Diabetes Medication

Practically everyone who has diabetes uses one or more drugs to help to manage it. But most of these medications are expensive, and the U.S. Food and Drug Administration approved far fewer diabetes drugs in the past 10 years than between 1995 and 2004.

At the annual meeting of the American Diabetes Association in Boston earlier this month, thousands of diabetes professionals listened with interest as four experts explained why. I represented HealthCentral.com during the entire conference and made a point to be in the audience as four experts brought us up to speed about the “Costs of Medications for Diabetes.”

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More and more of us who have type 2 diabetes take one of the new drugs that mimic the action of the GLP-1 hormone so that we can manage blood sugar better. When we do, we are often pleasantly surprised to learn that taking one of these two drugs can also help us to lose a lot of weight.

Now, a  study by Dutch researchers at the Diabetes Center of the VU University Medical Center in Amsterdam  shows us how this positive side effect happens.

Researchers had been trying to learn how those drugs could help us get down to a normal weight, so the Dutch researchers used sophisticated techniques to see how they work. They studied one type of these GLP-1 mimetics called exenatide, which we use in the U.S. as the brands Bydureon and Byetta.

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Most diabetes drugs cause us to gain weight. But those in the rather new class of drugs called GLP-1 inhibitors actually lead to weight loss.

People with type 2 diabetes take these drugs by injection. Insulin, the drug that people with type 1 have to inject to manage their diabetes, is notorious for leading to weight gain.

Clinical trial studies show that people with diabetes who take one of these new GLP-1 drugs generally loose weight. I know that they help us lose weight because I lost so much weight myself when my doctor switched me from the older drugs.

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Like most of us, my health insurance covers some of the cost of medications. But because I don’t need any diabetes medication and am in good health, I use few prescription drugs and don’t come close to reaching my deductible. So I pay the whole cost out of my pocket for the few medications that I get from time to time.

Consequently, I have had to learn that American pharmacies operate like third-world businesses in one important respect. We have to negotiate with them.

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Insulin has usually been the last resort for those of us who have type 2 diabetes. “If you don’t shape up, I’m going to make you inject insulin,” is a threat we may hear from our doctors.

When all else fails and our blood sugar is still too high after trying the pills for diabetes, many of us go on insulin, although usually with reluctance. But by that time most of the beta cells of our pancreas that store and release insulin into the bloodstream have also failed.

Ongoing research at Toronto’s Mount Sinai Hospital suggests that we’ve got it backwards. When people with type 2 diabetes take insulin for a short term soon after their diagnosis, it can have long-term effects.

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A possible connection between one of our newest and most important classes of diabetes drugs and pancreatic cancer has frightened many of us. But people with diabetes can now breathe easier.

The United States Food and Drug Administration and its European counterpart just released their joint findings concluding that these drugs, which include Byetta, Victoza, Bydureon, and Januvia, have “no compelling evidence of an increased risk of pancreatitis or pancreatic cancer.” The full-text of this report, “Pancreatic Safety of Incretin-Based Drugs — FDA and EMA Assessment,” is available free online in one of our most prestigious medical journals, The New England Journal of Medicine.

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