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-boot to Windows 7 upgrade cd (usually f12 than select cd rom from bios screen)
-Choose custom and install on partition or create new partition and start the windows install
-when asked to enter product key dont and uncheck the activate windows automatically when connected to the internet….click next
-when install is complete go to control panel>system>activate windows.
-Enter your product activation code
-click next…(the activation will fail)
-click activate by phone and call the number, follow the instructions on the automated call, enter the code that the automated 1800 number gives you…and click next
YOU HAVE JUST ACTIVATED A CLEAN INSTALL WITH A UPGRADE CD.. NO NEED TO BUY A FULL INSTALL CD.
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Case Western Reserve University has granted an 18-month, exclusive option to startup Thermalin Diabetes Inc. regarding a portfolio of insulin analogs. The company must reach certain milestones in order to exercise its option to obtain an exclusive license on therapies designed to help patients with diabetes.
Cleveland-based Thermalin Diabetes is developing treatments that it hopes will become an important part of the $12 billion, rapidly growing insulin market. Insulin is a therapeutic protein used to manage blood sugar levels. Innovations in the 1990s led to the introduction of insulin analogs with superior therapeutic performance.
“This is one of the coolest technologies that we’ve seen, because of the potential to serve mankind,” said Joseph Jankowski, Case Western Reserve’s associate vice president for technology management within the university’s Technology Transfer Office.
Potential for improved treatment of Type 1 and Type 2 diabetes results from the work of Dr. Michael Weiss, chairman of the Biochemistry Department at Case Western Reserve University’s School of Medicine. His approximately 20 years of research into the structure and function of biological molecules has focused on insulin, insulin analogs and insulin receptors.
New and improved insulin analogs will offer attractive alternatives for patients and may also revolutionize the use of insulin pumps. Jankowski said important characteristics of these insulin analogs are that they are faster acting with fewer side effects, have stability without refrigeration and are long acting with lower potential risk of cancer.
Thermalin Diabetes has closed more than $275,000 in seed financing from individual investors.
“We are very pleased to have the support of so many individuals in the Cleveland community,” said Weiss, who is founder and chief scientific officer of Thermalin Diabetes. “While we have a long way to go, I am hopeful that together we can create a great biotech success for Cleveland.”
Thermalin Diabetes also has received a $254,000 Phase I Small Business Technology Transfer Grant from the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health. This grant is intended to support the development of one of Thermalin’s insulin analogs through large animal testing. When the company achieves the grant’s specific aims, it will be eligible for significant additional grant funding to advance the compound to human clinical trials.
Among the company’s early backers is Dick Dietrich, co-founder of Integral Inc. and a long-time supporter of the Diabetes Association of Greater Cleveland and the Dietrich Diabetes Research Institute.
Weiss’ scientific work with insulin has been enriched by a gifted group of students and fellows. Colleagues at CWRU are Qing-xin Hua, S. Nakagawa, Zhu-li Wan, Nelson Phillips, Faramarz Ismail-Beigi and Jonathan Whittaker, and long-term collaborators are Guy Dodson (University of York, UK), Panno Katsoyannis (Mt. Sinai School of Medicine, NY) and Don Steiner (University of Chicago).
Source: Marv Kropko
Case Western Reserve University
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OTTAWA, Dec. 7 (Xinhua) — Diabetes will present a serious challenge to Canada in the next 20 years as the number of patients soars to about 10 percent of the total population, according to a report released Monday by the Canadian Diabetes Association.
In 2000, 1.3 million Canadians were living with diabetes, but that number is projected to rise to 2.5 million by next year and 3.7 million by 2020, states the report, entitled “An Economic Tsunami: the Cost of Diabetes in Canada.”
Meanwhile the total population with diabetes will rise from 4.2percent in 2000 to 7.3 percent in 2010, to 9.9 percent by 2020. About 10 percent of Canadians will be diagnosed with diabetes by 2020.
The increasing number of patients with the disease could set up an “economic tsunami,” presenting a huge burden to the health care system.
The cost of treating the disease will soar to 12.2 billion Canadian dollars (11.6 billion U.S. dollars) in 2010 and to almost 17 billion Canadian dollars (16 billion U.S. dollars) in the next decade, nearly double the costs of a decade ago.
The report attributes the soaring rates to Canada’s changing ethnic makeup, growing rates of obesity, sedentary lifestyle and aging population.
