Nettles & Dandelion Pesto Recipe
3c fresh nettles
1c fresh young (small) dandelion leaves
Juice of ½ lemon
1 tsp salt
1 clove garlic
1 tsp nutritional yeast
3/4c toasted walnuts
1/3-1/2c olive oil
Directions are on the video link below!
Handle nettles with gloves ON until after they’ve been scalded stingless. Harvest greens only in places without chemical sprays and domestic animal waste products. Wash thoroughly with filtered water separately, as only the nettles will need to be cooked briefly.
Toss all ingredients into a food processor (only 1/3c oil to start) and blend. Scrape. Add additional olive oil until desired consistency is reached. Taste!
My favorite uses for this recipe are 3-critter grilled cheese sandwich with pesto, pesto pasta, and—what we did with the batch made on the video—homemade pizza sauce!
Happy, healthy eating!
Type 2 Diabetes Course
TABLE 1
Listed below are some of the drugs that can increase the risk of being diagnosed with type 2 diabetes:
Drug name, Generic
Chlorothiazide
Hydrochlorothiazide
Chlorthalidone
Metolazone
Drug name, Brand
Diuril
HydroDiuril
Hygroton, Thalitone
Zaroxolyn
Drug Class
Thiazide
Diuretics
Indications for Use
Fluid accumulation; sometimes high blood pressure
Furosemide
Torsemide
Lasix
Demadex
Loop diuretics
Fluid accumulation,
High blood pressure
Metoprolol
Betaxolol
Bisoprolol
Timolol
Carvedilo
Toprol, Lopressor
Kerlone
Zebeta
Timoptic, Blocadren
Coreg
Beta blockers
High blood pressure; some also have approved indications for use in heart failure, migraine prevention, to prevent a second heart attack, chest pain
Albuterol
Levalbuterol
Ventolin, Proventil, ProAir
Xopenex
Short acting beta-2 agonists; bronchodilators
Bronchospasm; albuterol also is indicated for use in exercise-induced bronchospasm
Formoterol
(+budesonide)
Salmeterol
(+fluticasone)
Forodil, Perforomist
(Symbicort)
Serevent
(Advair, AirDuo)
Long acting
beta-2 agonists; bronchodilators
Asthma, COPD (chronic obstructive pulmonary disease, such as emphysema and chronic bronchitis), exercise-induced bronchospasm
Theophylline
TheoDur, Theocron, Theo-24, Elixophyllin
Methylxanthine; bronchodilator
Asthma, COPD
Atorvastatin
Simvastatin
Rosuvastatin
Fluvastatin
Pitavastatin
Lipitor
FloLipid, Zocor
Crestor, Ezallor
Lescol
Levalo
“Statins”
Anti-lipemic agents (lipid lowering agents)
High cholesterol levels in the blood (adults and children), to reduce the risk of heart attack, stroke, chest pain, stent placement in patients with/without past history of any of the above who also have multiple coronary heart disease risk factors; some are also approved for use in special types of lipid irregularities and high triglycerides
Niacin
Lithium
Slo-Niacin, Niacor, Niaspan
Eskalith, Lithobid
Vit. B3; Lowers lipids
Anti-mania
Various kinds of lipid abnormalities
Bipolar disorder (7 years and older)
Drug name, Generic
Drug name, Brand
Drug Class
Indications for Use
Aripiprazole
Risperidone
Olanzapine
Ziprasidone
Quetiapine
Lurasidone
Clozapine
Abilify
Risperdal, Perseris
Zyprexa
Geodon
Seroquel
Latuda
Clozaril, FasaClo, Versacloz
Anti-psychotics, often called “mood stabilizers”
Schizophrenia; some also have approval for use in major depressive disorder, bipolar disorder, suicidal behavior in schizophrenia or schizoaffective disorder, irritability in autism, bipolar mania, Tourette’s disorder
Neurontin, Gralise
Dilantin
Lamictal
Depakote
Anti-convulsants or anti-epileptics,
often called “mood stabilizers”
Partial (focal) seizures; others are indicated for use in nerve pain after shingles, generalized seizures, status epilepticus, bipolar disorder, mania, migraines,
Gabapentin
Phenytoin
Lamotrigine
Divalproex
Prednisone
Betamethasone
Cortisone
Hydrocortisone
Dexamethasone
Clobetasol
Methylprednisolone
Prednisolone
Triamcinolone
Desonide
Desoximetason
Deltasone
Diprolene
Compound E
Cortef, Solu-Cortef
Decadron
Clobex, Temovate
Medrol
Oropred, Millipred
Kenalog
Desowen, Tridesilon
Topicort
Corticosteroids
Anti-inflammatory or immune suppressant agents across most body systems and conditions: allergic, neoplastic, skin, blood, gut, eyes, joints, skin, immune, nervous, endocrine, respiratory, kidney; solid organ rejection. Used by mouth, applied to the skin, inhaled into the nose or mouth, or injected
Medroxyprogesterone
Levonorgestrel (found in mini-pills & combo contraceptives, too)
Provera,
Depo-Provera
Mirena, Lyletta, Skyla, Kyleena; Plan B, Next Choice, My Way, React, Option 2, Aftera
Progestins
Contraception and heavy menstrual bleeding; medroxyprogesterone is also indicated for use in lack of menstrual bleeding, endometriosis, endometrial overgrowth and cancer.
