Bible study

Newer diabetes options

Are You TOO Sweet? Newer Options for Diabetes

Posted on by Michelle Fritsch, Pharm.D.
Newer diabetes options
Newer diabetes medications to consider if you’re too sweet.

Do you remember when the treatment options for your type 2 diabetes were medicines that could make your blood sugar too low – oral medicine or insulin? The available options would also make you gain weight.

Those treatments are still available, and now there are improved versions of each. So, if you and your doctor and your healthcare team haven’t talked about options recently, now might be the time. The experts in the field, using the information from the latest studies, release guidelines. The latest guidelines from the American Diabetes Association have tables that provide comparisons between the options. These tables make a nice display to help you have a conversation with your doctor about which options might work best for you.

Those early medication options mentioned before would either help your pancreas release more insulin or would be an extra source of insulin.

Newer diabetes medication options

Here are ways other, newer medicines help control your diabetes:

  • control how your liver stores extra glucose (sugar) and when and how it lets it back out
  • control how your kidneys let your glucose out in your urine
  • impact how sugar is absorbed from the food you eat
  • mimic hormones that control how your body responds to sugar and insulin
  • slow down the rate food moves through your body keeping you feeling full longer
  • increasing how a cell responds to insulin

The body has many different steps in the way it handles the food you eat and how that food is turned from sugar into energy for your cells. Now, with these newer options, your diabetes can be treated with medicines that address more than one of those steps.

Combinations of medications can help control your diabetes more than one way at a time. Also, when you use combinations of medicines, you can usually use a lower dose. This helps cut down on side effects.

New insulin options

If a combination of medicines you take by mouth don’t help you reach your diabetes control goals, there are new insulins. The old insulins were dosed either around meals or twice a day. There are now basal insulins. These are dosed just once per day. They then provide some support to control your blood sugar all day and all night. Then, when you eat, your blood sugar does not climb as high.

Often, people who have been taking higher and higher doses of oral medicines find they can be on lower doses. The basal insulin helps decrease the need for so much oral medicine.

And, like we said before, using several different medicines helps you use lower doses of each. This is often easier to tolerate than high doses of one or two medicines.

NOTE, this information is all for type 2 diabetes. If you have type 1 you need insulin therapy only because your pancreas has quit working. The insulin is absolutely required. The oral medicines mentioned above won’t control your diabetes.

We have much more we can tell you about diabetes and treatment options. For more information, please contact us at www.medsmash.com/contact or call at 410-472-5078.

BIBLICAL APPLICATION

Diabetes (and other medical conditions) can be best treated with medication using different mechanisms. Treat different parts of the condition from all directions for the most comprehensive care.

I have been embarking on some new (to me) techniques for Bible study. Wow, there are so many ideas and methods out there! I am intrigued by all of the different ways we can approach the same scripture. And, as only God could do, I learn something different every time. Part of the reason I keep learning new things from the same scripture is that I am different every time I read it. The things happening in my life, the things that are exciting me, the things that are concerning me, the things happening with my friends and family are different. This changes my perspective. Also, my moods change. That can definitely impact how I approach anything I read or hear.

Then, there are all of these techniques and approaches I have been reading about. Some are obvious, and some, to me, seem really innovative. Here are some that I have been trying to incorporate:

  • When reading a small bit of scripture, read it over and over emphasizing a different word each time to see how that changes the meaning.
  • Research the history at the time it was written. Historical context helps to understand the culture and surrounding events.
  • Write down in a journal (or I write in the margins) insights, events, or ideas you get from that verse or chapter. (Date it so you can see it later. Often I find it strikes me a completely different way the next time I read it because I’m in a different frame of mind in different circumstances.)
  • Consider how the scripture you’re reading could be incorporated into your life today.
    • Sometimes this is an action, sometimes an new idea, sometimes a reflection on how great is our God, sometimes a prayer, sometimes a question to ponder.
  • Put yourself in the scripture. Try to imagine being there at that time. How did it probably look, sound, feel. How might you have gotten there? What are you probably wearing? Who else is there?
  • Read about the author of that chapter of the Bible. What do we know about that person? What was their perspective?
    • I like the Life Application Bible. It has information at the start of each chapter to start answering these questions. It has helped me dig a lot deeper and understand more concepts. There are application tidbits on each page.
  • Where else is this theme, story, or concept in the Bible?
  • Listen to the Bible being read to you. There are many online apps that include an audio version. Especially if you like to learn through hearing, this is a great method.
  • Read the same scripture as a friend and talk about it. Or better yet, talk about it in a Bible study group. I am always amazed at how we can read the very same thing and have completely different insights.

