Are People with Diabetes Taking Too Many Supplements?

This is one of the better blogs by a CDE and deserves readership by people with diabetes even though it is written for CDEs on the AADE website. Carla Cox is right that there has been resurgence in advertising for herbal and other supplements. Late night TV has many advertisements for drugs that are supposed to help people with diabetes get off diabetes medications and others to help with weight loss.

The National Center for Complementary and Alternative Medicine says that nearly 40 percent of Americans use health care methods that are not considered mainstream medicine. The website for the National Center for Complementary and Alternative Medicine is here. Over half of the people with diabetes reportedly take nutritional supplements. Of these people, persons with type 2 are twice as likely and those with type 1 to use nutritional supplements.

In reading on diabetes forums, I often see alpha lipoic acid, cinnamon, chromium, ginkgo biloba, and a few others mentioned for various other maladies. The biggest problem for Complementary and Alternative Medicine (CAM) Supplement use that Ms. Cox is concerned about is the lack of double-blinded randomized control trails for most of the supplements.

One source is American Diabetes Association Guide to Herbs and Nutritional Supplements: What You Need to Know from Aloe to Zinc. This book is available through most bookstores and many libraries.

I do appreciate that Ms. Cox made the following statement. “It’s important to recognize that all products that change the way our body works are drugs, whether they come from “natural” or synthetic sources.” It is a problem that herbal products and supplements lack production and marketing oversight and then must be proven to cause serious health problems before they can be removed from the market.

Ms. Cox concluded her blog with a statement to ask the patients which supplements they are taking and why. Then she instructs CDEs to assess whether the supplements are healthful, harmful, or just costing patients extra money they may ill afford.

This was not available when the blog was written, but the FDA has declared one problem people with diabetes have, inflammation, a disease. This will open the door for Big Pharma to manufacture drugs for inflammation and prevent CAM from dominating in this area. I know that Big Pharma is pushing the FDA to do this in more areas as well.

Junk Science Is Big Business

Junk science and studies are big business and the number of fabricated studies is growing by the day. What drives this big business? Money supplied by Big Pharma, Food, and Ag. What makes it so easy to fund these phony studies and obtain the ridiculous results? Money supplied by – you guessed it – Big Pharma, Big Food, and Big Agriculture. Then add to this Big Chemical.

Today it seems the mainstream media is always screaming about the latest study “proving” that supplements are bad and drugs are good. However, the “research” behind these headlines has been funded, manipulated, and packaged by Big Pharma.

Some to the techniques behind this include publication bias, “seeding” trials, ghostwritten studies, “perfect” patients, deceptively low doses, questionable methodologies, cherry-picking conclusions, skewed meta-analyses, tiny sample sizes, overly brief study periods, parroting press releases, reliance on Big Pharma’s advertising dollars, and hidden funders.

There are other methods used, but all are driven by money and how easy it is to hide conflicts of interest. All “researchers” are subject to this and don't argue that some are exempt. Even universities are part of this and have highly concealed conflicts of interest.

Many studies using participants strive for the “perfect” participant (or patient) who will provide the desired result. This is the reason that many participants are rejected. Think of the studies to undermine self-monitoring blood glucose (SMBG) where people that knew the value of blood glucose testing are eliminated from studies. Little or no education is given to the participants to prevent them from learning how to evaluate the testing and improve their lives by testing with a purpose. In addition, once the study is over, they receive no additional testing supplies or test strips.

Cherry-picking conclusions, skewed meta-analyses, tiny sample sizes, and overly brief study periods are often used together, but don't be surprised if only two of the four are used. Skewed meta-analyses and cherry-picking conclusions are often used together when there are many studies available. This allows the researchers to look for studies that arrive at the conclusions they want to promote.

Tiny sample sizes and overly brief study periods are popular when they know that longer study periods will yield results that don't fit what they are looking for reporting. They reduce the number of participants to have people that will also fit what they are attempting. What they are trying to prevent is having unexplainable outliers that would easily negate the study results.

If it had not been for Gretchen Becker and Jenny Ruhl, I would have continued learning only from the College of Hard Knocks and I urge you to read my blog and the links. When you have completed that, then you may have interest in this article of how Big Pharma and the Media sell junk science. Some of the headlines at the bottom of the article have crossed my computer screen and I have much the same reaction and moved on looking for reliable research.

This also helps explain why I get snarky with some of my blogs when I realize they are fake science. Reliable research is becoming scarce and harder to find. I enjoy reading a blog by Dr. Malcolm Kendrick as he does a lot of research on the topic of fake studies and he likes to report on misconduct by researchers and Big Pharma. He also writes about conflicts of interest.

Plot Between FDA and Big Pharma Thickens - P2

This press article is somewhat anticlimactic after the previous blog. It is still about Pfizer and the anti-smoking drug Chantix but dated on June 12, 2008. There are some things in the article that I have to question about why ABC News dot com did not check their facts since they had published a story about Chantix.

