Thiazide diuretics (WAS: Metformin again)

[Guest guest]

Vicki

> One of them was an osteoporosis study for

> Fosamax...it covered two years and at my last visit

> and tests was when my diabetes was discovered

> as an incidental finding. I had absolutely no symptoms.

> Furthermore, I got a notice from them about six months

> later that i'd been on the Fosamax placebo.

Did they follow up the possibility that Fosamax placebo causes diabetes,

Vicki? That would be as logical a conclusion as many that we see drawn from

study results from time to time.

I have just been shifted from Atacand 16mg to Atacand Plus 16/12.5 mg. The

difference is that Atacand Plus includes hydrochlorothiazide, a diuretic.

The package insert warns:

" Treatment with hydrochlorothiazide can degrade glucose tolerance. Your oral

diabetes medication and/or ýour insulin levels may need adjustment. If you

do not have a detected diabetes mellitus, taking hydrochlorothiazide may

cause it to appear. ... Thiazide diuretics increase the plasma uric acid

concentration and can cause gout in predisposed patients. "

In an article, I read the following:

" When you take diuretics you should observe the following:

- take the tablets early morning so that your sleep is not disturbed by the

increased urine output

- look out for signs of calcium deficiency: muscle cramps, constipation,

irregular heart beat

- look out for signs of dehydration, circulation problems and increased

tendency to form thromboses

- measure blood pressure, pulse and weight daily. "

None of this was mentioned to me by my internist nor by the pharmacist. I am

wondering if anybody on the list has experience with the effect of thiazide

diuretics on their blood glucose control (and the other things)?

-----Ursprüngliche Nachricht-----

Von:

An: <diabetes_integroups>

Gesendet: Mittwoch, 16. August 2000 18:16

Betreff: Re: Metformin again (WAS: Heart broken?)

> In a message dated 00-08-16 10:01:01 EDT, you write:

>

> <<

> Have you ever wondered, Dave, whether or not you might be taking part in

> some large long-term double-blind study to test the effect of large doses

of

> metformin? If it is properly conducted, they wouldn't tell you or your

> physician, would they? Why, you might even be one of those getting the

> placebo >>

>

> I don't know how it is where you are, , but here, if you're in a

study,

> you know about it. You have to sign stuff. I know...I've been in a few.

One

> of them was an osteoporosis study for Fosamax...it covered two years and

at

> my last visit and tests was when my diabetes was discovered as an

incidental

> finding. I had absolutely no symptoms. Furthermore, I got a notice from

them

> about six months later that i'd been on the Fosamax placebo. (However, for

> taking part in the study I got a year's free Fosamax). Vicki

>

>

>

>

>

>

> Public website for Diabetes International:

> http://www.msteri.com/diabetes-info/diabetes_int

>

>

>

>

>

[Guest guest]

In a message dated 00-08-17 09:32:59 EDT, you write:

<<

Did they follow up the possibility that Fosamax placebo causes diabetes,

Vicki? That would be as logical a conclusion as many that we see drawn from

study results from time to time.

>>

I also doubt that a placebo would have anything in it that would cause an

undiagnosed disease to declare itself. Vicki

[Guest guest]

Thornton wrote:

<< I have just been shifted from Atacand 16mg to Atacand Plus 16/12.5 mg.

The

difference is that Atacand Plus includes hydrochlorothiazide, a diuretic. >>

Why did the doc switch your meds? Were you displaying signs of edema, such

as puffy ankles? Or is the Atacand Plus just the new fad medicine? Whenever

possible, I think we should take separate pills, rather than these combos.

If you did show signs of edema, that can indicate you have too much

circulating insulin. It can also indicate heart trouble.

Susie

[Guest guest]

Carol

> The diuretic definitely made a difference to me.

> I wonder how much later would I have developed

> DM without it?

Or even if you would have developed it at all? We will never know!

But I bet you the same thing must have happened to a lot of people to get

that statement onto the package insert, at least in the German version.

I can't help wondering what the connection is between thiazide diuretics and

diabetes to make that " cause and effect " and if it doesn't conflict with the

doctor's oath not to inflict harm on his/her patients?

I am slowly getting the feeling that primary care physicians ought to give

ALL new patients a GTT - it would probably do more good than the traditional

" say Ah " , " cough! " and " does this hurt? " . I bet that it would alter the

diabetes statistics a little, too.

[Guest guest]

Carol

> The diuretic definitely made a difference to me.

> I wonder how much later would I have developed

> DM without it?

Or even if you would have developed it at all? We will never know!

But I bet you the same thing must have happened to a lot of people to get

that statement onto the package insert, at least in the German version.

I can't help wondering what the connection is between thiazide diuretics and

diabetes to make that " cause and effect " and if it doesn't conflict with the

doctor's oath not to inflict harm on his/her patients?

I am slowly getting the feeling that primary care physicians ought to give

ALL new patients a GTT - it would probably do more good than the traditional

" say Ah " , " cough! " and " does this hurt? " . I bet that it would alter the

diabetes statistics a little, too.

[Guest guest]

Carol

> The diuretic definitely made a difference to me.

> I wonder how much later would I have developed

> DM without it?

Or even if you would have developed it at all? We will never know!

But I bet you the same thing must have happened to a lot of people to get

that statement onto the package insert, at least in the German version.

I can't help wondering what the connection is between thiazide diuretics and

diabetes to make that " cause and effect " and if it doesn't conflict with the

doctor's oath not to inflict harm on his/her patients?

I am slowly getting the feeling that primary care physicians ought to give

ALL new patients a GTT - it would probably do more good than the traditional

" say Ah " , " cough! " and " does this hurt? " . I bet that it would alter the

diabetes statistics a little, too.

[Guest guest]

Susie

> Why did the doc switch your meds? Were you

> displaying signs of edema, such as puffy ankles?

No, no signs of oedema (?). He indicated that he had been thinking about it

for a long time and after hearing my valve noise decided now was the time to

switch. He claims the combination tablets are a gift from God - try them for

three weeks (don't throw the others away) and we will see how it goes.

Who knows, I might turn into one of the 30% who doesn't take his tablets and

lies about it - or I could keep on taking the simple Atacand and lie about

that, then see if he says: " Oh, I was right - there is a big improvement! " .

Do you think that is worth a try?

[Guest guest]

Susie

> Why did the doc switch your meds? Were you

> displaying signs of edema, such as puffy ankles?

No, no signs of oedema (?). He indicated that he had been thinking about it

for a long time and after hearing my valve noise decided now was the time to

switch. He claims the combination tablets are a gift from God - try them for

three weeks (don't throw the others away) and we will see how it goes.

Who knows, I might turn into one of the 30% who doesn't take his tablets and

lies about it - or I could keep on taking the simple Atacand and lie about

that, then see if he says: " Oh, I was right - there is a big improvement! " .

Do you think that is worth a try?

[Guest guest]

Susie

> Why did the doc switch your meds? Were you

> displaying signs of edema, such as puffy ankles?

No, no signs of oedema (?). He indicated that he had been thinking about it

for a long time and after hearing my valve noise decided now was the time to

switch. He claims the combination tablets are a gift from God - try them for

three weeks (don't throw the others away) and we will see how it goes.

Who knows, I might turn into one of the 30% who doesn't take his tablets and

lies about it - or I could keep on taking the simple Atacand and lie about

that, then see if he says: " Oh, I was right - there is a big improvement! " .

Do you think that is worth a try?