No doubt, there are many more.

God gave us his Word to be an integral part of our life.

2 Timothy 3:16-17 ESV

All Scripture is breathed out by God and profitable for teaching, for reproof, for correction, and for training in righteousness, that the man of God may be competent, equipped for every good work.

God’s Word can be a huge source of answers when you’re feeling lost, alone, hurt, confused.

Psalm 119:105 ESV

Your word is a lamp to my feet and a light to my path.

There’s not just one right way to study scripture. Like a combination of meds approach to diabetes, try a combination approach to reading your Bible.

Hebrews 4:12-13 MSG

 God means what he says. What he says goes. His powerful Word is sharp as a surgeon’s scalpel, cutting through everything, whether doubt or defense, laying us open to listen and obey. Nothing and no one is impervious to God’s Word. We can’t get away from it—no matter what.

My prayer is you’ll find it exciting and refreshing to try all sorts of new ways to get into your Bible. There is a never-ending amount of great information in there. It is always pertinent.

Blessings,

Michelle

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Who knows your WHOLE regimen of medicine?

Posted on by Michelle Fritsch, Pharm.D.
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Let your doctors and pharmacist know your WHOLE regimen.

Which of your providers or pharmacists knows your WHOLE regimen of your medicines? When you go to your doctor you are likely asked about the medications you take. Some practices will ask you to include that information on a piece of paper on a clipboard in the waiting room. Some will hand you a computer with a list of questions that include your medicines. Still others will have the person checking you in ask you about your medications.

Do you take a list of all of your medications with you to the doctor?

Your doctor needs to know the names, the strength, the dose, and exactly how you take each medication.

Rather than try to memorize and remember all of this, make a list before you leave home.

  • Some people take pictures of each medication label and keep them in their phone.
  • Some people use the ‘Medical ID’ app on their smartphone.
  • Some people keep a list printed and in their wallet where it can be easily found by emergency personnel if needed.

Do you include all medicines prescribed by all doctors?

Many of the people I meet think their doctors talk to one another and coordinate their care. Although this is the desire of your doctors, it often does not happen. Your doctors and other providers find it hard to catch up with one another. Even if they work for the same health-system, important details and explanations are often not shared.

  • Include all medications coming from all of your doctors on your list.
  • Don’t assume one doctor explained the latest changes to the other doctors.

Do you include all of the medicines and other substances you take?

All of the substances you take have the potential to interact with each other. This means they can be dangerous when combined. If no one knows each substance you take, then those interactions cannot be checked.  It is important to have a thorough screen of your WHOLE regimen.

Include these items even if you only take them once in awhile.

I highly encourage you to include all of these on your written list.

  • Over-the-counter pain medicine (e.g. Tylenol, ibuprofen, Aleve, aspirin)
  • Stomach ache or acid reflux medicine
  • Headache medicine
  • Allergy medication
  • Eye drops
  • Nose sprays
  • Cold, flu, congestion medicines
  • Constipation or diarrhea medicines
  • Medicated creams or ointments
  • Vitamins
  • Supplements
  • Herbal therapies
  • Marijuana
  • Illicit drugs (at least tell your doctor about these)

I am finding that the people who make the decisions about your prescription medicines do not know all of these important facts. The over-the-counter, herbal, vitamin, and other substances can have side effects, cause problems, and interact just as prescription medications can.

Consider all of these to be MEDICATIONS! Let your doctors and pharmacist know your entire list – your whole regimen!

For more information about the importance of your complete medication list, or for a detailed review of your medication list, please contact us at www.medsmash.com.

BIBLICAL APPLICATION

Just as there are a variety of medications that may be needed for overall health, there are a variety of things we need to include in our lives for our spiritual health. What are the components of your spiritual life?

In what ways do you acknowledge, praise, worship, study, talk with, share, enjoy, and spend time with God?

I liken the prescription medications from your primary doctor to Sunday worship and owning a Bible.

The specialist medications are like the Bible study, Sunday School, and other special short term studies.

What about the components that you choose for yourself from the smorgasbord of options? Do you include prayer, worship music, contemporary Christian music, daily devotions, meditation, accountability partners, online resources, or other choices?

Do you select a wide variety of options?

Do you stick to one or two?

Do you limit yourself to the Sunday morning selections?

Colossians 3:12-17 (MSG) gives several ideas about the many ways you can keep God active in your life.

