Ping: Louise

x-no-archive: yes


Biol Psychiatry. 2006 Dec 15;60(12):1343-9. Epub 2006 Aug 4. Links

Comment in:
Biol Psychiatry. 2008 Jan 1;63(1):e1; author reply e3.
Mifepristone versus placebo in the treatment of psychosis in patients
with psychotic major depression.
DeBattista C, Belanoff J, Glass S, Khan A, Horne RL, Blasey C, Carpenter
LL, Alva G.
Corcept Therapeutics, Menlo Park, California, USA. debattista@stanford.edu

BACKGROUND: Abnormalities in the hypothalamic pituitary adrenal axis
have been implicated in the pathophysiology of psychotic major
depression (PMD). Recent studies have suggested that the
antiglucocorticoid, mifepristone might have a role in the treatment of
PMD. The current study tested the efficacy of mifepristone treatment of
the psychotic symptoms of PMD. METHODS: 221 patients, aged 19 to 75
years, who met DSM-IV and SCID criteria for PMD and were not receiving
antidepressants or antipsychotics, participated in a double blind,
randomized, placebo controlled study. Patients were randomly assigned to
either 7 days of mifepristone (n = 105) or placebo (n = 116) followed by
21 days of usual treatment. RESULTS: Patients treated with mifepristone
were significantly more likely to achieve response, defined as a 30%
reduction in the Brief Psychiatric Rating Scale (BPRS). In addition,
mifepristone treated patients were significantly more likely to achieve
a 50% reduction in the BPRS Positive Symptom Scale (PSS). No significant
differences were observed on measures of depression. CONCLUSION: A seven
day course of mifepristone followed by usual treatment appears to be
effective and well tolerated in the treatment of psychosis in PMD. This
study suggests that the antiglucocorticoid, mifepristone, might
represent an alternative to traditional treatments of psychosis in
psychotic depression.
PMID: 16889757 [PubMed - indexed for MEDLINE]



Related Articles
• Clinical and biological effects of mifepristone treatment for
psychotic depression. [Neuropsychopharmacology. 2006]
• Rapid reversal of psychotic depression using mifepristone. [J Clin
Psychopharmacol. 2001]
• An open label trial of C-1073 (mifepristone) for psychotic major
depression. [Biol Psychiatry. 2002]
• An 8-week open-label trial of a 6-day course of mifepristone for the
treatment of psychotic depression. [J Clin Psychiatry. 2005]
• A double-blind randomized comparison of nortriptyline plus
perphenazine versus nortriptyline plus placebo in the treatment of
psychotic depression in late life. [J Clin Psychiatry. 2001]
• » See all Related Articles...

Susan wrote:
> x-no-archive: yes
>
>
> Biol Psychiatry. 2006 Dec 15;60(12):1343-9. Epub 2006 Aug 4. Links
>
> Comment in:
> Biol Psychiatry. 2008 Jan 1;63(1):e1; author reply e3.
> Mifepristone versus placebo in the treatment of psychosis in patients
> with psychotic major depression.
> DeBattista C, Belanoff J, Glass S, Khan A, Horne RL, Blasey C, Carpenter
> LL, Alva G.
> Corcept Therapeutics, Menlo Park, California, USA. debattista@stanford.edu
>
> BACKGROUND: Abnormalities in the hypothalamic pituitary adrenal axis
> have been implicated in the pathophysiology of psychotic major
> depression (PMD). Recent studies have suggested that the
> antiglucocorticoid, mifepristone might have a role in the treatment of
> PMD. The current study tested the efficacy of mifepristone treatment of
> the psychotic symptoms of PMD. METHODS: 221 patients, aged 19 to 75
> years, who met DSM-IV and SCID criteria for PMD and were not receiving
> antidepressants or antipsychotics, participated in a double blind,
> randomized, placebo controlled study. Patients were randomly assigned to
> either 7 days of mifepristone (n = 105) or placebo (n = 116) followed by
> 21 days of usual treatment. RESULTS: Patients treated with mifepristone
> were significantly more likely to achieve response, defined as a 30%
> reduction in the Brief Psychiatric Rating Scale (BPRS). In addition,
> mifepristone treated patients were significantly more likely to achieve
> a 50% reduction in the BPRS Positive Symptom Scale (PSS). No significant
> differences were observed on measures of depression. CONCLUSION: A seven
> day course of mifepristone followed by usual treatment appears to be
> effective and well tolerated in the treatment of psychosis in PMD. This
> study suggests that the antiglucocorticoid, mifepristone, might
> represent an alternative to traditional treatments of psychosis in
> psychotic depression.
> PMID: 16889757 [PubMed - indexed for MEDLINE]
>
>
>
> Related Articles
> • Clinical and biological effects of mifepristone treatment for
> psychotic depression. [Neuropsychopharmacology. 2006]
> • Rapid reversal of psychotic depression using mifepristone. [J Clin
> Psychopharmacol. 2001]
> • An open label trial of C-1073 (mifepristone) for psychotic major
> depression. [Biol Psychiatry. 2002]
> • An 8-week open-label trial of a 6-day course of mifepristone for
> the treatment of psychotic depression. [J Clin Psychiatry. 2005]
> • A double-blind randomized comparison of nortriptyline plus
> perphenazine versus nortriptyline plus placebo in the treatment of
> psychotic depression in late life. [J Clin Psychiatry. 2001]
> • » See all Related Articles...
Thanks for the references. They are interesting.

However, I do not suffer from Psychotic Major Depression.

Louise

Susan wrote:
> x-no-archive: yes
>
>
> Biol Psychiatry. 2006 Dec 15;60(12):1343-9. Epub 2006 Aug 4. Links
>
> Comment in:
> Biol Psychiatry. 2008 Jan 1;63(1):e1; author reply e3.
> Mifepristone versus placebo in the treatment of psychosis in patients
> with psychotic major depression.
> DeBattista C, Belanoff J, Glass S, Khan A, Horne RL, Blasey C, Carpenter
> LL, Alva G.
> Corcept Therapeutics, Menlo Park, California, USA. debattista@stanford.edu
>
> BACKGROUND: Abnormalities in the hypothalamic pituitary adrenal axis
> have been implicated in the pathophysiology of psychotic major
> depression (PMD). Recent studies have suggested that the
> antiglucocorticoid, mifepristone might have a role in the treatment of
> PMD. The current study tested the efficacy of mifepristone treatment of
> the psychotic symptoms of PMD. METHODS: 221 patients, aged 19 to 75
> years, who met DSM-IV and SCID criteria for PMD and were not receiving
> antidepressants or antipsychotics, participated in a double blind,
> randomized, placebo controlled study. Patients were randomly assigned to
> either 7 days of mifepristone (n = 105) or placebo (n = 116) followed by
> 21 days of usual treatment. RESULTS: Patients treated with mifepristone
> were significantly more likely to achieve response, defined as a 30%
> reduction in the Brief Psychiatric Rating Scale (BPRS). In addition,
> mifepristone treated patients were significantly more likely to achieve
> a 50% reduction in the BPRS Positive Symptom Scale (PSS). No significant
> differences were observed on measures of depression. CONCLUSION: A seven
> day course of mifepristone followed by usual treatment appears to be
> effective and well tolerated in the treatment of psychosis in PMD. This
> study suggests that the antiglucocorticoid, mifepristone, might
> represent an alternative to traditional treatments of psychosis in
> psychotic depression.
> PMID: 16889757 [PubMed - indexed for MEDLINE]
>
>
>
> Related Articles
> • Clinical and biological effects of mifepristone treatment for
> psychotic depression. [Neuropsychopharmacology. 2006]
> • Rapid reversal of psychotic depression using mifepristone. [J Clin
> Psychopharmacol. 2001]
> • An open label trial of C-1073 (mifepristone) for psychotic major
> depression. [Biol Psychiatry. 2002]
> • An 8-week open-label trial of a 6-day course of mifepristone for
> the treatment of psychotic depression. [J Clin Psychiatry. 2005]
> • A double-blind randomized comparison of nortriptyline plus
> perphenazine versus nortriptyline plus placebo in the treatment of
> psychotic depression in late life. [J Clin Psychiatry. 2001]
> • » See all Related Articles...

