ENDO 2017: The Endocrine Society Annual Meeting. April 19, 2017

Diabetes. Cost vs Benefits. Old Drugs vs New Drugs. The discussion of The Endocrine Society Annual Meeting 2017, Orlando. Florida.
I am not in Orlando. I wish I am there, but I am in NYC. I am not invited to the meeting. Why should I? Anyway, in all that discussions, how many diabetics took participation?

"Talk about alternative facts!" he (Dr Nathan) said playfully. He dismissed the notion that recent trial data make it possible to "personalize" diabetes treatment and again insisted that the only one to benefit from the recent surge of new drugs is the pharmaceutical industry.
Dr Drucker took offense at the suggestion that physicians are being influenced by drug companies: "I do not think my primary-care colleagues make decisions based on advertising," he said, to which Dr Nathan quickly responded, "I think that's naïve."

This is BEST in all discussions as I see it from my window in NYC. LOL! really? Whom do you holding for fool?
OK, a little bit about discussion. The Old Drug, the New Drug, ... injectable, oral, costly, cheap, what all these discussions about? Really, the discussions are about what?

Dr Nathan jumped on the bandwagon, putting his colleague on the spot by asking if he agreed the SGLT-2 inhibitors should be prescribed only to men who had previously experienced a myocardial infarction, because the increased risk for yeast infections seen as a side effect with these agents mostly affects women.

      Not really. Man have the same problem as woman. They have own genitalia, penis, and the yeast infection effect all urinary tract in any sex.
       According to  MI it is really not safe to Rx Invokana and other SGLT-2 to any diabetic. Invokana has strong effect on cardio disease and lead to cardio mortality. Personally, as diabetic, I do not take any diuretics, and Invokana is strongest diuretic. This is why people lost weight with Invokana. With longer invokana therapy Life style modifications follow, ultimate. Right to the point 'no return'.

In conclusion, he (Dr Drucker said) reiterated the many benefits of the newer drugs: effective at lowering HbA_1c; less hypoglycemia; weight loss; and reduced need for blood glucose monitoring. In addition, certain drugs have been shown to reduce the risk for nephropathy, strokes, and cardiovascular death.

      Let us start with reduce need for blood glucose monitoring, why new drug reduce these needs? really, say me, why? Because of weight loss? Because of HbA1c lowering? HbAic can be lowered with any medicine less then 1%. If it is 9.4% then any oral medicine will reduce HbA1c for 1%. Now how many medicine we have to take to reduce HbA1c down to 6.5% ? Do not count it, it never going in this way. HbA1c can be reduced down to 7.2% but never down to the 6.5% I do not know why, what is mystery in this numbers of diabetes, still, it is the fact. So, the question is, why with HbA1c >6.5%  diabetic does not need to monitor blood sugar level?
       I can be only agree with Dr. Drucker, there is no hypoglycemia. Where low blood sugar will come from? If new medicine does not work, and blood sugar still high, then there is no problem with low blood sugar, it still high.
      Weight loss. Really, what is the point for me to be concern about weight is this high or low?  Regardless if I do have high weight or low I cannot walk because of blood sugar so effected circulation ion my legs that skin melted, and I simple cannot walk, as my uncle 50 years ago.

"We are facing a huge challenge as a community," Dr Drucker said. "We need as many options as we can have to treat diabetes, because all of our patients are different."

     As I just said, whom do you fool Dr. Drucker? you do need as many options as you can to switch from one option to another, and be free from any responsibility for treatment you Rx. Prove? Simple. Only one option so far is effective, and it is INSULIN. Don't you know it? I bet you do.  The same as Dr. Joslin in his time you know very well the way of money flow, so you are ready put your net in right place.

Opening the debate to the audience, Dr Drucker soon found himself defending his opinions to another critic, who insisted that the findings from the EMPA-REG trial might not be as robust as reported and that physicians were now being encouraged to use empagliflozin (It is in a class of medications called sodium-glucose co-transporter 2 (SGLT2) inhibitors. Empagliflozin lowers blood sugar by causing the kidneys to get rid of more glucose in the urine. It is not used to treat type 1 diabetes (condition in which the body does not produce insulin and, therefore, cannot control the amount of sugar in the blood) or diabetic ketoacidosis (a serious condition that may develop if high blood sugar is not treated))  in patients who did not match the study criteria.

 Did I said it just above? If one drug did not work, such as Invokana, then Rx another one, the same but different name such as empagliflozin. Then switch to another one, and after all options done, return to number one. Perfect cure for diabetics type 2. Remember, there are 76000 of us die every year, just because of high blood sugar,. diabetes. Add here cardio we are very highly effected, and all what you want. We are in every line.

On the other side this leg effected more. I just cannot turn it. It is water retention. Water is all in body. I am not sure that Dr. Drucker has any idea, how to treat this condition. To put me on run? I am not able to walk. To stop to eat?I am very very full. I do have heart condition, and with this condition it is fullness in stead of hunger. This is Diabetes Type 2, insulin independent type of diabetes.  we are all independent from insulin. When I was in hospital, recently, I could not tolerate the pain, there were no insulin for me, so 300 units were stopped right away. two nights in hospital, and my blood sugar out of control, over 200 mg/dl. I come to hospital with perfectly controlled sugar. Do anyone really think, it is too fatty diet in NYC public hospitals?

"The conversation has to be unique to the patient in the room," Dr Drucker said, adding that the days of just prescribing something without involving the patient are long gone.

       I wish it really was true, still, the fact is, this is false.  The conversation about cost, what is this? Is this question to diabetic? It is not. The cost is important to health care company. Many of us do pay co-pay, and some even do not have any payment. So, what is this all about? Why doctors are so concern about cost? Really, it is very very interesing question, why all the time there are two most important question on the table of discussions, Cost and Weight Loss? Nether one of this point has any value. If I have to pay co-pay then it does not matter do I have to pay for Invokana or Insulin. The copay is the same, because of both medicine are brand.
      Another point of cost/effect discussion. If medicine such as insulin is effective then why I have to care too much to take not effective but low cost medicine such as Metformin? Do I really need to collect side effects? Or it is so effective to take SU and kill the rest of healthy working Islet cells? If insulin is effective then I can be complications - free, walk on both legs, look with two eyes, be Asthma-free, and do not take so much Excedrin to get rid from headache. Say me, what is benefits in any new drugs for me, diabetic type 2?
       I see only one benefit, to be accept permanent Life Style Modification. I am not ready to move in this direction. Thanks a lot.

      So lovely day today!!!!!!!!!!!!!!!! Insulin, 18 boxes, 90 pens Lantus Solo Star just dropped under my door!!!!!!!!!!!!!!!!!!!!!!!!! I would be able to carry on my 400 pound, and even more if I will get them right to the Summer, and beyond!
  http://ift.tt/2pQ9ZsU

• ENDO 2017: The Endocrine Society Annual Meeting

Diabetes Bigwigs Spar on Costs, Benefits of New vs Old Drugs

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