July 25, 2013

Diabetes Experts versus Diabetes Patients

When a couple members from the support group saw this title, one made the comment, “Here we go again!” I asked what he saw in the title and he said that it was another blog about oral medications. I had to agree, as that is my intent. I must declare I am on insulin (long acting and short acting) plus a minimal dosage of metformin.

I do believe it is time for patients to declare their intentions, especially if they are on some of the medications that are being reported with serious side effects. I have nothing against metformin in the extended release version, as the gastrointestinal side effects are often minimal when taking it. Many people have no side effects with the extended release version. And the fact that it is generic and the cost is affordable and makes this an economical treatment for type 2 patients.

Yet, our diabetes experts want to stack one oral medication on top of another oral medication for several medications. I complain that this is not good and this practice by physicians needs to stop, the AACE Diabetes Algorithms not withstanding. The American Diabetes Association and the American Association of Clinical Endocrinologists don't want this to happen and advise keeping patients on oral medications. The sad part of this advice is the corporate sponsors of these two organizations are the beneficiaries and the officers of the ADA and AACE receive fees from these same sponsors.

It is convenient for me that one of the studies reported out of the ADA 2103 Scientific Sessions June 22, is about stacking three medications and the author reports starting people newly diagnosed with type 2 on triple drug therapy. You may read about this ongoing study here at Medscape. This has to make the ADA and AACE very happy.  I hope this becomes fully tested as the side effects may be great and dangerous.

This relationship with the pharmaceutical companies has to end for any trust in the ADA and AACE to be restored. How can we place trust in the guidelines issued and the recommendations of their officers when we know that they are influenced heavily by the fees they receive from the pharmaceutical companies? Then in addition, they are well paid as officers from the contributions or sponsorships of these same pharmaceutical companies to their respective organizations.

Yes, I will continue to blog about the guidelines issued by the ADA and AACE, but everyone needs to be aware of the biases built in and the underlying motives for some of their misdirected guidelines. Comprehensive the guidelines are not and with the built in discrimination by researchers when they exclude the elderly and the young from participating in research, the people that are using the majority of the medications have not had the medications tested on them. This adds more reason to take a jaundiced view of the guidelines. Insulin anyone?

And before I forget, I salute the people with type 2 diabetes that are able to manage diabetes without medications. Some have been able to manage without medications from the start while others have been able to wean themselves off medications and continue to manage without further medications.

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