JARDIANCE. Medication for type 2 Diabetes. At what price improved A1C?

The following information about the kidney is from WebMD. I like its simplicity in describing the function of the kidneys….a very complicated process. Before I discuss Jardiance, an oral medication that is being prescribed to lower hemoglobin A1C, you should have a basic understanding of the kidneys.

“Your kidneys are two bean-shaped organs, each about the size of your fist. They are located near the middle of your back, just below the rib cage. The kidneys are sophisticated trash collectors. Every day, your kidneys process about 200 quarts of blood to sift out about 2 quarts of waste products and extra water. The waste and extra water become urine, which flows to your bladder through tubes called ureters. Your bladder stores urine until you go to the bathroom.”

The waste in your blood comes from the normal breakdown of active muscle and from the food you eat. Your body uses the food for energy and self-repair. After your body has taken what it needs from the food, waste circulates in the blood. . If your kidneys did not remove these wastes from the blood, waste would build up in the blood and damage your body.

The actual filtering occurs inside your kidneys. The nephrons, each kidney contains over a million nephrons, bring blood into the kidney. Tiny blood vessels (capillaries) intertwine with tiny urine-carrying tubes (tubules). A complicated chemical exchange takes place, as waste materials and water leave your blood and enter your urinary system.

At first, the tubules receive a combination of waste materials and chemicals that your body can still use. Your kidneys measure out chemicals like sodium, phosphorus, and potassium and release them back to the blood to return to the body. In this way, your kidneys regulate the body’s level of these substances. The right balance is necessary for life, but excess levels can be harmful.

In addition to removing wastes, your kidneys release three important hormones:

Erythropoietin (stimulates the bones to make red blood cells)
Renin ( regulates blood pressure)
Active Vitamin D (helps maintain calcium for bones and for normal chemical balance in the body.)
Credit to WebMD for the concise explanation of kidney function.

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As you can see, the kidneys serve many important bodily functions. If kidneys are unable to perform, toxins rise in the blood and death can ensue. If kidneys are damaged, they will filter out toxins to a lesser degree than normal.

If a person with diabetes has had very long term above-normal period or long term diabetes that is under control. The complications from diabetes related to high glucose levels that damage vessels.

Blood “sugar” is what it sounds like; sugar in the blood. Now, imagine that high blood glucose is similar to pancake syrup (sugar -containing). If you spill pancake syrup and don’t clean it up you will have 2 things: ants and HARDENED syrup. Another example: Dip an apple in hot, flavored syrup for a candy apple. When the apple cools, the sugar in the syrup hardens covering the apple

I tell my patients to think of blood glucose higher than normal as sweetened blood. If you test your blood glucose, you probably “know” your reading is high when you prick your finger. The blood droplet that forms will be darker/thicker then it is when blood glucose is normal. If the blood glucose is very high….blood looks like syrup!

Diabetes complications occur when high glucose impacts the blood vessels of the body. Diabetes is an endocrine disorder that causes vascular (blood vessel) damage. Have you ever heard of “hardening of the arteries?” High sugar in the blood hardens the blood vessel and “catches” fat as it travels throughout the blood stream.

High blood glucose also hardens in the blood vessels of the retina of the eye; retinopathy.

It crystallizes in the capillaries of the kidneys: nephropathy

It crystallizes on the nerve endings: Neuropathy

It crystallizes in the blood vessels, catching and cementing fat: CVD

If chronic excess blood glucose causes such horrific vascular complications, it follows that it would be inappropriate to filter higher glucose than is typical.

When you think of diabetes damage, you are probably aware that the kidneys are near the top of the list for organs that become impaired from long periods of high blood glucose. It’s becoming understood that long periods of moderately high blood glucose will also cause NEPHROPATHY.

JARDIANCE: ( empagliflozin )

When I first researched the diabetes medication; Jardiance, I actually had to re-read the information. Why would anyone with diabetes want a medication that passes MORE urine and blood glucose out the kidneys?

Jardiance lowers excess blood glucose by passing it through the kidneys! So, there is less glucose in the blood. HbA1C will definitely decrease (but only 1 point or so), if a person is on insulin or an oral blood glucose medication, hypoglycemia can occur.

This information is on the drug’s consumer website.

IMPORTANT SAFETY INFORMATION

What is the most important information I should know about JARDIANCE?

