September 12, 2008
Diabetes is a tough disease to treat. Recently, to the relief of those of us who treat it, more and more effective medications have become available. But at the same time, increasing media scrutiny has led to unfair targeting of the same drugs that are helping us to control blood sugar and ultimately to save lives.
Byetta is a case in point. Approved by the FDA in 2005, this drug effectively treats diabetes by mimicking the effects of incretin. This hormone stimulates insulin production in response to meals. Since this is the way insulin is supposed to work, Byetta can be a very effective drug, though the fact that it is injected make many patients reluctant to use it.
Still, since its approval, close to a million patients have used it. Byetta may also help a patient to lose weight, which can also help to control diabetes by decreasing the amount of insulin that is needed. The risk of life-threatening pancreatitis is only 1 in 10,000 patients, a very low number. But recent deaths from pancreatitis in patients that had been taking the drug lead the FDA to consider adding stern black-box warnings to the drug label. These warnings could severely limit the usefulness of a very effective drug. As I have written before about other crucial medicines, so again it is with Byetta, where fear of a disease should outweigh the fear of a rare drug side effect in a very useful drug.
Diabetes leads to millions of deaths from heart disease, kidney failure, stroke and vascular disease. But these deaths just aren't as sexy as the rare case of devastating pancreatitis in the news.
Marc Siegel , MD, is an internist and professor of medicine at New York University and the author of False Alarm: The Truth About the Epidemic of Fear