New LDL Guidelines LDL, or low density lipoprotein, is the so-called “bad” cholesterol that until recently we have all tried to keep under 100! Well, recent guidelines have drastically changed in order to accommodate results from a large (10,000 patients) study which clearly showed that patients getting to 77 will have a significantly lower risk for a major cardiovascular event (heart attack). Typically, it takes a Statin drug to drop the LDL to that level, although recently one of my diabetic Asian patients has had a documented lab result of 25!!, without any Statin (extremely rare). With these new guidelines, we may need to increase your Statin dose. Please cooperate.     FDA-Approved New Drug For Diabetics Who Are On Insulin Treatment. The new drug is called Pramlintide, and has a generic name of Symlin or Amylin. Amylin is actually a pancreatic hormone that is coming out of the Islets, and typically would be secreted along with insulin. It has a dual effect: to stabilize blood glucose fluctuations right after the meal, and to slow gastric emptying. It’s first effect is achieved by suppressing the hormone Glucagon, which would tend to stimulate glucose release by the liver. Clinical trials have shown that it causes a drop of 0.6% in HbA1c, and a weight drop of 3.1 pounds in the 52-week study period. The down-side is that this drug is available in injection only, and that it’s given to patients already on insulin. It’s new, and there is very little experience with it, but it may prove to be a God-send for some patients. Let’s give it a chance to prove itself.
Rimonabant – Too Good To Be True More information is made available about this fascinating agent which is a marijuana-receptor blocker (in the brain). Apparently, there are already three studies showing significant results. These studies were conducted over a one year and a two year periods, and both showed some weight drop, shrinking of abdominal circumference, and reduction of some of the features of the Metabolic Syndrome. The drug is not available yet, but with this track record, sure to be approved.
Alzheimer’s Disease and Insulin The most recent hypothesis about Alzheimer’s Disease (AD) involves insulin. It has been known for many decades that insulin is present and produced by the brain. What has not been reported is that insulin is significantly reduced in brains of patients with AD. In addition, receptors to insulin are also deficient. This may simply be directly related to the loss of brain tissue, however the scientists that discovered this phenomenon would like us to think that there is more to it than just a simple relationship - maybe in the future we'll be able to somehow introduce insulin into the central nervous system.
Byetta And yet another new diabetic drug.. The FDA has just approved a new drug for diabetics with type 2, who are not optimally controlled. The drug is a protein which is a synthetic version of a protein that is found in the saliva of the Gila monster! This “monster” is actually a lizard that lives in the Southwestern part of the US. Don’t ask me how this was originally discovered (I’ll try to look into it), but apparently this protein is identical to a hormone called GLP-1, which is normally secreted by the stomach after food ingestion. This protein is part of a group of hormones called incretins, with a main role of augmenting insulin secretion. The up-side is that they don’t cause hypoglycemia, however the down-side is that they need to be injected twice daily – Ouch!
No Diabetes Post Gastric Bypass Morbidly obese individuals with diabetes who undergo a gastric bypass procedure – cutting out a portion of the stomach – experience a very quick remission of their diabetes. Within days to weeks most (84%) of patients no longer need their diabetic medications, and come up with normal glucose levels on their glucometers. Obviously, that kind of response cannot be attributed to weight loss. Ghrelin, which is a hormone secreted by the stomach and the proximal small intestine, has been implicated. It is, in fact, the only known circulating appetite stimulant. Post gastric bypass, Ghrelin levels stay depressed. In addition to appetite suppression, Ghrelin also has actions which are diabetic-like. Eliminating Gherlin, therefore, probably accounts for the diabetic “remission” noticed.
Gadgets An innovative company has come up with a kea-chain USB hard drive which is capable of containing all medical information related to an individual’s medical history. In addition to written data, this can also contain x-ray data, as well as other forms of imaging. Data can be up-dated, and when patient arrives in the emergency room, all that needs to be done is plug the little hard drive in a computer and instantaneously access the data. This may prove to be standard procedure in the not too distant future. I’m looking for a donation, so we can start this at the Litvin Center for Diabetes.
Dr. Litvin's Blogs If you haven't had the pleasure of browsing through Dr. Litvin's blogs, you're in for a real treat. Dr. Litvin provides us with his commentary on diabetes and diabetes in the news. The following are some of the Blogs Dr. Litvin has written: Thomas Friedman's Flattening of the World The Matzah Diet Calories Galore Salmon for Dinner Big Breakthrough for the Food Industry Cancer of the Pancreas
New Features on Our Web Site - HTTP://DIABETES-DOCTOR.COM Over the next few weeks, we will be adding a new section to the site to handle Nutrition. We will have content such as suggested meals, sample recipes, dos and don't for diabetics and more! We have also added a Guest Book for our users to sign in and let us know what they think about our site. The Litvin Centers for Diabetes launched our new web site in January and already we're experiencing a lot of traffic and excitement about it! The site contains helpful tips and information to assist you with managing diabetes. There is new functionality, new content, user friendly navigation, and more! If you haven't visited us yet, please do so and tell others about it. The Litvin Centers for Diabetes is dedicated to improving those afflicted with diabetes.  We plan on adding additional functionality to this new website in the months to come.  We'll keep you posted on our progress.  In the meantime, visit us often and let us know what you think.  We welcome your feedback. Enjoy!

Fort Lee Office Hours	West Orange Office Hours
Day From To Mon 8:30 am 5:30 pm Tue 8:30 am 5:30 pm Wed CLOSED CLOSED Thu 8:30 am 5:30 pm Fri 9:00 am 1:00 pm Sat CLOSED CLOSED Sun CLOSED CLOSED	Day From To Mon CLOSED CLOSED Tue* 9:00 am 3:00 pm Wed 9:30 am 5:00 pm Thu CLOSED CLOSED Fri 9:30 am 4:30 pm Sat CLOSED CLOSED Sun CLOSED CLOSED *Dr. Litvin is in every other Tuesday of the month.
Fort Lee Address 158 Linwood Plaza Fort Lee, NJ 07024 201-461-0585	West Orange Address 622 Eagle Rock Avenue West Orange, NJ 07052 973-736-1221

Unsubscribe Instructions If you wish to remove yourself from future e-mailings from Litvin Centers For Diabetes, simply reply "remove" in the subject line. Please note that it may take up to  30 days to process your request. Privacy Statement For details on our e-mail practices, please visit our Privacy Policy.

Copyright © 2005 Diabetes-Doctor | All Rights Reserved