To stop the growth of the disease, the report calls for more resources to help patients manage their disease, a new Canadian diabetes strategy as well as an aboriginal diabetes initiative, and more investment in high-quality research.
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Type 2 diabetes and obesity are linked to an increased risk of certain cancers. Recently published studies suggested that insulin glargine (a synthetic insulin preparation marketed under the trade name Lantus), may be associated with a higher risk of certain cancers than other insulins or oral glucose lowering medications. However, these studies were unable to control for important factors such as obesity that may have driven the association.
On the other hand, a large randomized trial designed to examine another aspect of diabetes care, which used insulin glargine in one arm, showed no increase in the frequency of cancer with glargine.
To help resolve this important issue, scientists at the University of North Carolina at Chapel Hill are coordinating a large, multi-site retrospective study on insulin users with type 2 diabetes. The study is designed to determine if diabetic patients exposed to insulin glargine have a higher incidence of cancer than diabetic patients exposed to other insulins or to other glucose-lowering medications. Data will be collected from administrative and electronic-medical record databases.
Within this effort, there will be two parallel studies. The principal investigators of the first study are Laurel Habel, Ph.D. and Assiamira Ferrara, M.D., Ph.D. from the Division of Research at Kaiser Permanente Northern California and Daniel Strickland, Ph.D. at the Department of Research and Evaluation at Kaiser Permanente Southern California. Additional sites are being recruited nationwide to conduct a second study to allow for alternative, confirmatory and combined analyses.
The principal investigator of the study, John B. Buse, M.D., Ph.D. , chief of the Division of Endocrinology & Metabolism in the Department of Medicine at UNC, said, “This study is the largest effort to date that examines the hypothetical insulin-cancer relationship. Both its size and the quality of the data will clearly enable us to provide a much better estimate of the safety of glargine in particular and insulin in general with regards to cancer risk.”
The study plans to analyze data from about 400,000 people with diabetes, determine their use of diabetes treatments including insulin, and document the incidence of cancer. “We have recruited a truly exceptional group of scientists and resources from across the country to provide as definitive a resolution to the issue as possible over the next year and a half.” said Buse.
The study is being funded by a research grant from the sanofi-aventis company. In addition to Buse, the UNC team coordinating the effort includes Til Sturmer, M.D., M.P.H. and Lisa LaVange, Ph.D. respectively from the Pharmacoepidemiology Program in the Department of Epidemiology and the Collaborative Studies Coordinating Center in the Department of Biostatistics at the UNC Gillings School of Global Public Health as well as collaborators from UNC’s Translational and Clinical Sciences (TraCS) Institute, the academic home of the NIH Clinical and Translational Science Awards (CTSA); UNC’s Lineberger Comprehensive Cancer Center; the Cecil G. Sheps Center for Health Services Research; the Institute for Pharmacogenomics and Individualized Therapy in the Eshelman School of Pharmacy and the UNC Diabetes Center in the School of Medicine. Scientists from the American Diabetes Association and the American Cancer Society are providing voluntary technical advice.
Source
University of North Carolina at Chapel Hill School of Medicine
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Veggies in Pregnancy Lowers Child’s Diabetes Risk DATE: November 13, 2009
Children born to mothers who ate plenty of vegetables during pregnancy are less likely to have type 1 diabetes, Swedish researchers say. “This is the first study to show a link between vegetable intake during pregnancy and the risk of the child subsequently developing type 1 diabetes, but more studies of various kinds will be needed before we can say anything definitive,” study author Hilde Brekke, a clinical nutritionist at the Sahlgrenska Academy at the University of Gothenburg, said in a news release from the university.
Brekke and colleagues studied 6,000 5-year-olds and found that 3 percent either had fully developed type 1 diabetes or had elevated levels of antibodies that indicate a risk of developing the disease. The risk was twice as high in children whose mothers rarely ate vegetables during pregnancy, and lowest among children whose mothers ate vegetables every day of their pregnancy. The study was recently published online in the journal Pediatric Diabetes. “We cannot say with certainty on the basis of this study that it’s the vegetables themselves that have this protective effect, but other factors related to vegetable intake, such as the mother’s standard of education, do not seem to explain the link,” Brekke said. “Nor can this protection be explained by other measured dietary factors or other known risk factors.” While it’s not known what actually causes type 1 diabetes, factors believed to play a role include immunological mechanisms, environmental toxins and genetic variations. Type 1 diabetes occurs throughout the world but is most common in Finland and Sweden.
