Diabetes

[Jhanananda]

Wakix (pitolisant)

Wakix

Active Substance: pitolisant
Common Name: pitolisant
ATC Code: N07XX11
Marketing Authorisation Holder: Bioprojet Pharma
Active Substance: pitolisant
Status: Authorised
Authorisation Date: 2016-03-31
Therapeutic Area: Narcolepsy
Pharmacotherapeutic Group: Other nervous system drugs
Therapeutic Indication

Wakix is indicated in adults for the treatment of narcolepsy with or without cataplexy (see also section 5.1).
What is Wakix and what is it used for?

Wakix is a medicine used to treat adults with narcolepsy. Narcolepsy is a long-term sleep disorder which affects the brain’s ability to regulate the normal sleep-wake cycle. This leads to symptoms such as an irresistible urge to sleep, even at inappropriate times and places, and disturbed night-time sleep. Some patients also have episodes of severe muscle weakness (cataplexy) that can cause collapse. Wakix is used in patients with or without cataplexy.

Wakix contains the active substance pitolisant. Because the number of patients with narcolepsy is low, the disease is considered ‘rare’, and Wakix was designated an ‘orphan medicine’ (a medicine used in rare diseases) on 10 July 2007.
How is Wakix used?

Wakix can only be obtained with a prescription and treatment should be started by a doctor experienced in the treatment of sleep disorders.

Wakix is available as tablets (4.5 and 18 mg). During the first week of treatment, the recommended dose is 9 mg per day, taken in the morning during breakfast. During the second week of treatment, the dose can be increased to 18 mg per day or decreased to 4.5 mg per day. During the third week, the dose may be further increased to the maximum dose of 36 mg per day. Wakix should always be used at the lowest effective dose.

In patients with moderately reduced liver function or with kidney problems, the maximum dose should be 18 mg per day.

For more information, see the package leaflet.
How does Wakix work?

The active substance in Wakix, pitolisant, works by attaching to receptors in the brain called ‘histamine H3 receptors’. This increases the activity of certain brain cells called ‘histamine neurons’, which are important for keeping the body awake.
What benefits of Wakix have been shown in studies?

Wakix has been investigated in 2 main studies involving a total of 261 adults with narcolepsy, the majority of whom also had cataplexy. The studies compared Wakix with placebo (a dummy treatment). The main measure of effectiveness was based on how sleepy patients felt during daytime, assessed using the Epworth Sleepiness Scale or ESS. This is a standard scale used in patients with narcolepsy which ranges from 0 to 24.

The first study showed that Wakix was more effective than placebo at reducing daytime sleepiness: patients taking Wakix had an average reduction of 3 points more in the ESS scale than those taking placebo after 8 weeks of treatment. Results from this study also showed a decrease in the number of cataplexy attacks. The second study, however, did not show a difference between Wakix and placebo at reducing sleepiness or cataplexy.

When looking at sleepiness with an objective test called Maintenance of Wakefulness Test or MWT, the results of the two studies together showed that Wakix significantly improved wakefulness compared with placebo.

In a further study in 105 patients with narcolepsy and cataplexy, Wakix was also more effective than placebo at reducing the number of cataplexy attacks per week: the number of cataplexy attacks decreased from around 9 to around 3 per week in patients taking Wakix, while it remained at around 7 per week in patients taking placebo.
What are the risks associated with Wakix?

The most common side effects with Wakix (which may affect up to 1 in 10 people) are insomnia (difficulty sleeping), headache, nausea (feeling sick), anxiety, irritability, dizziness, depression, tremor, sleep disorders, tiredness, vomiting, vertigo (a spinning sensation) and dyspepsia (heartburn). Serious but rare side effects are abnormal loss of weight and spontaneous abortion. For the full list of all side effects reported with Wakix, see the package leaflet.

Wakix must not be used in patients with severely reduced liver function and in women who are breastfeeding. For the full list of restrictions, see the package leaflet.
Why is Wakix approved?

The overall data available demonstrate that Wakix has a positive effect on the two major symptoms of narcolepsy, excessive daytime sleepiness and cataplexy. In addition, Wakix works differently from currently available treatments and therefore offers an alternative treatment option. The safety profile of Wakix is considered acceptable, with no major safety concerns identified.

