Study: Many diabetics taking drug that could kill
Gumbo
ous-drug.htm
Study: Many diabetics taking drug that could kill
CHICAGO (AP) - A significant number of patients with diabetes are
inappropriately prescribed a common drug that could kill them, a study
suggests.
The study on metformin, also sold as Glucophage, is one of several on
diabetes published in Wednesday's Journal of the American Medical
Association. It's the first JAMA issue devoted entirely to research on
diabetes, which has reached epidemic levels and afflicts about 17 million
people nationwide.
Glucophage helps the body use insulin and is among the most common drugs to
treat Type II diabetes, which is linked to obesity and is sometimes called
adult-onset, although it has started appearing in children.
The drug package insert warns that Glucophage can cause a rare side effect
called lactic acidosis, a buildup of lactic acid in the blood that is fatal
in about half of all cases. The label says the drug should not be used by
patients with kidney disease or those who are taking drugs for heart
failure.
But nearly one-fourth of patients met at least one of those criteria in the
study, which involved 100 Glucophage outpatient prescriptions from a
University of North Carolina hospital pharmacy in Chapel Hill. None of the
patients had developed lactic acidosis, said lead researcher Cheryl Horlen,
who now works at Campbell University in Buies Creek, N.C.
The study "may underestimate the frequency of contraindications and it is
difficult to determine whether clinicians are aware they are prescribing
metformin against a black-box warning," the researchers said, referring to
highlighted cautionary information required by the government on labels of
drugs that could have serious side effects.
University of Pittsburgh researchers and several recent European studies
found similar rates of inappropriate use, and Horlen said the problem isn't
unique to the University of North Carolina.
Bonnie Jacobs, a spokeswoman for Glucophage maker Bristol-Myers Squibb, said
the warnings "are clearly outlined" on the label.
Diabetes impairs the body's ability to produce or make proper use of
insulin, resulting in elevated blood sugar levels that can damage the
kidneys, heart, eyes and other organs.
"I can't imagine anybody in the United States who doesn't have someone in
their family or some close friend with diabetes. It's such a big problem
right now," JAMA editor Dr. Catherine DeAngelis said.
Recent research from Harvard Medical School and Public Citizen Health
Research Group suggests that doctors don't pay close enough attention to
drug warning labels, a problem also raised by the Food and Drug
Administration.
Dr. Malcolm Taylor, president of the Association of Black Cardiologists,
said patients' lack of knowledge about diabetes drugs might be partly to
blame, and he said many are unaware of diabetes' complications, which
include heart disease and kidney failure.
His group and the American Association of Diabetes Educators are launching a
nationwide education campaign this week, including a Web site, to raise
awareness about the link between diabetes and heart disease, the leading
cause of diabetes-related death.
In other JAMA research, a Kaiser Permanente study suggests that giving
blacks and whites similar health care access can help ease racial
disparities in rates of complications such as severe kidney disease, which
affects blacks disproportionately.
However, the study of 62,432 patients enrolled in a northern California
Kaiser insurance plan found some differences persisted despite equal access,
suggesting genetic differences may explain the racial disparities, Kaiser
scientist Andrew Karter said.
In a JAMA editorial, Dr. Christopher Saudek, president of the American
Diabetes Association, said the featured studies underscore the need for
insurers and policymakers to adequately address chronic diseases like
diabetes, which require a lifetime of treatment rather than a quick fix.
"We should be paying to keep people out of the hospital, to keep them as
pain-free as possible and as free from complications," Saudek said.
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REP
wrote:
> The drug package insert warns that Glucophage can cause a rare side effect
> called lactic acidosis, a buildup of lactic acid in the blood that is fatal
> in about half of all cases. The label says the drug should not be used by
> patients with kidney disease or those who are taking drugs for heart
> failure.
I'm lucky to have a doctor who doesn't feel compelled to prescribe whatever
new, expensive drug the manufacturers are pushing. I've always known I
cannot take Glucophage.
Jonathan W. Mills
"Gumbo" <gumbo_toao1@-hotmail.com> wrote:
> The drug package insert warns that Glucophage can cause a rare side effect
> called lactic acidosis, a buildup of lactic acid in the blood that is fatal
> in about half of all cases. The label says the drug should not be used by
> patients with kidney disease or those who are taking drugs for heart
> failure.
REP <r...@inanna.com> wrote:
>I'm lucky to have a doctor who doesn't feel compelled to prescribe whatever
>new, expensive drug the manufacturers are pushing. I've always known I
>cannot take Glucophage.
OLD, "expensive" Glucophage just became much CHEAPER as the generic metformin.
For me under my plan, it is now $10 per month compared to $25. I'm lucky to
have a doctor who discusses the pros and cons of every medication I've taken,
and a pharmacy that prints out an extensive list of symptoms to watch out for
when taking the meds.
For me the possibility of lactic acidosis is old news. The good news, again
for me, is that metformin helps keep my Bgs under control. I don't take
insulin, and my doctor was jubilant when I went off of it. He was happier
than I was. Apparently, in his experience, it is difficult to get T2's to
lose weight and exercise, so few people succeed in returning to an oral
medication regimen after being on insulin. Please don't flame me -- I'm just
reporting what he told me. I personally don't have any numbers...but
someone of you out there probably do! :-)
Cheers,
Jonathan
T2 since '92
Fasting Bg today = 51 (missed dinner last night :-(
REP
(Jonathan W. Mills) wrote:
> "Gumbo" <gumbo_toao1@-hotmail.com> wrote:
>
> > The drug package insert warns that Glucophage can cause a rare side effect
> > called lactic acidosis, a buildup of lactic acid in the blood that is fatal
> > in about half of all cases. The label says the drug should not be used by
> > patients with kidney disease or those who are taking drugs for heart
> > failure.
>
>
> REP <r...@inanna.com> wrote:
>
> >I'm lucky to have a doctor who doesn't feel compelled to prescribe whatever
> >new, expensive drug the manufacturers are pushing. I've always known I
> >cannot take Glucophage.
>
>
> OLD, "expensive" Glucophage just became much CHEAPER as the generic metformin.
> For me under my plan, it is now $10 per month compared to $25.
All my drugs - even Actos and Cozaar - are $5 per 100 days supply with my plan.
>I'm lucky to
> have a doctor who discusses the pros and cons of every medication I've taken,
> and a pharmacy that prints out an extensive list of symptoms to watch out for
> when taking the meds.
I'm aware that I have non-diabetic kidney disease, which is a good thing,
because when I'm seen by other than my usual doctor, it's a good bet that
they'll tell me to take ibuprofen. Once, at the ER, even after I told them
repeatedly that I have kidney disease, they tried to give me Toradol.
Either drug could be fatal to me. Glucophage could be, too.
Labels are nice, but knowing what's going on with a medical condition is
even better!