Diabetes, Expenses, And Medication

Articles

Diabetes, Expenses, And Medication

By Brooks A. Mick, M.D.
Oct. 28, 2006

Drea-ea-ea-ea-eam, dream, dream, dream

Drea-ea-ea-ea-eam, dream, dream, dream

--The Everly Brothers

The DREAM study is beginning to sink into the consciousness of physicians and the treatment of diabetes will likely never be the same. DREAM stands for Diabetes Reduction Assessment with Ramapril and Rosiglitazone Medication. In over 5000 patients who had risk factors for diabetes but who had not yet developed the disease by statistical criteria, patients given rosiglitazone for 3 years were 60% less likely to develop diabetes.

And day in and day out I see the ravages of diabetes: heart attacks, strokes, kidney failure. The DREAM trial statisticians calculated that for each 1000 people treated, 144 people would be prevented, over the three years of the study, from developing diabetes. That doesn't sound like many people, but those 144 people would have increased risks of vascular disease and a higher probability of ending up on dialysis than non-diabetic patients, and thus a great health care dollar savings would result.

And the news is even better. A Merck drug, Januvia, has just been approved and is on the market already. This is the first incretin enhancing agent, is a single tablet a day, and attacks the disease of diabetes much closer to its basic pathology than other agents.

We have always known that the available medications and treatment methods, diet, exercise, sulfonylurea agents, and insulin didn't really slow the development of the disease. In other words, controlling the sugar for a time didn't stop the progressionof the disease of diabetes. Diabetes is NOT simply elevated blood sugar. Even if the treatment was controlling the sugar, the pancreatic islet cells continued to deteriorate and eventually treatment had to be intensified or eventually failed.

I predict that the use of the incretin enhancers (and the TZD drugs like rosiglitazone used in the DREAM trial) will improve the care of diabetes many fold and I am urging all patients with diabetes and their families and friends and overweight people and people with a family history of diabetes to get really serious about this and start saving some money to use to purchase the new agents coming along. Insurance companies aren't likely to be covering these agents at low cost in the near future.

But if you, as a diabetic or prediabetic, refuse these agents because they cost too much, you are being penny wise and pound foolish. Worse, you will be shortening your life and making your later years miserable. It's no fun to try to enjoy your retirement years with heart failure, a stroke, or going to a dialysis clinic 3 times a week and feeling punk anyway.

Walmart, by the way, is starting a program in many states, so far mainly along the East Coast, wherein they will sell one month of any generic drug for four dollars. I'm getting requests for patients to switch them to generic drugs. This would be a considerable bargain IF the generic agent will work as well as a newer brand-name drug for which generics are not yet available. With the TZD drugs and the new incretin enhancer, there is no generic available and won't be for years. But you should plan on affording them one way or another. Cancel some cable TV channels. Drive less. Buy a cheaper car. Whatever you have to do to afford the new drugs, as they will keep you healthy and you will live longer, and is that not worth a few more bucks?

------------

About the author Brooks A. Mick: Physician, still practicing medicine but retired from the US Army. Write just for the fun of it, but working on novel in the vein of Tom Clancy's politico-military genre.

Email: brooks15@cox.net

Comment on this article here!

------------

All articles are EXCLUSIVE to Useless-Knowledge.com and are not allowed to be posted on other websites. ARTICLE THIEVES WILL BE PROSECUTED!