For clarification - I'm on the BP spectrum, non-psychotic,
diagnosed BPII

x-no-archive: yes

louise wrote:

> For clarification - I'm on the BP spectrum, non-psychotic, diagnosed BPII


Louise, I wasn't speculating as to your diagnosis so much as wanting to
provide information on the mechanism. Bipolar disorder is a very
frequent manifestation of hypercortisolemia, which should always be
evaluated with a multitude of tests before a psych diagnosis is given,
especially since both the cortisol and the psych meds can cause diabetes
or worsen it and make it treatment resistant.

Mifepristone works for BPD.

Susan

On Aug 5, 9:45*am, Susan <neverm...@nomail.com> wrote:
> x-no-archive: yes
>
> louise wrote:
> > For clarification - I'm on the BP spectrum, non-psychotic, diagnosed BPII
>
> Louise, I wasn't speculating as to your diagnosis so much as wanting to
> provide information on the mechanism. *Bipolar disorder is a very
> frequent manifestation of hypercortisolemia, which should always be
> evaluated with a multitude of tests before a psych diagnosis is given,
> especially since both the cortisol and the psych meds can cause diabetes
> or worsen it and make it treatment resistant.
>
> Mifepristone works for BPD.
>
> Susan

Susan: Regarding possible adverse effects possibly related to high
dose metformin, Did you say you were aware of either the FDA and or
the drug company looking into adrenal suppression and or electrolyte
imbalances as a result? I also would like to look into this potential
problem but I thought you can tell me how far you have gone with it
which could save me a step or two in researching it in terms of what
is being done about it if in fact metformin is the culprit. Thanks.

Larry/T2
Lantus/reduced dose metformin/low dose Amaryl.
2nd degree heart block/ resolving ?

x-no0-archive: yes

Larry wrote:

> Susan: Regarding possible adverse effects possibly related to high
> dose metformin, Did you say you were aware of either the FDA and or
> the drug company looking into adrenal suppression and or electrolyte
> imbalances as a result? I also would like to look into this potential
> problem but I thought you can tell me how far you have gone with it
> which could save me a step or two in researching it in terms of what
> is being done about it if in fact metformin is the culprit. Thanks.


No, I didn't say that. You may be recalling that I mentioned the NIH is
undertaking to study how badly statins suppress adrenal function, since
all of our adrenal steroids are manufactured from LDL cholesterol, which
goes up when our body needs more of those hormones.

The FDA and drug companies are completely useless and negligent in this
regard. For example, they list symptoms of adrenal suppression and
failure for a million drugs in the PDR, but fail to mention that the
drugs are causing adrenal failure or suppression outright. This came to
light for me when I told an inf. diseases doc I couldn't take anti
fungals because they shut down adrenal function, particularly
ketoconazole. He'd been rx'ing this drug for decades; it's used to
treat Cushing's syndrome because it literally shuts down cortisol
production in the adrenals. There are case reports of adrenal failure
with other anti fungals, too. When we looked it up, nowhere was it
mentioned, just the non specific symptoms of adrenal failure; nausea,
headache, weakness, fatigue, etc...

Susan

On Aug 6, 8:47*am, Susan <neverm...@nomail.com> wrote:
> x-no0-archive: yes
>
> Larry wrote:
> > Susan: Regarding possible adverse effects possibly related to high
> > dose metformin, Did you say you were aware of either the FDA and or
> > the drug company looking into adrenal suppression and or electrolyte
> > imbalances as a result? I also would like to look into this potential
> > problem but I thought you can tell me how far you have gone with it
> > which could save me a step or two in researching it in terms of what
> > is being done about it if in fact metformin is the culprit. Thanks.
>
> No, I didn't say that. You may be recalling that I mentioned the NIH is
> undertaking to study how badly statins suppress adrenal function, since
> all of our adrenal steroids are manufactured from LDL cholesterol, which
> goes up when our body needs more of those hormones.
>
> The FDA and drug companies are completely useless and negligent in this
> regard. *For example, they list symptoms of adrenal suppression and
> failure for a million drugs in the PDR, but fail to mention that the
> drugs are causing adrenal failure or suppression outright. *This came to
> light for me when I told an inf. diseases doc I couldn't take anti
> fungals because they shut down adrenal function, particularly
> ketoconazole. *He'd been rx'ing this drug for decades; it's used to
> treat Cushing's syndrome because it literally shuts down cortisol
> production in the adrenals. *There are case reports of adrenal failure
> with other anti fungals, too. *When we looked it up, nowhere was it
> mentioned, just the non specific symptoms of adrenal failure; nausea,
> headache, weakness, fatigue, etc...
>
> Susan

Thank you Susan for your input. Yes I do remember your comments about
Statins. Right now I am wondering about electroyte imbalance which
metformin may cause. Particulary high potassium levels that it may
cause. As you may know electrolyte imbalance can cause heart block in
some patients of which I am coping with at the moment.

Larry

x-no-archive: yes

Larry wrote:

> Thank you Susan for your input. Yes I do remember your comments about
> Statins. Right now I am wondering about electroyte imbalance which
> metformin may cause. Particulary high potassium levels that it may
> cause. As you may know electrolyte imbalance can cause heart block in
> some patients of which I am coping with at the moment.

I think you need to have endocrine evaluation, and a standing renin and
aldosterone test (stand upright for 30 minutes prior to and during blood
draw) and other adrenal hormones.

In addition, if you're having problems with electrolyte balance, perhaps
you need to stop the metformin for a while and see if things improve.

Also, don't ever pump your fist or allow a tight tournequet to be used
for your serum testing; it raises the potassium results and renders them
completely inaccurate, as will shaking of the test tube, or sitting out
too long after draw.

Susan

On Aug 6, 2:19*pm, Susan <neverm...@nomail.com> wrote:
> x-no-archive: yes
>
> Larry wrote:
> > Thank you Susan for your input. Yes I do remember your comments about
> > Statins. Right now I am wondering about electroyte imbalance which
> > metformin may cause. Particulary high potassium levels that it may
> > cause. As you may know electrolyte imbalance can cause heart block in
> > some patients of which I am coping with at the moment.
>
> I think you need to have endocrine evaluation, and a standing renin and
> aldosterone test (stand upright for 30 minutes prior to and during blood
> draw) and other adrenal hormones.
>
> In addition, if you're having problems with electrolyte balance, perhaps
> you need to stop the metformin for a while and see if things improve.
>
> Also, don't ever pump your fist or allow a tight tournequet to be used
> for your serum testing; it raises the potassium results and renders them
> completely inaccurate, as will shaking of the test tube, or sitting out
> too long after draw.
>
> Susan

Hello Susan: Just saw my Endo. today here in San Diego. Pretty
competent young Doc I'd say. Anyway at my request GAD test was done
and results today show 14+... high and indicates LADA. I've been
diagnosed by at least 2 doc before as T2. I do believe the recent
findings particularly supported by todays GAD results. So now
metformin, actos are dc'd, amaryl tapered and more insulin ( bolus
PP ) added. Where is dear "old Al?"

