Invokana – Worth the Risks?


And… are medications the only way to manage type 2 diabetes? –

Rebecca Roentsch Montrone, BS –  Certified Holistic Health Practitioner

What is Invokana, anyway?

SGLT-2 inhibitors are a new class of medication for treating type 2 diabetes.  Unlike metformin – which helps improve sensitivity to the efforts of insulin to move excess glucose out of the blood stream into the cells of the body– SGLT-2 inhibitors curb the reabsorption of glucose back into the bloodstream through the kidneys.  Metformin is the classic, frontline medication prescribed for metabolic syndrome, prediabetes, and type 2 diabetes and has been used with a solid safety record since the 1970s.

Invokana was the first of this new class of medication to be approved by the FDA, with Farxiga following behind.  Currently there are three SGLT-2 inhibiting drugs on the market, as well as four combination medications, most of them combined with metformin in one way, shape, or another.

Three months prior to FDA approval of Invokana in March of 2013, concerns were raised by the agency’s regulator regarding possible cardiovascular injury, kidney damage and bone health risk.

In spite of those concerns, the FDA approved Invokana with the mandate that five post-marketing studies be conducted to evaluate potential problems such as pancreatitis, hypersensitivity, photosensitivity, liver abnormalities, pregnancy problems, and pediatric studies.

What problems are being seen with the use of these drugs?

Kidney problems – 457 reports of serious adverse events related to the kidneys in a report from the Institute of Safe Medication Practices (ISMP) in May of 2015, to include kidney failure, impairment and stones; dehydration, hypersensitivity, and abnormal weight loss.

Then, since May, 2015, the FDA has issued five drug safety communications regarding serious adverse events such as life-threatening ketoacidosis, severe electrolyte imbalances, acute kidney injury, possible increased risk of limb amputation, higher risk of bone fracture, sepsis and urosepsis, as well as urogenital infections.

If you knew this about a medication prescribed for you, would you want to take it?

Here’s the thing.  You are the guinea pig when being prescribed a new type of medication, especially when potentially significant risks to your health were already identified prior to FDA approval.  What’s more, the jury is completely out when it comes to the possible long-term risks associated with this class of medication.  But…the real clincher here is that in the majority of cases, type 2 diabetes can be prevented, controlled, and in many cases reversed without medication.

Why do I have type 2 diabetes? How does this differ from type 1 diabetes?

Type 1 diabetes is caused by damage to the pancreas that destroys the beta cells in the Islets of Langerhans, responsible for the production of insulin.  Without insulin, you will die due to ketoacidosis, a process that causes very rapid metabolism of fat cells for energy, because without insulin the body cannot use glucose. Type 1 diabetes is a completely different disease than type 2 diabetes and is most often related to an autoimmune attack on the pancreas.  Some of the reasons scientifically attributed to this process include an infection somewhere else in the body causing immune-system confusion, vaccination side effects, and early consumption of cow’s milk.

When it comes to type 2 diabetes, however, most people “lifestyle” their way into it by way of poor dietary choices, lack of exercise, and cumulative effects over time.  In most cases, type 2 diabetes is not inevitable if you know how to prevent it with lifestyle changes, control it with lifestyle changes, and even reverse it with lifestyle changes.

What do I do?

Change your diet  Eat a whole food diet based on whole foods, elimination of processed foods, grains, and simple sugars.  Plenty of veggies, moderate whole fruit, moderate good-quality protein, and plenty of healthy fats, such as real butter, animal lard, olive oil, coconut oil.  (Yes, I really do mean that!) That’s it.  Just do it.  This will starve your bloodstream of excess glucose, taking a load off the work of the pancreas when it comes to insulin production, and lowering all of that body fat that puts a strain on so many areas of health.

Try a program such as the Whole30 for just 30 days and see if you are not impressed; I know you will be!  But, you say, “Becky!  Does that mean you’re blaming ME for having Type 2 diabetes??”  Yeah, actually; kinda sorta.  I do know one person who is skinny, eats well, and has type 2 diabetes, but this situation is by far an exception to the rule.  In addition, you will be getting so many nutrients from the diet you have not been getting all along.

Get regular exercise – Weight training is best.  Key to the type 2 diabetes problem is the inability of the cells of the body to accept insulin’s efforts to move excess glucose from the bloodstream into the cells of the body.  Once the muscles burn off their liquid glucose supply, they are hungry for more, and this helps with insulin sensitivity.

Employ the use of some key foods, herbs, & nutrients – such as chocolate (believe it or not!), cinnamon, Beta glucans, chromium, Vitamin D, lipoic acid, Gymnema sylvestre, ginseng

 AND… too good to be true?  Did you know it is possible to regenerate insulin-producing beta cells?  That’s amazing, as this would apply to type 1 diabetics, as well:  arginine, avocado, berberine, chard, corn silk, curcumin, genistein, honey, nigella sativa (black seed), and stevia.

 Just be careful if you are on medication for the treatment of diabetes…

As you begin to employ some of these approaches and strategies, keep an eye on your blood glucose levels.  They will likely dip low, which is the point, but you need to be careful.  Be sure to keep in touch with your physician so your medication can be adjusted as appropriate.