2. A BRIEF REVIEW OF THE CURRENT DIABETES DRUGS Two of the largest selling drugs, to help control blood sugar, are Avandia® and Actos®. In the first six months of 2007 increasingly adverse reports were widely publicized about these as a result of new printed scientific studies in peer-reviewed journals:
1. Female Diabetics using these drugs have started to develop fractures of the hands,
arms, and lower extremities. This was not reported in the Clinical Trials that led to drug approval by the FDA. The mechanisms for these fractures is unknown, but the general class of drugs that Avandia® and Actos® belong to have a multitude of properties.
2. Diabetics on these drugs appear to have increased risks for “heart attacks” due to
Coronary Artery Disease, over and above the increased risk caused by Diabetes. The cardiologists who have raised this concern are from the Cleveland Clinic, the institution that helped to point out the cardiac risks of unselected prescribing of Vioxx®. This matter on Avandia® and Actos® is under study and review, but adds to another well-known, proven cardiac risk of Avandia® and Actos® in this next item.
3. These two drugs are acknowledged as causing water retention and weight gain. It is
an inherent effect of this particular class of oral Diabetes drugs. This problem is exaggerated by the overlooked fact that in many Diabetics, the muscle cells of the heart (“the myocardial cells”) are deficient in Glutathione and as a result sustain damage to the energy-producing parts of these muscle cells, the mitochondria. The average Diabetic, therefore, has an inadequate Cardiac Reserve and can go into Heart Failure and die, as a result.
There are a number of Diabetic drugs to control blood sugar in addition to insulin Avandia® and Actos®. Insulin is injected and is often poorly used by people who have Diabetes, with the result being “over-shooting” and becoming “woozy” or “under-shooting” and risking Diabetic keto-acidosis and semi-coma. The others are briefly described here with information as printed in the 2007 Physicians Desk Reference (PDR):
1. Metformin® is used alone and in combinations. It is complicated to use because
kidney abnormalities, which are common in Diabetics, can cause abnormal metformin levels. Rarely, a fatal complication termed lactic acidosis, can develop and carries a “Black Box” warning in the PDR. It also causes Nausea, Vomiting, Diarrhea and Headaches. It has several adverse drug-drug interactions.
2. Precose® causes gastro-intestinal problems, because of its mechanism of actions.
There are changes and elevations in liver enzymes. “…A few cases of fulminant hepatitis with fatal outcome have been reported…” but the relationship to Precose® “…is unclear…”
3. Starlix® causes a significant incidence of hypoglycemia, compared to placebo,
resulting in dizziness and confusion. There are adverse drug-drug interactions that can result in more hypoglycemia.
4. Byetta® is given by injection, twice daily. It must be given within 60 minutes
before the morning and evening meals. Not after a meal. It causes Nausea, Vomiting, Diarrhea, “feeling jittery”, Dizziness, Headaches. The patient may develop antibodies to Byetta® 5. Symlin® is given by injection. It has a “Black Box” warning regarding “severe
hypoglycemia”. There are adverse drug-drug interactions because Symlin® may alter the absorption of orally administered drugs.
6. Sulfonylureas, including Glimepiride cause hypoglycemia, Vomiting, G-I pain,
and Diarrhea. Drug-drug interactions may lead to loss of control of blood glucose. This drug carries a Warning of a potential increased risk of cardiovascular mortality.
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