A week ago, the media was all abuzz about a new study published in the New England Journal of Medicine showing that the oral drug Actos can prevent diabetes. At first we at the 'Mine didn't pay much attention, because of course we're more concerned with what happens to people who already have diabetes. But the buzz didn't stop. Forbes blogger Matthew Herper wrote a great piece about why side effects make this a bad idea.
So we've been chewing on this news all week, and just couldn't resist adding our 2 cents on why this study is dumb. Errr, 10 cents that is:
1. The study was financed by the company that makes this drug! No surprise it came out in their favor! Talk about your self-fulfilling prophecies.
2. It's counter-intuitive (and counter-productive) to treat type 2 diabetes with a drug that clearly causes weight gain.
3. Pre-diabetes is defined as elevated fasting glucose. If you give folks any glucose-lowering drug (metformin, glipizide, or insulin!), their fasting glucose levels go down. So how is this prevention? Isn't giving people Actos for high BGs just basic treatment for diabetes?
4. This drug is in the same class as Avandia, which has been known to cause serious complications in individuals and has already been banned in Europe, and has been greatly restricted in the US!
5. The European Medicines Agency has opened a study investigating whether Actos is linked to cancer. They're in the middle of a 10-year study. So you want patients to take their pick of diabetes or cancer risk?!
6. Other research suggests that about three out of every 100 people who take Actos or Avandia develop heart failure as a result!
7. The study doesn't address how long patients have to stay on Actos to avoid "full-blown diabetes." Just a year? Or indefinitely? Again, is this really prevention or just garden variety treatment?
8. According to Kelly Close of the diabetes consultancy Close Concerns, seeking FDA approval for this use of Actos is a "non-starter":
"This class of drugs is going generic in 2012... (and) no companies have yet tried to get approval for a drug specifically for pre-diabetes. It would take so long that these drugs will go generic before that, and then the companies will lose interest because they can't make money off it."
9. In the meantime, encouraging docs to use this drug for pre-diabetes would constitute "off-label use." (evil!)
10. At the core of it: do we really want to encourage people to med up unnecessarily? Wouldn't diet and exercise be healthier than embarking on a potential lifetime of "prevention" medication?
And... Bonus reason: This is so old news (2008)!
btw, were you thinking April's Fools here? Think again!!