Larry/T2 changed to T 1 1/2 after 6 years of IR drugs which did very
little. Misdiagnosis from the beginning.

On Thu, 7 Aug 2008 21:34:51 -0700 (PDT), Larry <boelkowj@aol.com>
wrote:

>Larry/T2 changed to T 1 1/2 after 6 years of IR drugs which did very
>little. Misdiagnosis from the beginning.

Wow!! Glad it's sorted now!

Nicky.
T2 dx 05/04 + underactive thyroid
D&E, 100ug thyroxine
Last A1c 5.4% BMI 25

On Thu, 7 Aug 2008 21:34:51 -0700 (PDT), Larry
<boelkowj@aol.com> wrote:

>On Aug 6, 2:19*pm, Susan <neverm...@nomail.com> wrote:
>> x-no-archive: yes
>>
>> Larry wrote:
>> > Thank you Susan for your input. Yes I do remember your comments about
>> > Statins. Right now I am wondering about electroyte imbalance which
>> > metformin may cause. Particulary high potassium levels that it may
>> > cause. As you may know electrolyte imbalance can cause heart block in
>> > some patients of which I am coping with at the moment.
>>
>> I think you need to have endocrine evaluation, and a standing renin and
>> aldosterone test (stand upright for 30 minutes prior to and during blood
>> draw) and other adrenal hormones.
>>
>> In addition, if you're having problems with electrolyte balance, perhaps
>> you need to stop the metformin for a while and see if things improve.
>>
>> Also, don't ever pump your fist or allow a tight tournequet to be used
>> for your serum testing; it raises the potassium results and renders them
>> completely inaccurate, as will shaking of the test tube, or sitting out
>> too long after draw.
>>
>> Susan
>
>Hello Susan: Just saw my Endo. today here in San Diego. Pretty
>competent young Doc I'd say. Anyway at my request GAD test was done
>and results today show 14+... high and indicates LADA. I've been
>diagnosed by at least 2 doc before as T2. I do believe the recent
>findings particularly supported by todays GAD results. So now
>metformin, actos are dc'd, amaryl tapered and more insulin ( bolus
>PP ) added. Where is dear "old Al?"
>
>Larry/T2 changed to T 1 1/2 after 6 years of IR drugs which did very
>little. Misdiagnosis from the beginning.

Remind me. Haven't you suspected this for a while?

Good to know you can stop wondering and get on with the
right treatment.

Cheers, Alan, T2, Australia.
--
Everything in Moderation - Except Laughter.
Blog http://loraldiabetes.blogspot.com
DLife column http://tinyurl.com/5v74xr
http://loraltravel.blogspot.com (The Taj Mahal)

On Aug 8, 3:21*pm, Alan S <loralgtweightandca...@gmail.com> wrote:
> On Thu, 7 Aug 2008 21:34:51 -0700 (PDT), Larry
>
>
>
>
>
> <boelk...@aol.com> wrote:
> >On Aug 6, 2:19*pm, Susan <neverm...@nomail.com> wrote:
> >> x-no-archive: yes
>
> >> Larry wrote:
> >> > Thank you Susan for your input. Yes I do remember your comments about
> >> > Statins. Right now I am wondering about electroyte imbalance which
> >> > metformin may cause. Particulary high potassium levels that it may
> >> > cause. As you may know electrolyte imbalance can cause heart block in
> >> > some patients of which I am coping with at the moment.
>
> >> I think you need to have endocrine evaluation, and a standing renin and
> >> aldosterone test (stand upright for 30 minutes prior to and during blood
> >> draw) and other adrenal hormones.
>
> >> In addition, if you're having problems with electrolyte balance, perhaps
> >> you need to stop the metformin for a while and see if things improve.
>
> >> Also, don't ever pump your fist or allow a tight tournequet to be used
> >> for your serum testing; it raises the potassium results and renders them
> >> completely inaccurate, as will shaking of the test tube, or sitting out
> >> too long after draw.
>
> >> Susan
>
> >Hello Susan: Just saw my Endo. today here in San Diego. Pretty
> >competent young Doc I'd say. Anyway at my request GAD test was done
> >and results today show 14+... high and indicates LADA. I've been
> >diagnosed by at least 2 doc before as T2. I do believe the recent
> >findings particularly supported by todays GAD results. So now
> >metformin, actos are dc'd, amaryl tapered and more insulin ( bolus
> >PP ) added. Where is dear "old Al?"
>
> >Larry/T2 changed to T 1 1/2 after 6 years of IR drugs which did very
> >little. Misdiagnosis from the beginning.
>
> Remind me. Haven't you suspected this for a while?
>
> Good to know you can stop wondering and get on with the
> right treatment.
>
> Cheers, Alan, T2, Australia.
> --
> Everything in Moderation - Except Laughter.
> Bloghttp://loraldiabetes.blogspot.com
> DLife columnhttp://tinyurl.com/5v74xrhttp://loraltravel.blogspot.com(The Taj Mahal)- Hide quoted text -
>
> - Show quoted text -

Alan: I have never been overweight, metformin never seemed to improve
things. C-peptide seemed to show mid range endogenous insulin so doc
continued to assume I was T2 and treated as such adding on Actos and
then Amaryl. I managed to keep my A1c in low 7s with lots of exercise
and pretty good dieting. Actos didn't do anything and Amaryl worked to
improve fbg levels for a little while. I insisted to see an Endo and
also insisted that a GAD be done. So you know once again how patients
need to take charge as best they can. Consequently I've been over
medicated and have a heart block which could be related. This may
resolve itself since most orals are being tapered or dcd at this time.
Thanks for asking.

Larry

x-no-archive: yes

Larry wrote:

> Alan: I have never been overweight, metformin never seemed to improve
> things. C-peptide seemed to show mid range endogenous insulin so doc
> continued to assume I was T2 and treated as such adding on Actos and
> then Amaryl. I managed to keep my A1c in low 7s with lots of exercise
> and pretty good dieting. Actos didn't do anything and Amaryl worked to
> improve fbg levels for a little while. I insisted to see an Endo and
> also insisted that a GAD be done. So you know once again how patients
> need to take charge as best they can. Consequently I've been over
> medicated and have a heart block which could be related. This may
> resolve itself since most orals are being tapered or dcd at this time.
> Thanks for asking.
>


Larry, so sorry it took so long and that you had to find your own
diagnosis, like so many of us, while docs mess around and fumble.

I hope things will improve now that you're on the right track.

