Category Archives: Medications

A Set Aside Diabetes Medication May Make a Huge Comeback

In the history of medical science there have been numerous medications that were designed for one purpose, yet found success treating something entirely different. This is true of the drug Viagra and it may be true of Fenofibrate (brand names include Antara, Fenoglide, Lipofen, Lofibra, TriCor, Triglide).

This drug was designed to prevent heart disease. Long-term research shows that it did not work effectively to take care of this issue in a preventative way. What this ultimately means for most drugs is they would be set aside and rarely prescribed. In most cases they are pulled from the shelves and discontinued. Fenofibrate may be making a comeback, but not as preventative medicine for heart disease.

Research based in Australia, New Zealand and Finland followed 9,795 patients and discovered that the use of Fenofibrate may actually be a potent drug that seems to significantly reduce the potential of amputations among Type 2 diabetics. This study was conducted over a five-year period.

Current statistics indicate about 10% of Type 2 diabetics will lose at least a part of a lower limb to amputation. Fenofibrate could reduce the instance of the need for invasive surgery and long-term rehabilitation.

The truth is this information was buried in a 2005 study that was designed to prove or disprove Fenofibrates ability to serve as a heart drug. When the results showed it did not, the study was set aside. A new look at this study revealed findings that had been overlooked because it was not the original intent of the study.

Some amputation risk groups saw as much as a 50% decline in amputations when compared to others who were not taking Fenofibrates. The Lancet journal interpreted these findings; “Treatment with fenofibrate was associated with a lower risk of amputations, particularly minor amputations without known large-vessel disease, probably through non-lipid mechanisms. These findings could lead to a change in standard treatment for the prevention of diabetes-related lower-limb amputations.” Patients at risk for a first time amputation saw a 36% decrease when using Fenofibrates.

The Lancet also reported, “Fenofibrate has previously been shown to reduce macrovascular and microvascular complications of type 2 diabetes.”

This report suggests that a drug that has already proven helpful to Type 2 diabetics may actually provide greater support and amputation prevention than originally thought.

Medical science has moved toward statin-based drugs to help patients prevent heart disease. Fenofibrates could realistically be used to provide new support it had not previously been given credit for when used in conjunctions with statins.

As medical science moves forward in learning how drugs interact with our bodies and work to provide support for greater health the onus will still remain on the topic of education. In many cases diabetes can be avoided, prevented or delayed by participating in a lifestyle alteration that includes understanding how food interacts with your body and why physical activity is important in the process of effective glucose control.

In many cases a less active lifestyle is the norm in the 21st century. It can take concentration and dedication to buck the normal trend of a sedentary lifestyle in order to embrace one that includes more activity and a healthier variety of food. The end result is almost always positive and can often be managed without drugs.

However, when a diabetes diagnosis is given you will need to consider the possibility of a medical regimen to help you reach goals in managed care. The effects will be even greater when you become an active partner in your own care.

The Metformin Connection: Dead Fish

If you thought your diabetic medication smelled like dead fish – you’re not alone. New research seeks to determine if the smell of the medication may actually contribute to a common side effect – nausea.

The medication is known as Metformin, which WebMD describes as, “an oral drug commonly used to treat type 2 diabetes. [It] generally has few serious side effects, but gastrointestinal upset and nausea are common. Although these effects have been well documented in studies, researchers say one unique characteristic of the pills may have been overlooked as a potential cause of the nausea: their strong fishy odor.”

The generic equivalent of this drug is known as Glucophage. WebMD describes this diabetic drug. “Metformin is used with a proper diet and exercise program to control high blood sugar in people with type 2 diabetes (non-insulin-dependent diabetes). Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, and sexual function problems. Proper control of diabetes may also lessen your risk of a heart attack or stroke. Metformin belongs to the class of drugs known as biguanides. It works by helping to restore your body’s proper response to the insulin you naturally produce, and by decreasing the amount of sugar that your liver makes and that your stomach/intestines absorb.”

So while this drug serves a great purpose in the control of diabetes it can be disheartening when the medication cannot be taken because of issues related to its odor.