JARDIANCE can cause serious side effects, including:

Serious urinary tract infections. Serious urinary tract infections can occur in people taking JARDIANCE and may lead to hospitalization. Tell your doctor if you have symptoms of a urinary tract infection such as a burning feeling when passing urine, a need to urinate often or right away, pain in the lower part of your stomach or pelvis, or blood in the urine. Sometimes people also may have a fever, back pain, nausea or vomiting.
Vaginal yeast infection. Women who take JARDIANCE may get vaginal yeast infections. Talk to your doctor if you experience vaginal odor, white or yellowish vaginal discharge (discharge may be lumpy or look like cottage cheese), and/or vaginal itching.

Dehydration. JARDIANCE can cause some people to have dehydration (the loss of body water and salt). Dehydration may cause you to feel dizzy, faint, light-headed, or weak, especially when you stand up. You may be at a higher risk of dehydration if you: have low blood pressure, take medicines to lower your blood pressure, including water pills (diuretics), are on a low salt diet, have kidney problems, are 65 years of age or older.
Ketoacidosis (increased ketones in your blood or urine). Ketoacidosis is a serious condition and may need to be treated in the hospital. Ketoacidosis may lead to death. Ketoacidosis occurs in people with type 1 diabetes and can also occur in people with type 2 diabetes taking JARDIANCE, even if blood sugar is less than 250 mg/dL. Stop taking JARDIANCE and call your doctor right away if you get any of the following symptoms, and if possible, check for ketones in your urine: nausea, vomiting, stomach-area (abdominal) pain, tiredness, or trouble breathing.
Yeast infection of the penis. Men who take JARDIANCE may get a yeast infection of the skin around the penis, especially uncircumcised males and those with chronic infections. Talk to your doctor if you experience redness, itching or swelling of the penis, rash of the penis, foul smelling discharge from the penis, and/or pain in the skin around the penis.
Do not take JARDIANCE if you have severe kidney problems or are on dialysis.
What should I tell my doctor before using JARDIANCE?

Tell your doctor if you have kidney problems. Your doctor may do blood tests to check your kidneys before and during your treatment with JARDIANCE. Also tell your doctor if you have liver problems; have a history of urinary tract infections or problems with urination; are going to have surgery; are eating less due to illness, surgery, or a change in your diet; have or have had problems with your pancreas, including pancreatitis or surgery on your pancreas; drink alcohol very often, or drink a lot of alcohol in the short term (“binge” drinking); have any other medical conditions; are pregnant or planning to become pregnant. It is unknown if JARDIANCE will harm your unborn baby. Tell your doctor if you are breastfeeding, or plan to breastfeed. It is unknown if JARDIANCE passes into your breast milk.

Tell your doctor about all the medicines you take including prescription and over-the-counter medicines, vitamins, and herbal supplements. Especially tell your doctor if you take water pills (diuretics) or medicines that can lower your blood sugar such as insulin.

What are other possible side effects of JARDIANCE?

Low blood sugar (hypoglycemia): if you take JARDIANCE with another medicine that can cause low blood sugar, such as sulfonylurea or insulin, your risk of low blood sugar is higher. The dose of your sulfonylurea or insulin may need to be lowered. Symptoms of low blood sugar may include headache, drowsiness, weakness, dizziness, confusion, irritability, hunger, fast heartbeat, sweating, shaking or feeling jittery.
Kidney Problems. Sudden kidney injury has happened in people taking JARDIANCE. Talk to your doctor right away if you reduce the amount you eat or drink, or if you lose liquids; for example, from vomiting, diarrhea, or being in the sun too long.
Increased fats in your blood (cholesterol).

I’m not a fan of Jardiance. My preference is to normalize blood sugar with diet and exercise so you don’t need to find ways to “remove excess blood sugar’ from the blood.

Before you try a medication that overworks the kidneys….organs that are already in danger from chronic high blood glucose….ask your MD for 8 weeks following The Metabolism Miracle by Diane Kress. This 3 Step Plan normalizes blood glucose and provides the very best blood glucose and hemoglobin A1C possible on the LEAST amount of medication.

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About Diane Kress

Author of The New York Times Bestseller; The Metabolism Miracle, The Metabolism Miracle Cookbook, and The Diabetes Miracle. and The Metabolism Miracle, Revised Edition. Owner, developer, and administrator of The Metabolism Miracle's support site: www.Miracle-Ville.com. Registered Dietitian, Certified Diabetes Educator, www.themetabolismmiracle.com www.thediabetesmiracle.com www.miracle-ville.com Email: dietquestions@ymail.com
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