Susan

On Sat, 9 Aug 2008 06:42:49 -0700 (PDT), Larry
<boelkowj@aol.com> wrote:

>On Aug 8, 3:21*pm, Alan S <loralgtweightandca...@gmail.com> wrote:
>> On Thu, 7 Aug 2008 21:34:51 -0700 (PDT), Larry
>>
>>
>>
>>
>>
>> <boelk...@aol.com> wrote:
>> >On Aug 6, 2:19*pm, Susan <neverm...@nomail.com> wrote:
>> >> x-no-archive: yes
>>
>> >> Larry wrote:
>> >> > Thank you Susan for your input. Yes I do remember your comments about
>> >> > Statins. Right now I am wondering about electroyte imbalance which
>> >> > metformin may cause. Particulary high potassium levels that it may
>> >> > cause. As you may know electrolyte imbalance can cause heart block in
>> >> > some patients of which I am coping with at the moment.
>>
>> >> I think you need to have endocrine evaluation, and a standing renin and
>> >> aldosterone test (stand upright for 30 minutes prior to and during blood
>> >> draw) and other adrenal hormones.
>>
>> >> In addition, if you're having problems with electrolyte balance, perhaps
>> >> you need to stop the metformin for a while and see if things improve.
>>
>> >> Also, don't ever pump your fist or allow a tight tournequet to be used
>> >> for your serum testing; it raises the potassium results and renders them
>> >> completely inaccurate, as will shaking of the test tube, or sitting out
>> >> too long after draw.
>>
>> >> Susan
>>
>> >Hello Susan: Just saw my Endo. today here in San Diego. Pretty
>> >competent young Doc I'd say. Anyway at my request GAD test was done
>> >and results today show 14+... high and indicates LADA. I've been
>> >diagnosed by at least 2 doc before as T2. I do believe the recent
>> >findings particularly supported by todays GAD results. So now
>> >metformin, actos are dc'd, amaryl tapered and more insulin ( bolus
>> >PP ) added. Where is dear "old Al?"
>>
>> >Larry/T2 changed to T 1 1/2 after 6 years of IR drugs which did very
>> >little. Misdiagnosis from the beginning.
>>
>> Remind me. Haven't you suspected this for a while?
>>
>> Good to know you can stop wondering and get on with the
>> right treatment.
>>
>> Cheers, Alan, T2, Australia.
>> --
>> Everything in Moderation - Except Laughter.
>> Bloghttp://loraldiabetes.blogspot.com
>> DLife columnhttp://tinyurl.com/5v74xrhttp://loraltravel.blogspot.com(The Taj Mahal)- Hide quoted text -
>>
>> - Show quoted text -
>
>Alan: I have never been overweight, metformin never seemed to improve
>things. C-peptide seemed to show mid range endogenous insulin so doc
>continued to assume I was T2 and treated as such adding on Actos and
>then Amaryl. I managed to keep my A1c in low 7s with lots of exercise
>and pretty good dieting. Actos didn't do anything and Amaryl worked to
>improve fbg levels for a little while. I insisted to see an Endo and
>also insisted that a GAD be done. So you know once again how patients
>need to take charge as best they can. Consequently I've been over
>medicated and have a heart block which could be related. This may
>resolve itself since most orals are being tapered or dcd at this time.
>Thanks for asking.
>
>Larry

From reading the various forums I'm on, I'm starting to
believe that the traditional binary Type 1/Type 2 diagnosis
made in a hurry by overworked GPs is masking a significantly
higher number of MODY, LADA and variants not yet given a
name than the medical profession realises are part of the
diabetes spectrum.

I'm fairly certain I'm a "straight" Type 2, if there is such
a thing, in that my pancreas presently works but I've got
minimal first-phase response and I have insulin resistance;
but I'm also certain that there are a lot more people like
yourself who are being incorrectly treated for their
variant.


Cheers, Alan, T2, Australia.
--
Everything in Moderation - Except Laughter.
Blog http://loraldiabetes.blogspot.com
DLife column http://tinyurl.com/5v74xr
http://loraltravel.blogspot.com (The Taj Mahal)

Larry wrote:
> On Aug 8, 3:21 pm, Alan S <loralgtweightandca...@gmail.com> wrote:
>> On Thu, 7 Aug 2008 21:34:51 -0700 (PDT), Larry
>>
>>
>>
>>
>>
>> <boelk...@aol.com> wrote:
>>> On Aug 6, 2:19 pm, Susan <neverm...@nomail.com> wrote:
>>>> x-no-archive: yes
>>>> Larry wrote:
>>>>> Thank you Susan for your input. Yes I do remember your comments about
>>>>> Statins. Right now I am wondering about electroyte imbalance which
>>>>> metformin may cause. Particulary high potassium levels that it may
>>>>> cause. As you may know electrolyte imbalance can cause heart block in
>>>>> some patients of which I am coping with at the moment.
>>>> I think you need to have endocrine evaluation, and a standing renin and
>>>> aldosterone test (stand upright for 30 minutes prior to and during blood
>>>> draw) and other adrenal hormones.
>>>> In addition, if you're having problems with electrolyte balance, perhaps
>>>> you need to stop the metformin for a while and see if things improve.
>>>> Also, don't ever pump your fist or allow a tight tournequet to be used
>>>> for your serum testing; it raises the potassium results and renders them
>>>> completely inaccurate, as will shaking of the test tube, or sitting out
>>>> too long after draw.
>>>> Susan
>>> Hello Susan: Just saw my Endo. today here in San Diego. Pretty
>>> competent young Doc I'd say. Anyway at my request GAD test was done
>>> and results today show 14+... high and indicates LADA. I've been
>>> diagnosed by at least 2 doc before as T2. I do believe the recent
>>> findings particularly supported by todays GAD results. So now
>>> metformin, actos are dc'd, amaryl tapered and more insulin ( bolus
>>> PP ) added. Where is dear "old Al?"
>>> Larry/T2 changed to T 1 1/2 after 6 years of IR drugs which did very
>>> little. Misdiagnosis from the beginning.
>> Remind me. Haven't you suspected this for a while?
>>
>> Good to know you can stop wondering and get on with the
>> right treatment.
>>
>> Cheers, Alan, T2, Australia.
>> --
>> Everything in Moderation - Except Laughter.
>> Bloghttp://loraldiabetes.blogspot.com
>> DLife columnhttp://tinyurl.com/5v74xrhttp://loraltravel.blogspot.com(The Taj Mahal)- Hide quoted text -
>>
>> - Show quoted text -
>
> Alan: I have never been overweight, metformin never seemed to improve
> things. C-peptide seemed to show mid range endogenous insulin so doc
> continued to assume I was T2 and treated as such adding on Actos and
> then Amaryl. I managed to keep my A1c in low 7s with lots of exercise
> and pretty good dieting. Actos didn't do anything and Amaryl worked to
> improve fbg levels for a little while. I insisted to see an Endo and
> also insisted that a GAD be done. So you know once again how patients
> need to take charge as best they can. Consequently I've been over
> medicated and have a heart block which could be related. This may
> resolve itself since most orals are being tapered or dcd at this time.
> Thanks for asking.
>
> Larry
what was your GAD result?

are you on insulin now that pills have been discontinued?