So, chosen by God for this new life of love, dress in the wardrobe God picked out for you: compassion, kindness, humility, quiet strength, discipline. Be even-tempered, content with second place, quick to forgive an offense. Forgive as quickly and completely as the Master forgave you. And regardless of what else you put on, wear love. It’s your basic, all-purpose garment. Never be without it.

Let the peace of Christ keep you in tune with each other, in step with each other. None of this going off and doing your own thing. And cultivate thankfulness. Let the Word of Christ—the Message—have the run of the house. Give it plenty of room in your lives. Instruct and direct one another using good common sense. And sing, sing your hearts out to God! Let every detail in your lives—words, actions, whatever—be done in the name of the Master, Jesus, thanking God the Father every step of the way.

There are so many ways you can get to know God better. Even if you have been studying and worshipping for decades, there is more to learn and more love to experience.

Then there is prayer. There is real power in prayer.

James 5:13-16 (ESV)

Is anyone among you suffering? Let him pray. Is anyone cheerful? Let him sing praise. Is anyone among you sick? Let him call for the elders of the church, and let them pray over him, anointing him with oil in the name of the Lord. And the prayer of faith will save the one who is sick, and the Lord will raise him up. And if he has committed sins, he will be forgiven. Therefore, confess your sins to one another and pray for one another, that you may be healed. The prayer of a righteous person has great power as it is working.

Prayer that acknowledges God and His will and timing can do great things. Never overlook the power of prayer.

It is my hope this has inspired you to add some more elements to your daily walk with God. The God who created the Universe and who loves you beyond measure looks forward to each and every remedy you select to stay close to Him and know Him better.

Blessings,

Michelle

I have diabetes – let the pills fix it!

Posted on by Michelle Fritsch, Pharm.D.
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Diabetes – let the pills fix it

 

Medications to treat diabetes have revolutionized the treatment of this condition. The number of people with diabetes has been increasing for many years. So, a lot of emphasis has been put on finding new treatments. The number of new types of medications to treat diabetes has greatly increased even in the last five years. This is GREAT news!

So, with all of these new and the older tried and true treatments, diabetes is in good control, right? Surely with all of these options, diabetes is a problem of the past.

Unfortunately, it’s more complex than that. The same things that are causing this increase in number of people with diabetes need to be at the core of the treatment. So what are these things?

At the core of diabetes management

The primary link to the growing number of people with diabetes is the growth of the population. I’m not referring to number of people, I’m referring to SIZE of people.

Obesity has been on the rise. As a population we have gained significant weight. This is one of the main risk factors for diabetes. It is also a risk factor for high blood pressure, high cholesterol, heart disease, and stroke.

So, besides medications to treat diabetes, changes in diet, exercise, and weight are key parts of treatment. Diet and exercise changes are the best way to manage weight. They are not always the most fun and certainly not the easiest. There are all sorts of ‘quick fix’ schemes for weight management that sound very enticing. But, after all is considered, none of these are as safe or effective as true, daily, positive changes in food and movement.

Daily changes

Move every day. Spend less time in a chair and more walking, participating in dance or games, cleaning, or doing other things that are active.

Diet changes are best made in moderation. Sudden, huge diet changes are very hard to sustain. A few simple changes can make a big different. Try some of these:

  • Avoid second helpings
  • Eat a bit smaller portions
  • Cut back on white bread, crackers, pasta
    • Replace with those with higher grain content
  • Eat some more vegetables in place of bread and sweets
  • Eat some more fruit in place of sweets

It is important to make changes that you can make new habits. Keep up these gradual changes over time.

Be good to yourself. If you occasionally slip and fall back in old habits, pick yourself up, forgive yourself, and try again. As you adopt healthier habits, your weight decreases, and you move more, you will start to feel better and more energetic. That will made it easier to continue to make positive changes.

If you want to talk about more details aobut how you can start making these changes, contact us at www.medsmash.com.

BIBLICAL APPLICATION

Just as it is tempting to let pills fix medical health, it is tempting to let Sunday church fix our spiritual health.

If you go to church most Sundays, you have all you need for spiritual growth and development, right?

Peter had some very insightful instruction about spiritual growth.

1 Peter 2:1-5 ESV

So put away all malice and all deceit and hypocrisy and envy and all slander. Like newborn infants, long for the pure spiritual milk, that by it you may grow up into salvation— if indeed you have tasted that the Lord is good. As you come to him, a living stone rejected by men but in the sight of God chosen and precious, you yourselves like living stones are being built up as a spiritual house, to be a holy priesthood, to offer spiritual sacrifices acceptable to God through Jesus Christ.

