Avandia and Actos may double risk of fractures?

Several news sources (including the Washington Post) reported a new analysis that Avandia and Actos may double the risk of bone fractures in women.

This study(PDF) did an analysis of 10 randomized, controlled, trials that evaluated 13,715 people with diabetes who were taking Actos(pioglitazone), Avandia(rosiglitazone), or neither drug. It concluded that these medications reduced bone density in the spine and hips of women. A similar effect was not found for men.

Both of these drugs belong to the Thiazolidinediones class. They are used by people with type 2 diabetes to help control their blood sugar levels.

In an associated commentary(PDF) the Canadian Medical Association Journal asks whether the side effects of these drugs outweigh their benefits. Thiazolidinediones have already been associated with increased risks for heart attack, especially in older adults.

Earlier this year an FDA advisory panel had called for longer term trials of new drugs for type 2 diabetes. Currently these drugs are mainly tested to determine if they help control blood sugar levels.

Labels: Actos, Avandia, FDA, fractures, risk

posted by Bernard @ 11:56 AM 0 Comments Links to this post  

Cost of diabetes care in the UK

A new 12-page report published by Diabetes UK calls diabetes (all types) one of the biggest health challenges for the UK.

This report, Diabetes: beware the silent assassin (PDF) shows that diabetes costs the NHS (National Health Service) in the UK £1 million ($1.72 million) per hour, and causes more deaths that prostate and breast cancer combined.

If this is true for the UK (population 60 million, and 2.3 million with diabetes), you can image the impact in the US, which has five times as many people and about ten times more people with diabetes.



Diabetes is a serious disease with no simple solutions, there may not be all that much we can do in the short term to reduce the impact. Although page seven of the report does have some suggestions for reducing the risk of developing type 2 diabetes.

In my mind one of the key factors for success in diabetes management is having a good support organization. These days I can't recommend a better place for support than TuDiabetes.com. It's an amazing resource for sharing information and getting help with all types of diabetes-related issues and I wish many more folks with diabetes were benefiting from the site.

Drop by and try it out.

Labels: community, costs, diabetes, risk

posted by Bernard @ 5:53 PM 0 Comments Links to this post  

My alleged heart attack

To stop you from worrying I have not had a heart attack. Or any inkling of one.

Recently when I saw my excellent endo we had a discussion about whether I should continue to take a statin to reduce my cholesterol.

I've been taking Lipitor for about a year. I changed my use of the medicine (this may not work for you) from a 10mg pill every day to half of a 10mg pill every other day. I see a substantial reduction in my cholesterol level with this dose and I don't seem to have any of the possible side effects, thank God.

But a while ago, I read news about investigations into the benefits of taking statins. This was why I had the conversation. I was especially taken by the quote from the NY Times article.

"If a patient has had a heart attack," Dr. Afilalo said, "they generally should be on a statin."

For people who haven't had a heart attack the investigation showed there isn't as much evidence that taking statins provides a substantial benefit to enough folks to justify everyone taking it.

I was shocked by her response. "But you've already had a heart attack." For a moment I thought I was in an alternate dimension. I reminded her that I'd not actually had one. She told me that type 1 diabetes increases my risk of heart problems. Just as much as if I'd actually had one. Yikes.

Now I do really like and respect my endo. I've moved medical offices to follow her from Massachusetts to New Hampshire. But I still like to verify what I'm told, it's my natural cynical nature.

Then earlier this month I saw this news report. She was right! A recent study found that folks with diabetes (both type 1 and type 2) have double the risk for a heart attack.

So for now I'll be staying on my statin and living with yet another drug to reduce the risk of "bad things" happening in my future.


Attribution: This beautiful picture was taken by Conny. She retains all rights to the image and I'm grateful to her for letting me use it in this post.

Labels: diabetes, health, heart, risk, statins

posted by Bernard @ 5:40 PM 6 Comments Links to this post