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When the Treatment Might Be Worse Than the Disease
The pros and cons of dealing with a new diabetes drug.

By Walt Raleigh

A physician friend of mine once observed wryly, “I like to prescribe the new drugs just as quickly as I can, while they’re still working miracles and they don’t have any side effects.”

Ouch.

But there’s a lot of truth in that. New drugs come on the market, and they’re all the greatest thing since sliced bread... until the kind of data that you can only get when large populations of patients have been taking them for a while becomes available.

I’m not a doctor, and I don’t play one on dLife. I’m just trying to be an educated consumer and sort out the information that is available to me and make some sense of it all; I want to understand both the risks and the benefits of any medication that I take regularly.

Here’s the latest poser:

If you’ve been following the news lately, you know that researchers at the prestigious Cleveland Clinic have reported in the New England Journal of Medicine that GlaxoSmithKline’s new diabetes drug, Avandia, may increase the risk of heart attack for diabetes patients by up to 43%.

Right now, some of you are thinking: Oh my God! The risk of heart disease in diabetes patients is high enough already... so we should all stop taking Avandia immediately, right?

The story got a lot of play in the national news media, and that kind of panicked reaction was the entirely understandable result.

But it’s just not that simple.

Here’s the word straight from the lead researcher who published the study:

Researcher Steven Nissen, M.D., is chairman of Cleveland Clinic's cardiovascular medicine department. Nissen, past president of the American College of Cardiology, was one of the first doctors to raise the alarm about the heart risks posed by Vioxx. Nissen says his findings are valid, but he warns that the data are not definitive and must be confirmed by further studies.

"What patients need to know is there is some evidence of cardiovascular harm from Avandia — but there is not any reason to panic," Nissen tells WebMD.

So what should you do, if you’re taking Avandia now?
Talk to your doctor(s). Figure out what the best decision is for you.

Like almost everything in life, you have to balance the known risks and make the best decision you can with the best information you have at the time.

If you’re responding to treatment with Avandia and you haven’t done well with other diabetes medications, you might decide that this is a compelling argument to stay with the medication.

Or you might decide that you want to get off this medication right away and try something else.

Right now, the science looks pretty scary. But early reports have been wrong before, and though more definitive studies are underway, the results won’t be in until next year at the earliest.

Ineffectively managed diabetes has all kinds of known bad effects. It’s too bad that, at times like this, anxiety over how you’re managing it has to be one of them.