The Agency’s Committee for Medicinal Products for Human Use (CHMP) therefore decided that Wakix’s benefits are greater than its risks and recommended that it be approved for use in the EU.
What measures are being taken to ensure the safe and effective use of Wakix?

A risk management plan has been developed to ensure that Wakix is used as safely as possible. Based on this plan, safety information has been included in the summary of product characteristics and the package leaflet for Wakix, including the appropriate precautions to be followed by healthcare professionals and patients.

In addition, the company that markets Wakix will carry out an observational study to collect information on the safety of the medicine when used in medical practice.

Further information can be found in the summary of the risk management plan.
Other information about Wakix

The European Commission granted a marketing authorisation valid throughout the European Union for Wakix on 31 March 2016.

For more information about treatment with Wakix, read the package leaflet (also part of the EPAR) or contact your doctor or pharmacist.

Source: European Medicines Agency

[Jhanananda]

Ciproxifan hydrochloride

Synonym: Cyclopropyl[4-[3-(1H-imidazol-4-yl)propoxyl]phenyl]-methanone hydrochloride ]Ciproxifan hydrochloride
≥98% (HPLC), solid

Synonym: Cyclopropyl[4-[3-(1H-imidazol-4-yl)propoxyl]phenyl]-methanone hydrochloride

Description
Packaging

5, 25 mg in glass bottle
Biochem/physiol Actions

Ciproxifan belongs to a novel chemical series of histamine H3-receptor antagonists. In vitro, it behaved as a competitive antagonist at the H3 autoreceptor controlling 3H histamine release from synaptosomes and displayed similar Ki values (0.5-1.9 nM) at the H3 receptor controlling the electrically-induced contraction of guinea pig ileum or at the brain H3 receptor labeled with 125I-iodoproxyfan. Ciproxifan appears to be an orally bioavailable, extremely potent and selective H3-receptor antagonist whose vigilance- and attention-promoting effects are promising for therapeutic applications in aging disorders.
Features and Benefits

This compound is featured on the Histamine Receptors page of the Handbook of Receptor Classification and Signal Transduction. To browse other handbook pages, click here.

[Jhanananda]

New Diabetes Drug Approved by FDA

Jan. 9, 2014 -- A new pill to treat adults with type 2 diabetes has been approved by the U.S. Food and Drug Administration.

Farxiga (dapaglifozin) tablets were approved to improve patients' blood sugar control, in combination with diet and exercise. The approval is based on findings from 16 clinical trials that included more than 9,400 people with type 2 diabetes.

An increased number of bladder cancers were diagnosed among patients who took the drug

A Complete List of Diabetes Medications

Amylinomimetic drug

Pramlintide (SymlinPen 120, SymlinPen 60) is an amylinomimetic drug. It’s an injectable drug used before meals. It works by delaying the time your stomach takes to empty itself. It reduces glucagon secretion after meals. This lowers your blood sugar. It also reduces appetite through a central mechanism.

lpha-glucosidase inhibitors

These medications help your body break down starchy foods and table sugar. This effect lowers your blood sugar levels. For the best results, you should take these drugs before meals. These drugs include:

    acarbose (Precose)
    miglitol (Glyset)

Biguanides

Biguanides decrease how much sugar your liver makes. They decrease how much sugar your intestines absorb, make your body more sensitive to insulin, and help your muscles absorb glucose. The most common biguanide is metformin (Glucophage, Metformin Hydrochloride ER, Glumetza, Riomet, Fortamet).

