He’s back

He’s back

“The federal government’s dietary guidelines have changed little since first being issued in 1980. A revised set of recommendations released this month includes a new cap on added sugar, but this is unlikely to end the guidelines failure for 35 years to check the rise of obesity and diabetes. The problem, simply put, is a reliance on weak science.”

These words were penned by none other than that crusading cardiologist, yes the good doctor Steven Nissen. Yes, it seems that the good doctor after wreaking havoc in the diabetes drug space with his now debunked meta-analysis has set his sights on the governments dietary guidelines. And in the ultimate form of chutzpah he states that weak science is the reason these guidelines have not worked. Weak science, really.

Keep in mind this is the same guy who got Avandia and Actos pulled from the market based largely on a meta-analysis that was nothing more than fuzzy math. A meta-analysis which as we noted has since been debunked but only after severe damage had been inflicted. Damage which lingers to this day as the approval process for diabetes medications takes much longer due to the additional cardiovascular studies required by the FDA. And let’s not forget the additional costs of these studies which makes an already expensive process even more expensive.

It seems the good doctor just isn’t happy unless he has a cause to champion and the spotlight is not shinning brightly on just how brilliant he is. For reasons we have never understood this crusading cardiologist isn’t content sticking with his expertise but must venture into areas like diabetes, something he is not an expert in.

This would be different if something good had come from the mess he created, if something actually grew from the manure he spread around.  Yet, it is difficult to say that we are any better off today than we were back when the Avandia controversy came to light. Are diabetes medications any safer? The honest answer is we don’t know the answer. Has the approval process become easier, are new medications getting to the market faster? No and No. Has the approval process gotten longer and become even more expensive? Yes, and Yes. Have these cardiovascular studies provided valuable insight? That’s hard to say. In the case of Jardiance, it has but the same cannot be said for other new diabetes medications. For many of these newer drugs all these studies have shown is that these drugs may or may not have an impact on cardiovascular events. Simply put they have not answered questions and in many cases have only created more questions.

From the beginning Diabetic Investor’s main concern was Nissen’s fuzzy meta-analysis would make things worse. That it would not help physicians answer what seems like a very simple question patients ask all the time; Is this drug safe? That this fuzzy math would not get patients to take their medications as prescribed but would have the exact opposite effect, which is exactly what happened. Even though Nissen targeted Avandia many patients stopped taking any diabetes medications fearing they too had issues.

The simple fact is the good doctor and his followers just can’t accept the fact there is no such thing as a completely “safe” drug. These zealots have lost all perspective and sense of balance. Listen, no one in their right mind wants to see even a single patient have a serious adverse event caused by the medications they are taking. However, does this mean we pull a drug from the market which is helping millions of patients just because a handful are having issues? This is classic let’s kill a mosquito with a nuclear weapon thinking. It’s not just foolish and stupid but also very dangerous.

Later on in his piece, which by the way was published in today’s Wall Street Journal (sorry we should have mentioned that earlier) the good doctor writes:

“Diseases caused by poor eating habits destroy lives and cost the nation trillions in health care. When wrong nutritional advice is dispensed to the public, scientists lose credibility”. Well Steve scientists also lose credibility when the use fuzzy math and underhanded tactics to create a controversy which impacted millions of unsuspecting patients. Scientist lose even more credibility when their analysis is proved to be nothing more than fuzzy math. Ultimately they lose credibility when they stray from there area of expertise and start pontificating about disease states they know nothing about. Worst of all they lose all credibility when it becomes obvious that they really don’t care about the well-being of the patient and only want their 15 minutes of fame.

Steve you’ve had your 15 minutes do us all a favor and go back to cardiology.