Friday, June 23, 2006

Are these new drugs for diabetes as wonderful as they seem?

As a type 1 diabetic, I'm always keen to read - and comment on - articles about diabetes, such as this one.

My first complaint is the way that the article portrays type 2 diabetes. It's common for diabetes-related news to talk about the epidemic proportions of type 2 diabetes, but frequently they blur the differences between the two diseases.

Type 1 diabetes is an inability to produce insulin. Usually type 1 is caused by an inherited autoimmune response, which means that the person's immune system decided - for some unknown reason - to kill its own pancreas. Type 1 is treated by injecting insulin to replace what the body doesn't make.

Type 2 diabetes is an inability to use one's own insulin, even though the pancreas may produce more than it should be, in an attempt to compensate. This version of diabetes is a completely different disease, just with the same effect of high blood sugar: obesity from poor diet and lack of exercise decrease the body's ability to use insulin. Type 2 is often seen as genetic, but truthfully, it's not known which part is genetic: the weight issues, or the diabetes. Type 2 is treated by taking pills to resensitize the body to medication, and by modifying the person's exercise and diet.

End of story.

When both conditions occur, it is not really bad type 2. A person can have type 1 and type 2 diabetes simultaneously. However, a type 2 diabetic that doesn't take care of themselves may have to inject insulin - not because their bodies lose the abilities to produce it, as the article suggests, but because they have type 2 so bad that the pills are unable to fully resensitize their bodies to insulin.

Now, here's my other beef with this article. The article talks about the ability of this new drug, Byetta, to cause weight loss in patients. That makes me nervous. I can just see the drug being abused by people who are obsessed about their weight. The article talks about the high demand for the drug - yeah, ya think?! As overweight people in a society obsessed with slimness, diabetes is not their only concern.

I suppose I should mention that type 2 diabetes is not the "life sentence" that type 1 is - that is to say, type 2 diabetes can often be completely reversed with proper diet and exercise. To translate again, diabetes 2 is an end result of people getting fat and not taking care of themselves - which is why we've seen a tremendous rise in the number of cases, especially in the United States, where eating has almost become a sport.

With this in mind, it seems to me that losing the weight via Byetta is an "easy way out" that will fail to teach these people the importance of diet and exercise in controlling their condition; instead, they'll become dependent on the drug to control their weight for them - which is probably what the drug companies want, come to think of it. Anyway, my point is that this drug could easily become a crutch, instead of a solution.

Also, I don't know if the drug companies have tested the effects of losing weight via Byetta - an unnatural method. Chemically induced weight loss has never seemed to be very healthy - or very effective.

As a side note about the other drugs they mention in the article - I've heard about the inhaled insulin before, and personally I'm not crazy about the idea. I don't like sniffing things, and I'm not at all surprised that the drug causes less effective breathing. And personally, I don't think giving myself injections is that bad - the needles are about 35 gauge, for heaven's sake, and less than half an inch long. Most of the time I can't even feel them!

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