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A clinical trial at the Veterans Affairs Puget Sound Health Care System and the University of Washington will address new approaches to prevent the development of type 2 diabetes or slow its progression.
The Restoring Insulin Secretion, or RISE, Study will examine the effects of three such medication regimens.  Each will be administered for 12 months. Thestudyis a nationwide program looking at the effects of various treatments to preserve insulin secretion and thereby prevent the development of diabetes or its progression early in the disease. The study, sponsored by the National Institutes of Health, is currently recruiting patients. More details are available at the National Institute of Health’s clinical trials website, identifier: NCT01779362.
People who are newly diagnosed with type 2 diabetes are usually treated with a combination of diet, exercise, and an oral medication (eg, pills). Insulin is generally given once per day, either in the morning or at bedtime.  Usually the doses start small (since it is difficult to know what the requirement will be at first), but the dose is gradually increased to the correct dose, the dose that will keep the blood sugar level in the normal range. Most people with type 2 diabetes who start insulin, do so on top of another oral medication, such as metformin.   However, there are instances when type 2 diabetic patients are treated only with insulin. If a long-acting insulin or a twice daily injection of intermediate-acting insulin is not adequate to control blood sugar levels, a more intensive insulin treatment regimen may be recommended, such as is used in type 1 diabetic patients.
The Diabetes Media Foundation is a 501(c)(3) tax-exempt nonprofit media organization devoted to informing, educating, and generating community around living a healthy life with diabetes. In development for the last 13 years, Invokana employs a “novel mechanism of action” to lower blood sugar in type 2 diabetics, Bloomgarden says. Invokana works by inhibiting sodium glucose co-transporter 2, a carrier that aids in the reabsorption of glucose into the bloodstream through the kidneys, which occurs during the process in which blood is filtered through the kidneys. Because Invokana is such a powerful diuretic, it can help lower a person’s systolic blood pressure, which made some clinical trial subjects feel dizzy and even faint in the first three months while taking the drug. Additionally, because Invokana blocks absorption of glucose, it could reduce a person’s weight. This method of reducing blood sugar by blocking glucose absorption in the kidneys proved safe and effective through nine clinical trials involving 10,285 participants, according to Janssen Pharmaceuticals. Even though the FDA voted 10 to five to approve Invokana, the jury is still partially out on the drug’s complete safety and the long-term effects of the new class of medication.
Even though Invokana is a creative and apparently effective new way of reducing blood sugar, Bloomgarden says that metformin, or Glucophage is, and will most likely remain, the primary drug for treating type 2 diabetes. The FDA said Invokana can be used in conjunction with other drugs, such as metformin, in patients as long as they do not have suffer from any kidney function impairment. Patients won’t have to wait long to get their hands on Invokana if their doctor prescribes it for them. I am taking Invokana alone, as I am allergic to all othet medications for type 2 diabeties it works well keeping my sugars controlled, just have to drink a lot of water, but that is ok.
Just started with Invokana about 2 weeks now (taking in addition to other type 2 meds and have seen a considerable drop in blood sugar readings. After I eat breakfast and take my blood sugar two hours after eating it is actually lower than when I take it first thing in the morning before I take my medications.
I know that the price of this medication is high in cost but I really feel if it works for me which it is my life is more important to me than the money. Have been taking Invokana 100 mg for 4 weeks now and have just started to have cramps and diarrhea every day. I have been on Invokana for 1 week now and have had the best results I have had in 2 years. I can’t tell how much of my positive result was caused by Invokana and how much to attribute to Weight Watchers. When I get my A1c measure, the lab also reports the average (according to their measure of "average" for the result). At least .5% difference, and that's a pretty big difference when you are trying to gain tight control and think you're at your target, when, surprise!
After four years, 26 percent fewer people needed to go on diabetes medication in the Mediterranean diet, compared to the low-fat group.
So, if you like these foods and think a Mediterranean diet might work for you, that’s great, she said.
APPRECIATE IF YOU GIVE A FACEBOOK LIKE or subscribeRSS feed to get new articles in your email. The drug liraglutide, taken at high doses, helps many with type 2 diabetes shed pounds, new research has found.


