Diabetes Self-Management Blog

My plans for getting out of town are not going well this year. Because my friend Sandy works in the medical field, she takes continuing medical education (CME) courses here and there and I sometimes tag along.

This month, we were going to go to San Francisco for a long weekend. I have friends there and some favorite restaurants, so I was looking forward to it.

Well, Sandy quit her job and went back to school, so a long weekend in San Francisco gave way to an overnighter in Louisville. That’s OK. I have a favorite store in southern Indiana and was looking forward to trying out a new restaurant in Louisville. I could hardly wait to hit the road. That would have been last Friday.

“Would have been?” Yep. The night before we were to leave, Sandy called. “Have you seen the weather report?” she asked.

Good ol’ Mother Nature. Stuck at home after all, I took the opportunity to do a little digging about liraglutide (brand name Victoza), a new drug for Type 2 diabetes that was approved on Jan. 25, 2010, and should be available sometime in March.

Victoza is a glucagon-like peptide-1 (GLP-1) agonist, as is exenatide (Byetta). (Byetta has been linked to an increased risk of pancreatitis, and people who took Victoza during five clinical trials had more incidences of pancreatitis than those who took other diabetes drugs.)

Because rodent studies showed an increased incidence of tumors (and sometimes cancer) of the thyroid gland, the FDA is requiring the manufacturer of Victoza to conduct a five-year study to evaluate thyroid cancer risk. (The risks of other cancers, hypoglycemia, pancreatitis, and allergic reactions will also be evaulated.) The company also must establish a cancer registry to track incidence of thyroid cancer each year over the next 15 years. (To be fair, I should tell you that the rats were given a dose eight times the amount recommended for humans.)

In addition, the FDA said in a prepared release, the manufacturer must provide a “Medication Guide and a Communication Plan to help patients and providers understand the risks of Victoza and to ensure that the benefits of the drug outweigh the risk of acute pancreatitis and the potential risk of medullary thyroid cancer.”

(And if you believe all doctors are going to sit down with their patients and go through all of that stuff, I have a bridge in Brooklyn for sale.)

If your doctor prescribes Victoza, what should you do? Like many things, you really need to determine whether the benefits outweigh the risks. Victoza does lower HbA1cs, can contribute to weight loss, should not cause hypoglycemia, and is a once-a-day injection (compared to twice a day for Byetta). It’s not recommended for use as a first-line drug, so you would be taking it in addition to other diabetes drugs. Besides, while the risks are there — and all diabetes drugs carry risks — they’re usually fairly rare.

I’m taking two antibiotics that carry strong warnings about higher risks of tendon inflammation or injury. The risk is even higher if you’ve already had tendonitis (which I have had) or a torn tendon.

The reason I’m taking the antibiotics is because I have an infection stemming from surgeries for a ruptured Achilles tendon. Am I concerned? A little. But I’m more concerned about getting rid of the bacteria that’s causing the infection. The drugs prescribed are ones that specifically target the bacteria I have.

In the meantime, I keep a close watch on my body for signs of a tendon flare-up. And you should pay attention to your body, and should keep up with preventative measures, if you take any diabetes drug. Also educate yourself about warnings or side effects of all of the drugs you take. If you’re concerned about the side effects connected with diabetes drugs, there’s always insulin.

It’s really up to us to be proactive about our health. After all, who cares about our health more than we do?

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