Older (and cheaper) drugs found to be better for diabetics

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Back in May, I wrote about the relatively new diabetes drug rosiglitazone (Avandia) and, specifically, the then new research which linked it with a substantially increased risk of heart disease [1]. By coincidence, rosiglitazone was also the focus of attention of a review conducted by a scientific group known as the Cochrane Collaboration. The research was led by Dr Bernd Richter of Dusseldorf’s Heinrich-Heine University in Germany, and was published in the latest edition of the Cochrane Library journal.

This review, an analysis of data obtained from some 18 trials and 8000 patients revealed that rosiglitazone found little evidence that it improved with quality or quantity of diabetics’ lives. Notice, that the researchers in this study have focused on real measures of actual health, not just so-called ‘surrogate’ markers for health such as blood sugar levels.

In addition, the Cochrane researchers found that taking rosiglitazone generally caused weight gain ” up to about 5 kg (11 lbs) per person. And as with previous analyses, rosiglitazone was found to be associated with an increased risk of swelling (oedema), bone fractures and heart failure.

Dr Richter is quoted as saying: I see a bundle of adverse effects, and I don’t see really good positive effects. He also noted that the adverse effects of this drug does potentially represent a big public health problem, because of the sheer numbers of people taking it, adding: ‘On a global scale, tiny risks can translate into big effects, because millions of people are taking it.

There is a thought that it is perhaps unethical for more research on rosiglitazone to be conducted, on the basis that less hazardous alternatives are available that are as effective in terms of blood sugar reduction. As it happens, a review published this week in the Annals of Internal Medicine has found that the older (and cheaper) drug metformin has the best risk/benefit profile of all the diabetes drugs currently available [2].


1. Diabetes drug linked with adverse effects on health – again

2. Bolen S, et al. Systematic Review: Comparative Effectiveness and Safety of Oral Medications for Type 2 Diabetes Mellitus. Annals of Internal Medicine 2007 147(6) [Epub ahead of print].

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