Note for anyone with type 2 diabetes

[Lanya]

http://www.washingtonpost.com/wp-dyn/content/article/2006/10/17/AR2006101700437.html


Merck Diabetes Drug Wins Federal OK

By ANDREW BRIDGES
The Associated Press
Tuesday, October 17, 2006; 7:01 PM

WASHINGTON -- Diabetics gained a new way of controlling their blood sugar levels Tuesday with federal approval of a novel pill for Type 2 diabetes, which affects about 20 million Americans.

The Food and Drug Administration said it approved Januvia, which enhances the body's own ability to lower blood sugar levels, after clinical trials showing the new pill works just as well as older diabetes drugs, but with fewer side effects like weight gain. The drug is made by Merck and Co. Inc.
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[Michael Tee]

Hey!  Thanks, Lanya.  I'm OK on my current medication (Metformin) but that's good news for somebody, I'm sure.  So far the key to this fucking thing seems to be diet and exercise and exercise and diet and diet and exercise . . . I'm getting to the point where I don't even miss lemon meringue pie.  (That's a lie.)  But I can sprint for any bus in the city or climb any staircase without the slightest effect on my breathing.  It's amazing.

[Lanya]

"But I can sprint for any bus in the city or climb any staircase without the slightest effect on my breathing.  It's amazing."

I can't do that! Of course  I also  don't go to the gym and I need to  lose about 20 pounds.   

I think I'll be one of those mall walkers this winter, because I need the exercise.  As much as I hate the mall, at least it's warm and there's coffee there.

[Michael Tee]

Good luck with the mall walking.  It's like anything else, you really gotta discipline yourself to it.  But you absolutely have to have headphones and music (or lectures) if you're mall walking because otherwise the monotony will kill ya.

[BT]

I walk a mile around town with my neighbor who also has had a heart attack at least 3 times a week.It is hilly terrain so we get the leg burn on the final 1/4 mile.

 When i want to work on upper body strength i take the dog with me. You are correct in that diet and exercise can keep blood sugar levels under control. That and a conscientious effort to control portions and lose unnecessary weight. I've dropped about 40 pounds in the last year and a half.

[Michael Tee]

Portion control is probably the least mentioned and the most important part of dieting. 40 lbs. is really impressive.  Congratulations and keep it up.  I used to walk outdoors in the summer and fall of my heart attack rehab and I loved it.  Was up to three miles in 48 minutes, but I couldn't stand driving to the malls in winter so I got a recumbent bike for one of the kids' empty bedrooms upstairs and now I work out there for regular exercise and just hike the ravines around here whenever I can.  Two weeks ago, saw the salmon spawning, leaping little waterfalls and through rapids - -  just one of those unexpected treats that you don't get from working out indoors, but I sure get a lot of reading done on the bike that I probably wouldn't do otherwise.  It's funny but I am actually getting some very positive experiences out of what is, of course, a disease.  One of my doctors says, "Think of it more as a wake-up call."

[BT]

One of the biggest benefits i get from my walks with my neighbor is psychological. I drove him to the hospital when he had his, talked him through the emergency room process and since i had my three attacks first i was his faithful indian guide through his ordeal, and in helping him understand what was going on , it helped put what i had been going through in perspective. Things like side effects of the meds or fluctuations in energy levels. It is good to have a charter member of the brotherhood of the stent walking with you as you examine mortality and its implications.

[Amianthus]

You are correct in that diet and exercise can keep blood sugar levels under control. That and a conscientious effort to control portions and lose unnecessary weight.

I was involved with a study at Johns Hopkins a few years ago. One of the things the study showed was that regular dairy intake is also very good for your heart.

[Michael Tee]

<< i was his faithful indian guide through his ordeal, and in helping him understand what was going on , it helped put what i had been going through in perspective. Things like side effects of the meds or fluctuations in energy levels. >>

Your friend is lucky he had you.  Here we are enrolled in a 1-year program, but the first six months are the intensive part of it.  We met for two hours once a week for lectures followed by individually-calibrated and supervised exercises with by physiotherapists, technicians, kinesiologists and OTs.  The lectures are with pharmacologists, cardiologists, dieticians (very important, and we were encouraged to schedule as many one-on-one sessions with the dietician as we need,) and psychiatrists (also available for one-on-one.)  The psychiatrist lectures were really annoying - - coloured pie-charts showing the emotional stages we were supposed to pass through after a heart attack or stroke.  Nothing you couldn't have figured out for yourself, but then afterwards in group sessions it became apparent that some folks really benefitted from this stuff because they hadn't figured it out for themselves - - they were mostly salt-of-the-earth working class types, who had never had the time or the luxury to sit around analyzing their own navels and stuffing their heads with pop psychology, brought up in some kind of Calvinistic "complaining is sin" environment and I think they were helped just by knowing that other people were in the same emotional boat as they were.  By the end of the first six months, everyone had pretty well settled into the exercise & diet routine that they needed and the sessions were more motivational, still followed by supervised exercise.

In retrospect, the most valuable lectures for me were:  winter walking (DON'T! not at first, anyway); reading the labels on food products; and drugs.  I didn't realize how many alternatives there were and my doctor had never told me - - I just went out and bought whatever he wrote down and ate them.

The program was fantastic.  It told me everything I needed or wanted to know.  And it was all free.

[Amianthus]

The program was fantastic.  It told me everything I needed or wanted to know.  And it was all free.

Sounds similar to the study I was involved in with Johns Hopkins, only it was two years, with several followups.

And it was better than free - they paid me to be involved.

[Michael Tee]

Well, first of all, this wasn't a study, this is normal health care available to any Canadian who had a heart attack or stroke, although to be absolutely fair I don't know if it's available all over Ontario or the other Provinces.   Obviously people in northern Ontario are going to have to make do with less.

And it doesn't necessarily end after a year - - they tell us, come back whenever you need a refresher or have a problem.  I'm sure if there are patients who aren't out of the woods at the end of their first year, they'd just stay in the program as long as need be.

[Lanya]

..."this is normal health care available to any Canadian who had a heart attack or stroke..."
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That's fantastic.   I wish we had something here like that.   

[BT]

That's fantastic.   I wish we had something here like that.   

We do. It just isn't paid for by the state.