Metformin can also be combined with other drugs for type 2 diabetes. It’s an ingredient in the following medications:

    metformin-alogliptin (Kazano)
    metformin-canagliflozin (Invokamet)
    metformin-dapagliflozin (Xigduo XR)
    metformin-empagliflozin (Synjardy)
    metformin-glipizide
    metformin-glyburide (Glucovance)
    metformin-linagliptin (Jentadueto)
    metformin-pioglitazone (Actoplus)
    metformin-repaglinide (PrandiMet)
    metformin-rosiglitazone (Avandamet)
    metformin-saxagliptin (Kombiglyze XR)
    metformin-sitagliptin (Janumet)

Dopamine agonist

Bromocriptine (Parlodel) is a dopamine agonist. It’s not known exactly how this drug works to treat type 2 diabetes. It may affect rhythms in your body and prevent insulin resistance.
DPP-4 inhibitors

DPP-4 inhibitors help the body continue to make insulin. They work by reducing blood sugar without causing hypoglycemia (low blood sugar). These drugs can also help the pancreas make more insulin. These drugs include:

    alogliptin (Nesina)
    alogliptin-metformin (Kazano)
    alogliptin-pioglitazone (Oseni)
    linagliptin (Tradjenta)
    linagliptin-empagliflozin (Glyxambi)
    linagliptin-metformin (Jentadueto)
    saxagliptin (Onglyza)
    saxagliptin-metformin (Kombiglyze XR)
    sitagliptin (Januvia)
    sitagliptin-metformin (Janumet and Janumet XR)
    sitagliptin and simvastatin (Juvisync)

Glucagon-like peptides (incretin mimetics)

These drugs are similar to the natural hormone called incretin. They increase B-cell growth and how much insulin your body uses. They decrease your appetite and how much glucagon your body uses. They also slow stomach emptying. These are all important actions for people with diabetes. These drugs include:

    albiglutide (Tanzeum)
    dulaglutide (Trulicity)
    exenatide (Byetta)
    exenatide extended-release (Bydureon)
    liraglutide (Victoza)

Meglitinides

These medications help your body release insulin. However, in some cases, they may lower your blood sugar too much. These drugs aren’t for everyone. They include:

    nateglinide (Starlix)
    repaglinide (Prandin)
    repaglinide-metformin (Prandimet)

Sodium glucose transporter (SGLT) 2 inhibitors

These drugs work by preventing the kidneys from holding on to glucose. Instead, your body gets rid of the glucose through your urine. These drugs include:

    dapagliflozin (Farxiga)
    dapagliflozin-metformin (Xigduo XR)
    canagliflozin (Invokana)
    canagliflozin-metformin (Invokamet)
    empagliflozin (Jardiance)
    empagliflozin-linagliptin (Glyxambi)
    empagliflozin-metformin (Synjardy)

Sulfonylureas

These are among the oldest diabetes drugs still used today. They work by stimulating the pancreas with the help of beta cells. This causes your body to make more insulin. These drugs include:

    glimepiride (Amaryl)
    glimepiride-pioglitazone (Duetact)
    glimeperide-rosiglitazone (Avandaryl)
    gliclazide
    glipizide (Glucotrol)
    glipizide-metformin (Metaglip)
    glyburide (DiaBeta, Glynase, Micronase)
    glyburide-metformin (Glucovance)
    chlorpropamide (Diabinese)
    tolazamide (Tolinase)
    tolbutamide (Orinase, Tol-Tab)

Thiazolidinediones

These medications work by decreasing glucose in your liver. They also help your fat cells use insulin better. These drugs come with an increased risk of heart disease. If your doctor gives you one of these drugs, they will watch your heart function during treatment. These drugs include:

    rosiglitazone (Avandia)
    rosiglitazone-glimepiride (Avandaryl)
    rosiglitizone-metformin (Amaryl M)
    pioglitazone (Actos)
    pioglitazone-alogliptin (Oseni)
    pioglitazone-glimepiride (Duetact)
    pioglitazone-metformin (Actoplus Met, Actoplus Met XR)

Other drugs
Other drugs

People with type 1 and type 2 diabetes often need to take other medications to treat conditions that are common with diabetes. These drugs can include:

    aspirin for heart health
    drugs for high cholesterol
    high blood pressure medications

Top 6 Breakthrough Diabetes Treatments You May Have Missed

The American Diabetes Association (ADA) estimates a person diagnosed at age 50 dies six years earlier than a person without diabetes. One in three American adults will have diabetes in the year 2050 if current trends continue.

Close to 29 million Americans, or 9% of the population, currently have diabetes. The vast majority of people, about 90 to 95 percent of those diagnosed with diabetes, have type 2 diabetes, according to the ADA.

