Comments on: Has The Avandia Controversy Scared Diabetics? http://www.pharmalot.com/2007/12/has-the-avandia-controversy-scared-diabetics/ News, Comment and Conversation Sun, 21 Mar 2010 07:58:10 +0000 http://wordpress.org/?v=2.6.2 By: Robert W. Donnell http://www.pharmalot.com/2007/12/has-the-avandia-controversy-scared-diabetics/#comment-78111 Robert W. Donnell Fri, 04 Jan 2008 02:53:50 +0000 http://www.pharmalot.com/2007/12/has-the-avandia-controversy-scared-diabetics/#comment-78111 Although probably few consumers are looking at the evidence (they're more likely swayed by the hype)the evidence on macrovascular outcomes for some other DM-2 treatments is disturbing. Among DM-2 pharmacologic agents only metformin and pioglitazone have any evidence of macrovascular benefit. As I documented in posts linked below, there is good and growing evidence that sulfonylureas are associated with not only macrovascular harm but also increased mortality. There is also weaker evidence that insulin may be associated with macrovascular harm in type 2 diabetes. Finally, although the TZDs are much maligned for their ability to cause macular edema, insulin causes it too. http://doctorrw.blogspot.com/2007/06/avandia-two-questions_8882.html http://doctorrw.blogspot.com/2007/09/avandia-and-actose-are-there-lessons.html Although probably few consumers are looking at the evidence (they’re more likely swayed by the hype)the evidence on macrovascular outcomes for some other DM-2 treatments is disturbing. Among DM-2 pharmacologic agents only metformin and pioglitazone have any evidence of macrovascular benefit.

As I documented in posts linked below, there is good and growing evidence that sulfonylureas are associated with not only macrovascular harm but also increased mortality. There is also weaker evidence that insulin may be associated with macrovascular harm in type 2 diabetes.

Finally, although the TZDs are much maligned for their ability to cause macular edema, insulin causes it too.

http://doctorrw.blogspot.com/2007/06/avandia-two-questions_8882.html

http://doctorrw.blogspot.com/2007/09/avandia-and-actose-are-there-lessons.html

]]> By: AmyT of www.diabetesmine.com http://www.pharmalot.com/2007/12/has-the-avandia-controversy-scared-diabetics/#comment-76783 AmyT of www.diabetesmine.com Thu, 03 Jan 2008 03:32:46 +0000 http://www.pharmalot.com/2007/12/has-the-avandia-controversy-scared-diabetics/#comment-76783 OMG, if this is true then Merck's Januvia is SO next. Check out the nearly 100 reader comments on this post: www.diabetesmine.com/2007/02/much_ado_about_.html Lots of nasty, as-yet-undocumented side effects. OMG, if this is true then Merck’s Januvia is SO next. Check out the nearly 100 reader comments on this post:

http://www.diabetesmine.com/2007/02/much_ado_about_.html

Lots of nasty, as-yet-undocumented side effects.

]]> By: Hank http://www.pharmalot.com/2007/12/has-the-avandia-controversy-scared-diabetics/#comment-68057 Hank Sat, 29 Dec 2007 23:08:35 +0000 http://www.pharmalot.com/2007/12/has-the-avandia-controversy-scared-diabetics/#comment-68057 I agree with the general view that diet, exercise, and other lfestyle options - and the gold-standard RCTS that support these approaches - have been mostly left out of public discussion of tx options. At the same time, I believe that some of the voices that figure in "Prescription for Disaster" should arouse as much suspicion as anything from pharma. The Life Extension Foundation, for example, is as full of self-interested hype as anything anywhere. And, in fact, it's sometimes the same folks. A number of the supplement companies are now owned by big pharma. So....beware. Sometimes the "alternative" is genuine; sometimes it isn't. I agree with the general view that diet, exercise, and other lfestyle options - and the gold-standard RCTS that support these approaches - have been mostly left out of public discussion of tx options.

At the same time, I believe that some of the voices that figure in “Prescription for Disaster” should arouse as much suspicion as anything from pharma. The Life Extension Foundation, for example, is as full of self-interested hype as anything anywhere.

And, in fact, it’s sometimes the same folks. A number of the supplement companies are now owned by big pharma. So….beware. Sometimes the “alternative” is genuine; sometimes it isn’t.

