gluconeogenesis.
Because just saying that word is very hard, we don’t try to explain this.
Instead, we create a meal plan that recommends that diabetics eat more carbohydrates.
This is because when you have a disease that is defined by having elevated blood glucose, it just makes sense to eat even more glucose.
Does this make sense to you?
Again – probably way too complicated to explain to a patient with diabetes.
To help avoid discussions about food, we tell patients that the real problem is their body doesn’t make enough insulin or that it doesn’t use it properly.
Because it just makes sense that this suddenly happened to over 700 Million people worldwide, just like that!
Of course, way too complicated to dive into that, so we don’t even try.
Bring On The Drugs!
Whenever you are faced with complicated medical decisions, the best solution is to take a drug. Especially when you want to be Always Diabetic.
More drug money also equals more donations, more research, and a better chance of finding a cure. Or at least finding more drugs!
Drug Complications
If for some reason you aren’t happy with all of the complications that diabetes itself provides, drugs can add even more.
There are three outstanding possible points for pain.
- Reactions
- Side effects
- Risks
We asked Dr. Chat, GPT (Glucose Problem Therapist) and she defines them as follows:
Drug Reaction
A drug reaction, or adverse drug reaction, is a harmful or unintended response to a medication.
Side Effect
A side effect is a secondary, typically undesirable effect of a drug or medical treatment. Side effects occur along with the desired therapeutic effect of a drug. They can range from mild to severe and are usually predictable and often dose-dependent.
Risk
A risk refers to the potential for experiencing a negative outcome from a drug. This term is used especially in the context of the likelihood of occurrence of a serious adverse event or complication as a result of taking the medication.
We then asked Dr. Chat to please provide us with the reactions, side effects, and risks of each of the most commonly used type 2 diabetes medications.
1. Metformin
- Side Effects: Gastrointestinal issues such as nausea, vomiting, diarrhea, and abdominal pain are common. Some people may also experience a metallic taste.
- Reactions: Lactic acidosis is a rare but serious reaction, particularly in those with kidney impairment or conditions leading to hypoxia.
- Risks: Vitamin B12 deficiency with long-term use.
2. Sulfonylureas (e.g., glyburide, glipizide, glimepiride)
- Side Effects: Weight gain and hypoglycemia are the most common side effects.
- Reactions: Severe hypoglycemia, especially if meals are skipped or with excessive alcohol intake.
- Risks: May not be effective long-term as beta-cell function declines.
3. Thiazolidinediones (e.g., pioglitazone, rosiglitazone)
- Side Effects: Weight gain, fluid retention, and increased risk of bone fractures.
- Reactions: Can exacerbate heart failure in susceptible individuals.
- Risks: Long-term use has been linked with an increased risk of bladder cancer (pioglitazone) and cardiovascular events (rosiglitazone)
4. DPP-4 Inhibitors (e.g., sitagliptin, saxagliptin, linagliptin)
- Side Effects: Generally well tolerated, but some may experience joint pain, and nausea.
- Reactions: Rare cases of pancreatitis.
- Risks: Potential increased risk of heart failure with some drugs in this class (e.g., saxagliptin).
5. GLP-1 Receptor Agonists (e.g., liraglutide, exenatide, dulaglutide)
- Side Effects: Nausea, vomiting, diarrhea, and possible weight loss.
- Reactions: Rare cases of pancreatitis; thyroid tumors have been observed in animal studies.
- Risks: Need for injection, which could be a barrier for some patients; potential medullary thyroid carcinoma.
6. SGLT2 Inhibitors (e.g., canagliflozin, dapagliflozin, empagliflozin)
- Side Effects: Genital infections, urinary tract infections, and increased urination.
- Reactions: Ketoacidosis, even in cases where blood sugar isn’t very high.
- Risks: Lower limb amputation risk (particularly with canagliflozin); rare cases of Fournier’s gangrene.
7. Alpha-Glucosidase Inhibitors (e.g., acarbose, miglitol)
- Side Effects: Gastrointestinal effects such as flatulence, diarrhea, and abdominal pain.
- Reactions: Hypoglycemia when combined with other glucose-lowering drugs.
- Risks: Limited efficacy and gastrointestinal side effects may limit use.
8. Meglitinides (e.g., repaglinide, nateglinide)
- Side Effects: Similar to sulfonylureas, primarily hypoglycemia and weight gain.
- Reactions: Hypoglycemia risk is particularly notable due to the short action of the drug.
- Risks: Less data on long-term cardiovascular outcomes compared to other drugs.
How These Drugs Operate
According to Dr. Chat, all of these drugs are designed to manage elevated blood sugar levels in individuals with type 2 diabetes. Each class of drugs works through different mechanisms to achieve this goal:
- Metformin reduces glucose production in the liver, increases insulin sensitivity, and enhances glucose uptake by muscles.
- Sulfonylureas stimulate the pancreas to produce more insulin.
- Thiazolidinediones improve insulin sensitivity and also reduce glucose production in the liver.
- DPP-4 Inhibitors work by prolonging the action of incretin hormones, which increase insulin release in response to meals and decrease the amount of glucose produced by the liver.
- GLP-1 Receptor Agonists mimic the incretin hormones that the body usually produces after a meal to enhance insulin production and lower glucagon secretion.
- SGLT2 Inhibitors prevent the kidneys from reabsorbing glucose back into the blood, promoting the excretion of glucose through urine.
- Alpha-Glucosidase Inhibitors slow the breakdown of starches in the gut, delaying the absorption of glucose into the bloodstream.
- Meglitinides stimulate insulin secretion from the pancreas but are faster acting and have a shorter duration of action compared to sulfonylureas.
Each drug aims to lower blood sugar levels to a safe range, thereby helping to prevent or manage complications associated with high blood sugar, such as nerve damage, kidney disease, and cardiovascular problems
Conclusion
Diabetes is defined, diagnosed, and treated as elevated blood glucose. There is no requirement for humans to eat one single gram of carbohydrates. Stop adding it to your system by eating more of it.
This continuous elevated blood glucose is toxic and causes dozens of complications for everyone, especially diabetics.
Diabetes drugs are designed in one way or another to remove or reduce blood glucose. They come with a myriad of their own complications.
Remove the glucose yourself. Stop eating it.
Diabetes is not a disease. It is a poisoning.
The dose makes the poison, and you’ve exceeded your dose.