Beating a dead horse, kicking a man while he’s down

Beating a dead horse, kicking a man while he’s down

This week the
European Association for the study of Diabetes (EASD) is holding their annual
conference in Vienna, Austria. Not expectedly there’s a host of news coming out
of the conference, unfortunately most of what Diabetic Investor has seen is
either irrelevant or a rehash of information that has already been covered.

Case in
point, everyone knows that there is an increased incidence in bone fractures
associated with Avandia and Actos. Even though this risk is well known, and has
been discussed at great length Science Daily found it necessary to publish yet another
study that shows this risk to be real. Perhaps the good folks at Science Daily
thought there was an endocrinologist living in cave somewhere who wasn’t aware
of this piece of information.

Diabetic
Investor finds this information even more irrelevant when you consider that
Avandia sales have fallen to the bottom of the ocean since the drug was linked
to an increased risk of adverse cardiovascular events. It’s about time
researchers moved on from researching Avandia and onto to more mundane things
like how we can develop better drugs to treat the millions of patients with
diabetes.

Case in point
number two; there is no direct link or causality between Lantus and cancer.
Here as well the studies that brought this controversy public have largely been
debunked by every respected researcher. Even the authors of the studies which were
published in Diabetologia didn’t believe
Lantus actually caused cancer. Not content to let any issue go uninvestigated a
panel was held at EASD to discuss this issue. And surprise, surprise the consensus
coming out of this brilliant discussion was the data does not support that
insulin use actually causes cancer. Equally brilliant was the contention that
the evidence used to link Lantus to cancer is weak. And shock of all shock, the
researchers noted that even more research is needed to confirm what everyone
has been saying since these studies became public.

While
Diabetic Investor doesn’t have a problem with research we have a major problem with
throwing money and resources studying the same thing over and over. Just how
many studies do we need telling us that there is an increased incidence of bone
fractures for patients on either Avandia or Actos? Do we really need another
set of studies to tell us that there is no direct link between insulin usage
and cancer? Are these researchers so desperate to see their names in print that
they cannot think of other issues to research? And people wonder why the
patients with diabetes who live in the real world are so frustrated. Could it
be that by living with diabetes everyday they don’t want to be told something
they already know? Is it possible that they just might be a little more
interested in research that either leads to a cure or develops better treatment
options?  

Diabetic
Investor is sure there is a group of researchers out there studying Januvia
usage and pancreatitis or Byetta usage and pancreatitis. Never mind that
patients with diabetes are at greater risk of developing pancreatitis or that
in both cases the incidence rate of pancreatitis was actually LOWER than the
diabetes population in general. As sure as night follows day, researchers
wanting to understand every possible angle will study this issue. That is what researchers
do.

Unfortunately
research takes time and by the time the research is done, reviewed and
published; patients with diabetes will still be at greater risk of developing pancreatitis
just because they have diabetes. And Diabetic Investor can almost guarantee that
we will once again see those immortals words; “While we cannot prove with certainty
that these drugs do not cause pancreatitis, we do believe this issue warrants
further study.”

One
just might think that these researchers being the very smart people they are
would understand another fact; you cannot use the word certainty in any paper
relating to drugs. If we have learned anything over the past few years it’s no
drug no matter how well tested is free from adverse events, nor is it possible
to predict with any degree of confidence that adverse events won’t show up
until well after the drug has been on the market.

Although
Diabetic Investor is not a researcher, more often than not drugs that do lead to
serious adverse events are quickly discovered. This is why most drugs in
development don’t make it to the FDA. When it comes to drug development failure
is the norm, success the exception. Should a dangerous drug somehow make it to
market, it doesn’t take long for this danger to become public knowledge, i.e.
Rezulin.

The
issue here isn’t whether or not research should be done; it would be foolish to
suggest research should not be conducted. The real question that should be
asked here is, will the research being done add any new or useful information that
will help patients with diabetes and the physicians that treat them. Rehashing
facts that are already well known serves no useful purpose and is a waste of resources
which would be better allocated elsewhere.

The
bottom line here is researchers would be well to remember that if it walks like
a duck, talks like a duck – by golly it is a duck.