However, the latest diabetes news is encouraging. New drugs, improved monitoring devices and an understanding of how diet and exercise can impact diabetes is adding up to positive outcomes for patients. As reported in August 2014 from research in The Lancet Diabetes & Endocrinology, the vast majority of people with type 2 diabetes are living longer lives due to better medications and treatments for both the disease and the numerous complications that result from type 2 diabetes. High blood sugar levels can increase the risk for serious complications due to diabetes such as vision loss, peripheral nerve damage, kidney impairment, hard-to-treat infections, impotence and heart disease.

 1. Alogliptin (Nesina, Kazano, Oseni): Approved January 2013

On January 25, 2013, Takeda Pharmaceutical received approval for alogliptin, a type 2 diabetes drug. Alogliptin is a dipeptidyl peptidase IV (DPP-4) inhibitor that stimulates the release of insulin by preventing GLP-1, a compound that helps to lower blood sugar, from breaking down. Alogliptin was approved in three products:

    In the stand-alone form as Nesina.
    In combination with metformin as Kazano.
    Combined with pioglitazone as Oseni.

Oseni’s label contains a boxed warning for congestive heart failure due to the pioglitazone component. Pioglitazone (Actos), an oral thiazolidinedione used in type 2 diabetes, is also made by Takeda, but the Actos patent expired in 3Q 2012, opening the door for generics and competition. Nesina gives Takeda a new exclusive medicine in the diabetes market.
2. Invokana: Approved March 2013

Invokana (canagliflozain) from Janssen Pharmaceuticals is the first in a new class of type 2 diabetes drugs that was FDA approved in March 2013. Invokana is a sodium-glucose co-transporter 2 (SGLT2) inhibitor that blocks the reabsorption of glucose (blood sugar) by the kidneys and increases glucose excretion in the urine. This oral diabetes treatment is indicated to improve blood sugar control in conjunction with diet and exercise in patients with type 2 diabetes.

In clinical trials with Invokana, an improvement in hemoglobin A1c (a measure of blood sugar control) and fasting blood sugar levels in trials of more than 10,000 patients secured FDA approval. Dehydration (the loss of body water and salt), which may lead to dizziness, fainting, especially when standing up, and genital yeast infections are important side effects.

Invokamet was FDA approved in August 2014, and is a combined, fixed-dose tablet of canagliflozin and metformin. Metformin, often a first-line treatment for patients with newly diagnosed type 2 diabetes, decreases the production of glucose in the liver and improves the body’s response to insulin for patients who have developed insulin resistance. Additional treatments like canagliflozin can be added to metformin for better diabetes control.

In May 2015 the FDA warned consumers and healthcare providers on important side effects associated with the class of SGLT-2 inhibitors (Invokana (canagliflozin), Invokamet (canagliflozin and metformin), Farxiga (dapagliflozin), Xigduo XR (dapagliflozin and metformin extended-release), Jardiance (empagliflozin), Glyxambi (empagliflozin and linagliptin), Synjardy (empagliflozin and metformin): a risk of ketoacidosis (too much acid in the blood) and serious urinary tract infections. Patients should stop taking their SGLT2 inhibitor and seek medical attention immediately if they have any symptoms of ketoacidosis such as nausea, vomiting, abdominal pain, tiredness, and trouble breathing. Patients should also be alert for signs and symptoms of a urinary tract infection, such as a feeling of burning when urinating or the need to urinate often or right away; pain in the lower part of the stomach area or pelvis; fever; or blood in the urine.
3. Farxiga: Approved January 2014

In January 2014, the U.S. Food and Drug Administration (FDA) approved Farxiga (dapagliflozin) tablets to improve glycemic (sugar) control, along with diet and exercise, in adults with type 2 diabetes. Like Invokana, Farxiga is also a sodium-glucose co-transporter 2 (SGLT2) inhibitor. Farxiga’s effectiveness was shown in 16 clinical trials involving more than 9,400 patients. Treatment with Farxiga has been studied alone or in combination with other type 2 diabetes medications, including metformin.

