Updates to Blood Sugar 101

Page Changed: DPP-4 Inhibitors Januvia, Onglyza, Trajenta, Combiglyze, Janumet, and Jentadueto
Content Added:

Flaws in Studies Purporting to Refute Dr. Butler's Findings

As soon as Dr. Butler's study came out, there was a rush to publish studies that supposedly refute it, funded, not so surprisingly by the companies who are earning billions of dollars from these highly profitable drugs.

A good example is this one:

UPDATE 2-Doctors get good and bad safety news on diabetes drugs

This study claimed to find no sign of pancreatic disease with Onglyza, but there are several reasons to discount this finding:

1. The study only lasted 2 years, which is far too short a time for the changes in pancreatic architecture discovered by Dr. Butler to result in overt pancreatitis.

2. Cancers also take much longer than 2 years to cause symptoms. Pancreatic cancer, in particular, is almost always symptom free until it is too late for any treatment to keep the patient from dying within a few months. The patients in Dr. Butler's study who took Januvia and died with small precancerous tumors in their pancreases and abnormal cells throughout their pancreatic tissue had no symptoms suggesting anything was wrong with them.The only cases of pancreatitis or pancreatic cancer which were evaluated in this study were those that produced symptoms.
There is no way to study the cells of a living pancreas without destroying it, which is why Dr. Butler was forced to study the pancreases of people who have died of head injuries. Any study that assures you that these drugs are not damaging the pancreas which does not examine pancreatic tissue is not conclusive. (And remember, that there are several studies of huge databases of people who are taking these drugs that have already found a small rise in the numbers of cases of pancreatitis among people taking them.)

Given how cancers progress, it will take 10 years or more for the pancreatic tumors these drugs are capable of growing to cause the epidemic of pancreatic cancer deaths that I fear is coming. By the time the deaths appear, it will be too late to do anything.

Until someone shows you 10 years worth of data that show no significant increase in cases of either pancreatitis or pancreatic cancer in people taking any incretin drug, be very skeptical of studies claiming they are safe.

The British Medical Journal looked into this issue and found disturbing signs of suppression of evidence suggesting this is a very real problem: Discussed here: Medcscape: BMJ Digs Deep Into Incretins and Pancreatic Cancer Debate.
The actual BMJ review is found here:

Has pancreatic damage from glucagon suppressing diabetes drugs been underplayed?

Onglyza Found to Increase the Incidence of Heart Failure

The drug company that ran the study of Onglyza discussed in the previous paragraph was attempting to show that Onglyza decreased heart attack deaths. What they found instead was that though Onglyza did not cause more heart attacks, but it didn't decrease their number either. Even more worrisome was their unexpected finding that Onglyza increased the incidence of heart failure, a weakening of the heart muscle that is almost always fatal within a 5 year period. Quoting the Reuters report: "The co-principal investigator on the Onglyza study, Dr. Deepak Bhatt, said he believed the heart failure issue seen with Onglyza was very likely a class effect common to all DPP-4s."