I encourage you to read the rest of this chapter of 1 Peter.

2 Peter 1:5-8 ESV

For this very reason, make every effort to supplement your faith with virtue, and virtue with knowledge, and knowledge with self-control, and self-control with steadfastness, and steadfastness with godliness, and godliness with brotherly affection, and brotherly affection with love. For if these qualities are yours and are increasing, they keep you from being ineffective or unfruitful in the knowledge of our Lord Jesus Christ.

2 Peter 3:18 ESV

But grow in the grace and knowledge of our Lord and Savior Jesus Christ. To him be the glory both now and to the day of eternity. Amen.

Another verse with some instruction about spiritual growth is:

2 Timothy 3:16-17 ESV

All Scripture is breathed out by God and profitable for teaching, for reproof, for correction, and for training in righteousness, that the man of God may be competent, equipped for every good work.

Growing in your faith is a lifelong quest. With each new thing you learn, your perspective changes and you realize there is so much more to learn.

Sundays, church, and fellowship are incredibly important! And so are all of the other ways you spend time with God and the Bible and other growth opportunities.

Blessings,

Michelle

Medications to avoid when over age 65

Posted on by Michelle Fritsch, Pharm.D.

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Since 1991 there has been a group of geriatricians and other physicians identifying medicines that might be inappropriate in people over age 65. Dr. Mark Beers originally led this group, so it is called the ‘Beers Criteria’. This list has been updated every few years. The most recent update was this month.

The medications on this list have SAFER and/or MORE EFFECTIVE options available.

Some of the reasons for medications to make the list include:

  • blood pressure lowering medicines that cause more dizziness and falls than other options
  • medicines with anticholinergic (very drying) effects that can have several negative effects including worsening memory
  • anxiety medicines that cause thinking/memory problems and falls
  • depression medicines that cause several problems
  • allergy medicines that cause drowsiness, driving accidents, and falls
  • medicines that are cleared from the body through the kidneys which slow down with age
  • medicines that are cleared from the body through the liver which can slow down with age
  • medicines that are ok at low doses but dangerous at high doses
  • medicines that can cause delirium
  • medicines that can worsen memory
  • medicines that can cause constipation
  • medicines that can make urination with prostate enlargement even more difficult

This year, for the first time, guidelines for safer options to replace these dangerous medicines were written. This is exciting news!

If you are over 65, please talk with your prescribers about these lists of potentially inappropriate medicines and these lists of safe alternatives.

For a personal evaluation of your medicines, please contact www.medsmash.com.

Biblical Application

In your daily walk with God, what are the most effective steps and activities? What does the Bible say you should do regularly?

And, where are the pitfalls? What should you avoid?

Just as the Beers List guides prescribers to select the most beneficial and safest medicines, the Bible guides our spiritual practices. Your heart, your tongue, your thoughts, your study, your time, and your actions are included in this guidance.

Romans 12:2 ESV

Do not be conformed to this world, but be transformed by the renewal of your mind, that by testing you may discern what is the will of God, what is good and acceptable and perfect.

Colossians 3:5-10 ESV

Put to death therefore what is earthly in you: sexual immorality, impurity, passion, evil desire, and covetousness, which is idolatry. On account of these the wrath of God is coming. In these you too once walked, when you were living in them. But now you must put them all away: anger, wrath, malice, slander, and obscene talk from your mouth. Do not lie to one another, seeing that you have put off the old self with its practices and have put on the new self, which is being renewed in knowledge after the image of its creator.

James 1:19-20 ESV

Know this, my beloved brothers: let every person be quick to hear, slow to speak, slow to anger; for the anger of man does not produce the righteousness of God.

Ephesians 4:32 ESV

Be kind to one another, tenderhearted, forgiving one another, as God in Christ forgave you.

James 1:22-27 ESV

But be doers of the word, and not hearers only, deceiving yourselves. For if anyone is a hearer of the word and not a doer, he is like a man who looks intently at his natural face in a mirror. For he looks at himself and goes away and at once forgets what he was like. But the one who looks into the perfect law, the law of liberty, and perseveres, being no hearer who forgets but a doer who acts, he will be blessed in his doing. If anyone thinks he is religious and does not bridle his tongue but deceives his heart, this person’s religion is worthless. Religion that is pure and undefiled before God, the Father, is this: to visit orphans and widows in their affliction, and to keep oneself unstained from the world.

There are certainly many more verses that guide our lives. These can be a start in developing a strategy to avoid inappropriate, dangerous behaviors and replace them with life-giving, holy options.

Blessings,

Michelle