By November 18th 2011, Avandia will no longer be available for prescription in the United States. The prescription drug for type II diabetes will only be available through a special mail order program for those who were already taking the drug, saw no improvement in their diabetes when taking different drugs, and who have been informed of all the risk associated with Avandia. Those risks include a greater chance of heart failure and death. Similar action is being taken in the UK. In the interim, GlaxoSmithKline (GKS), the drug’s manufacturer, is facing more than 13,000 lawsuits, and is expected to settle upwards of $1 to $6 billion dollars in damages.
Avandia has been such a popular medication for type 2 diabetes because it significantly lowers the A1C by 1 to 2%. The A1C is the 3 month average of blood sugar. In diabetics, it tends to be greater than 6.0%, which corresponds to about 126 mg/dl on a glucometer, the high end of normal. The American Diabetes Association recommends all diabetics try to bring their A1C down to at least 7%, a level shown to be associated with a far lower chance of damage to the heart, kidneys, eyes, and nerves than when compared to higher levels.
Though the FDA pulled Avandia over concern from studies link it to a higher risk of death due to heart problems, studies also showed Avandia increased the chance of eye damage and stroke. It is ironic that while many diabetics die of heart disease or stroke while losing their sight, Avandia causes the very problems it’s supposed to help. Some patients with bad experiences on the drug reported gaining more than 20 pounds in water and fat (not everyone gains this much of course). Avandia does cause water retention, and since it increases insulin sensitivity in all cells including fat cells, it also causes fat gain.
Given this laundry list of horrific side effects and law suits, I can understand why some people would cry conspiracy at the pharmaceutical industry. Avandia is certainly the poster child for anyone who already has such beliefs. That such a drug stayed on the market for over a decade despite the FDA having received early warnings of problems is an outrage.
Unfortunately, Avandia will not be the last drug to hurt more than help. I am no fan of “Big Pharma,” but despite all the above, I don’t believe such drugs are “designed to keep us sick” as I’ve heard from certain folks. I also understand why doctors prescribed it. If you go to a doctor with a fasting blood sugar over 300 mg/dl and an A1C of more than 8%, they are going to throw the strongest drug they have at you to try to bring it down.
Nearly every diabetic in that situation will have been told to diet and exercise more than once to control their blood sugar, but for whatever reason have not or will not. However, they are willing to take medication. Now, that in NO WAY makes it right to give those patients a drug that might literally kill them, but I think it does help explain why it was prescribed.
My answer to the problem is this. We can’t trust drug companies to come to the rescue. As I wrote in my book, The New Diabetes Prescription, there is no pill that can cure diabetes, and many types of the oral medications available to us actually make us gain weight. That’s their nature - drugs that increase insulin increase fat. Meanwhile, the American Diabetes Association advocates weight loss as the number one treatment for type II diabetes, and I agree. Studies have shown losing 5 to 10% of your bodyweight can control diabetes as well or better than most oral medications. That would nullify the need for drugs like Avandia.
If we step up as a community, it won’t matter what slip ups the FDA or pharmaceutical companies make. We’ll have already beaten the disease through our own actions. I was able to get off Metformin and Precose once I lost enough weight. I know most of you can do the same. No one is going to do it for us. So walk more. Eat better. See a physical therapist for that aching joint. Cut the soda. Throw out the white bread. Make it happen.
Diabetes runs in families - we all have an overweight loved one at risk of this. We owe it to ourselves and to our families to get better. We owe it to them to exemplify what control really means.
- Aaron Snyder