--
kate
type 1 since 1987
www.diabetic-chat.org
www.diabetic-talk.org
http://www.diabetes-support.org.uk/n...diagnosed.html

On Aug 9, 3:02*pm, Tiger_Lily <m...@privacy.net> wrote:
> Larry wrote:
> > On Aug 8, 3:21 pm, Alan S <loralgtweightandca...@gmail.com> wrote:
> >> On Thu, 7 Aug 2008 21:34:51 -0700 (PDT), Larry
>
> >> <boelk...@aol.com> wrote:
> >>> On Aug 6, 2:19 pm, Susan <neverm...@nomail.com> wrote:
> >>>> x-no-archive: yes
> >>>> Larry wrote:
> >>>>> Thank you Susan for your input. Yes I do remember your comments about
> >>>>> Statins. Right now I am wondering about electroyte imbalance which
> >>>>> metformin may cause. Particulary high potassium levels that it may
> >>>>> cause. As you may know electrolyte imbalance can cause heart block in
> >>>>> some patients of which I am coping with at the moment.
> >>>> I think you need to have endocrine evaluation, and a standing renin and
> >>>> aldosterone test (stand upright for 30 minutes prior to and during blood
> >>>> draw) and other adrenal hormones.
> >>>> In addition, if you're having problems with electrolyte balance, perhaps
> >>>> you need to stop the metformin for a while and see if things improve..
> >>>> Also, don't ever pump your fist or allow a tight tournequet to be used
> >>>> for your serum testing; it raises the potassium results and renders them
> >>>> completely inaccurate, as will shaking of the test tube, or sitting out
> >>>> too long after draw.
> >>>> Susan
> >>> Hello Susan: Just saw my Endo. today here in San Diego. Pretty
> >>> competent young Doc I'd say. Anyway at my request GAD test was done
> >>> and results today show 14+... high and indicates LADA. I've been
> >>> diagnosed by at least 2 doc before as T2. I do believe the recent
> >>> findings particularly supported by todays GAD results. So now
> >>> metformin, actos are dc'd, amaryl tapered and more insulin ( bolus
> >>> PP ) added. Where is dear "old Al?"
> >>> Larry/T2 changed to T 1 1/2 after 6 years of IR drugs which did very
> >>> little. Misdiagnosis from the beginning.
> >> Remind me. Haven't you suspected this for a while?
>
> >> Good to know you can stop wondering and get on with the
> >> right treatment.
>
> >> Cheers, Alan, T2, Australia.
> >> --
> >> Everything in Moderation - Except Laughter.
> >> Bloghttp://loraldiabetes.blogspot.com
> >> DLife columnhttp://tinyurl.com/5v74xrhttp://loraltravel.blogspot.com(TheTaj Mahal)- Hide quoted text -
>
> >> - Show quoted text -
>
> > Alan: I have never been overweight, metformin never seemed to improve
> > things. C-peptide seemed to show mid range endogenous insulin so doc
> > continued to assume I was T2 and treated as such adding on Actos and
> > then Amaryl. I managed to keep my A1c in low 7s with lots of exercise
> > and pretty good dieting. Actos didn't do anything and Amaryl worked to
> > improve fbg levels for a little while. I insisted to see an Endo and
> > also insisted that a GAD be done. So you know once again how patients
> > need to take charge as best they can. Consequently I've been over
> > medicated and have a heart block which could be related. This may
> > resolve itself since most orals are being tapered or dcd at this time.
> > Thanks for asking.
>
> > Larry
>
> what was your GAD result?
>
> are you on insulin now that pills have been discontinued?
>
> --
> kate
> type 1 since 1987www.diabetic-chat.orgwww.diabetic-talk.orghttp://www.diabetes-support.org.uk/newly%20diagnosed.html- Hide quoted text -
>
> - Show quoted text -

Kate: I am still on Amaryl at 4mg/day but expect to drop that drug
very soon. Metformin and Actos are now dcd. ( I was just reading that
some docs think Actos/Avandia can be beneficial in preserving the
remaining little function of b-cells. I'm not sure about that). Lantus
9 IU at bedtime has been working wonders to improve fbg levels down to
normal range for first time since diagnosed some years ago. Now I am
starting Novalog short acting before breakfast and lunch. Maybe dinner
as well but usually don't have high bg levels post dinner for some
reason. I think of insulin therapy as a needed habit ... no more
difficult than carrying a pack of cigarettes around for smokers I
guess. .if you know what I mean.

Larry

Larry wrote:
> On Aug 9, 3:02 pm, Tiger_Lily <m...@privacy.net> wrote:
>> Larry wrote:
>>> On Aug 8, 3:21 pm, Alan S <loralgtweightandca...@gmail.com> wrote:
>>>> On Thu, 7 Aug 2008 21:34:51 -0700 (PDT), Larry
>>>> <boelk...@aol.com> wrote:
>>>>> On Aug 6, 2:19 pm, Susan <neverm...@nomail.com> wrote:
>>>>>> x-no-archive: yes
>>>>>> Larry wrote:
>>>>>>> Thank you Susan for your input. Yes I do remember your comments about
>>>>>>> Statins. Right now I am wondering about electroyte imbalance which
>>>>>>> metformin may cause. Particulary high potassium levels that it may
>>>>>>> cause. As you may know electrolyte imbalance can cause heart block in
>>>>>>> some patients of which I am coping with at the moment.
>>>>>> I think you need to have endocrine evaluation, and a standing renin and
>>>>>> aldosterone test (stand upright for 30 minutes prior to and during blood
>>>>>> draw) and other adrenal hormones.
>>>>>> In addition, if you're having problems with electrolyte balance, perhaps
>>>>>> you need to stop the metformin for a while and see if things improve.
>>>>>> Also, don't ever pump your fist or allow a tight tournequet to be used
>>>>>> for your serum testing; it raises the potassium results and renders them
>>>>>> completely inaccurate, as will shaking of the test tube, or sitting out
>>>>>> too long after draw.
>>>>>> Susan
>>>>> Hello Susan: Just saw my Endo. today here in San Diego. Pretty
>>>>> competent young Doc I'd say. Anyway at my request GAD test was done
>>>>> and results today show 14+... high and indicates LADA. I've been
>>>>> diagnosed by at least 2 doc before as T2. I do believe the recent
>>>>> findings particularly supported by todays GAD results. So now
>>>>> metformin, actos are dc'd, amaryl tapered and more insulin ( bolus
>>>>> PP ) added. Where is dear "old Al?"
>>>>> Larry/T2 changed to T 1 1/2 after 6 years of IR drugs which did very
>>>>> little. Misdiagnosis from the beginning.
>>>> Remind me. Haven't you suspected this for a while?
>>>> Good to know you can stop wondering and get on with the
>>>> right treatment.
>>>> Cheers, Alan, T2, Australia.
>>>> --
>>>> Everything in Moderation - Except Laughter.
>>>> Bloghttp://loraldiabetes.blogspot.com
>>>> DLife columnhttp://tinyurl.com/5v74xrhttp://loraltravel.blogspot.com(TheTaj Mahal)- Hide quoted text -
>>>> - Show quoted text -
>>> Alan: I have never been overweight, metformin never seemed to improve
>>> things. C-peptide seemed to show mid range endogenous insulin so doc
>>> continued to assume I was T2 and treated as such adding on Actos and
>>> then Amaryl. I managed to keep my A1c in low 7s with lots of exercise
>>> and pretty good dieting. Actos didn't do anything and Amaryl worked to
>>> improve fbg levels for a little while. I insisted to see an Endo and
>>> also insisted that a GAD be done. So you know once again how patients
>>> need to take charge as best they can. Consequently I've been over
>>> medicated and have a heart block which could be related. This may
>>> resolve itself since most orals are being tapered or dcd at this time.
>>> Thanks for asking.
>>> Larry
>> what was your GAD result?
>>
>> are you on insulin now that pills have been discontinued?
>>
>> --
>> kate
>> type 1 since 1987www.diabetic-chat.orgwww.diabetic-talk.orghttp://www.diabetes-support.org.uk/newly%20diagnosed.html- Hide quoted text -
>>
>> - Show quoted text -
>
> Kate: I am still on Amaryl at 4mg/day but expect to drop that drug
> very soon. Metformin and Actos are now dcd. ( I was just reading that
> some docs think Actos/Avandia can be beneficial in preserving the
> remaining little function of b-cells. I'm not sure about that). Lantus
> 9 IU at bedtime has been working wonders to improve fbg levels down to
> normal range for first time since diagnosed some years ago. Now I am
> starting Novalog short acting before breakfast and lunch. Maybe dinner
> as well but usually don't have high bg levels post dinner for some
> reason. I think of insulin therapy as a needed habit ... no more
> difficult than carrying a pack of cigarettes around for smokers I
> guess. .if you know what I mean.
>
> Larry
>
>

