Diabetes Still Isn't Easy
Diabetes Still Isn't Easy

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How Misleading Drug Claims Can Interfere with the Medical Care of Diabetics

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Over the last decade, there has been the development and approval of a group of medications that fall in the broad category of “incretins.” They are off-shoots of a natural product that we produce called “glucagon like peptide”(GLP). The background observation was that if you administer glucose intravenously vs. orally, the oral route evokes a stronger insulin response from the pancreas. Thus, when glucose enters the body through the GI tract after being swallowed, it stimulates another substance that enhances the beta-cell response to glucose and there is a greater increment in insulin release. Thus, the name incretin. 

When given from the outside, GLP is destroyed very rapidly, so two techniques were developed to deliver GLP as a drug. First, give a substance that blocks the enzyme that breaks down GLP so that the natural GLP would last longer. Second, create an analogue by altering the GLP and give it as an injection. Both have been very effective. The injectable analogue has been very effective in assisting with weight loss. All of this is geared to facilitate normalizing blood glucose and reducing the risk for diabetes complications such as heart attacks, strokes, blindness, kidney failure, loss of limb, and many others.

There had been a question about whether or not inflammation of the pancreas was a complication of this treatment, as well as whether or not there was an increased risk for pancreatic cancer. To date, there has been no evidence to support either of these questions. The FDA in the US, the major diabetes and endocrine organizations, and the European diabetes community all have stated that there is no credible evidence for the association of these drugs with pancreatitis or pancreatic cancer.

Nevertheless, there is incessant inappropriate lawyer advertising that if you took even one dose of these medications and you develop either pancreatitis or pancreatic cancer you may be eligible for a financial award. Some patients as a result have been wary of taking these medications. In as much as there is no evidence for these consequences, it is inappropriate and misleading to advertise that these are real observations. If this continues and enough people are affected, the numbers who will develop the aforementioned diabetic complications will rise, preventable outcomes on the heads of those who recklessly use scare tactics to keep people from the best treatments. 

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About the Author


MD, FACP

Dr. Bernstein is director of the diabetes management program at the Friedman Diabetes Institute.

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