Sunday 2 August 2015

New Drug May Treat High Potassium Level (新的药物可治疗高钾水平)

New Drug May Treat High Potassium Level (新的药物可治疗高钾水平)
Introduction
I decided to write a topic on Potassium as it is something closed to me.  It is important to me during my dialysis days as well as post-transplant.  In fact, it plays an important role for a healthy individual.
Why Potassium is important?
Potassium is necessary for the heart, kidneys and other organs to work so enabling them to function properly so to transit nerve signals, muscle contractions, fluid balance, and various chemical reactions.
Health problems due to insufficient potassium include leg cramps, muscle weakness, irregular heartbeats, and in serious cases, paralysis.
Doctor has advised a friend to take more bananas to increase his potassium level so to prevent cramps.
What is hyperkalaemia?
People with advanced diabetes will lead to damage to the kidneys.  As a result, it can cause potassium levels to increase to dangerous levels, which is termed hyperkalaemia (高钾血症).
"High potassium is a problem seen in people with advanced kidney disease and advanced diabetes with kidney disease and with people with heart failure," said lead researcher Dr. George Bakris, a professor of medicine at the University of Chicago.
Hyperkalaemia can lead to life-threatening cardiac arrhythmia and sudden death.
Traditional Treatments
Bakris said a change in diet is the traditional approach.  At that times, I have to avoid fruits and vegetables to lower my potassium levels, which include Bananas, tomato, avocados, spinach those that are high in this mineral.
In addition, I have to take Resinsodio and mix with water if the restricted diet did not achieve the desirable results.  It has to be taken continually if the potassium level is deemed high.
Information on the new drug
Relypsa Inc. (NASDAQ:RLYP), a biopharmaceutical company, announced a new drug, Patiromer, will significantly reduce potassium levels when taken for a month and the effect will last for a year, researchers found.
Patiromer is a potassium binder, taken orally, twice a day, with a small amount of water, for the treatment of hyperkalemia.
As explained by Dr. Bakris, Patiromer will reliably bind potassium throughout the entire gastrointestinal tract, which helps remove potassium from the body.  Such process compares favorably as to the existing drug where only bind potassium in the lower intestine.
Clinical Trial
A total of 306 patients with CKD stages 3 to 5 and type 2 diabetes had been selected for this one-year trial.  All selected patients had mild-to-moderate hyperkalemia.
Clinical results showed that taking Patiromer has significantly reduced blood potassium levels across all dose groups in patients with either mild or moderate hyperkalemia at week 4 and the effect would maintain throughout the 52 weeks.
Patiromer was well tolerated by all patients over the 52 weeks of treatment.  Some common adverse events:
·      9.2% experienced worsening of CKD
·      8.6% experienced hypomagnesemia
·      7.9% experienced of hypertension (7.9 percent)
·      6.3% experienced constipation (6.3 percent) and
·      5.6% experienced diarrhea
No adverse events of worsening CKD were considered by investigators to be related to Patiromer.
Additional information
Please visit followings for additional information:
Diabetes and kidney disease – American Diabetes Association
Patiromer trial presented by Dr. Bakris and published by JAMA – The Journal of the American Medical Association 
Latest developments
Relypsa announced that the U.S. Food and Drug Administration (FDA) has assigned a Prescription Drug User Fee Act (PDUFA) action date of October 21, 2015 for completion of the review of the New Drug Application (NDA) for the investigational agent Patiromer.
If Patiromer is approved, it will be the first new therapeutic made available for the treatment of hyperkalemia in over 50 years.
I suggest the following Posts for your Reading:
·     Hypoglycaemia
Disclaimer: I am not a Medical Doctor. All my blog postings are based on my personal experience that I've went thru and what I've read up from the internet. If you've any symptoms of diabetes OR want to better manage your health, I strongly urge you to have regular medical-ups to avoid future complications. In addition, control your diet portions and have regular exercise. 

(我不是一位医生。所有我的博克投稿是我的个人经验,并且我从互联网读了。如果您有糖尿病的任何症状或要更好处理您的健康,我强烈敦促您有规则健康检以避免未来复杂化另外,控制您的饮食部分并且有定期运动.)


Monday 15 June 2015

Hypoglycaemia {Update#1} (低血糖症)

Hypoglycaemia {Update#1} (低血糖)

In this update, I wish to share my recent experience of hypoglycaemia and what is the appropriate ways to treat it under different circumstances.

In one of my meals, I took slice fish and vegetable soup WITHOUT any carbohydrates items, such as brown rice and wholemeal bread, to go along.  At exactly two hours after my meal, my glucose level was 3.9mmol/L.  Please read on how to treat Hypoglycemia.

According to the Dietitian, I have to include a portion of carbohydrates item in all my meals to avoid Hypoglycaemia.  Without any carbohydrates item, the system/insulin will use up the any carbohydrates item as store in my body.

What is Hypoglycaemia?

It is a medical term for Low Blood Sugar.  The principal problems arise from an inadequate supply of glucose to the brain.  The most common forms of hypoglycemia occur as a complication of treatment of diabetes mellitus with insulin.

What is the acceptable glucose level?

In local term, the acceptable glucose is above 4.0 mmol/L. Symptoms of hypoglycaemia will develop when the glucose falls below 4 mmol/L

Symptoms of hypoglycemia that I have experienced:
·      Sweating
·      Shaking or trembling
·      Hunger
·      Mood changes such as sad or angry
·      Confusion
·      Anxiety

Other reports mentioned that if blood sugar drops very low, the person may not be able to respond, becomes unconscious or has a seizure.

