My Pill Is Not My Savior

I’m lucky enough to have hooked up with a great endocrinologist who happens to be one of the people pharmaceutical companies rely on for Phase III trails of their anti-diabetes drugs. (Phase III trials are the last step before drugs go to the Food and Drug Administration for final marketing approval.)

Over the last four years, he’s involved me in three drug trials, including one for a drug that was very much like Byetta. Byetta is the diabetes drug that caused a sensation when it was introduced in 2005 because one of its happy side effects was sometimes dramatic weight loss.

I didn’t lose any weight on the Byetta analog, I suspect because I was on placebo. Although that was disappointing, I was consoled by the fact that I was receiving regular check-ups and consultations from a very intelligent, humorous, and well-read man, and getting paid a small stipend to boot.

Currently I’m testing dapagliflozin, a once-daily oral drug that works by shunting glucose to the kidneys and the urine stream, bypassing the digestive system. By directing some of my glucose intake away from my bloodstream, where it can cause damage, the drug reduces the wear and tear of diabetes on my body. The only side effect seems to be an extra trip or two to the bathroom each day.  

A very pleasant bonus is that the drug also seems to be helping me lose some weight. Not a lot, but, still, noticeable—perhaps 4 lbs. over the past month. I mentioned this to my endocrinologist the last time I was in for a routine follow-up, and it prompted him to deliver a bit of wisdom: “This is great news that this drug is helping you lose weight. But never let a pill become your savior or the source of your weight loss.”

He went on to explain that the old prescription of diet and exercise would apply to me until the day (may it be far, far off) I die. “Never depend on a drug to do what you should be doing for yourself.” He said this to me affectionately and sweetly, but also with a tone that told me he was speaking to me from years of experience.

I’ve been thinking about what he said in the days since I last saw him. My dapagliflozin, which I will be on only through June, is kind of like those rockets they attach to a jet that needs help taking off from a very short runway. They give a great initial boost, but once the plane is airborne, it must rely on its own engines to cover the rest of the distance.

Time for me to head out and walk a couple of miles.

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