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More bad news on diabetes

By | August 19, 2008, 11:27am PDT

Summary: The standard protocol for prediabetes thus remains weight loss and exercise. The oldest pill in the doctor’s bag, metformin, is your only choice if you can’t follow that advice.

ByettaTwo new classes of diabetes drugs are having trouble in tests, leaving doctors treating the epidemic in something approaching despair.

The leading Glucagon-like peptide-1 (GLP-1) drug, Byetta, has been linked to the deaths of two people from pancreatitis.

This comes just as its maker, Amylin Pharmaceuticals, was preparing to deliver a timed-release version to the market, a weekly pill to take the place of twice-daily injections.

The news puts those plans in doubt, since the drug’s effect can’t be “turned off” if a pancreatic problem develops.

A second new class of drug, protease dipeptidyl peptidase (DPP-IV), acts to increase the effectiveness of naturally-occurring GLP-1, but its safety and efficacy is not fully established, especially with long-term use.

Given the problems with GLP-1s, expect enormous reluctance to accept such results at face value. This is bad news for DPP-IV drugs like Januvia, which is taken as a daily pill.

But it’s worse news for patients. Those with advanced diabetes have concerns about drugs they might take. Those with prediabetes face the fact there are few drugs for them at all. That number was estimated at 12 million in 2003.

The standard protocol for prediabetes thus remains weight loss and exercise. The oldest pill in the doctor’s bag, metformin, is your only choice if you can’t follow that advice. 

Sorry, no miracles today.

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Disclosure

Dana Blankenhorn

Dana Blankenhorn has been a journalist, writer and part-time futurist for over 30 years. At the present moment I run only a personal blog in addition to my ZDNet open source blog. DanaBlankenhorn.Com has the subtitle The War Against Oil. In the past I have used it to write about political history, e-commerce, personal matters, some ideas related to open source, and The World of Always On, which is the idea of using sensors, motes and RFID to turn WiFi links into platforms for applications which live in the air. My IRA account at Schwab holds a few tech shares, most notably some Intel and Applied Materials, but there are no open source companies in it. I don’t even own any CBS stock.

Biography

Dana Blankenhorn

Dana Blankenhorn has been a business journalist since 1978, and has covered technology since 1982. He launched the Interactive Age Daily, the first daily coverage of the Internet to launch with a magazine, in September 1994.

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Thanks for that link!
Ken_z 20th Aug 2008
I'm sitting with my 4th jumbo cup of
coffee this morning reading your link.
Ooops!

I move to decaf about 4 PM, but will
gradually wean myself off of the real stuff
by shifting earlier in the day. Then it will
only be a matter of not buying anything
buy decaf. If it's not in the house I can't
make it, or drink it.
0 Votes
+ -
If you are physically
frgough Updated - 19th Aug 2008
incapable of losing weight or exercising, you have worse concerns
than being possibly pre-diabetic.

I love how you always take the most extreme cases you can find
(unable to exercise and lose weight) and extrapolate it to the
most common problem faced by health care.
0 Votes
+ -
Physical fitness helps...
John L. Ries 19th Aug 2008
...but not everyone is diabetic because they are or were fat.
0 Votes
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You are what you EAT, PERIOD.
Intellihence 19th Aug 2008
Plain & simply, fat and lazy Americans get up off your hinds
and work. Excercise please. Your medical problems are
becoming worse & taxpayers are fed up of paying more &
more because of your laziness. The government really should
stop helping people who refuse to help themselves.
0 Votes
+ -
Really...
BitTwiddler 20th Aug 2008
Last I read, this is a world-wide problem, not a US problem.
0 Votes
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Indeed...
BitTwiddler 20th Aug 2008
Some people gain weight BECAUSE of Diabetes.
0 Votes
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Cluetrain...
techboy_z 19th Aug 2008
Quit eating fast food, packaged foods, and drinking soda 3x/day. Drink milk, eat veggies, go for a run (or...if you cannot physically run/bike/walk...go swimming - even an obese person can get a workout in at the pool - the water supports you).

Out of all that...I have to think the soda epidemic is at the heart of things. I honestly cannot believe what I see every day - people arrive at work, drinking a soda at *breakfast* time! Then another at lunch. That is sooo foreign to me. I was brought up that "pop rots your teeth and your stomach from the acid, and has too much sugar." We drank OJ in morning, milk at lunch and dinner. Water in between.
0 Votes
+ -
Everything you have stated is so true. If only people would
diet and exercise properly, their would be less problems with
their HEALTH.
0 Votes
+ -
On Being a fat guy
hrpuffnstuff 19th Aug 2008
As an obese person with a surprisingly normal blood pressure of 110 over 70, I feel I am the most qualified to say the following:

"Attention fat folk, wake up and stop whining and blaming everything else but the fact u eat alot and don't exercise for your weight issues"

I see these shows with obese folk and I feel no pity at all because of the simple fact that I , along with them, let ourselves get to that point. Now granted I'm not bedridden and don't do badly for myself but I have to ask at what point did u realize u had an issue? I am at almost 400 pounds and 40 years old and realized it has to stop now or else I am a dead man.
We all make choices in our lives and have to be responsible for owning up and making amends for those choices.
0 Votes
+ -
Thanks for that link!
Ken_z 20th Aug 2008
I'm sitting with my 4th jumbo cup of
coffee this morning reading your link.
Ooops!

I move to decaf about 4 PM, but will
gradually wean myself off of the real stuff
by shifting earlier in the day. Then it will
only be a matter of not buying anything
buy decaf. If it's not in the house I can't
make it, or drink it.
0 Votes
+ -
I'm glad I held off...
BitTwiddler 20th Aug 2008
Actually, my insurance won't cover these 'new' drugs anyway, and they are hardly affordable for the average person.

Metformin, Amaryl, Lantus and and Humalog Insulins are my primary defense these days.

Avandia worked well, but my Doctor DC'd it due to the reported problems.

I don't think we can trust ANY new drug until it's past 5 years in use these days. I think the pharm companies are in profit mode (get it out there fast) instead of safety mode these days.

I'll take proven, cheaper 10+ year old meds any day.

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