Quote Now a new report from the nonprofit organization Institute for Safe Medicine Practices cites nearly 1,000 adverse event reports associated with Chantix. That report, released late last month, has prompted the Federal Aviation Administration to ban the drug's use among commercial pilots. Unquote

Now from the June 17, 2008 article – Quote The FAA has prohibited commercial airline pilots from using Chantix because of its possible side effects. Unquote  Yes, the difference of two words “ban” and “prohibit”, but in the world of commercial safety, there is little distinction between the two words. Both indicate that the pilot would be grounded and possibly lose a commercial aviation license for using Chantix.

The biggest plus for the article is that finally shows FDA is doing what it should have back in 2008 when it only warned the Veterans Administration of problems. One does have to wonder how they swept that story under the rug. It does not speak well for the FDA and their review procedures when they can issue a warning to another government agency (that chose to ignore it) and then to ignore the public in the face of mounting evidence. Reminiscent of Avandia anyone?

So this does indeed raise an issue of how much collusion is happening between the FDA and Big Pharma. Are certain interests within the FDA not alerting the public and taking actions at the behest of Big Pharma? With some hesitation, I would have to agree that some evidence certainly indicates that to be happening. I had thought maybe Jo was pushing a little in her blog, but after reading the two articles, I would have to agree with her.

I certainly am more concerned about the safety of many drugs and the side-effects that are not made public until after the elephant has done the damage.

For those that need to read Jo's blog, it is here. For those that did not read the June 17, 2008 article about the abuse of our veterans, it is here and the June 12, 2008 article can be found here.  NOTE:  Jo's blog no longer exists - 10/28/13

Plot Between FDA and Big Pharma Thickens - P1

Normally, I leave topics like this for others, but my dander is up and I feel our government is again abusing our veterans and the Federal Food and Drug Administration plus the Veterans Administration is in bed with Big Pharma. This is a combination that I can't in good conscience look the other way on. My thanks go out to another blogger Jo who blogs at joscafe dot com for blogging about this and providing the links. And I don't care that this is not about diabetes.

Since I am also a veteran, I am compelled to write this and am still pulling my thoughts together. I am not even sure how many parts - I am putting this in two parts. First, I will concentrate on the abuse of our veterans and the shame of our government in cooperation with Big Pharma (Pfizer is just one of many and the maker of the drug being exposed) is doing to our veterans. It is a disgrace that our history is such a minefield for our veterans since the end of WWII and probably goes back further than that. Many veterans have been part of cruel medical experiments since then, and the Iraq and Afghanistan conflicts is proving no exception.

Why our Veterans Administration insists on being part of this disgrace is beyond comprehension. Many of our veterans end up in mental institutions because of the experiments they are subjected to and I have to wonder it this is not a part of the increased suicide rate among returning veterans. Even though the article is from June 17, 2008, this and much similar studies are still taking place today.

The ABC News dot go dot com story is properly titled “ 'Disposable Heroes': Veterans Used To Test Suicide-Linked Drugs”. Mentally distressed veterans are being recruited for government tests on pharmaceutical drugs linked to suicide and other violent side effects. One of the human experiments involves the anti-smoking drug Chantix.

Veterans Administration doctors were warned on November 20, 2007, January 18, 2008 and February 1, 2008, by the FDA and Pfizer, but did not issue a warning to the veterans until February 29, 2008.

The following is quoted from the press article to show how little respect the Veterans Administration has for the lives of our veterans. Quote "How this study continued in the face of these difficulties is almost impossible to understand," said Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania.

Doctors at the Veterans Administration say they acted as quickly as they could.

"This didn't justify an emergency warning at that level," said Dr. Miles McFall, co-administrator of the VA study.

Dr. McFall said there is no proof that Elliott's breakdown was caused by Chantix and he sees no reason to discontinue the study(1). Some 140 veterans diagnosed with Post Traumatic Stress Disorder continue to receive Chantix as part of a smoking cessation study.

Dr. McFall says the VA decided to continue the Chantix study because "it would be depriving our veterans of an effective method of treatment to help them stop smoking."

Caplan, one of the country's leading medical ethicists, said he was stunned by the VA's decision to continue the Chantix experiment.

"Why take the group most a risk and keep them going? That doesn't make any sense, once you know the risk is there," he said.

Chantix is one of the drugs being used in an estimated 25 clinical studies using veterans by the VA.

Pfizer maintains that "the benefits of Chantix outweigh the risks" and that it continues to do further studies on the drug.

The FAA has prohibited commercial airline pilots from using Chantix because of its possible side effects. Unquote

This is my opinion, but doctors like McFall are the mad people in today's military and need to be convicted for their crimes against our veterans. Please read the full news article for the full impact.
 
(1)  This is standard military denial.  If you say if often enough and to enough people you can see them actually believing this.  (Agent Orange from Viet Nam Conflict anyone?)