]]> By: sid http://www.pharmalot.com/2007/12/has-the-avandia-controversy-scared-diabetics/#comment-67904 sid Sat, 29 Dec 2007 20:52:00 +0000 http://www.pharmalot.com/2007/12/has-the-avandia-controversy-scared-diabetics/#comment-67904 Thom, That's funny -- people are more concerned with diet and exercise. That's rich. Have you looked around the grocery store? All I see are obese, sedentary people. But if you think a scare story about Avandia has created a huge change in the last month, you have a better eye than I do. Thom,

That’s funny — people are more concerned with diet and exercise. That’s rich. Have you looked around the grocery store? All I see are obese, sedentary people. But if you think a scare story about Avandia has created a huge change in the last month, you have a better eye than I do.

]]> By: pg http://www.pharmalot.com/2007/12/has-the-avandia-controversy-scared-diabetics/#comment-67568 pg Sat, 29 Dec 2007 17:17:22 +0000 http://www.pharmalot.com/2007/12/has-the-avandia-controversy-scared-diabetics/#comment-67568 Thats not suprising Matt, given just how dangerous bad regulation of the drug industry is: <a href="http://video.google.com/videoplay?docid=-2502546838698762400&q=prescription+for+disaster&total=45&start=0&num=10&so=0&type=search&plindex=0" rel="nofollow">Prescription for Disaster</a> Thats not suprising Matt, given just how dangerous bad regulation of the drug industry is:

Prescription for Disaster

]]> By: Matt http://www.pharmalot.com/2007/12/has-the-avandia-controversy-scared-diabetics/#comment-67556 Matt Sat, 29 Dec 2007 17:09:57 +0000 http://www.pharmalot.com/2007/12/has-the-avandia-controversy-scared-diabetics/#comment-67556 Any time a drop in prescriptions is noted, someone is quick to claim that people are making uneducated and dangerous decisions regarding their health, while chosing to take the drug in the first place is no less dangerous. Its funny how the drug industry regards an educated public as dangerous. Any time a drop in prescriptions is noted, someone is quick to claim that people are making uneducated and dangerous decisions regarding their health, while chosing to take the drug in the first place is no less dangerous.

Its funny how the drug industry regards an educated public as dangerous.

]]> By: Thom http://www.pharmalot.com/2007/12/has-the-avandia-controversy-scared-diabetics/#comment-65880 Thom Fri, 28 Dec 2007 22:50:12 +0000 http://www.pharmalot.com/2007/12/has-the-avandia-controversy-scared-diabetics/#comment-65880 Rising's "analysis" reads more like an editorial with cheerleading for the drug industry. Maybe the reason that there are less scrips for diabetics is because more of them actually DO understand the risks of medications and are trying to treat diabetes with exercise and diet change? Rising’s “analysis” reads more like an editorial with cheerleading for the drug industry.

Maybe the reason that there are less scrips for diabetics is because more of them actually DO understand the risks of medications and are trying to treat diabetes with exercise and diet change?

]]> By: Lisa Van S http://www.pharmalot.com/2007/12/has-the-avandia-controversy-scared-diabetics/#comment-64689 Lisa Van S Fri, 28 Dec 2007 06:37:02 +0000 http://www.pharmalot.com/2007/12/has-the-avandia-controversy-scared-diabetics/#comment-64689 Physician,.. now that's funny.. Physician,.. now that’s funny..

]]> By: Chris http://www.pharmalot.com/2007/12/has-the-avandia-controversy-scared-diabetics/#comment-64414 Chris Fri, 28 Dec 2007 01:00:35 +0000 http://www.pharmalot.com/2007/12/has-the-avandia-controversy-scared-diabetics/#comment-64414 This would have been a much more interesting story if it was written by a physician rather than an industry investor analyst. Like he's really concerned about the diabetics. Get real. This would have been a much more interesting story if it was written by a physician rather than an industry investor analyst. Like he’s really concerned about the diabetics. Get real.

]]> By: Hank http://www.pharmalot.com/2007/12/has-the-avandia-controversy-scared-diabetics/#comment-63768 Hank Thu, 27 Dec 2007 16:08:19 +0000 http://www.pharmalot.com/2007/12/has-the-avandia-controversy-scared-diabetics/#comment-63768 Agree, Ed. Another way to say it is that _both_ benefits and risks are often extremely hard to (a) access fully and (b) communicate to pts, whether that be via their docs, DTC, etc.. Maybe it wouldn't help much, but I think everyone should have fluency re: relative risk and NNT numbers. To the degree that data are available, both the over-hype as well as the over-panic might at least be modulated. Agree, Ed. Another way to say it is that _both_ benefits and risks are often extremely hard to (a) access fully and (b) communicate to pts, whether that be via their docs, DTC, etc..

Maybe it wouldn’t help much, but I think everyone should have fluency re: relative risk and NNT numbers. To the degree that data are available, both the over-hype as well as the over-panic might at least be modulated.

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