Diabetes Drugs Cause Pancreatitis, Heart Failure And Hypoglycaemia

| November 28, 2013

At the American College of Rheumatology Annual Meeting in San Diego this October, scientists from the prestigious Brigham and Women’s Hospital in Boston presented research findings that suggested a class of diabetes drugs could cut the risk of autoimmune diseases. Their conclusions were not based on clinical trials but on an analysis of data from US health insurance claims.

Great news, according to the researchers, for people with a family history of autoimmune diseases – such as rheumatoid arthritis, lupus, inflammatory bowel disease, psoriasis or multiple sclerosis. Possibly a new therapy, too, for treating these diseases. Isn’t modern medicine wonderful?

No, I’m afraid it isn’t. Because this seemingly positive announcement is actually the tip of a rather grubby iceberg. The lead author of the study commented ‘Further research is needed to determine the effect and safety of DPP4i in the non-diabetic population’. So, just what are the drugs in question and what safety issues might be involved?

DPP4i stands for dipeptidyl peptidase-4 inhibitors, a class of drugs that includes sitagliptin (Januvia). If that name sounds familiar, it was the subject of studies in 2011 and 2012 that linked it to increased risks of acute pancreatitis and pancreatic cancer, as I reported in The Real Diabetes Truth on 28 March 2013.

Since those studies hit the news, Big Pharma has been doing all it can to rubbish them and to rehabilitate sitagliptin and similar drugs as safe treatment options, in the minds of doctors if not in reality. Just one month before the study on autoimmune diseases was presented, the results of two trials of DPP4i (saxagliptin and alogliptin) were published side by side in the New England Journal of Medicine, trumpeting the findings that these drugs pose no increased risk of pancreatitis or pancreatic malignancy and no increase in the risk of a heart attack or stroke, either.

As usual, though, one has to read the small print, not just the headlines put out by Big Pharma’s PR machine. In the alogliptin trial, which involved type 2 diabetes patients who had unstable angina or who had survived a heart attack, 50 per cent more patients in the group receiving the drug suffered acute pancreatitis than in the placebo group. However, because of the small numbers involved, this finding was ‘not statistically significant’ – in other words it could be conveniently ignored.

In the saxagliptin trial, there was a statistically significant 27 per cent increase in hospitalizations for heart failure in patients with type 2 diabetes. Heart failure – a weakness of the heart muscle that causes breathlessness, fatigue and ankle swelling – is a major cause of death in people with diabetes. In addition, saxagliptin also increased the frequency of hypoglycaemia – dangerously low blood sugar levels.

All of these alarming results were simply brushed under the carpet. Could that be because both of these trials were funded by Big Pharma (Bristol-Myers Squibb, Astra Zeneca and Takeda) and all of the researchers were being paid by these companies?

It is not hard to see what is going on here. A lucrative class of drugs is marketed without adequate safety testing. When problems become apparent, Big Pharma goes into denial and attempts to counter the findings with its own clinical trials, carefully set up to provide the results it wants. The inconvenient negative findings from these trials are hushed up and the drugs under suspicion are given the ‘all clear’. Then (and you can almost hear the ‘ker-chingg’ of the cash till here), a new use is suddenly found for them – another unsuspecting patient group and a potential source of more profits for Big Pharma.

How to protect yourself from the dangers of DPP4i drugs

• If you are taking one of these drugs (their names all end in ‘-gliptin’) talk to your doctor about their possible side effects and ask for a safer alternative.

• Immediately report any symptoms of undue fatigue, breathlessness or water retention, as these could potentially indicate heart failure.

• A severe, dull ache around the top of your stomach and sometimes in your back, too, could be a sign of acute pancreatitis. Your abdomen may also be painful when pressed. See a doctor and get diagnostic blood tests.

• Use a low GL diet, exercise, nutritional supplements and herbs to reduce your reliance on medication, as described in earlier posts here on The Real Diabetes Truth.

When it comes to diabetes drugs, metformin is one of the most commonly prescribed. But up until now, scientists have only had a partial understanding of the way that it works. A new study has revealed that metformin reduces harmful fat molecules in the liver, which then allows insulin to work better and lower blood sugar levels. I shall be giving you the details of these findings, and what they mean for diabetes patients, in my next blog post.

Wishing you the best of health,

Martin Hum
PhD DHD Nutritionist
for Real Diabetes Truth

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1. Kim SC. Dipeptidyl peptidase-4 inhibitors in type 2 diabetes may reduce the risk of autoimmune diseases. ACR/ARHP Annual Meeting, San Diego, 26-30 October 2013.

2. White WB, Cannon CP, Heller SR et al. Alogliptin after acute coronary syndrome in patients with type 2 diabetes. N Engl J Med. 2013; 369:1327-1335

3. Scirica BM, Bhatt DL, Braunwald E et al. Saxagliptin and cardiovascular outcomes in patients with type 2 diabetes mellitus. N Engl J Med. 2013; 369:1317-1326.

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