Why would anybody consider taking this T2 medication

[Krystyna23040]

I read about this new wonder drug for T2D on our diabetes.co.uk website.

When we have LCHF and metformin if we need a bit more help if LCHF isn't enough to bring down BS - why oh why would Novo Nordisk think anybody would want to risk all the issues that this drug could cause:

The first glucagon-like peptide-1 (GLP-1) receptor agonist in tablet form has been approved for people with type 2 diabetes in the US.

Rybelsus, (medication name semaglutide) has been approved by the US's official drugs body the Food and Drug Administration (FDA).

Rybelsus will carry a 'boxed warning' that there is a potential increased risk of thyroid c-cell tumors. Additional warnings regarding the drug relate to pancreatitis, diabetic retinopathy, hypoglycemia, acute kidney injury and hypersensitivity reactions.

Novo Nordisk executive vice-president and chief science officer Mads Krogsgaard Thomsen said: "We are very excited that we can make the first oral GLP-1 available in the US and thereby expand the treatment options for adults living with type 2 diabetes.

Sorry for the rant - reading about this drug made me feel quite angry.

 

[Member496333]

Seems the risks are fairly substantial, and unless an insulin deficiency has been diagnosed, provoking the pancreas to secrete more and more is not a great idea for the longer term prognosis of T2DM. In fact artificially stimulating a pancreas that is already giving up the ghost probably isn't ideal either.

Personally I’ll take a steak instead.

 

[Krystyna23040]

Seems the risks are fairly substantial, and unless an insulin deficiency has been diagnosed, provoking the pancreas to secrete more and more is not a great idea for the longer term prognosis of T2DM. In fact artificially stimulating a pancreas that is already giving up the ghost probably isn't ideal either.

Personally I’ll take a steak instead.

I agree - but it's got to be rib-eye steak, my favourite.

 

[Daibell]

Hi. All of the previous 'xxxxtide' drugs of which there are several have side effects and are probably best avoided if possible. As usual LCHF plus Metformin are typically the best start point.

 

[ianf0ster]

When we have LCHF and metformin if we need a bit more help if LCHF isn't enough to bring down BS - why oh why would Novo Nordisk think anybody would want to risk all the issues that this drug could cause:

Hi Krystyna,
I think you are missing the point here. The pharma companies are not charities nor are they philanthropic, they exist to make a profit - so it helps if they can find ways to make patients dependent upon their products for life. Otherwise they have to charge huge prices for medicinal cures - because they only get 1 sale per patient.
So long as they can convince the regulating authorities (without cheating) then it may be quite ethical to unleash their Sales Force to target Doctors and drive sales of any of their most profitable drugs.

Whether it actually makes sense for a knowledgeable patient to actually take the drug (if prescribed) is of no concern because fortunately for the drug companies, there are very few knowledgeable patients!

 

[LittleGreyCat]

I was (and still am) weighing up Semaglutide as the next step in treatment after Metformin.

The upside was the claim that it protected Beta cells and could stimulate Beta cell recovery.
It also suppresses glucagon production, which I suspect is one of my issues with dawn phenomenon.
The downsides were some of the side effects and the fact that it required a weekly injection.

A pill makes it more attractive.

Semaglutide via injection is a standard treatment in the UK.
So I think it is very short sighted to ask how anybody could even consider taking it when there are probably people on this forum who are currently being treated with this drug.

 

[Krystyna23040]

Hi Krystyna,
I think you are missing the point here. The pharma companies are not charities nor are they philanthropic, they exist to make a profit - so it helps if they can find ways to make patients dependent upon their products for life. Otherwise they have to charge huge prices for medicinal cures - because they only get 1 sale per patient.
So long as they can convince the regulating authorities (without cheating) then it may be quite ethical to unleash their Sales Force to target Doctors and drive sales of any of their most profitable drugs.

Whether it actually makes sense for a knowledgeable patient to actually take the drug (if prescribed) is of no concern because fortunately for the drug companies, there are very few knowledgeable patients!

