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Diabetes Medications

Diabetes Medications

Oral diabetes medications -- diabetes pills -- help to artificially control blood sugar levels in people whose bodies still produce some insulin (the majority of people with type 2 diabetes).

These diabetes drugs are usually prescribed to people with type 2 diabetes along with recommendations for making specific dietary changes and getting regular exercise.
However, most people do not make the dietary changes! And, for the people who do make the dietary changes, the drugs cancel out the benefits of eating healthy!
Most diabetics believe that the drugs are working because they lower their blood sugar levels. That's where the confusion and misunderstanding about these drugs occur.  We all agree that these drugs lower the blood sugar, but the diabetic pays a huge price due to the long term side effects caused by these drugs and the ongoing damage being caused by the diabetes.

Diabetes pills work in one of three ways:
1. Stimulate the pancreas to release more insulin (causing you to gain weight)
2. Increase the body's sensitivity to the insulin that is already present (but causes damage to the liver/kidneys)
3. Slow the breakdown of foods (especially starches) into glucose (but doesn't really work that well).
Key Point: But, the diabetic pills do absolutely nothing to stop the progression of the diabetes! 100% of all diabetics who continue to take diabetic pills eventually end up on insulin -- unless they die first.
Note: According to a panel of doctors, metformin is insurance for people who aren't following their diet and exercise plan. The message to insulin-resistant America from their doctors: "We don't think you're going to help yourself, so here, take this pill."

The Power of the Death to Diabetes Program:  In general, if you  follow the 10 steps of the Death to Diabetes Program, eat the 5 "super" foods, and avoid the 5 "dead" foods, then, within 3 to 9 months (depending on how long you've been diabetic, the number of drugs you're taking, and your age), your blood glucose level should be within the normal range (80-100 mg/dL) and your hemoglobin A1C should be close to the normal range (less than 6%) after 6 to 12 months. At some point, you may want to check your fast blood glucose level without taking the diabetic medication for a day or so. This will give you an indication of how close you are to the normal range without the drugs.

Why is this important? Because the diabetic medication keeps your body in a diabetic state!! The longer you take the drugs, the more dependent your body becomes on the drugs!!

Categories of Diabetes Pills:

Sulfonylureas: These diabetes pills lower blood sugar by stimulating the pancreas to release more insulin. The first drugs of this type that were developed -- Dymelor, Diabinese, Orinase and Tolinase -- are not as widely used since they tend to be less potent and shorter-acting drugs than the newer sulfonylureas.
Second generation sulfonylureas include Glucotrol (glipizide), as well as Micronase, Diabeta, and Glynase (all contain glyburide). 
A third generation called Amaryl (glimepiride) is also available.

Sulfonylureas work best when taken at the same time each day. Glyburide and glipizide are shorter-acting versions. Glyburide (Micronase and Diabeta), and Glipizide (Glucotrol) are usually taken twice a day, half before breakfast and half before dinner. Sustained-release versions called Glynase or Glucotrol XL are also available.

Glucotrol (Glipizide): Glucotrol controls diabetes by stimulating the pancreas to secrete more insulin. Treatment with Glucotrol may increase the risk of death from cardiovascular disease.
Glimepiride (Amaryl): Amaryl lowers blood sugar by stimulating the pancreas to produce more insulin. Amaryl is often prescribed along with the insulin-boosting drug Glucophage. It may also be used in conjunction with insulin and other diabetes drugs.

Glyburide + Metformin (Glucovance):  is a combination of 2 drugs —glyburide and metformin — that attack high blood sugar levels in several ways. The glyburide component stimulates the pancreas to produce more insulin and helps the body use it properly. The metformin component also encourages proper insulin utilization, and in addition works to decrease sugar production and absorption.