DATE: November 06, 2009
Research shows exercise and changes in diet successfully turn back the clock. November is American Diabetes Month. Bariatric physician Dr. Caroline Cederquist, M.D. says there’s no time like this month to start living healthy. Right now, 57 million people in America are at risk for type 2 diabetes. These are staggering numbers for a much too common disease that leads to serious health issues: two out of three people with diabetes die from heart disease or stroke and many suffer nerve damage and kidney failure as well. With awareness and action, diabetes is preventable. Experts urge those 57 million at-risk Americans to make the changes that could save their lives.
November is American Diabetes Month. Bariatric physician Dr. Caroline Cederquist, M.D. says there’s no time like this month to start living healthy. While it’s commonly known that exercise and weight loss can lower risk, the numbers are still astounding. “Getting in half an hour of moderate physical activity a few days a week, as well as reducing body weight by 5-10%, can cut your risk of developing diabetes by a whopping 58%,” Dr. Cederquist states. As a result of exchanging a sedentary lifestyle for an active one, you could lower the threat by more than half. The reality of these statistics should motivate everyone to hit the gym or go for a long walk after dinner. While physical activity can significantly improve odds, there’s more to diabetes prevention than exercise. The connection between diabetes and carbohydrates is also important to understand. “Research indicates that the body absorbs carbohydrates from different foods at varying rates, leading to diverse effects on levels of blood glucose and insulin.” “Simple carbohydrate foods–such as white rice, white bread, and refined sugar–score high on the glycemic index. These foods cause a rapid spike and then a drop in blood glucose.” “High-fiber foods –like the complex carbohydrates found in whole grains–are lower on the glycemic index and have a more gradual effect on blood sugar and insulin,” Dr. Cederquist explains. “Because high-glycemic index foods abruptly and significantly increase blood glucose levels, they increase the body’s demand for insulin.” “This may contribute to problems with the pancreas, the organ that produces insulin, eventually leading to diabetes.” “Making time for exercise as well as eating a proper diet could change, and even save, your life,” Dr. Cederquist summarizes. Dr. Caroline Cederquist, M.D. is board certified in family medicine and bariatrics, the specialty of medical weight loss.
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Higher Blood Pressure Tied to Fructose Consumption DATE: October 30, 2009
A diet high in a form of sugar found in sweetened soft drinks and junk food raises blood pressure among men, according to research likely to mean more bad news for beverage companies and restaurant chains. One of two studies released last month provided the first evidence that fructose helps raise blood pressure. It also found that the drug allopurinol, used to treat gout, can alleviate the effect by reducing uric acid levels in the body. The second study, which measured fructose intake in mice, suggested that people who consume junk foods and sweetened soft drinks at night could gain weight faster than those who don’t.
“These results suggest that excessive fructose intake may have a role in the worldwide epidemic of obesity and diabetes,” said Dr. Richard Johnson of the University of Colorado-Denver, who studied the link between blood pressure and men. The findings provide the latest evidence of ties between sugar-rich diets and health problems that have prompted some experts to call for a tax on sugary soft drinks. Fructose accounts for about half the sugar molecules in table sugar and in high-fructose corn syrup, the sweetener used in many packaged foods. Johnson and colleagues at the Mateo Orfila Hospital in Spain studied 74 men given 200 grams of fructose per day on top of their regular diet. That amount is well above a daily intake of 50 grams to 70 grams of fructose consumed by most American adults. Half the men were also given allopurinol. After two weeks, the men who received only the fructose registered increases of six millimeters in systolic blood pressure — the top reading — and about three millimeters in diastolic or the bottom reading, the researchers told an American Heart Association meeting in Chicago. Most of their blood pressure readings returned to normal levels after two months. The men who did not get allopurinol also were twice as likely to develop metabolic syndrome, measured by risk factors such as too much abdominal fat, high blood pressure and poor cholesterol readings. By contrast, those given allopurinol and fructose had significantly lower uric acid levels, and virtually no increase in systolic blood pressure or higher risk of metabolic syndrome.
For the second study, researchers in Ohio studied mice given fructose water to drink. Some had unrestricted access, while others received it during the day or at night. “The first thing we noticed was that the mice on restricted access rushed to their drinking bottles to load up on the sweetened beverage, similar to teenagers who drink too many soft drinks,” said Mariana Morris of Wright State University in Dayton, Ohio. The mice that drank fructose water during their regular daylight sleeping hours gained more weight and had higher stress hormone levels than the other mice. “This model may be similar to the human condition of night time bingeing of fructose-laden foods and beverages,” Morris said. The American Heart Association says women should eat no more than 100 calories of added processed sugar per day, or six teaspoons (25 grams), while most men should keep it to just 150 calories or nine teaspoons (37.5 grams). On average Americans consume 22 teaspoons (90 grams) or 355 calories of added sugar each day.