The most common side effects of Farxiga include genital yeast infections, urinary tract infections, and changes in urination frequency.
4. Tanzeum: Approved April 2014

GSK’s Tanzeum (albiglutide), approved in April 2014, is classified as a glucagon-like peptide-1 (GLP-1) receptor agonist. GLP-1 is a hormone that helps normalize blood sugar levels in patients with type 2 diabetes. Tanzeum binds to GLP-1 to stimulate the release of glucose-dependent insulin, while blocking release of sugar-boosting glucagon from the pancreas. Tanzeum is given by subcutaneous (under the skin) injection, and, as with most diabetes treatments, is to be used alongside diet and exercise.

The safety and effectiveness of Tanzeum was shown in eight clinical trials involving over 2,000 participants with type 2 diabetes. Tanzeum was studied alone and in use with other type 2 diabetes treatments, including metformin, glimepiride, pioglitazone, and insulin. Tanzeum has a boxed warning that thyroid tumors have been seen in rodent studies with similar drugs (although animal studies do not always translate to human effects). Byetta and Victoza are other popular drugs in the same class as Tanzeum.
5. Jardiance: Approved May 2014

In May 2014, the FDA approved the third SGLT blocker to enter the U.S. market, Jardiance (empagliflozin). In seven type 2 diabetes clinical trials with about 4,500 people, Boehringer Ingelheim’s Jardiance improved hemoglobin A1c levels compared to placebo. Jardiance can also be used with metformin, sulfonylureas, pioglitazone, and insulin.

Jardiance side effects may include dehydration and low blood pressure that can result in dizziness, fainting, yeast infections, low blood sugar with insulin or insulin secretagogues, elevation in LDL cholesterol, and impaired kidney function. The FDA has asked Boehringer Ingelheim for Jardiance post-marketing studies looking at effectiveness and safety in children and at heart outcomes studies in all populations.
6. Afrezza: Approved June 2014

Afrezza (insulin human) Inhalation Powder was approved by the FDA in June 2014. Afrezza is an ultra rapid-acting inhaled insulin that is administered with meals to improve glycemic control in adult diabetics. In clinical trials, Afrezza was evaluated in 24-week studies in both type 1 and type 2 diabetic patients. In 1,026 type 1 patients also using long-acting insulin, Afrezza effectiveness to lower blood sugar (A1c) provided less A1c reduction than insulin aspart (an injectable fast-acting insulin), and the difference was statistically significant. In 1,991 type 2 patients also using oral antidiabetic agents, inhaled Afrezza did significantly lower A1c compared to a placebo group (also using oral antidiabetics) in a 24-week study.

Afrezza, because it is inhaled and not injected, may cause the serious side effect of bronchospasm in patients with asthma or chronic obstructive pulmonary disease (COPD), and should not be used in these patients. The most common adverse reactions associated with Afrezza in clinical trials were hypoglycemia (low blood sugar), cough, and throat pain or irritation.

Exubera, another previously approved inhaled insulin, was withdrawn from the U.S. market in 2007 due to lack of sales. The fate of Afrezza sales waits to be seen, although some analysts predict sales could reach $1.6 billion if the novel dosage form catches on.

[Jhanananda]

An interesting article, Is Diabetes Really a Vitamin Deficiency Disease?

Ground-breaking new research offers hope for the millions of sufferers of diabetes around the world. While the exact cause of diabetes has eluded researchers and doctors for many years, exciting research shows that a vitamin deficiency may actually be at the cause (or one of the causes) for the debilitating, and frequently, life-threatening disease.

The research, published in Endocrine Journal, shows that vitamin A is essential for the proper functioning of the beta cells of the pancreas. The beta cells are responsible for producing insulin, which in turn helps to regulate blood sugar levels. In type 2 diabetes, which makes up about 95 percent of the 29 million diabetics in the United States, the beta cells stop producing sufficient insulin or the body stops responding to it. In the remaining 5 percent of people, type 1 diabetes occurs when the immune system destroys the beta cells, rendering them incapable of producing adequate insulin.

