We now know many of the new, hot Type II diabetes drugs don’t effectively control blood sugar. And they come with a slew of dangerous side effects.
So–does big pharma simply throw in the towel when one (or more) of its new, expensive drugs underperforms?
Of course not.
They distract you by creating a “debate” about an older, effective drug to muddy the waters.
Last month, big pharma employed this underhanded tactic and created a quite stir about the standby drug metformin at a European conference on Type II diabetes.
Of course, metformin is a proven, safe, effective, and inexpensive drug to treat high blood sugar. It derives from an ancient herbal remedy long known in Europe as French lilac. And its major “side effects” appear to be markedly lowering the risk of cancer and probably protecting against brain and neurological diseases. (One caveat is that metformin can cause some people to lose vitamin B12. So always supplement with a good B complex, which is good advice in any case.)
But it seems metformin may work too well.
You see, metformin went off patent years ago. And we now have good generic forms of it. So it’s no longer the cash cow it once was for big pharma.
The newer diabetes drugs are still on patent…they’re much more expensive…and much more profitable, if only people would buy them.
But as I alluded to earlier, these newer drugs aren’t any more effective (or even as effective). Metformin has already proven itself, and continues to prove itself every day, in tens of millions of patients. In fact, a brand-new study published in JAMA Internal Medicine found that metformin is the best first-line drug treatment for Type II diabetes. And when people took other, newer drugs–such as Januvia–they had to add another drug to their regimen to get their blood sugar under control.
This kind of pairing is another old trick big pharma employs. When a cash-cow drug doesn’t work, pair it with a drug that does work, so you can continue to sell the useless drug anyway.
Plus, these newer Type II diabetes drugs have serious safety problems. In fact, in the September issue of my Insiders’ Cures newsletter, I told subscribers about all their dangerous side effects. Many of the newer drugs commonly cause low blood pressure in older patients, which can be a very dangerous condition. (Plus, as I told you yesterday, mild high blood pressure may actually benefit older people). In addition, these drugs appear to raise the risk of other common chronic diseases.
So you can see why the recent “debate” about metformin at that European conference on diabetes struck me as downright tomfoolery.
Thankfully, a sensible, no-nonsense American expert from SUNY-Brooklyn pointed out some of the existing evidence that supports first-line use of metformin.
First, he pointed to a 1995 study published in the New England Journal of Medicine (NEJM), one of the mainstream’s most respected publications. The study showed metformin is very effective at reducing long-term hemoglobin A1C, the gold standard measure for showing blood sugar levels. Of course, the doctor used this 1995 study as historic context. But he could have gone back much farther and made the point that French lilac (from which metformin derives) has been used medicinally in Europe since the Middle Ages.
Next, the doctor pointed to a 1998 paper published in the Lancet (the British equivalent of NEJM). This study linked metformin to less weight gain and fewer attacks of low blood sugar compared to both insulin and the newer diabetes drugs. The study actually showed that metformin might even help facilitate weight loss.
Then, doctor pointed to a third metformin study, a 2006 paper also published in the NEJM. This third study showed that metformin reduces complications associated with diabetes, such as eye, kidney and nerve damage.
Plus, researchers in this 2006 study found metformin reduced diabetes-associated mortality far better than the newer drugs. In fact, it reduced cardiovascular mortality by 42 percent and reduced the risk of a heart attack by 39 percent.
Overall, researchers linked metformin to a 40 percent lower all-cause mortality risk. Yet the newer diabetes drugs caused a 50 to 60 percent increase in all-cause mortality risk. Good doctors can’t ignore that breathtaking difference.
Finally, metformin appears to delay the development of Type II diabetes in men and women with prediabetes.
By comparison, the newer thiazolidinedione diabetes drugs can cause weight gain, edema (tissue swelling), congestive heart failure, and bone fracture. The newer sulfonylurea drugs cause frequent low blood sugar attacks, GI side effects, including nausea and vomiting, which create poor compliance. They also cause acute pancreatitis, as well as increased heart failure, hospitalizations, and fungal infections.
The European “debate” then moved on to discuss the secondary observations about metformin for prevention of heart disease and cancer. One dissenting doctor claimed we need more research to prove that metformin lowers the risk of cancer.
That point was a master sleight of hand.
The studies that showed metformin appears to lower cancer risk were actually designed to prove the drug is safe and effective for lowering blood sugar as a treatment for diabetes. But because millions of patients were treated successfully for so long, researchers also observed these patients have a lower risk of developing many types of cancer. Including hard-to-treat pancreatic, liver and endometrial cancers.
These metformin studies were designed to show effectiveness for diabetes. They weren’t designed to show effectiveness for cancer. That benefit was observed as a secondary effect. But now, we supposedly need to “debate” the need for more research about these secondary observations?
Of course, one reason why we don’t have more recent studies on metformin is that it’s now off patent. And big pharma isn’t going to pay for any more studies on a drug from which it can’t profit.
The whole “debate” is ridiculous. Designed to muddy the waters.
But all it takes is the clueless medical media to run a headline claiming there’s a new “debate” about the use of metformin. Then, harried physicians who are too busy to read beyond the headlines (about 90 percent according to the American Medical Association), suddenly have seeds of doubt planted about metformin. So when the drug salesman comes around touting the benefits of the newer, expensive, on patent diabetes drugs, the physician just might buy their junk logic.
As I’ve said before, there is virtually no reason to take any drug other than metformin for high blood sugar. If your doctor recommends a different medication, ask him why. Unless there is a very specific reason why he feels you should be taking a different drug, ask if you can try metformin first.
- “Metformin in Diabetes: Evidence Overwhelming, or Unclear?” Medscape (www.medscape.com) 9/26/2014
- “Initial Choice of Oral Glucose-Lowering Medication for Diabetes Mellitus: : A Patient-Centered Comparative Effectiveness Study,” JAMA Intern Med. Published online 10/27/2014