How to treat hypoglycaemia under following circumstances:
·      If you experience hypoglycaemia symptom with a blood sugar that is 4.0mmol/L and above, treat it with a small carbohydrates snack.
Blood Sugar Level
4.0mmol/L and above
<4.0mmol/L
<2.8mmol/L
Treatments
Take a small carbohydrates snack
Take 15-20g of rapid-acting carbohydrates, e.g.:
Ø Take 3-4 teaspoons of sugar / glucose power
Ø 4-5 glucose tablets
Ø 150-200ml sweetened soft drinks / juice

Take 30g of rapid-acting carbohydrates, e.g.:
Ø Take 6 teaspoons of sugar / glucose power
Ø 8 glucose tablets
Ø 300ml sweetened soft drinks / juice

Further actions
No further actions are required
Re-test after 15 minutes – is the blood sugar >4.0mmol/L?
Follow-up actions
Not Applicable
YES – Depend on when is the next as a starchy carbohydrate may be necessary
NO!!
Ø Repeat the above step until blood sugar >4.0mmol/L
Ø Seek treatment immediately if blood sugar <4.0mmol/L for 2 cycles
Follow up treatment POST hypoglycaemia
Within 1 hour
NO additional carbohydrates snack.  Go ahead to have meal.
More than 1 hour
Take long acting carbohydrates, e.g.: biscuits or bread.
Personally, I take one slice of wholemeal bread.
Do note that this is only a general guideline.  Discuss with your doctor and adjust according to requirements.

As a diabetic, I always carry my Nano, needed strips and lancets wherever I go.
My other Relevant Posts for your Reading (您能其他相关的博):

·      Post-Transplant, Osteoporosis & Right Diet (后移植、骨质疏松症 & 正确的饮食)

·      Eating Healthy to Lower Your Blood Pressure {Update#1} (吃健康降低您的血压)

·      Difference between Glycosylated Hemoglobin (HbA1c) and Blood Glucose (葡基化的血红蛋白 (HbA1c) 和血糖之间的别)

Disclaimer: I am not a Medical Doctor. All my blog postings are based on my personal experience that I've went thru and what I've read up from the internet. If you've any symptoms of diabetes OR want to better manage your health, I strongly urge you to have regular medical-ups to avoid future complications. In addition, control your diet portions and have regular exercise. 

(我不是一位医生。所有我的博克投稿是我的个人经验,并且我从互联网读了。如果您有糖尿病的任何症状或要更好处理您的健康,我强烈敦促您有规则健康检以避免未来复杂化另外,控制您的饮食部分并且有定期运动.)


Sunday 14 June 2015

FDA Approved Humalog KwikPen® for Type 1 & 2 Diabetes (粮食与药物管理局批准Humalog KwikPen® 治疗糖尿)

In May 2015, The U.S. Food and Drug Administration (FDA) approved Eli Lilly’s Humalog U-200 KwikPen (insulin lispro 200 units/mL; U-200) for people with type 1 and type 2 diabetes.  It is a prefilled insulin pen containing a double strength formulation of the rapid acting insulin Humalog – This offers patients a pen that lasts longer between pen changes, allowing for fewer changes every month.

According to David Kendall, M.D., Vice President of Medical Affairs, at Lilly Diabetes. "Humalog U-200 KwikPen represents a new option for people with diabetes. Fewer pen changes per month may help people who require higher daily doses of mealtime insulin better fit their treatment in their daily lives."

The approval of Humalog U-200 KwikPen was based on a demonstration of the bioequivalence of Humalog 200 units/mL relative to Humalog 100 units/mL in a pharmacokinetic / pharmacodynamic study. The most common side effect of Humalog is Hypoglycemia (low blood sugar) that may be severe and cause unconsciousness, seizures and death.  See my post on Hypoglycemia.

Once opened, Humalog prefilled pens should be thrown away after 28 days, even if insulin remains.

Humalog U-200 KwikPen was approved in the European Union since October 2014.

The Humalog U-200 KwikPen is expected to hit the shelves of U.S. pharmacies in August 2015.

For more information about the Humalog U200 KwikPen, click here for Full Prescribing Information from Eli Lilly.

My other Relevant Posts for your Reading (您能其他相关的博):

·      Post-Transplant, Osteoporosis & Right Diet (后移植、骨质疏松症 & 正确的饮食)

·      Eating Healthy to Lower Your Blood Pressure {Update#1} (吃健康降低您的血压)

·      Difference between Glycosylated Hemoglobin (HbA1c) and Blood Glucose (葡基化的血红蛋白 (HbA1c) 和血糖之间的别)

Disclaimer: I am not a Medical Doctor. All my blog postings are based on my personal experience that I've went thru and what I've read up from the internet. If you've any symptoms of diabetes OR want to better manage your health, I strongly urge you to have regular medical-ups to avoid future complications. In addition, control your diet portions and have regular exercise. 

(我不是一位医生。所有我的博克投稿是我的个人经验,并且我从互联网读了。如果您有糖尿病的任何症状或要更好处理您的健康,我强烈敦促您有规则健康检以避免未来复杂化另外,控制您的饮食部分并且有定期运动.)