Febuxostat
Modafinil
Amitriptyline
Desipramine
Doxepin
Imipramine
Notriptyline
Moxifloxacin
Ciprofloxacin
Levofloxacin
Uloric
Provigil
Elavil
Norpramin
Sinequan, Silenor
Tofranil
Pamelor
Avelox
Cipro
Levaquin
Xanthine derivative
Central nervous system stimulant
Anti-depressants
Antibiotics, fluoroquinolones
derivative
Gout
Narcolepsy, obstructive sleep apnea, shift work sleep disorder
Major depressive disorder; some have indications for use in bipolar disorder, sleep issues, anxiety, bed-wetting
All kinds of infections that are susceptible to these agents. Can also cause LOW blood glucose!
TABLE 2
Below are the drugs currently used to treat type 2 diabetes. The average drop in hemoglobin A1c (HbA1c) is also listed. HbA1c is roughly an average blood glucose over the past 2-3 months. (Normal HbA1c is 4.0-5.6%, pre-diabetes is 5.7-6.4%, diabetes is 6.5% and higher.)
Drug name, Generic
Drug names, Brand
Drug Class
AVG DROP in HbA1c
Blackbox Warning
Glyburide
Glipizide
Glimepiride
Metformin
Acarbose
Miglitol
Rosiglitazone
Pioglitazone
Repaglinide
Nateglinide
Exenatide
Lixisenatide
*Dulaglutide
*Liraglutide
*Semaglutide
Pramlintide
Sitagliptin
Vildagliptin
Saxagliptin
Linagliptin
*Canagliflozin
Empagliflozin
Dapagliflozin
Diabeta, Glycron, Glynase, Micronase
Glucotrol, Amaryl
Glucophage
Precose
Glyset
Avandia
Actos
Prandin
Starlix
Bydureon, Byetta
Lyxumia
Trulicity
Victoza
Ozempic
Symlin
Januvia
Galvus
Onglyza
Tradjenta
Inkovana
Farxiga
Jardiance
Sulfonylureas
Biguanides
α-glucosidase inhibitors
Thiazolidinediones
(aka “glitazones”)
Meglitinides
(aka “glinides”)
Glucagon-like Peptide receptor-1
(GLP-1) agonists
Amylin analog
DiPeptidyl Peptase-4 (DPP-4) inhibitors
Sodium-Glucose co-transporter Type-2 (SGLT-2) inhibitors
1-2%
1-2%
0.5%
1-1.5%
1-1.5%
1%
0.4-0.6%
0.8%
0.6-1.2%
Lactic acidosis
Congestive heart failure
*Thyroid C-cell tumors and medullary thyroid cancer
Severe hypoglycemia
*Limb amputations
This list is pretty much in chronological order, with the first class of anti-diabetic drugs on the market (the sulfonylureas, 1957) listed at the top, and the most recent drug class released into the marketplace (the SGLT-2 inhibitors, 2013) at the bottom. As you may have noticed, the older drugs tend to have a greater effect on hemoglobin A1c. (They also happen to be a whole lot less expensive, as they’re available in the generic form! And, they’ve been around long enough for interested parties to understand what nutrients they waste.)
Let’s make some comparisons. If a type 2 diabetic happens to have a HbA1c of 7.9% and takes metformin, we’d expect the HbA1c to drop to as low as 5.9%. That’s great! The patient would then be considered “controlled” and in the pre-diabetic category.
But what if the patient has a HbA1c of 17.9%? Lowering that by the full 2 points only gets the patient to 15.9%. That’s still very diabetic! No wonder patients end up on a handful of meds to manage a disease, including the use of injectable insulin. Yikes! The new agents entering the market are combinations of the ones listed above.
TABLE 3
Black Box Warning for Metformin (Glucophage, a biguanide)
WARNING: LACTIC ACIDOSIS
Postmarketing case of metformin-associated lactic acidosis have resulted in death, hypothermia, hypertension and resistant bradyarrthythmias. The onset of metformin associated lactic acidosis is often subtle, accompanied only by nonspecific symptoms such as malaise, myalgias, respiratory distress, somnolence, and abdominal pain. Metformin associated lactic acidosis was characterized by elevated blood lactate level (>5 mmol/liter). anion gap acidosis (without evidence of ketonuria or ketonomia), an increased lactate/pyruvate ratio; and metformin plasma levels generally >5 mcg /ml.