Three years after she made medical history and was freed from painful insulin injections, 9 year old Lilly Jaffe is just beginning to understand how much her story changed the course of diabetes research and treatment. Since her breakthrough, 70 other children and several adults in the U.S. also have been able to switch from insulin shots to oral medication. And last month, her story inspired Illinois’ adoption of “Lilly’s Law,” which established a registry in hopes of helping other children and gathering more genetic information on diabetes. “When I first got off insulin, I was happy, a little nervous and confused,” Lilly said during an interview at her North Shore Chicago home. “Now I know that if I hadn’t shared my story, then none of those children would have known about this. I want even more people to know.”
Lilly’s story began when researchers at the University of Chicago found she had a rare genetic mutation known as monogenic diabetes. Although she had been taking insulin injections since she was a baby, the discovery allowed her to take pills usually used to treat a milder Type 2 diabetes instead. A September 2006 story about Lilly’s diagnosis by Tribune science writer Peter Gorner triggered hundreds of inquiries from families across the U.S. who believed their children might also have the genetic mutation. Some of those were among the 70 that, indeed, had the same mutation as Lilly; others possessed a different genetic variant that formed the basis for another groundbreaking research paper published in 2007. This summer, Lilly was able to share her remarkable tale with dozens of other children affected by diabetes when she traveled to London. Along with her mother, Laurie Jaffe, she attended a neonatal diabetes conference with the two British researchers who discovered her mutation, Dr. Andrew Hattersley and Dr. Frances Ashcroft. “That was incredible for Lilly because she got to meet and make friends with some children that were directly affected by her story,” her mother said.
After Lilly’s life-changing switch from injections to pills, Laurie Jaffe began moderating an e-mail discussion among parents with children who have monogenic diabetes. Initially, it was little more than an online support group, but through the discussions the families stumbled onto links between the mutation and neurological issues and began gathering informal data on a brand new field of diabetes research. Dr. Louis Philipson, medical director of the Kovler Diabetes Center at the University of Chicago, said it was well-known that some diabetes patients with mutations also have neurological problems. Therefore, he and his colleagues follow the family discussion group closely. Philipson and his team have begun working with neurodevelopmental experts to better understand the connection between diabetes and the brain. “These genes that cause diabetes are not only expressed in the cells that make insulin, but are playing a role in the brain and elsewhere,” Philipson said. “It is a relatively new (study) area … less than five years. It points out how exciting a time this is for medicine and biology, to better understand the role of genes in disease.”Lilly was diagnosed with Type 1 diabetes, the more serious form, at the age of 1 month. Also known as juvenile diabetes, Type 1 is most often diagnosed in childhood and adolescence, but it strikes adults as well. About 15,000 children are diagnosed with diabetes in the U.S. every year, according to the Juvenile Diabetes Research Foundation.
Lilly started with insulin shots to stabilize her blood sugar, but after two frightening nighttime seizures, she was switched to an insulin pump that was attached to her hip. With the pump, Lilly’s mother still had to monitor her glucose levels about 10 times a day and move the painful infusion sites from leg to leg to avoid irritation and infection. In June 2006, her parents learned about Philipson’s cutting-edge diabetes research. He told them of a new study that showed some children diagnosed with Type 1 diabetes in the first six months of life actually have an unusual mutation of Type 1 that can be treated with pills. Soon, Lilly was found to have the rare genetic mutation. A couple of months later, Lilly was able to start the first grade completely insulin-free, taking five glyburide pills twice a day. With Lilly now in fourth grade and leading a more active life, her mother said the goal now is to identify more people, advance research and eventually find a cure. Researchers estimate there are about 2,000 people in the U.S. with Lilly’s genetic mutation who could benefit from the breakthrough. “There are so many more people out there that can be helped, but it’s (a matter of) identifying them,” Laurie Jaffe said. “And it’s not just children. … The adults that have been found are those that have had children with monogenic diabetes.” Hoping to find more patients and gather more genetic information to study, University of Chicago doctors proposed the creation of the first state-mandated diabetes registry. They crafted legislation after joining forces with Rep. Tom Cross (R-Oswego), whose 16-year-old daughter, Reynolds, has Type 1 diabetes, although not the mutation. The bill officially became “Lilly’s Law” when signed by Gov. Pat Quinn last month. Lilly’s Law requires Illinois physicians to register all children with diabetes onset before 12 months of age to the state Department of Public Health. Its backers hope the registry, which was approved as a 3-year-pilot program, leads to further advances in understanding the genetic cause of diabetes. “Many of the genes that cause special forms of diabetes are not yet known,” Philipson said. “This is not only for the knowledge, but for specific treatment and for the family members to understand the genetic risks to future generations.” After Lilly stopped taking insulin, her mother said that one of her first questions was whether her two cousins with Type 1 diabetes could get off insulin, too. She was disappointed to learn they didn’t have the mutation, so they could not. “Now, we’re committed to finding cures for our nieces, cousins, and all our friends,” Laurie Jaffe said.