interesting that you have been left on the Amaryl

does the Dr have a reason for this, when you are on insulin?

--
kate
type 1 since 1987
www.diabetic-chat.org
www.diabetic-talk.org
http://www.diabetes-support.org.uk/n...diagnosed.html

On Aug 10, 9:36*am, Tiger_Lily <m...@privacy.net> wrote:
> Larry wrote:
> > On Aug 9, 3:02 pm, Tiger_Lily <m...@privacy.net> wrote:
> >> Larry wrote:
> >>> On Aug 8, 3:21 pm, Alan S <loralgtweightandca...@gmail.com> wrote:
> >>>> On Thu, 7 Aug 2008 21:34:51 -0700 (PDT), Larry
> >>>> <boelk...@aol.com> wrote:
> >>>>> On Aug 6, 2:19 pm, Susan <neverm...@nomail.com> wrote:
> >>>>>> x-no-archive: yes
> >>>>>> Larry wrote:
> >>>>>>> Thank you Susan for your input. Yes I do remember your comments about
> >>>>>>> Statins. Right now I am wondering about electroyte imbalance which
> >>>>>>> metformin may cause. Particulary high potassium levels that it may
> >>>>>>> cause. As you may know electrolyte imbalance can cause heart block in
> >>>>>>> some patients of which I am coping with at the moment.
> >>>>>> I think you need to have endocrine evaluation, and a standing renin and
> >>>>>> aldosterone test (stand upright for 30 minutes prior to and duringblood
> >>>>>> draw) and other adrenal hormones.
> >>>>>> In addition, if you're having problems with electrolyte balance, perhaps
> >>>>>> you need to stop the metformin for a while and see if things improve.
> >>>>>> Also, don't ever pump your fist or allow a tight tournequet to be used
> >>>>>> for your serum testing; it raises the potassium results and renders them
> >>>>>> completely inaccurate, as will shaking of the test tube, or sitting out
> >>>>>> too long after draw.
> >>>>>> Susan
> >>>>> Hello Susan: Just saw my Endo. today here in San Diego. Pretty
> >>>>> competent young Doc I'd say. Anyway at my request GAD test was done
> >>>>> and results today show 14+... high and indicates LADA. I've been
> >>>>> diagnosed by at least 2 doc before as T2. I do believe the recent
> >>>>> findings particularly supported by todays GAD results. So now
> >>>>> metformin, actos are dc'd, amaryl tapered and more insulin ( bolus
> >>>>> PP ) added. Where is dear "old Al?"
> >>>>> Larry/T2 changed to T 1 1/2 after 6 years of IR drugs which did very
> >>>>> little. Misdiagnosis from the beginning.
> >>>> Remind me. Haven't you suspected this for a while?
> >>>> Good to know you can stop wondering and get on with the
> >>>> right treatment.
> >>>> Cheers, Alan, T2, Australia.
> >>>> --
> >>>> Everything in Moderation - Except Laughter.
> >>>> Bloghttp://loraldiabetes.blogspot.com
> >>>> DLife columnhttp://tinyurl.com/5v74xrhttp://loraltravel.blogspot.com(TheTajMahal)- Hide quoted text -
> >>>> - Show quoted text -
> >>> Alan: I have never been overweight, metformin never seemed to improve
> >>> things. C-peptide seemed to show mid range endogenous insulin so doc
> >>> continued to assume I was T2 and treated as such adding on Actos and
> >>> then Amaryl. I managed to keep my A1c in low 7s with lots of exercise
> >>> and pretty good dieting. Actos didn't do anything and Amaryl worked to
> >>> improve fbg levels for a little while. I insisted to see an Endo and
> >>> also insisted that a GAD be done. So you know once again how patients
> >>> need to take charge as best they can. Consequently I've been over
> >>> medicated and have a heart block which could be related. This may
> >>> resolve itself since most orals are being tapered or dcd at this time..
> >>> Thanks for asking.
> >>> Larry
> >> what was your GAD result?
>
> >> are you on insulin now that pills have been discontinued?
>
> >> --
> >> kate
> >> type 1 since 1987www.diabetic-chat.orgwww.diabetic-talk.orghttp://www.diabetes-support...Hide quoted text -
>
> >> - Show quoted text -
>
> > Kate: I am still on Amaryl at 4mg/day but expect to drop that drug
> > very soon. Metformin and Actos are now dcd. ( I was just reading that
> > some docs think Actos/Avandia can be beneficial in preserving the
> > remaining little function of b-cells. I'm not sure about that). Lantus
> > 9 IU at bedtime has been working wonders to improve fbg levels down to
> > normal range for first time since diagnosed some years ago. Now I am
> > starting Novalog short acting before breakfast and lunch. Maybe dinner
> > as well but usually don't have high bg levels post dinner for some
> > reason. I think of insulin therapy as a needed habit ... no more
> > difficult than carrying a pack of cigarettes around for smokers I
> > guess. .if you know what I mean.
>
> > Larry
>
> interesting that you have been left on the Amaryl
>
> does the Dr have a reason for this, when you are on insulin?
>
> --
> kate
> type 1 since 1987www.diabetic-chat.orgwww.diabetic-talk.orghttp://www.diabetes-support.org.uk/newly%20diagnosed.html- Hide quoted text -
>
> - Show quoted text -

Kate: GAD Ab was 13.5... I am just starting at low dose Novalog 1-2 IU
prior to meals. I am sure Amaryl will be weaned off very soon as
Insulin dose is increased. I guess I am getting some benefit from
Amaryl in the meantime even though it might be a stressor on the
pancreas. I agree sooner the better to get off Amaryl. Plan to check
with Endo in a week or so.