WARNING: Glucovance has been known to cause a dangerous condition called lactic acidosis, a buildup of lactic acid in the blood. Lactic acidosis is a medical emergency that requires immediate treatment in the hospital. Notify your doctor without delay if you experience any of the following symptoms:

A slow or irregular heartbeat; a cold, dizzy, or light-headed feeling; a weak, tired, or uncomfortable feeling; stomach discomfort; trouble breathing; unusual muscle pain

Side Effects:
Hypoglycemia (low blood sugar)
Upset stomach, Nausea
Skin rash or itching
Weight gain 

Glipizide and similar medications may increase the risk of death due to heart or blood vessel problems. This warning is based on research of medications similar to glipizide. However, it is unclear at this time how important this risk may be in people taking glipizide.
If you have certain medical conditions, such as liver or kidney problems, talk to your healthcare provider before starting treatment. You may need to take a lower dosage of glipizide. To help reduce the risks of dangerous drug interactions, your healthcare provider also needs to know about any medications you are taking.

Biguanides (Metformin): These diabetes pills prevent the liver from releasing stored sugar. They also supposedly improve insulin's ability to move sugar into cells especially into the muscle cells. Biguanides should not be used in people who have kidney damage or heart failure because of the risk of precipitating a severe build up of acid (called lactic acidosis) in these patients.
An example of a biguanide includes metformin (Glucophage, Glucophage XR, Riomet, Fortamet and Glumetza).

Note: Two drugs from the biguanide class, metformin and phenformin, were developed in 1957. Unfortunately, phenformin reached the U.S. market first and resulted in several deaths from lactic acidosis. When this risk surfaced, phenformin was pulled from drugstore shelves worldwide. Metformin was eventually found to be 20 times less likely to cause lactic acidosis, but it was tainted by the history of its cousin. Metformin first became available in France in 1979 and has been widely used in Europe since then, but it was not cleared for use in Type 2 diabetes in the U.S. until 1994.
Dosage Range: 500 - 2550 mg, 2-3 times a day

Metformin is usually the first drug that doctors prescribe. Unfortunately, because of the marketing efforts of the drug companies, doctors prescribe metformin in the form of combination pills like Janumet that cost a lot more and include relatively untested drugs that have serious side effects.

WARNING: Metformin can rarely cause a serious (sometimes fatal) condition called lactic acidosis. Stop taking metformin and seek immediate medical attention if you develop any of the following symptoms of lactic acidosis: unusual tiredness, severe drowsiness, chills, blue/cold skin, muscle pain, fast/difficult breathing, unusually slow/irregular heartbeat.

Lactic acidosis is more likely to occur in patients who have certain medical conditions, including kidney or liver disease, conditions that may cause a low oxygen blood level or poor circulation (e.g., severe congestive heart failure, recent heart attack, recent stroke), heavy alcohol use, a severe loss of body fluids (dehydration), X-ray or scanning procedures that require an injectable iodinated contrast drug, recent surgery, or a serious infection. Tell your doctor immediately if any of these conditions occur or if you notice a big change in your overall health. You may need to stop taking metformin temporarily. The elderly are also at higher risk, especially those older than 80 years who have not had kidney tests.

Side Effects of Glucophage:
Nausea, stomach upset, diarrhea, or a metallic taste in the mouth may occur at first as your body adjusts to the medication. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. If stomach symptoms return later (after you are on the same dose for several days or weeks), tell your doctor immediately. Stomach symptoms that occur after the first days of your treatment may be a sign of lactic acidosis.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: kidney disease, liver disease, conditions that may cause a low level of oxygen in the blood or poor circulation (e.g., severe congestive heart failure, recent heart attack, recent stroke), metabolic acidosis (e.g., diabetic ketoacidosis), serious infection, severe loss of body fluids (dehydration).

Before using this medication, tell your doctor or pharmacist your medical history, especially of: adrenal/pituitary gland problems, severe breathing problems (e.g., obstructive lung disease, severe asthma), blood problems (e.g., anemia, vitamin B12 deficiency), fertility problems (e.g., ovulation problems), alcohol use.

Thiazolidinediones: These diabetes pills improve insulin's effectiveness (improving insulin resistance) in muscle and in fat tissue. They lower the amount of sugar released by the liver and make fat cells more sensitive to the effects of insulin. Actos and Avandia are the two drugs of this class.  These drugs may take a few weeks before they have an effect in lowering blood sugar. They should be used with caution in people with heart failure. Your doctor will do periodic blood testing of your liver function when using this diabetes medicine.