In the new study, researchers found that there are many vitamin A receptors on the surface of beta cells. In an interview with Medical News Today, study co-author Albert Salehi of the University of Lund, Sweden, stated: “When we discovered that insulin cells have a cell surface expressed receptor for vitamin A, we thought it was important to find out why and what the purpose is of a cell surface receptor interacting with vitamin A mediating a rapid response to vitamin A.”

When the researchers partially blocked the vitamin A receptors, thereby eliminating the ability of vitamin A to bind to the beta cells, they made the discovery that the beta cells were unable to adequately secrete insulin in response to sugar. They also found that a vitamin A deficiency prevented the beta cells from coping with inflammation. A complete vitamin A deficiency caused the death of the beta cells.

This new research offers hope for an effective treatment for the millions of diabetics, and many others who may be able to prevent the disease altogether with adequate vitamin A intake.

In other research published in the medical journal Nature Communications, researchers found that vitamin A plays an important role in the prevention and possible treatment of pancreatic cancer. Check out my blog “The Vitamin Discovery that May Help Prevent Pancreatic Cancer” for more information.

Other recent research published in the British Journal of Pharmacology, found that vitamin A offers hope for those suffering from lung diseases like COPD or emphysema.

Well on all 4 counts I could benefit from taking vitamin A, so I am going to try it.

[Jhanananda]

I bought the highest dosage of vitamin A that I could find this weekend, and started on it.

This morning someone sent me a link to a rather interesting article, which is about a Common Medication Can Actually Prevent Type 1 Diabetes

There's new hope for stopping Type 1 diabetes in its tracks after researchers discovered an existing drug can prevent the condition from developing – and the same techniques used here could also be applied to other diseases.

The drug in question is methyldopa, currently on the World Health Organisation's list of essential drugs having been used for more than 50 years to treat high blood pressure in pregnant women and children.

By running an analysis of thousands of drugs through a supercomputer, the team of researchers was able to pinpoint methyldopa as a drug able to block the DQ8 molecule. The antigen is found in a proportion of the population and has been implemented in auto immune responses.

It appears in some 60 percent of people at risk from developing Type 1 diabetes.

"This is the first personalised treatment for Type 1 diabetes prevention," says one of the team, Aaron Michels from the University of Colorado Anschutz Medical Campus. "This is very significant development."

Based on the supercomputer calculations, the scientists found that methyldopa not only blocked the binding of DQ8 but didn't harm the immune functions of other cells, which is often the case with drugs that interfere with the body's immune system.

Overall, the research covered a period of 10 years – after the supercomputer analysis, the drug was tested in mice and in 20 patients with Type 1 diabetes through a clinical trial. The new drug is taken orally, three times a day.

While it's not a full cure (work on that continues), methyldopa could help delay, or even limit the onset of Type 1 diabetes – a disease that currently starts mostly in childhood.

"We can now predict with almost 100 percent accuracy who is likely to get Type 1 diabetes," says Michels. "The goal with this drug is to delay or prevent the onset of the disease among those at risk."

That 100 percent prediction rate is made possible by looking at a variety of genetic and biological markers, including autoantibodies in the blood. Those at risk could now be put on a course of treatment to ward of the development of diabetes.

With diagnosed cases of Type 1 and Type 2 diabetes on the rise in the United States – and the Type 1 condition believed to affect around 1.25 million people in the US alone – such treatments could make a huge difference.

Accounting for about 5-10 percent of people with diabetes, Type 1 involves the body's own immune system attacking the pancreas, stopping the production of insulin and hampering the absorption of glucose and the production of energy.

In Type 2 diabetes, the body can't process the insulin it does make properly.

Methyldopa is far from the first drug to show benefits in treating health issues other than the ones it was first designed for, but we now have better ways to spot these extra powers: this idea of identifying certain molecules and then applying modern-day computing power to find drugs that block them could work in other situations too.

"This study has significant implications for treatment of diabetes and also other autoimmune diseases," says one of the researchers, David Ostrov from the University of Florida.

"This study suggests that the same approach may be adapted to prevent autoimmune diseases such as rheumatoid arthritis, coeliac disease, multiple sclerosis, systemic lupus erythematosus and others."

The research has been published in the Journal of Clinical Investigation.