No official documentation exists as to the number of diabetics who have stopped or refused to use Metformin because of its distinctive smell, however there is plenty of online evidence that individuals are staying away from the drug for this very reason.

In a recent report, published in the Annals of Internal Medicine, researchers describe, “two cases in which patients discontinued use of generic metformin because of what they described as the nauseating smell of the drug,” according to WebMD.

The odor of this drug has even been liked to, “old locker room sweat socks”. While it is not conducive to positive image the odor is only linked to the immediate release version of the prescribed drug.

If you have an issue with the smell of your metformin or glucophage you should inquire about the availability of “film-coated, extended-release formulation of metformin as an alternative.”

Doctors will benefit from your honesty about the drug. If you are nauseated because of the smell this information will have a different meaning for them than if you experience stomach upset as a side effect of prescribed use. By knowing the exact reason for your discomfort your physician may be able to provide a solution.

“First synthesized and found to reduce blood sugar in the 1920s, metformin was forgotten for the next two decades as research shifted to insulin and other anti-diabetic drugs. Interest in metformin was rekindled in the late 1940s after several reports that it could reduce blood sugar levels in people, and in 1957, French physician Jean Sterne published the first clinical trial of metformin as a treatment for diabetes. It was introduced to the United Kingdom in 1958, Canada in 1972, and the United States in 1995. Metformin is now believed to be the most widely prescribed anti-diabetic drug in the world; in the United States alone, more than 40 million prescriptions were filled in 2008 for its generic formulations.” (Source: Wikipedia)

Avandia Under Fire

What if you knew that by adding a diabetic drug to your daily medical regimen you increased your risk of heart failure by more than 50%? Would you take the drug? One California County is taking a drug company to court to seek the removal of the drug from circulation.

According to VOAnews, “The [Santa Clara County] lawsuit was spurred by a report on the drug released by the U.S. Senate … That report accused the drug company of withholding information about side effects of serious heart problems, including death.  At issue now is whether Avandia should be taken off the market.”

The VOAnews report stated that, “In 2007, Dr. Steven Nissen published a study showing that those taking Avandia had a 43 percent higher risk of having a heart attack and a 64 percent greater chance of dying from a heart attack than those not taking the drug. ‘We’ve been warning about this for two and a half years,’ he said. ‘There really isn’t a good reason for physicians to continue to prescribe the drug. It’s time to get it off the market.’”

Dr. Yasser Ousman at Washington Hospital Center disagrees. Ousman is quoted by VOA as saying, “There are a number of drugs that have been tested in these individuals and Avandia is one of them, and actually, it is quite effective in improving the blood sugar, in normalizing the blood sugar or delaying the occurrence of diabetes in these individuals.”

Ousman further suggests, “If you look at the large studies, that were published over the last several years, including a large number of patients comparing Avandia to a placebo or other drugs, there was actually no increase in that risk.  That risk was based on smaller studies.”

Basing his findings on more than 40 clinical trials, Nissen said, “What bothers me the most is that every month that goes by, more people are harmed by a drug that people simply don’t need.”

The Food and Drug Administration have planned further review of the drug in July, but has cautioned against the discontinued use of Avandia without the advise of your primary health care provider.

The case against GlaxoSmithCline in California has to do with what is claimed as false advertising. There is the suggestion that the drug manufacturer knew the drug could cause heart issues long before they ever issued any warnings that this could be a side effect of using the medication. A Senate report even suggests that the FDA may bear some responsibility in the lack of information passed on to patients.

The VOAnews article further indicates, “A study on Avandia funded by GlaxoSmithKline published last year, found no increase in heart attacks. But it found a significant increase in the risk of heart failure where the heart cannot pump enough blood to the organs or muscles. A number of cases resulted in hospitalization or death.” states that Santa Clara County in California “Wants the company to pay back money from all sales of Avandia in California since 1999, as well as pay restitution for medical treatment provided to Avandia users who suffered heart problems.” The county has spent around $2 million on the purchase of Avandia as part of it’s own health program over the years. The lawsuit may have been precipitated by the fact that Santa Clara County has a public hospital and the County is seeking to make decisions in the best interest of their municipal health care facility as well as the patients who use their hospital.