These drugs include Actos (pioglitazone), Avandia (rosiglitazone), and Avandamet (rosiglitazone and metformin).

Side Effects:
Elevated liver enzymes (liver damage)
Liver failure
Respiratory infections and sinusitis
Fluid retention (This may lead to heart failure)
Mild anemia
Increased risk for upper arm or foot fractures (women)

WARNING: The thiazolidinedione medication troglitazone (Rezulin) has been removed from the market in the United States and some European countries. Troglitazone has been shown to cause severe liver problems in a small number of people who take it.

Alpha-glucosidase inhibitors: include Precose and Glyset. These drugs block enzymes that help digest starches, slowing the rise in blood sugar. These diabetes pills may cause diarrhea or gas. They can lower hemoglobin A1c by 0.5%-1%. 

Side Effects:
Stomach upset (gas, diarrhea, nausea, cramps) 

Meglitinides: include Prandin and Starlix. These diabetes medicines lower blood sugar by stimulating the pancreas to release more insulin. The effects of these diabetes pills depend on the level of glucose. They are said to be glucose dependent. High sugars make this class of diabetes medicines release insulin. This is unlike the sulfonylureas that cause an increase in insulin release, regardless of glucose levels, and can lead to hypoglycemia. 

Side Effects:
Hypoglycemia (low blood sugar)
Stomach upset
Sore throat 

Dipeptidyl peptidase IV (DPP-IV) inhibitors: include Januvia. The DPP-IV inhibitors (Januvia) work to lower blood sugar in patients with type 2 diabetes by increasing insulin secretion from the pancreas and reducing sugar production. These diabetes pills increase insulin secretion when blood sugars are high. They also signal the liver to stop producing excess amounts of sugar. DPP-IV inhibitors control sugar without causing weight gain. The medication may be taken alone or with other medications such as metformin. 

Combination therapy: There are several combination diabetes pills that combine two medications into one tablet. One example of this is Glucovance, which combines glyburide (a sulfonylurea) and metformin. Others include Metaglip, which combines glipizide (a sulfonylurea) and metformin; Avandamet which utilizes both metformin and rosiglitazone (Avandia) in one; and Janumet, which combines Januvia and metformin. 

Studies have been done showing that some diabetes pills may fuel the diabetes and its complications. Both metformin and Precose have been shown to increase a person's risk of developing type 2 diabetic complications, particularly when lifestyle changes of a proper diet and regular exercise are not implemented. Actos has been shown to increase the risk of heart attack, stroke, and premature death in those with type 2 diabetes. 

This list is not complete as there may be other drugs that can interact with Januvia and can potentially lower blood sugar, such as:
probenecid (Benemid);
nonsteroidal anti-inflammatory drugs (NSAIDs);
aspirin or other salicylates (including Pepto-Bismol);
sulfa drugs (Bactrim and others);
a monoamine oxidase inhibitor (MAOI);or
beta-blockers (Tenormin and others). 

Prescription Drugs -- The Answer?

Prescription drugs help to (artificially) lower your blood pressure, blood glucose, and cholesterol -- but, are they really the answer to you improving your health? Go to the following web pages for more information about the danger of prescription drugs:
Note: If you want to safely wean off these dangerous drugs, start a sound nutritional program and get the How to Wean Off Drugs Safely ebook.
Note: Are you aware that one of the "acceptable" side effects of taking these drugs is death??


