Hi, Johnie and clb1968,
The doctor, as expected, was most pleased. I forgot to mention that my triglycerides in the past 3 months have dropped from 87 to 67. The doctor says the improvement in the A1c is better than he would have expected from using Actose. So, he's told me to keep on keeping on and check back in another four months. He also tells me I can quit checking my BGs, since my record of them for the past three months show that they are mostly normal (with occasional wanderings into slightly abnormal ranges, which he expects will disappear if I continue on Atkins, especially if Atkins generates another 20 pounds of weight loss).
Several interesting things came out of the conversation with him. As to BGs:
1. He say BGs after eating are a far better early indicator of disposition to diabetes than fasting BGs.
2. He emphasized that sustained exercise is critically important to alter insulin resistence and to change glucose metabolism in pre-diabetic people. Optimum exercise is to get one's heart into the aerobic range for an hour, five days a week.
Johnie, I asked him about your report of the warning on the Zocor packaging. Here's what he tells me about statins generally when combined with niacin:
1. Statins essentially treat only one part of the lipid panel -- the low and very low density lipoproteins. They do not have much effect on HDL or triglycerides.
2. Niacin has its greatest impact on lowering triglycerides and raising HDL.
3. Consequently, when combined with statins (any of them), niacin and statins together give you a much greater punch in cholesterol management than either of them by themselves. He tells me there is extensive research evidence advocating the combination of niacin and statin drugs, and he has several hundred patients who use both. He claims that over the past 15 years of practice, he has only seen slightly elevated liver enzymes in three patients who are taking statin/niacin combos, out of hundreds under his care. All three of these, he says, were also taking numerous other meds for other conditions, and he is not at all sure that the abnormal liver enzymes were caused by either statins or niacin.
Originally, I was put on Zocor after my heart attack in 1995. About 1998, I learned about niacin therapy from a friend, and after researching it, I decided to try it myself. Part of my rationale was, frankly, financial -- I was out of work, had no insurance coverage, and I could afford $12 a month for niacin more than I could afford $70 a month for Zocor. So, I stopped taking Zocor, and began ramping up on niacin, until I reached the highest therapeutic dose without the side effects which typically cause people to stop niacin supplementation (i.e. 3,000 mg daily, in three doses).
Then, I told my doctor what I had done. He checked my lipid panel and noted that my HDL had dramatically improved, and my LDL was only slightly elevated over what it had been when I was on Zocor alone. He strongly urged me to begin Zocor and niacin together, especially as I was tolerating niacin so well (I have no side effects from it at all). Sure enough, my LDL dropped even lower than it had been, my HDL continued to rise slowly, and the combo produced a much better lipid profile than either of them alone had done.
I now combine niacin with Lipitor. Doc says niacin works very well with any statin.
Now, when I asked him about that warning on the Zocor lable, he laughed. "That notice comes from the drug company's legal department. They're always looking for ways to reduce their liability."
"I wondered about that," I said. "In fact, I was wondering if the warning didn't come from the marketing department, which didn't want people taking less Zocor."
"No, no," he countered. "It was actually the marketing department which caused that warning notice to be removed. It happened about a month ago. People like your friend were asking their doctors about Zocor and niacin, and the doctors simply began switching people from Zocor to some other statin. Zocor has taken a real hit in the market place, and they just now removed that warning."
How 'bout them apples?
Homesar