Larry

Larry wrote:
> On Aug 10, 9:36 am, Tiger_Lily <m...@privacy.net> wrote:
>> Larry wrote:
>>> On Aug 9, 3:02 pm, Tiger_Lily <m...@privacy.net> wrote:
>>>> Larry wrote:
>>>>> On Aug 8, 3:21 pm, Alan S <loralgtweightandca...@gmail.com> wrote:
>>>>>> On Thu, 7 Aug 2008 21:34:51 -0700 (PDT), Larry
>>>>>> <boelk...@aol.com> wrote:
>>>>>>> On Aug 6, 2:19 pm, Susan <neverm...@nomail.com> wrote:
>>>>>>>> x-no-archive: yes
>>>>>>>> Larry wrote:
>>>>>>>>> Thank you Susan for your input. Yes I do remember your comments about
>>>>>>>>> Statins. Right now I am wondering about electroyte imbalance which
>>>>>>>>> metformin may cause. Particulary high potassium levels that it may
>>>>>>>>> cause. As you may know electrolyte imbalance can cause heart block in
>>>>>>>>> some patients of which I am coping with at the moment.
>>>>>>>> I think you need to have endocrine evaluation, and a standing renin and
>>>>>>>> aldosterone test (stand upright for 30 minutes prior to and during blood
>>>>>>>> draw) and other adrenal hormones.
>>>>>>>> In addition, if you're having problems with electrolyte balance, perhaps
>>>>>>>> you need to stop the metformin for a while and see if things improve.
>>>>>>>> Also, don't ever pump your fist or allow a tight tournequet to be used
>>>>>>>> for your serum testing; it raises the potassium results and renders them
>>>>>>>> completely inaccurate, as will shaking of the test tube, or sitting out
>>>>>>>> too long after draw.
>>>>>>>> Susan
>>>>>>> Hello Susan: Just saw my Endo. today here in San Diego. Pretty
>>>>>>> competent young Doc I'd say. Anyway at my request GAD test was done
>>>>>>> and results today show 14+... high and indicates LADA. I've been
>>>>>>> diagnosed by at least 2 doc before as T2. I do believe the recent
>>>>>>> findings particularly supported by todays GAD results. So now
>>>>>>> metformin, actos are dc'd, amaryl tapered and more insulin ( bolus
>>>>>>> PP ) added. Where is dear "old Al?"
>>>>>>> Larry/T2 changed to T 1 1/2 after 6 years of IR drugs which did very
>>>>>>> little. Misdiagnosis from the beginning.
>>>>>> Remind me. Haven't you suspected this for a while?
>>>>>> Good to know you can stop wondering and get on with the
>>>>>> right treatment.
>>>>>> Cheers, Alan, T2, Australia.
>>>>>> --
>>>>>> Everything in Moderation - Except Laughter.
>>>>>> Bloghttp://loraldiabetes.blogspot.com
>>>>>> DLife columnhttp://tinyurl.com/5v74xrhttp://loraltravel.blogspot.com(TheTajMahal)- Hide quoted text -
>>>>>> - Show quoted text -
>>>>> Alan: I have never been overweight, metformin never seemed to improve
>>>>> things. C-peptide seemed to show mid range endogenous insulin so doc
>>>>> continued to assume I was T2 and treated as such adding on Actos and
>>>>> then Amaryl. I managed to keep my A1c in low 7s with lots of exercise
>>>>> and pretty good dieting. Actos didn't do anything and Amaryl worked to
>>>>> improve fbg levels for a little while. I insisted to see an Endo and
>>>>> also insisted that a GAD be done. So you know once again how patients
>>>>> need to take charge as best they can. Consequently I've been over
>>>>> medicated and have a heart block which could be related. This may
>>>>> resolve itself since most orals are being tapered or dcd at this time.
>>>>> Thanks for asking.
>>>>> Larry
>>>> what was your GAD result?
>>>> are you on insulin now that pills have been discontinued?
>>>> --
>>>> kate
>>>> type 1 since 1987www.diabetic-chat.orgwww.diabetic-talk.orghttp://www.diabetes-support...Hide quoted text -
>>>> - Show quoted text -
>>> Kate: I am still on Amaryl at 4mg/day but expect to drop that drug
>>> very soon. Metformin and Actos are now dcd. ( I was just reading that
>>> some docs think Actos/Avandia can be beneficial in preserving the
>>> remaining little function of b-cells. I'm not sure about that). Lantus
>>> 9 IU at bedtime has been working wonders to improve fbg levels down to
>>> normal range for first time since diagnosed some years ago. Now I am
>>> starting Novalog short acting before breakfast and lunch. Maybe dinner
>>> as well but usually don't have high bg levels post dinner for some
>>> reason. I think of insulin therapy as a needed habit ... no more
>>> difficult than carrying a pack of cigarettes around for smokers I
>>> guess. .if you know what I mean.
>>> Larry
>> interesting that you have been left on the Amaryl
>>
>> does the Dr have a reason for this, when you are on insulin?
>>
>> --
>> kate
>> type 1 since 1987www.diabetic-chat.orgwww.diabetic-talk.orghttp://www.diabetes-support.org.uk/newly%20diagnosed.html- Hide quoted text -
>>
>> - Show quoted text -
>
> Kate: GAD Ab was 13.5... I am just starting at low dose Novalog 1-2 IU
> prior to meals. I am sure Amaryl will be weaned off very soon as
> Insulin dose is increased. I guess I am getting some benefit from
> Amaryl in the meantime even though it might be a stressor on the
> pancreas. I agree sooner the better to get off Amaryl. Plan to check
> with Endo in a week or so.
>
> Larry

ahhhhhhhh you have things under control

excellent! (question answered)

--
kate
type 1 since 1987
www.diabetic-chat.org
www.diabetic-talk.org
http://www.diabetes-support.org.uk/n...diagnosed.html

