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!

https://vimeo.com/411265284

​

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!

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.