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Foods to Help Prevent Diabetes DATE: October 09, 2009
New guidelines from Harvard advises US consumers on the the types of food, beverages or ingredients that can help ward off diabetes, with recommendations including moderate coffee and alcohol alongside fiber and nuts. Havard Medical School’s report Healthy Eating for Type 2 Diabetes, explains how food choices, as well as weight control, can help manage and “even prevent” diabetes. The authors of the paper, which is designed as guidance to consumers, say that research into the relationship between eating specific types of foods and diabetes risk is “limited and the results somewhat controversial.”
They drew their conclusions from studies that required people to report what they ate or drank, and pointed out these were considered less rigorous than those in which people are assigned to follow different diets. Both men and women who eat plenty of whole grains had a roughly 40 percent lower risk of diabetes than those who eat little, with cereals, breads, and grains apparently the most beneficial. “Fiber slows the digestion of food, so glucose is released into the bloodstream more gradually, and you feel full longer,” writes the paper. “This can help you avoid overeating and becoming overweight, thus reducing your risk of diabetes. Soluble fiber in particular appears to improve both blood sugar and insulin sensitivity, and high-fiber diets may even lower the need for insulin.”
Women who eat nuts or peanut butter at least five times a week have a 20 to 30 percent lower risk of diabetes than those who rarely eat them. However the authors stressed that “these are not wonder foods that will magically ward off diabetes.” They said there is no specific ‘diabetes diet’ that prohibits sugar and lists other ingredients to avoid, but said people with diabetes should follow the same dietary advice as most people, but with extra emphasis on controlling weight and keeping blood sugar, blood pressure, and cholesterol values as close to normal as possible. The authors recommended a well-balanced diet that emphasizes fruit, vegetables, whole grains, and lean protein, while watching calorie intake and getting regular exercise.
Among the high risk foods, women who drink two or more sugary soft drinks have a 24 percent higher risk of developing diabetes compared to those who consume less than one per month, and two or more daily fruit drinks (with little real fruit juice) lead to a 31 percent higher risk. Women who eat around one serving of red meat a day have about a 20 percent higher risk of diabetes than those who eat at least one serving a week, and men who eat processed meats five times a week are nearly twice as likely to develop diabetes as men who eat such foods just twice a month. One study documented a 30 percent increased risk of diabetes among women who ate the most trans fats compared to those who ate the least. The report quoted American Heart Association findings that the incidence of hypertension is twice as common among people with diabetes as it is among the general public. It recommended the equivalent of approximately one teaspoon of table salt, saying that most Americans consume much more. It also warned that too many refined carbohydrates, from which valuable nutrients, fiber, and vitamins are removed during the refinement process, can cause a significant spike in blood sugar and increase insulin requirements if eaten in large quantities.
The report also highlighted the potential benefits of some products not traditionally considered to be ‘healthy’. It noted that one cup of coffee a day could lower diabetes risk by 13 percent and two cups a day could cut the risk by 42 percent, compared to people who drink none. While warning that alcohol can be a double-edged sword because of its detrimental effect on heart health, the report reveals that men who have two to four drinks per week had a 25 percent lower risk than teetotalers. Five to six drinks per week drops the risk by 33 percent and one drink a day cut risk by 43 percent. “There’s some evidence that light to moderate alcohol intake can lower insulin resistance and enhance glucose metabolism in people with diabetes,” wrote the authors. “It’s also well documented that alcohol improves insulin sensitivity only when people drink light to moderate amounts.” Heavy consumption has the opposite effect, they said.
