With the US Food and Drug Administration (FDA) severely restricting access to the diabetes medication, <"http://www.yourlawyer.com/topics/overview/avandia">Avandia, and the European Medicines Agency suggesting the controversial medication be banned, many diabetics are left wondering about safe alternatives. As we have written previously, this summerâ€™s FDA hearings concluded that Avandiaâ€™s risks outweigh benefits; however, notes CNN, the panel was split over a ban.
In the US, about 24 million peopleâ€”a figure that translates to about eight percentâ€”have been diagnosed with diabetes, said CNN, noting that those with Type 2 diabetes total mostâ€”90 percentâ€”of this figure, citing the National Diabetes Information Clearinghouse.
About 600,000 diabetics in the US take GlaxoSmithKlineâ€™s Avandia, but that number is expected to decline significantly thanks to the FDAâ€™s action. Patients in the US will only have access to Avandia if they and their doctors attest that they have tried every other diabetes medicine and that patients have been made aware of Avandiaâ€™s cardiac side effects. Patients already taking Avandia who want to continue will have to sign statements that they understand the risks. But, says, CNN, there are other options.
Metformin, an oral medication â€œis generally accepted as the initial medical therapy choice for patients with type 2 diabetes,” said Dr. David Kendall, Chief Scientific and Medical Officer for the American Diabetes Association, wrote CNN. “It lowers the blood sugar without the risk of it going too low,” he added, quoted CNN. Metformin with sulfonylureas, which better enables the pancreas to produce additional insulin, are another option, according to Dr. David Nathan, director of the diabetes center at Massachusetts General Hospital, wrote CNN. “If your blood control isn’t working with metformin alone, this combination is often the next line of defense,” quoted CNN. Also, Metformin with insulin is an option, said Dr. Nathan, wrote CNN. “It’s also worth noting that insulin is the only medicine we treat people with that’s naturally occurring in the body,” said Nathan, quoted CNN.
Pioglitazone, in the same class of Avandia, known as Actosâ€”the only drug in this class which will not been banned if Avandia is pulled, is another option, wrote CNN. “With all drugs in this class, there is a risk of fluid retention and weight gain, however, Actos has not been implicated to increase the risk of heart attack,” said Dr. Kendall, quoted CNN. Of note, Actos is not recommend for cardiac patients. DPP-4 inhibitors, a new class of drug that lowers blood glucose by helping produce insulin when needed, and which prevents â€œthe liver from depositing stored glucose into the bloodâ€ is available as a pill, soon, as a weekly injection, said CNN.
Each medication has pros and cons; a comparison is accessible at the Agency for Healthcare Research and Quality at: http://www.effectivehealthcare.ahrq.gov/repFiles/OralHypo_Clin_07.02.08.pdf
As Dr. Kendal points out, “Anyone who has just developed diabetes, who can control their blood sugar with food intake, can manage with eating healthy and exercising and not taking a medication,” quoted CNN. “The absolute best alternative therapy to treat diabetes is to lose weight,” said Dr. Nathan. “The problem is that many patients fail, and that’s why we turn to medication,” he added, quoted CNN.
Centers for Disease Control (CDC) indicates that over 72 million U.S adults are obese, putting them at increased risk for a number of diseases, such as type 2 diabetes, said CNN. The National Diabetes Education Program offers information on seven areas in which to focus on the management of diabetes and blood sugar: It can be accessed here.