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What is Type II Diabetes?
Type II diabetes is the most prevalent kind of diabetes in the United States, making up approximately 90-95% of all cases. Also known as non-insulin dependent, ketosis-resistant, or adult onset diabetes, it is generally a disease that manifests itself after the teen years. The pathology of the disease consists of peripheral tissue insulin resistance, increased output of glucose from the liver, and decreased release of insulin from the pancreas. With these three things working in opposition of the body's desire to properly use glucose, inevitably all that unused sugar hangs around in the bloodstream where it can cause a host of problems for the unfortunate victim in the future. Such problems may include peripheral nerve pain and diminished sensation, deteriorating eyesight and kidney function, and high risk for heart disease.
What is My Risk for Type II Diabetes?
Probably one of the most important potentially modifiable risk factors for diabetes is obesity. With the obesity epidemic on the rise the importance of healthy lifestyles and diet is becoming more and more important in our culture. (Take this fact as a friendly reminder that we as a society need to instill healthy lifestyles and eating habits into our youth!) Some of the other risk factors for Type II diabetes are characteristics of "the metabolic syndrome" and may include any 3 of the following--waist size male: >40in. and female: >35in, triglycerides >150, HDL cholesterol--male <40 and female <50, blood pressure >130/85, fasting blood sugar >100, or being on medication for any of the mentioned prob
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lems.
So, What is Avandia® and Who Takes it Anyway?
Avandia® is a drug that belongs to the class of oral diabetes medications called thiazolidinediones, also known as "insulin sensitizers". Avandia® and the other drug in this class, Actos®, work in the body by sensitizing a receptor found primarily in fat, skeletal muscle, and liver tissues and stimulate those cells to more readily uptake all that glucose that is hanging around in the blood. In doing so, these medications help to "sensitize" cells to use glucose more efficiently to overcome the "insulin resistance". Type II diabetes is the population in which this drug is indicated and approved for use. In a sense, the thiazolidinediones, also known as TZD's, help the body to improve the body's use of naturally produced insulin. This class of drugs is not approved for use in Type I diabetes and should not be used in patients with New York Heart Association (NYHA) Class III or IV heart failure. Also, any patient taking Avandia® should be monitored for cardiovascular problems during treatment.
What is the All the Recent Hype?
There was a meta-analysis that was published in the New England Journal of Medicine in the May 21, 2007 issue concerning the use of Avandia®. This was actually a compilation of the results of 42 different studies previously done and the authors found a slight increased risk of cardiovascular events such as heart failure, heart attack, and chest pain in patients who took Avandia®. However, this risk is not a major shock to the medical community given that
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many people with Type II diabetes, all other things aside, are already at increased risk for cardiovascular disease since having diabetes is a major risk factor for that disease. GlaxoSmithKline, the manufacturer of Avandia®, also has the increased cardiovascular risks clearly stated in the "Warnings" section of the package insert that accompanies the medication. It seems as though this "new" information is not really new, just resurfacing with a different perspective. However, the FDA is currently reviewing this information and the degree of cardiovascular risk is yet to be determined.
So, What Now?
If you currently take Avandia® it is recommended that you do not stop taking your medication on your own, but rather contact your physician and make a joint decision on whether or not you should continue with your Avandia® therapy or if it should be stopped. This kind of decision can only be done by balancing risk and benefit, and the best way to do this is by speaking with your physician. As of this date, Avandia® is still available in the U.S. Market and is currently being dispensed to millions of Americans to successfully treat Type II diabetes. Additional information can be found at www.avandia.com.
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