Diabetes Drug Gets FDA Warning Due to Amputation Risk. Now what? May 18, 2017

Diabetes Drug Gets FDA Warning Due to Amputation Risk

Canagliflozin tied to a doubling of amputations of legs, feet, agency says

By Robert Preidt

Wednesday, May 17, 2017
http://ift.tt/2qwHtjS

     Really, after this warning what I suppose to do? Well, there are all the time one answer to the any question I do have:

Patients taking canagliflozin should immediately notify their health care providers if they develop new pain or tenderness, sores or ulcers, or infections in the legs or feet, the FDA said in a news release. Patients should not stop taking their medication without first talking to their health care provider.

     So easy to say, 'new pain' but say me when pain is 'new' and what is difference with 'old pain'? As I said, it is easy to put all on paper, and let someone to do the rest of the problem.
     Now there is another problem, I did notify my doctor, and what? What doctor suppose to say to me? Read the rest, and do not stop to take Invokana.  Invokana is alredy put me in risk of amputation, there are sores and ulcers already developed, but ... 'do not stop to take Invokana'! Thanks a lot!!!!!!

Before prescribing canagliflozin to patients, doctors should consider factors that may predispose patients to the need for amputations, including a history of prior amputation, peripheral vascular disease, neuropathy, and diabetic foot ulcers, the FDA said.

   Sure, the history is important. I do love history, but I prefer to deal with any problem in present time, as soon as problem was developed. So, say me, what diabetic does not have 'predispose' to the amputation, or neuropathy, or vascular complications? What diabetic is not predisposed to edema and water retention? Show me this study, the evidence that when I hold Rx to Invokana I do not hold ticket to surgery which will lead me to lost both legs, and eventually to very painful and miserable end in nursing home? Thanks a lot! This ticket is not mine!
Jardiance or Invokana Cardiovascular Mortality. November 26, 2015
 Invokana Clinical Trial alert. May 20, 2016.
 FDA Invokana Warning. December 5, 2015
 No thanks to ALL SGLT2 INHIBITORS. October 5, 2016

    I posted many times, why Invokana is not right medicine for me. Some posts are very popular, some not. From the first time I read that Invokana approved by FDA as medicine to treat diabetes type 2 I knew, I will not take it. So, I said 'no' to Invokana every time when I was in medical clinic and doctors suggested it as treatment for my problem. I am glad I did. In the beginning it was just logic, just thinking. Now it is far away from that.
     If one will take a look at how my legs looks like today, one will see why we do have amputations. Diabetes is all about water making. No one do know for sure why diabetics make water, edema, very severe edema. It is so severe that water does not go out in regular way but through the skin. Skin start to melt. After skin gone the flesh start to melt. And so on.
     It is every one know that we are, diabetics type 2, do have slow healing wounds and easy developed infections. Not so many of us do know that infection is not only on the surface of the skin, on the legs. Infection like abscess can sit on the heart, on the lungs, on any inner organ of our bodies.
     Now the question is, how all these problems can be solved with weight loss? Simple, very simple question, how infection can be treated with weight loss surgery? No, infection would be treated with antibiotics. Why? Infection is bacteria or virus, and it cannot be removed with surgical knife. The question is, what is diabetes?
      Diabetes is pancreas disorder. It is not high blood sugar or amount of trips into bathroom. It is not amount of pounds on bathroom scale. It is ability of pancreas to secret insulin, it is health and well being. If this taken into consideration, and if the look at the problem changed its angle then it is very easy to see, Invokana, highly effective to lose weight and reduce water from the body in the beginning of therapy, is not the solution to address pancreas health.
      Why really Invokana lead to amputations? At first, it is blood clotting. With reduced water amount in blood clots develops, and clots reduce vein efficiency to let blood and oxygen to flow. Lost circulation leads to amputation.
      With Invokana there is still no insulin in blood stream, because of Invokana does not increase insulin supply. So, the problem which lead to diabetes in first place, still present. Blood sugar getting high, regardless diabetic take Invokana or not.
       Why doctors still insist, diabetic still need to take Invokana? Because of as soon as diabetic stop to take Invokana Edema fatally can increase and close the airways to breath. This is really very very danger situation. To address to this condition only one way  doctors do have, Rx Diuretics to reduce swelling. Diuretics does not solve the problem. Regardless of any amount of diuretics doctor Rx to diabetic, blood sugar still rising.
       I really do not know if amputation would reduce mortality. What I do know, after one surgery diabetic will need another surgery, and so so on till the final breath.