[Jhanananda]

with the last entry showing a possible treatment for type 1 diabetes, it makes me curious what specifically defines type 1 verses type 2 diabetes.

Diabetes mellitus
Diabetes mellitus (DM), commonly referred to as diabetes, is a group of metabolic disorders in which there are high blood sugar levels over a prolonged period.[7] Symptoms of high blood sugar include frequent urination, increased thirst, and increased hunger.[2] If left untreated, diabetes can cause many complications.[2] Acute complications can include diabetic ketoacidosis, hyperosmolar hyperglycemic state, or death.[3] Serious long-term complications include cardiovascular disease, stroke, chronic kidney disease, foot ulcers, and damage to the eyes.[2]

Diabetes is due to either the pancreas not producing enough insulin or the cells of the body not responding properly to the insulin produced.[8] There are three main types of diabetes mellitus:[2]

    Type 1 DM results from the pancreas's failure to produce enough insulin.[2] This form was previously referred to as "insulin-dependent diabetes mellitus" (IDDM) or "juvenile diabetes".[2] The cause is unknown.[2]
    Type 2 DM begins with insulin resistance, a condition in which cells fail to respond to insulin properly.[2] As the disease progresses a lack of insulin may also develop.[9] This form was previously referred to as "non insulin-dependent diabetes mellitus" (NIDDM) or "adult-onset diabetes".[2] The most common cause is excessive body weight and insufficient exercise.[2]
    Gestational diabetes is the third main form, and occurs when pregnant women without a previous history of diabetes develop high blood sugar levels.[2]

[Jhanananda]

For the last 8 years my mission has been hijacked by declining health, so my focus has been directed these years to ways of understanding my health issues and coming up with ways to remediate these issues. 

For the last year I have been relying upon HEPA air filters, which have improved my health considerably.  The problem has been in powering them via solar panels, and batteries.  This works on most days in Arizona, where we have 286 sunny days per year, but right now my solar panels are buried in snow, and the batteries are exhausted.

I happen to own 30 18ft long solar panels and 16 golf cart batteries, but my current van (a 1989 Ford Econoline 250) is too short to build a rack for these panels, and it could not carry 16 golf cart batteries.  So, I am currently looking into alternatives.

There is at least 1 H3 antihistamine, Ciproxifan available in the US, starting today.

Ciproxifan belongs to a novel chemical series of histamine H3-receptor antagonists. In vitro, it behaved as a competitive antagonist at the H3 autoreceptor controlling 3H histamine release from synaptosomes and displayed similar Ki values (0.5-1.9 nM) at the H3 receptor controlling the electrically-induced contraction of guinea pig ileum or at the brain H3 receptor labeled with 125I-iodoproxyfan. Ciproxifan appears to be an orally bioavailable, extremely potent and selective H3-receptor antagonist whose vigilance- and attention-promoting effects are promising for therapeutic applications in aging disorders.

I have had considerable success in using herbal tonics for my condition for 45 years, however more research is needed to improve the effect of the herbal tonic.

In herbal medicine, an herbal tonic is used to help restore, tone and invigorate systems in the body or to promote general health and well-being.[1] An herbal tonic is a solution or other preparation made from a specially selected assortment of the kinds of plants known as herbs.

[Alexander]

Sorry to hear of your troubles, Jeff, and hope your health improves. We value your continued presence here, hell plane though it is. :)

[Jhanananda]

Thanks, Alexander, for voicing your kind support. 

Yes, I agree, material existence is a hell-plane; or a better way to put it, is biology, by necessity, is cruel. 

So, the message is, lead a disciplined, rigorous, self-aware, contemplative life that bares the superior fruit of attainment, and relinquish your entanglements with the material word; which I believe everyone on this forum, including you, are engaged in at one level or another.

[Jhanananda]

I have noticed that Prescott seems to have an unusually rich and wide range of fungi.  I have seen fungi here that I have seen no where else.  One of the interesting fungi is something called, "Fuligo septica."  Its more common names are: "scrambled egg slime," or "dog vomit slime mold," because it tends to look like bright yellow vomit with a color similar to egg yokes.

