WPADE.org

Researchers found the drugs Actos and Avandia may slow bone formation and increase the rate of bone loss. The study involved 1,020 patients with type 2 diabetes who had fractures between 1994-2005 as well as 3,728 patients with diabetes who had no fractures. Those taking Actos and Avandia were found to have double or triple the risk of hip and other non-spine fractures than those who did not take those drugs. The odds fro fracture were increased among those taking the drugs for 12-18 months, and the risk was higer for those taking them for two years or longer. Further research will be done to confirm the link between the drugs and risk of bone fracture. It is suggested that other oral hypoglycemic agents be prescribed for type 2 diabetes.
Annette Karnash, RN, BSN, MN

We are aware of the implications that diabetes has on various parts of the body. As educators, ti is most important to stress, to our patients, the need for annual comprehensive eye examinations by an ophthalmologists. Often a diagnosis of diabetes can be made during a simple eye exam, without the benefit of a blood test. The eyes are teh only organs that provide an unobstructed, non-invasive view of the blood vessels.
High cholesterol, high blood pressure, heart disease and diabetes all cause changes in the blood vessels of the eyes and can be seen readily when the retina, cornea and blood flow through the vessels is examined. Early detection is critical in the management of diabetes. A relatively new technological device may help to give advance notice in the treatment of diabetes and its complications by taking specialized photographs of the eye that reveal metabolic stress and tissue damange. This special photograph measures the specific characteristics of retinal disease and can monitor the severity of retinopathy.
Annette Karnash, RN, BSN, MN

Avandia, a drug used to treat type 2 diabetes, may also prevent diabetes in people at high risk. Predictions were that 50% of 5000 pre-diabetics would develop type 2 diabetes within three years without treatment. Patients were assigned, in the above described study, to either a placebo group or to a group prescribed with an 8mg dose of Avandia daily and were followed for three years. About 12% of those taking Avandia developed diabetes or died, compared to 26% who were given a placebo. About 50% of those taking the drug has normal blood glucose levels compared to 30% in the placebo group. Fourteen of those taking the drug developed heart failure compared to only 2 in the placebo group. Lifestyle changes can decrease the risk of developing diabetes by as much as 58%.
Annette Karash, RN, BSN, MN

Glucosamine and Chondroitin are found around the cells of cartilage and are thought to help repair and maintain cartilage by inhibiting inflammation, stimulating cell growth and providing cartilage with strength and endurance. Patients with diabetes who are taking long term Glucosamine, perhaps for arthritis, should be encouraged to monitor blood glucose frequently for elevations. Short term therapy should not affect insulin resistance.
Annette Karnash, RN, BSN, MN

Research has discovered a deficiency of Vitamin B12 among patients taking Metformin, especially when Metformin is used in high doses or for long periods of time. Taking the drug for three years or more doubled the risk. Screening for Vitamin B12 deficiency is recommended because a deficiency can cause damage to the nervous system.
Annette Karnash, RN, BSN, MN