Background Information about Insulin
When we eat, our bodies break food down into organic compounds, one of which is glucose. The cells of our bodies use glucose as a source of energy for movement, growth, repair, and other functions. But before the cells can use glucose, it must move from the bloodstream into the individual cells. This process requires insulin.
Insulin is produced by the beta cells in the islets of Langerhans in the pancreas. When glucose enters our blood, the pancreas should automatically produce the right amount of insulin to move glucose into our cells. People with type 1 diabetes produce no insulin. People with type 2 diabetes do not always produce enough insulin.
Types of Insulin
The following is a list of some of the more common insulin preparations available today.
-- Rapid-acting
-- Short-acting (Regular)
-- Intermediate-acting (NPH)
-- Intermediate and short-acting mixtures
-- Long-acting
Rapid-acting Insulin
-- Humalog (lispro)
-- Eli Lilly
-- NovoLog (aspart)
-- Novo Nordisk
Short-acting (Regular) Insulin
-- Humulin R
-- Eli Lilly
-- Novolin R
-- Novo Nordisk

Intermediate-acting (NPH) Insulin
-- Humulin N, L
-- Eli Lilly
-- Novolin N, L
-- Novo Nordisk

Intermediate and short-acting mixtures Insulin
-- Humulin 50/50
-- Humulin 70/30
-- Humalog Mix 75/25
-- Humalog Mix 50/50
-- Eli Lilly
-- Novolin 70/30
-- Novolog Mix 70/30
-- Novo Nordisk

Long-acting Insulin
-- Ultralente
-- Eli Lilly
-- Lantus (glargine)
-- Aventis
Note: Beware of the insulin addiction trap that many diabetics fall into! Don't let this happen to you! Read Chapter 12 of Death to Diabetes for more details.


Metformin (Glucophage) is the most-widely prescribed diabetic medication due to lower cost and less side effects than other diabetic drugs.

Unfortunately, research has shown that none of these diabetic drugs brings blood sugar levels down to anywhere near normal levels. So while an oral anti-diabetic drug might be "effective" by the FDA definition of the term, that effect might only be to lower a diabetic person's fasting blood sugar from a dangerously high 250 mg/dl to an only slightly less dangerous 150 mg/dl -- a level which is still high enough to encourage the development of serious complications. 
So metformin alone will not likely bring your blood sugars back into the normal range.

Facts about Metformin

Metformin is the generic name of the drug also marketed as Glucophage. It has been used to control diabetic blood sugars since the 1970s in Europe. It was also the subject of a detailed study intended to see whether it could prevent impaired glucose tolerance from progressing to actual diabetes.

Diabetes Prevention Program Research Group; Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin. NEJM, Volume 346:393-403 February 7, 2002 Number 6

Metformin is available in an extended release form, Metformin ER (Glucophage XR) which is supposed to be a bit easier on the digestive system.

Metformin is a cheap generic drug. Usually, it is the first drug that most doctors prescribe. Unfortunately, because of the marketing efforts of the drug companies, this doesn't always happen. All too often, doctors prescribe metformin in the form of combination pills like Janumet that cost 15 times what metformin alone costs and include relatively untested drugs that have serious side effects.

You will do much better and be much safer taking the plain generic metformin rather than one of these combos. In addition, the combo pills because they include drugs whose dosage is fixed make it impossible to adjust the metformin dose to the one that is right for you. Metformin is a drug where the effective dose may vary greatly with your body size.

What Metformin Does

Metformin Inhibits the Liver's Production of Glucose

There is some scholarly debate about what exactly it is that Metformin does, but most researchers agree that in most people Metformin suppresses the production of glucose in the liver. Metformin may lower fasting blood sugar by limiting the liver's production of glucose rather than by making cells more sensitive to insulin.
A mouse study published on May 15, 2009 suggests that Metformin works to lower blood sugar by directly stimulating a gene in the liver which is how it shuts off glucose production. Rather than by improving insulin sensitivity, it bypasses the broken insulin signaling. This is okay in the short term, but, may not be ideal over the long term.

Metformin and Insulin Suppress Hepatic Gluconeogenesis through Phosphorylation of CREB Binding Protein Ling He et al,, Cell Volume 137, Issue 4, 635-646, 15 May 2009. doi:10.1016/j.cell.2009.03.016

New Information on how Metformin works. Diabetes in Control May 27, 2009.

Top 10 Overall Metformin Side Effects

The following is a summary of the top 10 side effects reported by diabetic patients, based on reports from the FDA and diabetic community.