Risk factors for metformin -associated lactic acidosis include renal impairment,concomitant use of certain drugs (e.g carbonic anhydrase inhibitors such as topiramate), age 65 years old or greater, having a radiological study with contrast, surgery and other procedures, hypoxic states (e.g acute congestive heart failure), excessive alcohol intake and hepatic impairment.
Steps to reduce the risk of and manage metformin-associated lactic acidosis in this high risk group provided. If metformin-associated lactic acidosis is suspected, immediately discontinue GLUCOPHAGE or GLUCOPHAGE XR and institute general supportive measures in a hospital setting.
Prompt hemodialysis is recommended.
Black Box Warning for Rosiglitazone and Pioglitazone (Avandia and Actos, thiazolidinediones)
Congestive Heart failure:
Thiazolidinediones, including rosiglitazone,cause or exacerbate congestive heart failure(CHF) in some patients, After initiation of rosiglitazone and after dose increase, observe patients carefully for sign and symptoms of heart failure (including excessive, rapid weight gain,dyspnea;and /or edema). If these sign and symptoms develop, manage the heart failure according to current standards of care. Furthermore, consider discontinuation or dose reduction of rosiglitazone. Rosiglitazone is not recommended in patients with symptomatic heart failure. Initiation of rosiglitazone in patients with established New York Heart Association (NYHA) class III or IV heart failure is contradicted.
Myocardial Infarction:
A meta-analysis of 52 clinical trials (mean duration, 6 months; 16, 995 total patients), most of which compared rosiglitazone with placebo, showed rosiglitazone to be associated with a statistically significant increased risk of myocardial infarction (MI). Three other trails(mean duration, 46 months; 14,067 total patients) comparing rosiglitazone with some other approved oral antidiabetic agents or placebo showed a statistically non significant increased risk of MI and a statistically non significant decreased risk of death. There have been no clinical trials directly comparing the cardiovascular risk of rosiglitazone and pioglitazone, another thiazolidinedione, but in a separate trial, pioglitazone (when compared with placebo) did not show an increased risk of MI or death.
Black Box Warning for Pramlintide (Symlin, amylin analog)
WARNING:SEVERE HYPOGLYCEMIA
Symlin use with insulin increase the risk of severe hypoglycemia, particularly in patients with type 1 diabetes. When severe hypoglycemia occurs, It is seen with in 3 hours following a Symlin injection. Serious injuries may occur if severe hypoglycemia occurs while operating a motor vehicle, heavy machinery, or while engaging in other high risk activities. Appropriate patient selection, careful patient instruction, and insulin dose reduction are critical elements in reducing this risk.
Black Box Warning for Liraglutide/Victoza, Albiglutide/Tanzeum, Dulaglutide/Trulicity and Semaglutide/Ozempic; GLP-1 agonists
WARNING:RISK OF THYROID C-CELL TUMORS
Liraglutide (albiglutide,dulaglutide, and semaglutide) causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors at clinically relevant exposure in both genders of rats and mice. It is unknown whether VICTOZA (TANZEUM, TRULICITY,OZEMPIC) causes thyroid C-cell tumors, including medullary thyroid carcinona (MTC), in humans, as the human relevance of liraglutide (albiglutide,dulaglutide, and semaglutide) induced rodent thyroid C-cell tumors has not been determined.
VICTOZA (TANZEUM, TRULICITY, OZEMPIC) is contraindicated in patient with a personal or family history of MTC and in patient with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Counsel patients regarding the potential risk fro MTC with the use of VICTOZA (TANZEUM, TRULICITY, OZEMPIC) and inform them of symptoms of thyroid tumors (e.g a mass in the neck, dysphagia, dyspnea, persistent hoarseness). Routine monitoring of serum calcitonin or using thyroid ultrasound is of uncertain value for early detection of MTC in patients treated with VICTOZA (TANZEUM , TRULICITY, OZEMPIC).
Black Box Warning for Canagliflozin (Invokana, SGLT-2 inhibitor)
WARNING:LOWER LIMB AMPUTATION
An approximately 2-fold increased risk of lower limb amputations associated with INVOKANA (canagliflozin) use was observed in CANVAS and CANVAS-R, two large, randomized, placebo-controlled trials in patients with type 2 diabetes who had established cardiovascular disease(CVD) or were at risk for CVD.
Amputations of the toe and midfoot were most frequent;however, amputations involving the leg were also observed. Some patients had multiple amputations, some involving both limbs.
Before initiating, consider factors, that may increase the risk of amputations, such as a history of prior amputation, neuropathy, and diabetic foot ulcers.
Monitor patients receiving INVOKANA (canagliflozin) for infection, new pain or tenderness, sores or ulcer involving the lower limbs, and discontinue if these complications occur.