The higher 3-milligram dose, approved as a weight loss drug and sold as Saxenda, produces more weight loss than the lower 1.8 mg. The higher dose drug also produced more lowering of blood sugar than the lower dose did, the researchers found. While the results are considered encouraging, one stumbling block is that the higher dose is not approved for diabetes treatment in the U.S. The finding from the new study that the higher dose produces more weight loss is no surprise, says Maria Pena, MD, director of the Center for Weight Management at Lenox Hill Hospital, New York. Sign Up for the FREE EndocrineWeb eNewsletter and receive treatment and research updates, news, and helpful tips on managing your condition.
Participants will be treated with medications normally used for people who have had diabetes for at least one year. The UW and VA diabetes research group in Seattle is one of three recruiting adult patients for the medication trial, along with the University of Chicago and Indiana University in Indianapolis.
Steven Kahn, professor of medicine, Division of Metabolism, Endocrinology and Nutrition, at the University of Washington,  leads the Seattle clinical trial and is also chairs the national study. To be eligible, patients must be between 20 and 65 years old, have prediabetes or self-reported type 2 diabetes for less than one year, and must not have taken any medications to treat diabetes in the past. Some oral medications, such as metformin help insulin that is available in the body to work better. People taking insulin alone often require two injections of intermediate-acting insulin or one injection of long-acting insulin per day.
Food and Drug Administration means diabetics have a significant new tool for treating the disease, as well as for losing weight and improving their overall health. The excess glucose is then flushed out of the body, which is why Invokana also acts as a “potent diuretic,” Bloomgarden said.
It also worked with about the same effectiveness as sitagliptin, or Januvia, which inhibits enzymes and increases pancreatic function, Ren added. For extended periods, however, reducing blood pressure in a population of patients with typically higher than normal blood pressure as a result of their diabetes is a positive side effect.
According to Janssen Pharmaceuticals, clinical trials subjects taking the drug experienced a 3 percent weight loss compared to subjects taking a placebo.
The most common side effects experienced were vaginal yeast infections and urinary tract infections, according to the company. A drug called dapagliflozin, from Bristol-Myers Squibb and AstraZeneca, that also works as a SGLT2 inhibitor, for instance, was rejected for approval by the FDA in 2012 because of concerns it increased rates of bladder and breast cancers in subjects. However, Invokana can be taken by those already taking metformin and other medications, according to the FDA.
According to company spokesperson Christina Holden, Invokana is already being manufactured and field sales agents are already taking order from doctors. With the prescription she gave me a card to give to the pharmacy, now I get a year for free. I was taking Metformin only, but when it alone wasn’t controlling my glucose level my doctor put me on glimepiride.
I am working hard to get my numbers down and thought I was in a pretty good place, and then my endo burst my bubble by giving me a completely different average (not a true lab test at this point, we were just discussing numbers via email).
That's the chart I was using, but I think the new eAG must be lower, because those numbers are quite a bit different. Because people with diabetes are more likely to check their blood glucose more often when they are low (for example, first thing in the morning and before meals), the average of the readings on their meter is likely to be lower than their eAG.
If your numbers are "in a good place" the average on one test is meaningless in my opinion. I always look at my meter's 7 and 30 day averages and convert using this calculator before I get my A1c done. Dario Giugliano, a professor of endocrinology and metabolic diseases at the Second University of Naples in Italy.
Experts know that a weight loss of 5 to 10 percent of body weight can help those with type 2 diabetes improve their condition and the other risks that accompany it, such as heart disease. For that reason, insurance companies will not cover it when the doctor prescribes the higher dose for diabetes.
Please download the latest version of the Google Chrome, Mozilla Firefox, Apple Safari, or Windows Internet Explorer browser. The study will enroll individuals who have prediabetes or have been recently diagnosed with diabetes, but who are not taking medications to treat the condition.


The expectation is that the use of these medications before diabetes has developed will preserve or enhance the body’s ability to produce insulin, the hormone that is crucial to maintain normal blood sugar levels. But it is simply another medication that, unfortunately, needs to be given as a shot, instead of as a pill. Financial analysts are predicting that the drug will bring in more than $100 million in sales this year and top out at more than $660 million in annual sales by 2016. I was switched to Invokana after I had a seriously bad reaction with Toujeo ugh it didn’t work for me. Because I was getting dangerously low readings on the glimepiride, I decided to get a referral to an endocrinologist.
However, it has served me well for over a decade, enabled me to completely reverse my neuropathies, and I am currently off all meds except for insulin. The nice thing about this ADA calculator is that you can run it both directions: A1c-eAG and reverse.
I have to say that they often seem to turn up on site promoting the protagonisists of ultra-low carb diets. I'm just talking about general a1c charts floating around the interwebs, not labs or doctors office tests specifically. However, lifestyle changes can help prevent the disease and possibly reverse its course when instigated soon after diagnosis. Cholesterol levels and blood pressure readings were also more improved in the Mediterranean diet group vs. Grubb recommended that all people with diabetes work with a dietician to come up with an individualized eating plan that takes into account likes and dislikes.Giugliano said he would recommend the Mediterranean diet for people with type 2 diabetes because in addition to being lower in carbohydrates, the diet seems to have an effect on insulin sensitivity beyond its carbohydrate composition.
Over about a year, those on the high dose shed about 14 pounds, on average, while those on the lower dose lost an average of 11 pounds. Novo Nordisk, the drug's maker, funded the trial, known as the SCALE Diabetes Randomized Clinical Trial. He is hopeful that pressure to encourage insurers to cover the medicine will be successful, with the argument to cover them supported by findings from the research.
People respond to the medicine in different ways, with some losing more weight than others. The drug mimics a hormone made in the intestines that tells your brain it is full, experts say. The investigators aim to enroll 85 patients who will participate in the trial for 21 months.
Using a combination of treatments (oral medication plus insulin) often means that the person can take a lower dose of insulin, compared to insulin treatment used alone. My doctor put me on Invokana and also gave me a card so I can get a year’s free supply.
If there is a discrepancy between the two averages the 7 day is usually the most accurate.In theory A1c is a 3 month average but because not all red blood cells live 3 months the most recent readings carry a little more weight.
I suspect this may be because the older charts indicate much higher equivalent BGs than does ADAG for any given HbA1c (and thus make your control look worse). Regular exercise and changes in diet are among the most important lifestyle changes that can help manage type 2 diabetes.
The men and women administered the drugs and placebo as an injection under the skin, using an insulin pen device. I'm a T2 not on insulin and my readings tend to stay within a fairly narrow range, not sure if this would work with someone experiencing a wider range of readings.
Now if I check right after I eat, I might see like 250~300 but if I eat and wait like 2 hours and check, its back down in the 150 range normally. I tend to test 4 to 5 time a day unless my readings vary out of my usual range and I'm trying to figure out what is wrong. All groups were advised to reduce their caloric intake by 500 calories a day and to increase their physical activity to 150 minutes a week or more. Looking to to me so far other than I’ve gotten dizzy a few times for a couple seconds and I checked, my sugars were not too low.
Invokana has certainly helped and I will continue to take it until I no longer need it for control.




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