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Treating your type 2 diabetes? Don't overlook cholesterol management

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Posted: Monday, February 3, 2014 4:00 pm | Updated: 1:32 am, Tue Feb 11, 2014.

(BPT) - For the millions of Americans living with type 2 diabetes, a combination of diet, exercise and medication can help them control the condition. But even those who are doing everything right to manage their diabetes may be at higher risk of developing heart disease and stroke – if they fail to also treat their high “bad” cholesterol.

“It is estimated that more than half of adults with diabetes also have high cholesterol, which makes it imperative to treat both conditions, side-by-side,” says Dr. Sergio Rovner, an assistant professor at the Family Practice Department at Texas Tech Health Science Center and an endocrinologist in private practice at the Academy of Diabetes, Thyroid and Endocrine in El Paso, Texas.

The diabetes and high “bad” cholesterol connection

Type 2 diabetes and high “bad” cholesterol are closely connected. Having type 2 diabetes can cause the body to be more susceptible to developing high “bad” cholesterol. And, vice versa. Having high “bad’ cholesterol levels also increases the risk of developing type 2 diabetes.

The most common form of diabetes, type 2 diabetes accounts for 90 to 95 percent of all diagnosed cases, according to the Centers for Disease Control and Prevention (CDC). It is a chronic disease characterized by high glucose levels that occur because the body does not properly use insulin that is made, and over time some people with type 2 diabetes may lose the ability to make insulin. Type 2 diabetes is usually associated with older age, obesity, a history (either gestational or family history) of diabetes, sedentary lifestyle and ethnicity.

Some ethnic groups such as Asian-Americans, African-Americans and Hispanics are at higher risk of developing type 2 diabetes. In fact, 12 percent of Hispanics older than 20 have diabetes, as compared to eight percent of the general population, the CDC reports. And, this number is expected to increase by nearly 130 percent within the next 30 years. Factors that put Hispanics at higher risk of developing type 2 diabetes include differences in genetic makeup, social and cultural factors, and access to quality health care.

Cholesterol, a waxy fat-like substance, is necessary for normal body function, but when too much of a certain kind – LDL or “bad” cholesterol – builds up, it can block arteries and contribute to heart disease and stroke.

Many of the lifestyle changes that can help treat type 2 diabetes – increased physical activity, diet control – also are good for your cholesterol. If you are affected with both type 2 diabetes and high “bad” cholesterol, it’s important to treat these conditions in tandem.

Treating in tandem

While eating healthier and exercising more are initial ways to treat both type 2 diabetes and high “bad” cholesterol, medication is often needed. One medication that people may want to ask their doctor about is Welchol® (colesevelam hydrochloride) because it is the only FDA-approved prescription medication with one active ingredient that lowers both A1C levels and “bad” cholesterol levels in adults. The most common side effects seen in patients taking Welchol were constipation, indigestion and nausea. Welchol has not been shown to prevent heart disease or heart attacks.

If you have type 2 diabetes, be sure to talk to your doctor about cholesterol control and managing your diabetes. Your doctor can advise you on what treatment is best for you. To learn more about diabetes and cholesterol, visit www.diabetes.org. To learn more about Welchol, visit www.welchol.com or speak to your doctor.

What is Welchol (colesevelam HCl)?

Welchol, along with diet and exercise, lowers LDL or “bad” cholesterol. It can be taken alone or with other cholesterol-lowering medications known as statins.

Welchol lowers LDL cholesterol in boys, and in girls who have had a menstrual period, ages 10 to 17 years, with a condition known as heterozygous familial hypercholesterolemia (a genetic disorder that causes high cholesterol) alone or with other cholesterol-lowering medications known as statins after inadequate control with diet alone.

Welchol, along with diet and exercise, also lowers blood sugar levels in adult patients with type 2 diabetes mellitus when added to other anti-diabetes medications (metformin, sulfonylureas, or insulin).

Welchol should not be used to treat type 1 diabetes or diabetic ketoacidosis.

Welchol has not been studied with all anti-diabetes medications.

Welchol has not been studied in children younger than 10 years old or in girls who have not had a menstrual period.

Important Safety Information About Welchol (colesevelam HCl)

Welchol is available by prescription only. Ask your HCP if Welchol is right for you.

Welchol is not for everyone, especially those with:

  • a history of intestinal blockage,
  • blood triglyceride levels of greater than 500 mg/dL, or
  • a history of pancreatitis (inflammation of the pancreas) due to high triglyceride levels.

Welchol has not been shown to prevent heart disease or heart attacks.

Tell your health care provider (HCP) if you have high triglycerides (greater than 300 mg/dL).

Tell your HCP if you have stomach or intestinal problems, including gastroparesis (when the stomach takes too long to empty its contents), abnormal contractions of the digestive system, a history of major gastrointestinal tract surgery, if you have trouble swallowing, or if you have vitamin A, D, E, or K deficiencies.

Welchol has known interactions with cyclosporine, glimepiride, glipizide, glyburide, levothyroxine, certain birth control pills, olmesartan medoxomil, and metformin extended release (ER). Welchol has not been studied with all combinations of drugs and supplements. Please tell your HCP about all medications and supplements you may be taking before beginning Welchol, as your HCP may tell you to take your other medications and supplements 4 hours before taking Welchol.

Remember to tell your HCP if you are pregnant, plan to become pregnant, or are breastfeeding.

Welchol (colesevelam HCl) for Oral Suspension should not be taken in its dry form.

Welchol for Oral Suspension is recommended for, but not limited to, use in appropriate pediatric patients as well as any patient who has difficulty swallowing.

Phenylketonurics: Welchol for Oral Suspension contains 27 mg phenylalanine per 3.75 gram dose.

In clinical trials, the adverse reactions observed in ≥2% of patients, and more commonly with Welchol than placebo (“sugar pill”), regardless of investigator assessment of causality seen in:

  • Adult patients with high LDL (“bad” cholesterol) were: constipation, indigestion, nausea, accidental injury, weakness, sore throat , flu-like symptoms, runny nose, and muscle aches
  • Pediatric patients with high “bad” cholesterol were: inflamed nasal passages and throat, headache, fatigue, creatine phosphokinase (a muscle enzyme) increase, runny nose, and vomiting
  • Adult patients with type 2 diabetes, when added to other anti-diabetes medications, were: constipation, inflamed nasal passages and throat, indigestion, low blood sugar, nausea, and high blood pressure
  • Adult patients with type 2 diabetes, when taken alone (monotherapy), were: back pain, headache, diarrhea, low blood sugar, C-reactive protein increased, constipation, upper respiratory tract infection, high blood sugar, high blood pressure, blood creatinine phosphokinase increased, gastroesophageal reflux disease (GERD), and tooth abscess

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

For patients having difficulty affording their Daiichi Sankyo medication, please call the Daiichi Sankyo Patient Assistance Program at 1-866-268-7327 for more information or visit www.dsi.com/news/patientassistance.html.

Please see full Prescribing Information for Welchol or go to www.welchol.com.

© 2013 Daiichi Sankyo, Inc.



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