Why the new diabetes drugs on the horizon are going to be horrible and you read it here first.



Lets face it, Non insulin dependent diabetes mellitus is a preventable disease. Diet and exercise are overwhelmining effective in managing and preventing it, but despite that a huge percentage of the population become diabetic each year.

Diabetes is an insulin problem first, then its a blood sugar problem. There are some mechanisms involving body fat and muscle that make those tissues less receptive to blood sugar, the body makes and more and more insulin to perform the same task. You have heard that called insulin resistance, and that is the first phase of becoming diabetic. An insidious rise in fasting blood sugars over time mark the initiation of a process of becoming insulin resistant. Once insulin resistance is high enough your body can no longer effectively store away blood sugar, and you are now diabetic. The elevated blood sugar is inflammatory, and initiates a destructive disease process throughout the circulatory system.

High blood sugar is a sticky inflammatory nightmare, adhering to capilary walls and initiating a damaging chain reaction. It affects the eyes, the small distal vessels, kidneys, and heart. High blood sugar elevated heart disease and cancer risk.

Have no fear, a new class of drugs has been created to help with that problem, they assist the body in removing the blood sugar through the kidney. The kidney of course, is one of the structures commonly affected in diabetes, thousands of miles of tighly packed capilaries filter the blood and return clean blood to circulation, while passing metabolic waste out as urine. The kidneys are doing a lot, and now this new class of drug is going to change the mechanics of the renal system allowing more blood sugar to be spilled out in the urine.  canagliflozin (Invokana) is one of these new drugs.

Sounds great right? Hmmm.. not to me, and there are two reasons. The first is that the patient begins to climb the slippery slope of insulin resistance, food, and medication. Forgoing dietary discretion for phamaceutical intervention is part of the the problem already.  People think, I took the medication, ate bad food and still had no elevation in blood sugar. Everything must be ok. This prevents them from actively attempting to change the disease creating dynamic.

Meanwhile the kidneys are now forced to labor harder to choke out more sugar in the blood and expel it through the kidney apparatus.

I see nephrologists getting very busy in the coming years as more diabetics require kidney transplants from the use of these medications. The kidney actually works hard to prevent glucose from being urinated out, but these drugs called SGLT2 will interfere with that process.

I guess the worst thing about it, is in most cases the entire issue is reversible and preventable without dangerous medications.


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