This fungus might be the source of my winter time lung infections here, because

Human pathogenicity

This species is known to trigger episodes of asthma and allergic rhinitis in susceptible people.[20][21]

 I have seen it grow here, I found it growing in my old van, when I got so sick, and these are my major symptoms.

[Intuition]

Jhanananda, I am actually quite curious, after reading the history of this thread, to know how your health is doing this Winter?

[Jhanananda]

My health most of the year has been quite good with simply sleeping with my windows closed, and a small HEPA filter filtering the air that I breath when the body sleeps.  My vitals under this condition are normal, with even normal blood sugars.

However, it is one of Prescott's 2 peek allergy seasons. Consequently my vitals have declined with my blood sugars 4 ti9mes normal.  I have been in the ER once, and I am now seeing all of my doctors, who are quite concerned for my health.  With it being winter, then solar gain is about 1/2 what it is during the warmer months, which has meant I can only run my HEPA filter for about 4-6 hours a day.

Thus, I am now working on making improvements to my off-grid electrical system so that my camper van can be a 24/7 refuge from the allergens that are swamping us here in Prescott at this time of year.  In the long run I will  have to increase the number of solar panels from 2 to 8, which will cost me more money than I can muster in a short time.

The previous year has provided ample proof that my health is directly related to allergens in the air here.  My allergist did a blood test in 2016 that showed I had extreme allergies to pollen from at least 5 plants in this area.

Last week my allergist conducted an extensive skin test of many common allergens and found that I am allergic to just about everything in the Prescott area, including animal danders and mold spores.  It supports the cause of why my health went down the tubes nearly 9 years ago when I arrived here.  Prescott has thus become the "perfect storm" for my allergies.  However, there is a simple solution to my health problems.  Filter the air I breath with a HEPA filter.

Thanks-you for asking

[Intuition]

Damn, I'm sorry to hear that, but it's good to hear you have a solution. I really hope you can get the HEPA filter running for longer periods of time. It's a shame that you're allergic to so many plants in Prescott. Would it be possible for you to move out of Prescott, or do you have something keeping you tied there?

[Jhanananda]

Thank-you, Intuition, for your kind concern.  I completed repairs of the RV's electrical charging system, and linking my 4 deep cycle marine batteries to the van's alternator.  Now running the engine for 15 minutes gives me 6 hours of HEPA filter use.  Yesterday was an allergen spike here, so I stayed in the van running the HEPA filter for 18 hours.  After only the first half hour my respiratory symptoms were normalized; and this morning I found my blood sugar significantly reduced.  It suggests that I might need to have HEPA filtered air 24-7 during the allergy seasons here.

Now that I have a working solution to running a HEPA filter, then I can keep working on ways to keep it running longer.  I happen to own a 2KW gasoline generator, so my next goal is to attach it to the van.  At that point I can run it for 6 hour on only 1 gallon of gasoline.  Eventually I would like to cover the roof of my van with solar panels, which would mean I would only need to run the generator on cloudy days.

Yes, I can move from Prescott, except my decline in health has made it very difficult for me to do the necessary work to move. In the past I used to just drive until I stopped having an allergy response.  I found in most cases all I had to do was change my elevation by 2,000ft to find relief, but it meant I had to move every 3 months, and doing so kept me a victim of my allergies.  Being forced to do the necessary research to solve my many health problems has given me the benefit of developing equipment that allows me to remain longer in an area, if necessary.

[rougeleader115]

I actually had not heard of ephedra before! I researched it and was amazed by the history and usage. You continuously inspire me with your intelligence and ability to use the natural world scientifically. You have a very wholistic approach to dealing with life and i deeply appreciate learning these things about you.

I will mention this as another alternative for diabetes if you have not heard of it. I did not know we could consume certain types of frankincense. A woman that my herbal teacher learned from mentions in her book that Acacia gum resin is good for diabetes. She said that she makes acacia water for her diabetes, and it reduced her A1c from 6.8 to 5.9 in 2 months. She says it did not help her cholesterol but that it stayed the same.

I'm just going to put the link to that here, but her other items and information are definitely worth investigating.

https://www.robinsresinsplus.com/store/p11//arabic_gum.html#/

Best Wishes,
Rougeleader