LifeCare Chiropractic

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Januvia

New Diabetic Drugs and Cancer: 5 Reasons for Concern

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I have been very vocal in my opposition to the new class of diabetic drugs that affect the GLP-1 pathway derived from the gila monster.

But something never even occurred to me until I read an editorial attached to this article.  Something jaw dropping that I’m shocked I didn’t think about before.

Why on Earth would the gila monster, a very venomous reptile (although luckily also incredibly slow) produce a non-toxic substance in its saliva that positively affects its own gastrointestinal tract and the way it handles glucose?

Sounds like such a reasonable question once it’s been asked.  Here’s the answer.

The gila monster only eats several times per year.  In between meals, it’s entire GI tract shrinks from non-use and atrophies much like a deflated balloon.  But when it finally catches something slower than itself, the GI system of the gila monster has to go from zero to 60 in a very short period of time.  This is where the hormone GLP-1 comes in.

GLP-1 rapidly expands the GI tract of the gila monster, causing a rapid cell division of all the cells involved.  And then someone decided that this might be a good drug to treat diabetes.

They must’ve been smoking something considered illegal in most US states without a prescription to give a hormone that forces cells to rapidly divide to the point of danger.

This is likely why there is a growing strong undercurrent of researchers expressing grave concern over this entire class of drugs.  This particular study should feed their arguments further.  Researchers looked at the pancreas of diabetics (who had passed away and given their organs up for donation) and compared how it looked at under a microscope in those who had been on incretin therapy for his or her diabetes.  Here’s what they found:

  1. Those on incretin therapy had an approximately 40% increase in the mass of his or her pancreas.
  2. This increase came from both increased number of cells as well as precancerous cells (increased pancreatic intraepithelial neoplasia),
  3. The pancreata in those treated with incretin therapy had evidence of α-cell hyperplasia and glucagon-expressing microadenomas.
  4. β-Cell mass (the cells that produce insulin) was increased almost 600% in those taking incretins.
  5. Interestingly, despite this massive increase in beta cell numbers, diabetes persisted.

Overall, there were very clear concerns with precancerous and cancerous growth among the cells of the pancreas in these patients treated with incretin therapy.  For me, the most shocking aspect is the massive increase in the number of cells producing insulin, and yet this still wasn’t the answer for these patients.

In other words, despite doing (and, arguably, overdoing) what the class of drug is supposed to do, it still did nothing to fix the problem of the diabetes.

Guess that leaves lifestyle changes.

New Diabetic Drugs – Investor Profits or Public Safety?

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It seems like the general public has a very short memory.  When I ask patients if they remember the Vioxx debacle, more and more often the answer is no.

100,000+ heart attacks, lord knows how many deaths, billions in lawsuit payments, a 20/20 special and the revelation that Merck had fabricated clinical studies and got them published in major medical journals.  This all happened less than a decade ago.  Unless everyone has early onset dementia, one would think that something this dramatic would stand out in the American public’s memory.

But alas, I occasionally have patients coming in who had been given Celebrex (the only one in this class still on the market) and didn’t remember what had happened.  Heck–forget if the patient remembered–as a physician would you ever recommend this class of drugs given its history?

The real problem with Merck was that they knew there were cardiovascular problems several years before the dangers leaked out by an internal whistleblower.  This is why the lawsuits were filled and ultimately settled.  Good ole’ fashioned ethics would tell us that this is not a good way to run a business that cares for its customers.  Hold off bad news as long as you can while you rake in as much in profits as you can.

Good thing the cat’s out of the bag and it can’t happen again.

You, of course, know where this is going.

Regular readers of the Rantings know how I feel about the new fancy-dancy diabetic drugs that affect GLP-1 pathways and help manage diabetes.  If you haven’t read my previous blog articles on this topic, you can read them by clicking here.  These include drugs with names like Januvia, Byetta, Onglyza and Victosa.  The cost of these prescriptions typically run around $200 / month.  And they are being give out like candy to diabetics.

Worse, the drug manufacturers are desperately pushing the bonds of what they can be used for.  These uses include prediabetes and weight loss.  I have seen completely off label use of this class of drugs given to patients in my office for conditions they should NOT be used for.

At $200 / month, this class of drugs is very profitable.  Profitable enough for investors to shun warnings in lieu of profits.

You see, one of the greater concerns with this drug is the risk of developing acute pancreatitis.  If you or someone close to you has sufferred an attack of acute pancreatitis, you know this is incredibly painful and can even prove fatal.  There are concerns that the risk of developing acute pancreatitis are 10 times higher in those taking the drugs.

Here’s the problem.  According to this editorial, investors tied to the companies that manufacture these drugs knew the dangers at least a year before the FDA sent warning letters out to physicians.  While the jury is still out on on just how great the risk is vs the benefit on blood sugar control, the data presented currently looks pretty incriminating.  Personally, I would never consider taking this class of drug.

There’s a very good chance this whole thing could blow up in the near future.  Just make sure you’re not counted as part of the collateral damage.