Graedons

Joe Graedon and Dr. Teresa Graedon

Question: I am confused about tests for diabetes. I had some blood sugar measurements near 300. That means I have diabetes. However, my HbA1C blood test was always below 6, which I understand is considered normal. No doctor has been able to explain this discrepancy.

Then my physician ordered that nasty lengthy test where you have to have your blood sugar measured three times in two hours after you drink some sugary stuff. This test confirmed that my body can’t handle sugar well. The levels were out of whack.

I started taking medication for diabetes and was able to get my blood sugar levels down. Why didn’t the A1C test EVER indicate any issue?

Answer: A new study suggests that the oral glucose tolerance test (OGTT) you describe is far more accurate than the AIC blood test doctors often use. The researchers conducted both tests for 9,000 people who had not been diagnosed with diabetes (Annual Meeting of the Endocrine Society, March 2019). The OGTT revealed diabetes in many people whose levels of hemoglobin A1C were within the normal range.

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Question: You wrote that PPI drugs for acid reflux can put a person at risk for kidney disease. That happened to me.

I quit taking the PPI upon learning that I had Stage 3 kidney disease, and my kidney function is holding steady now. Changing from the PPI was a fairly easy process. I went to Zantac, and it works well in controlling my GERD. Why does anyone take these PPI medicines? They can be so detrimental to health.

Answer: GERD, or gastroesophageal reflux disease, is not only unpleasant, it also can lead to changes in the lining of the esophagus. Before proton pump inhibitors (PPIs) like esomeprazole (Nexium), lansoprazole (Prevacid) and omeprazole (Prilosec), doctors prescribed H2 blockers such as cimetidine (Tagamet), famotidine (Pepcid) and ranitidine (Zantac).

H2 blockers work reasonably well to control chronic heartburn without damaging the kidneys (Scientific Reports, online, Feb. 19, 2019).

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Question: You have written that statin-type cholesterol-lowering drugs can cause diabetes. You included pravastatin in that list. Historically, it lowers your chances of developing diabetes by 30 percent! For many people, statins will save their lives. It also can prevent Alzheimer’s disease. Please tell your readers the whole story.

Answer: For patients with heart disease, statins can indeed make a difference. There is quite a bit of controversy, though, about the benefit of statins for people who have not been diagnosed with heart disease (JAMA Internal Medicine, Nov. 15, 2016).

We understand why you might think pravastatin (Pravachol) is different from other statins when it comes to diabetes. An old study published in the journal Circulation (Jan. 23, 2001) reported that pravastatin reduced the risk of diabetes by 30 percent.

A new study, however, reports that “use of statins was associated with a 38 percent higher risk of incident Type 2 diabetes” (British Journal of Clinical Pharmacology, March 5, 2019). The authors did not find a difference between various statins when it came to the likelihood of developing diabetes.

As for preventing Alzheimer’s disease, that too has been controversial. A review of the available literature (Cochrane Database of Systematic Reviews, Jan. 4, 2016) found no credible evidence that statins “prevent cognitive decline or dementia.”

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Question: I had cracked lips with sores at the corners of my mouth. My dermatologist recommended a 1:1 mixture of OTC hydrocortisone cream and Monistat cream. I put a tiny dab of each on my finger and rubbed them together, then applied to the sores and red areas around my lips. That worked great! The sores started healing in a few days.

Answer: The technical term for your condition is angular cheilitis or perleche. The cause of the painful cracks at the corners of the mouth remains somewhat mysterious. Some experts blame a deficiency in B vitamins or minerals like zinc or iron. Others believe the fissures are triggered by a yeast overgrowth. Over-the-counter antifungal creams such as miconazole (Monistat) plus hydrocortisone cream are standard treatments (Journal of the Canadian Dental Association, May 9, 2013).

Joe Graedon is a pharmacologist; Dr. Teresa Graedon is a medical

anthropologist and nutrition expert. Questions for the Graedons can be sent to them using their website, www.peoplespharmacy.com, or by writing to the following address: Graedons’ People’s Pharmacy, King Features, 628 Virginia Drive, Orlando, FL 32803.

Columnists

Joe Graedon is a pharmacologist; Dr. Teresa Graedon is a medical anthropologist and nutrition expert.