      I do have edema right now. Edema come every time after clot dissolved. Every silent heart attack or silent stroke lead to edema. First it is pain. I usually do have very severe headache. So severe that I need more then 10 tablets of Excedrin. I take as much as I need to get rid of this pain. All doctors usually insist, I have to stop to take this medicine. The problem is only one, they demand I stop to take it, but there is nothing to reduce pain, severe headache I suffer from my childhood. So, regardless of doctors order I still take Excedrin and I take it in the amount I need to get free from pain.
      In this time in addition to headache I got chest pain, severe back pain. It is heart pain. So, I took Nitrostat, also in amount to be pain-free, and I do not count this amount. I just take it, and try to get some sleep.
     Then it started to be less painful, but weight go up and up. I was  in condition to lose weight, and it was about 20 or 30 pounds down. I was very happy with result. I was able to take shower, to dress by myself. Not so fast. Weight went up and up.
       I usually do not fight this condition. When weight go up there is some reason for this. The problem is, I never take diuretics. I do know, this is not for me. Also I do not use any diet. I do eat healthy, my lifestyle is most healthy as it can be. There is nothing to change. So, I simple take all as it is and still going.
      Edema got very severe. It started to be so severe that one day skin started slow melt. It went harder and harder. There are pictures of how all was  from the beginning. At the same time blood sugar went up and up. Dose of insulin I injected also went up and up. I still going as it was till pain become not acceptable. I went to ED in hospital, then to Wound Care Clinic.
      Now I am home, on my own and under care of my man. He wrap my legs, changes wounds dressing, and pay for bandages and wraps. He pays for everything. So, I still fighting.

The agency's decision is based on data from two large clinical trials showing that leg and foot amputations occurred about twice as often in patients taking canagliflozin as among those taking a placebo.

I no longer take 400 units of insulin. I down to 300 and less. My fasting sugar is good, and almost all blood tests are pretty good.

Canagliflozin is meant to be used with diet and exercise to lower blood sugar in adults with type 2 diabetes. It belongs to a class of drugs called sodium-glucose cotransporter-2 (SGLT2) inhibitors. These drugs lower blood sugar levels by causing the kidneys to remove sugar from the body through the urine.

      Well, there are many pictures on-line where diabetics pictured with leg problems before legs were amputated. Say me, what exercises  can be suggested to me? Doctor ordered I spent my time in bed with legs elevated. Now there is physio therapist come to my home to help to develop work out program which will work for me. LOL! There is no money to pay fro wound supply. But there are a lot of money to teach me how to hold my spoon. 
     I will say, how all thsi work. It work before diabetic entered into high stage when pancreas almost stopped to secret insulin. There is only one way to safe our lives, insulin. But we do have Invokana, or it is better Invokanamet. Then surgeon's knife take off one our leg after another till our hearts start to melt, and this is the Final.

I am not ready for amputation yet. I wrap both my legs to reduce edema. With edema reduced wound started to heal. It does not looks very good right now, but it is much better then it was before. Most important, all my dressing right now dry, no water or yellow fluid from under skin.

 I will post the all steps how all was done, and what would be at the end.
Right now my fasting sugar is normal. A1c=7.2%
I take 300 or less units of insulin Lantus Solo Star daily dose. This is only type of insulin I take. I tried many other types, no one worked as I need it.
I wrap both legs, and leave them wrapped for a few days.
For wound I use iodine.
I do not take any water pills, no diuretics, no Invokana.

via Ravenvoron