At this time marks the start of FDA hearings on Avandia (rosiglitazone), a preferred drug for diabetes. The listening to facilities on whether or not Avandia locations a affected person at greater threat of a coronary heart assault.
Sufferers taking Avandia could not notice that one of the first causes docs use Avandia is just not solely to decrease one’s blood sugar, however to thereby forestall coronary heart assaults. Thus the query is extremely related for each diabetic taking this medicine.
There isn’t any query that Avandia lowers blood sugar – that’s simply confirmed. The blood glucose-lowering results may be demonstrated over the course of weeks and months, with proof of on-going lower in blood sugar ranges for years. And since it’s well-known that top blood sugar (diabetes) is related to elevated threat of coronary heart assaults, it is just logical that decreasing blood sugar ranges ought to lower the chance of coronary heart assault (myocardial infarction).
But this isn’t essentially so. Would possibly Avandia be doing one thing else as but unidentified throughout the physique? That is usually the case with medicine. In truth, it has lengthy been identified that taking Avandia will increase the chance of liver issues. That’s the reason your physician checks the liver enzymes in your blood continuously. In sure sufferers Avandia additionally causes fluid retention that in some instances is related to congestive coronary heart failure. Clearly, Avandia does do one thing within the physique in addition to decrease blood sugar, however the query stays, which is extra harmful: to take the medication or not?
There are numerous medicines in the marketplace for diabetes. In fact, insulin is the prototype and a few may suppose the ultimate reply. However sufferers don’t like to inject themselves and so a quantity of oral medicines have been developed. Additionally, taking insulin tends to trigger weight achieve in Kind 2 diabetics, and since weight achieve is an enormous half of the issue to start with, to some extent it worsens the state of affairs.
Figuring out all this, do you have to cease taking Avandia? At this level the reply is we do not know. For the reason that drug was launched I have seen a only a few sufferers undergo from extra fluid retention, however since that drawback was acknowledged, the drug has not been suggested for sufferers with swelling or coronary heart failure. To this point, just a few of my sufferers have had irregular liver exams, and these have all been reversible with discontinuation of the drug. For my sufferers, Avandia has been efficient at decreasing blood sugars.
But the query stays, what about coronary heart assaults? This week the FDA will probably be reviewing knowledge from scientific trials concerning the use of Avandia (rosiglitazone), in addition to well being claims knowledge associated to its use. When all the knowledge is gathered, statisticians and physicians can have extra correct data on which to make an knowledgeable resolution. If we already knew the reply, the hearings could be pointless.
However what do you have to do within the meantime? Right here is a method to take into consideration the issue: if the reply has not change into clear over 10 years of use in hundreds of thousands of sufferers, the chance can’t be extraordinarily excessive and is unlikely to be a right away hazard. Due to this fact, you might have time to talk about this together with your physician. It might be that sure sufferers are in danger, whereas others usually are not. Figuring out these subgroups often is the key. Merely stopping Avandia and permitting your blood sugar to run excessive is unquestionably not a sensible transfer. If you’re afraid of the drug, see your physician to develop another plan. You probably have finished properly on Avandia and are hesitant to change medicine, remember the fact that we do not but have proof of elevated threat. Preserve your eye on the information for evaluation of the information, and speak together with your physician at your subsequent appointment.
Copyright 2010 Cynthia J. Koelker, M.D.