Larry wrote:
> On Aug 10, 2:43 pm, Tiger_Lily <m...@privacy.net> wrote:
>> Larry wrote:
>>> On Aug 10, 9:36 am, Tiger_Lily <m...@privacy.net> wrote:
>>>> Larry wrote:
>>>>> On Aug 9, 3:02 pm, Tiger_Lily <m...@privacy.net> wrote:
>>>>>> Larry wrote:
>>>>>>> On Aug 8, 3:21 pm, Alan S <loralgtweightandca...@gmail.com> wrote:
>>>>>>>> On Thu, 7 Aug 2008 21:34:51 -0700 (PDT), Larry
>>>>>>>> <boelk...@aol.com> wrote:
>>>>>>>>> On Aug 6, 2:19 pm, Susan <neverm...@nomail.com> wrote:
>>>>>>>>>> x-no-archive: yes
>>>>>>>>>> Larry wrote:
>>>>>>>>>>> Thank you Susan for your input. Yes I do remember your comments about
>>>>>>>>>>> Statins. Right now I am wondering about electroyte imbalance which
>>>>>>>>>>> metformin may cause. Particulary high potassium levels that it may
>>>>>>>>>>> cause. As you may know electrolyte imbalance can cause heart block in
>>>>>>>>>>> some patients of which I am coping with at the moment.
>>>>>>>>>> I think you need to have endocrine evaluation, and a standing renin and
>>>>>>>>>> aldosterone test (stand upright for 30 minutes prior to and during blood
>>>>>>>>>> draw) and other adrenal hormones.
>>>>>>>>>> In addition, if you're having problems with electrolyte balance, perhaps
>>>>>>>>>> you need to stop the metformin for a while and see if things improve.
>>>>>>>>>> Also, don't ever pump your fist or allow a tight tournequet to be used
>>>>>>>>>> for your serum testing; it raises the potassium results and renders them
>>>>>>>>>> completely inaccurate, as will shaking of the test tube, or sitting out
>>>>>>>>>> too long after draw.
>>>>>>>>>> Susan
>>>>>>>>> Hello Susan: Just saw my Endo. today here in San Diego. Pretty
>>>>>>>>> competent young Doc I'd say. Anyway at my request GAD test was done
>>>>>>>>> and results today show 14+... high and indicates LADA. I've been
>>>>>>>>> diagnosed by at least 2 doc before as T2. I do believe the recent
>>>>>>>>> findings particularly supported by todays GAD results. So now
>>>>>>>>> metformin, actos are dc'd, amaryl tapered and more insulin ( bolus
>>>>>>>>> PP ) added. Where is dear "old Al?"
>>>>>>>>> Larry/T2 changed to T 1 1/2 after 6 years of IR drugs which did very
>>>>>>>>> little. Misdiagnosis from the beginning.
>>>>>>>> Remind me. Haven't you suspected this for a while?
>>>>>>>> Good to know you can stop wondering and get on with the
>>>>>>>> right treatment.
>>>>>>>> Cheers, Alan, T2, Australia.
>>>>>>>> --
>>>>>>>> Everything in Moderation - Except Laughter.
>>>>>>>> Bloghttp://loraldiabetes.blogspot.com
>>>>>>>> DLife columnhttp://tinyurl.com/5v74xrhttp://loraltravel.blogspot.com(TheTajMahal)-Hide quoted text -
>>>>>>>> - Show quoted text -
>>>>>>> Alan: I have never been overweight, metformin never seemed to improve
>>>>>>> things. C-peptide seemed to show mid range endogenous insulin so doc
>>>>>>> continued to assume I was T2 and treated as such adding on Actos and
>>>>>>> then Amaryl. I managed to keep my A1c in low 7s with lots of exercise
>>>>>>> and pretty good dieting. Actos didn't do anything and Amaryl worked to
>>>>>>> improve fbg levels for a little while. I insisted to see an Endo and
>>>>>>> also insisted that a GAD be done. So you know once again how patients
>>>>>>> need to take charge as best they can. Consequently I've been over
>>>>>>> medicated and have a heart block which could be related. This may
>>>>>>> resolve itself since most orals are being tapered or dcd at this time.
>>>>>>> Thanks for asking.
>>>>>>> Larry
>>>>>> what was your GAD result?
>>>>>> are you on insulin now that pills have been discontinued?
>>>>>> --
>>>>>> kate
>>>>>> type 1 since 1987www.diabetic-chat.orgwww.diabetic-talk.orghttp://www.diabetes-support...quoted text -
>>>>>> - Show quoted text -
>>>>> Kate: I am still on Amaryl at 4mg/day but expect to drop that drug
>>>>> very soon. Metformin and Actos are now dcd. ( I was just reading that
>>>>> some docs think Actos/Avandia can be beneficial in preserving the
>>>>> remaining little function of b-cells. I'm not sure about that). Lantus
>>>>> 9 IU at bedtime has been working wonders to improve fbg levels down to
>>>>> normal range for first time since diagnosed some years ago. Now I am
>>>>> starting Novalog short acting before breakfast and lunch. Maybe dinner
>>>>> as well but usually don't have high bg levels post dinner for some
>>>>> reason. I think of insulin therapy as a needed habit ... no more
>>>>> difficult than carrying a pack of cigarettes around for smokers I
>>>>> guess. .if you know what I mean.
>>>>> Larry
>>>> interesting that you have been left on the Amaryl
>>>> does the Dr have a reason for this, when you are on insulin?
>>>> --
>>>> kate
>>>> type 1 since 1987www.diabetic-chat.orgwww.diabetic-talk.orghttp://www.diabetes-support...Hide quoted text -
>>>> - Show quoted text -
>>> Kate: GAD Ab was 13.5... I am just starting at low dose Novalog 1-2 IU
>>> prior to meals. I am sure Amaryl will be weaned off very soon as
>>> Insulin dose is increased. I guess I am getting some benefit from
>>> Amaryl in the meantime even though it might be a stressor on the
>>> pancreas. I agree sooner the better to get off Amaryl. Plan to check
>>> with Endo in a week or so.
>>> Larry
>> ahhhhhhhh you have things under control
>>
>> excellent! (question answered)
>>
>> --
>> kate
>> type 1 since 1987www.diabetic-chat.orgwww.diabetic-talk.orghttp://www.diabetes-support.org.uk/newly%20diagnosed.html- Hide quoted text -
>> 13.
>> - Show quoted text -
>
> Kate: This maybe should be a new thread... maybe not.. My GAD was
> reported at 13.02 U/ml. (URUP Labs). I tried to get there definition
> of U/ml since their range is 0.00-1.45 U/mL. I suspect that 13.02 is
> approximately 13 dilutions where 1 dilutions is equal to 2.0. If I am
> correct I still wonder why 13.02 rather than a multiple 13.0000 is
> reported. My understanding is 2 is one dilution 3 is two dilution etc.
> ie 1:2. 1:4, 1:8, 1:16 (the later is 4 U/mL).. ????
>
> Larry
tee hee

well, i 'got' the part where your GAD is 13.02 and NORMAL is 0.0 to 1.45

they didn't have GAD or c-peptide when i was diagnosed type 1, they went
on the ketones i had and the extremely quick weight loss (from 135 to 87
lbs in 3 weeks)

--
kate
type 1 since 1987
www.diabetic-chat.org
www.diabetic-talk.org
http://www.diabetes-support.org.uk/n...diagnosed.html

On Aug 10, 2:43*pm, Tiger_Lily <m...@privacy.net> wrote:
> Larry wrote:
> > On Aug 10, 9:36 am, Tiger_Lily <m...@privacy.net> wrote:
> >> Larry wrote:
> >>> On Aug 9, 3:02 pm, Tiger_Lily <m...@privacy.net> wrote:
> >>>> Larry wrote:
> >>>>> On Aug 8, 3:21 pm, Alan S <loralgtweightandca...@gmail.com> wrote:
> >>>>>> On Thu, 7 Aug 2008 21:34:51 -0700 (PDT), Larry
> >>>>>> <boelk...@aol.com> wrote:
> >>>>>>> On Aug 6, 2:19 pm, Susan <neverm...@nomail.com> wrote:
> >>>>>>>> x-no-archive: yes
> >>>>>>>> Larry wrote:
> >>>>>>>>> Thank you Susan for your input. Yes I do remember your commentsabout
> >>>>>>>>> Statins. Right now I am wondering about electroyte imbalance which
> >>>>>>>>> metformin may cause. Particulary high potassium levels that it may
> >>>>>>>>> cause. As you may know electrolyte imbalance can cause heart block in
> >>>>>>>>> some patients of which I am coping with at the moment.
> >>>>>>>> I think you need to have endocrine evaluation, and a standing renin and
> >>>>>>>> aldosterone test (stand upright for 30 minutes prior to and during blood
> >>>>>>>> draw) and other adrenal hormones.
> >>>>>>>> In addition, if you're having problems with electrolyte balance,perhaps
> >>>>>>>> you need to stop the metformin for a while and see if things improve.
> >>>>>>>> Also, don't ever pump your fist or allow a tight tournequet to be used
> >>>>>>>> for your serum testing; it raises the potassium results and renders them
> >>>>>>>> completely inaccurate, a