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Diet Can Help in Avoiding Drug Therapy
DATE: September 04, 2009
In the longest-term study of its kind, researchers pitted two popular diets head to head – a low-fat American Heart Association–style diet and a carb-controlled Mediterranean diet, each combined with regular physical activity – in a population of overweight patients who had Type 2 diabetes. Researchers found that over the four-year study, patients who adhered to the Mediterranean-style eating plan maintained lower blood-sugar levels for a longer time than those in the low-fat-diet group. On the basis of their findings, the study’s authors suggest that some diabetes patients may be able to substitute diet and exercise for blood-sugar-lowering medications.
The study involved 215 overweight adults in Naples, Italy, who were newly diagnosed with Type 2 diabetes. Patients were randomly divided into two diet groups: the low-fat eaters were instructed to follow a regimen rich in whole grains, fruits and vegetables and low in additional fats, sweets and high-fat snacks; no more than 30% of daily calories were to come from fat and no more than 10% from saturated fat. The Mediterranean-diet group was taught to eat lots of fruits, vegetables, whole grains and healthy fats, including olive oil, with an emphasis on lean protein sources such as fish, chicken and nuts. Mediterranean dieters were instructed to limit carbohydrate intake to less than 50% of their daily calories. All dieters were encouraged to exercise regularly and received regular nutrition counseling throughout the course of the study. Regardless of the specific eating plan, the study’s participants were required to restrict their daily caloric intake: 1,800 calories maximum per day for men, and 1,500 calories daily for women – a significant reduction from what the average American eats daily (about 2,600 calories for men and 1,800 calories for women, according to government statistics). By the end of the study, which was published in the Sept. 1 issue of the Annals of Internal Medicine, 56% of patients following the Mediterranean diet were able to control their blood sugar without medication, compared with 30% of those on the low-fat regimen. The Mediterranean dieters were also able to maintain slightly more weight loss than the low-fat group – 8.4 lb. vs. 7.1 lb. – and showed small improvements in triglyceride and HDL cholesterol (the good kind) levels, both risk factors for heart disease.
“A Mediterranean-style diet is a very important part in the treatment of diabetes. We knew that,” says Dr. Loren Greene, a New York University Medical Center endocrinologist, who was not involved in the study. “But there just hasn’t been a good study to confirm this before.” Some past studies have suggested that eating fewer carbohydrates can help diabetes patients lower their blood sugar. Other research has shown that intake of monounsaturated fats like olive oil can improve patients’ insulin sensitivity, allowing the body to naturally control blood sugar more effectively. The current study does not make clear, however, whether diet alone can reduce blood sugar enough to eliminate the use of diabetes medication or whether it is even advisable to forgo medication at all. Participants in the new study were kept off drugs when their A1C levels – a measurement that indicates a patient’s blood-sugar levels over the previous three months – were below 7%, the standard cutoff for what is considered controlled blood sugar. But “we don’t know for sure if people with A1C levels under 7% still need to be on drugs,” says Greene. “The research just hasn’t answered that question yet.” Recent studies suggest that using blood-sugar-controlling medication even among the 57 million Americans who have prediabetes – meaning they have elevated, but not dangerously high blood sugar and are at very high risk of developing diabetes – may prevent the development of heart disease and stroke. While diabetes doctors generally agree that the first line of defense against Type 2 diabetes should always be exercise and diet, many recommend also using drugs. For its part, the American Diabetes Association advises patients with Type 2 diabetes to make appropriate lifestyle changes and to start a drug regimen immediately upon diagnosis. Dr. R. Paul Robertson, a spokesperson for the organization, says that for people with diabetes, “the goal should not be to avoid drugs. It is to do everything you can to keep your sugar levels down.”
Still, many doctors acknowledge patients’ aversion to chronic drug-taking. “Almost universally, people don’t want to take medicine if they can avoid it,” says Greene. And physicians, including internist Dr. Christine Laine, who is the editor of the Annals of Internal Medicine, point out that the direct and indirect costs associated with taking a drug – even one as widely prescribed as the generic diabetes medication metformin – can serve as a barrier for many patients, especially among disadvantaged populations and those without health insurance. Whether avoidance of medication in certain cases proves to be reasonable, for now it can at least be used as an effective incentive to improve lifestyle habits, says Greene: “If you are told, ‘If you don’t want to go on medicine, stick to this diet,’ then that’s a pretty valuable tool at least for patient compliance.”
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