Side Effect How frequent is it:
Number of people
(% of total people)
1 Blood Glucose Increased
11,417 (13.25%)
2 Nausea
9,732 (11.30%)
3 Weight Decreased
7,496 (8.70%)
4 Diarrhea
5,649 (6.56%)
5 Vomiting (Nausea and vomiting)
5,251 (6.10%)
6 Fatigue
4,191 (4.87%)
7 Dizziness
3,827 (4.44%)
8 Drug Ineffective
3,694 (4.29%)
9 Blood Glucose Decreased
3,595 (4.17%)
10 Renal Failure Acute
3,456 (4.01%)


Diabetes Drug Causes Heart Attacks!               

Heart Attack Drug May Cause Diabetes!

Most people are aware that the diabetes drug Avandia is linked with tens of thousands of heart attacks, and the drug company GlaxoSmithKline knew of the risks for years but worked to keep them from the public, according to a Senate committee report.

What is ironic is that the beloved and popular cholesterol-lowering statin drugs — pretty much a guaranteed prescription if you have a heart attack — are increasingly being identified as a possible risk factor for diabetes (which is what happened to the author who took Lipitor for years).  Not only that, if you already have diabetes, you’re almost certain to end up on a statin, as well as being at higher risk for a heart attack!

So now we have the possible scenario:  patient has a heart attack.  Heart attack leads to  a statin drug.  Statin drug leads to diabetes.  Diabetes leads to diabetic drug.  Diabetic drug leads to heart attack.  Heart attack leads to … well, you get the picture.

So, what’s a diabetic to do?  There is hope.  You can break the cycle.  You can step away from this absurd pharmaceutical-laden lifestyle.  Proper diet and exercise does work.  It requires discipline, to be sure.  But if the alternative is a lifetime of medications that may turn out to be at odds with each other, which would you prefer?

For more information, refer to this web page about the Cholesterol-Heart Disease-Statin Drug Hoax.

What's Worse? Pills or Insulin Shots?
It's interesting that diabetics become upset about having to go on insulin after years of taking toxic pills such as metformin and glyburide. They should have been just as upset about having to take a diabetic pill that damages the liver and kidneys!

But, why don't diabetics get as upset about taking a pill as they do about taking an insulin shot?

Because we are conditioned to accept taking pills as normal!  It's so easy, convenient, and inexpensive to pop a little pill twice a day, and think that everything is fine. And, as the years pass by, we take more and more pills -- until one day we are taking 10 to 12 pills a day!

Taking pills are dangerous for 5 reasons:
1. Pills are convenient and easy to take, so pill-taking becomes an easy habit.

2. Pills give us a false sense of security that our health is improving, so we don't make the necessary lifestyle changes.
3. Pills slowly cause damage to the liver and/or kidneys, but we don't feel any discomfort; or, we get used to the discomfort of an upset stomach, constipation, diarrhea, headache, etc.
4. Pills lead to more potent pills, creating a biochemical dependency on the drugs. For diabetics, these pills eventually lead to insulin!
5. Most pills are somewhat inexpensive, but they eventually lead to more expensive drugs and expensive surgeries that some people can't afford.

So, pills eventually cause damage to the kidneys and liver, while  (excess) insulin leads to damage of the blood vessels and pancreas (atrophy). So, which is worse?
(They're both bad!)

Author's Perspective:As  I look back now, I was very fortunate that I was put on insulin shots right away instead of pills. Because I was so afraid of needles and injecting myself, I was actually motivated to reduce the number of insulin shots that I was taking. If I had been put on a diabetic pill such as metformin, I would have been happy, and I would have gladly accepted the fact that I would have to take a pill every day for the rest of my life. Ironically, trying to reduce my insulin shots from 4 to 3 led me on a journey of discovery and healing. After I had reduced my shots from 4 to 3, I was motivated to reduce my shots further. When I got down to 1 shot, I was so happy! But, at that time, I thought that I would have to take the one insulin shot every day for the rest of my life. And, I would have been happy with that. I never dreamed that I would get down to ZERO insulin shots! I was truly blessed -- no doubt about it!


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