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Study shows older diabetes drugs safe

Thursday, July 19, 2007

A recent analysis of diabetes drugs has shown that older, cheaper ones are as safe and effective as newer ones.

Diabetes has become an epidemic, affecting more than 18 million Americans, roughly 7 percent of the country's population. The majority of those affected have Type 2 Diabetes, which occurs when the body does not produce enough insulin or cannot use what it does produce.

The analysis was commissioned by the Federal Agency for Healthcare Research and Quality in 2005.

The results may further hurt the sales of Avandia, a blockbuster pill which was also recently tied to heart problems in a study published in May.

The beneficiary of the analysis is metformin, which is sold as Glucophage. The generic form of the pill sells for about $100 a year and works just as well as other diabetes pills. Another advantage of metformin is that it does not cause weight gain or an excessive drop in blood sugar, as well as lowering LDL, also known as bad cholesterol.

"If the body rejects a diabetes pill, then there is a need to change it," Clay County Public Health Nurse Jennifer Freese said. "Otherwise, there is no need to change to the newest medication because there may be problems with it down the line."

According to the analysis, all diabetes pills have the potential to cause problems, and patients should pick the right medication based on the side effects which matter most in their specific situation.

Other results of the analysis showed that some diabetes medications can cause a weight gain of up to 11 pounds, and Avandia, along with Actos, slightly raises good cholesterol, or HDL.

The FDA will be debating the safety of Avandia on July 30. The sale of the drug has dropped approximately 30 percent since a May 21 report linked it with an increased risk of a heart attack.

Even metformin has its own risks. It can cause a rare, but dangerous, side effect called lactic acidosis, a buildup of lactic acid in the blood. The pill should also not be taken by diabetics who have moderate kidney disease or a history of heart problems.

The analysis reviewed oral diabetes drugs, not insulin or other injected diabetes drugs.

It was found that most oral diabetes drugs lower "A1c" levels -- a key measure of high blood sugar -- by about 1 percentage point.

A percentage level of 5 is normal for non-diabetics.

Along with the analysis, Consumer Reports published a guide of the results, which also rated glipizide and glimepiride, sold as Amaryl and Glucotrol, as the best bets of diabetes pills.

Even with heavy marketing levels and a higher price, as much as $262 a month, no significant benefits were found in using the newer drugs.

"There is no reason to spend more on a newer drug which might not work as well as the one you might currently be taking," Freese said. "Choosing the best medication based on your health situation is vital, regardless of the price, or what might be new on the market."

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