You are absolutely right. If the pharma companies put the wellbeing of their patients first they would go out of business.. No pharma company in their right mind would promote LCHF instead of their drugs. Hopefully the tide will turn and they will in the end have to look for another source of revenue as more and more people with T2D become more knowledgeable.

 

[Krystyna23040]

I was (and still am) weighing up Semaglutide as the next step in treatment after Metformin.

The upside was the claim that it protected Beta cells and could stimulate Beta cell recovery.
It also suppresses glucagon production, which I suspect is one of my issues with dawn phenomenon.
The downsides were some of the side effects and the fact that it required a weekly injection.

A pill makes it more attractive.

Semaglutide via injection is a standard treatment in the UK.
So I think it is very short sighted to ask how anybody could even consider taking it when there are probably people on this forum who are currently being treated with this drug.

When I posted this I assumed that the side effects were from the pill form and not the injection so I do apologise if I have offended anyone on Semaglutide.

 

[LittleGreyCat]

When I posted this I assumed that the side effects were from the pill form and not the injection so I do apologise if I have offended anyone on Semaglutide.

I think the side effects are broadly the same and the ability to deliver the drug orally is a major step forward.

The next step after diet, exercise and Metformin are no longer delivering is a very tricky one, with a lot of potential downsides.
It seems that either you mess with the kidneys to pee more sugar out, or turn the wick up on the pancreas which can lead to the Beta cells burning out.
It seems that modern drugs are more effective than the original sulphonylureas but seem to potentially have more side effects.
Rock and a hard place, really, if you want to stay off insulin or other drugs with a strong risk of hypoglycemia.

 

[Krystyna23040]

I think the side effects are broadly the same and the ability to deliver the drug orally is a major step forward.

The next step after diet, exercise and Metformin are no longer delivering is a very tricky one, with a lot of potential downsides.
It seems that either you mess with the kidneys to pee more sugar out, or turn the wick up on the pancreas which can lead to the Beta cells burning out.
It seems that modern drugs are more effective than the original sulphonylureas but seem to potentially have more side effects.
Rock and a hard place, really, if you want to stay off insulin or other drugs with a strong risk of hypoglycemia.

I do agree that the next step after diet, exercise and Metformin are no longer delivering is a very tricky one. I was on Insulin for 4 years which I believe preserved my beta cells from burnout. The downside is the risk of hypo's.

I didn't like insulin because of the hypos. However, I would definitely go back on insulin over any other drug other than metformin. Where I went wrong with insulin is that I was eating lots of carbs. Lots of carbs means lots of insulin. So if you get it wrong it is very dangerous because the large amount of insulin injected can cause a dangerous hypo if you miscalculate.

Now I would do it low carb because small amount of carbs means a much smaller amount of insulin and if you get it wrong it will only be by a very small margin so much less risk of a hypo.

 

[There is no Spoon]

why oh why would Novo Nordisk think anybody would want to risk all the issues that this drug could cause:

Because people are desperate and easy lead.
Novo figure they can make a profit and some bean counter somewhere has figured out the cost in law suits form side effects is easily outweigh by the profits and bonuses they can pay themselves.

Do you not know how business works?

 

[Tophat1900]

I read about this new wonder drug for T2D on our diabetes.co.uk website.

When we have LCHF and metformin if we need a bit more help if LCHF isn't enough to bring down BS - why oh why would Novo Nordisk think anybody would want to risk all the issues that this drug could cause:

The first glucagon-like peptide-1 (GLP-1) receptor agonist in tablet form has been approved for people with type 2 diabetes in the US.

Rybelsus, (medication name semaglutide) has been approved by the US's official drugs body the Food and Drug Administration (FDA).

Rybelsus will carry a 'boxed warning' that there is a potential increased risk of thyroid c-cell tumors. Additional warnings regarding the drug relate to pancreatitis, diabetic retinopathy, hypoglycemia, acute kidney injury and hypersensitivity reactions.

Novo Nordisk executive vice-president and chief science officer Mads Krogsgaard Thomsen said: "We are very excited that we can make the first oral GLP-1 available in the US and thereby expand the treatment options for adults living with type 2 diabetes.

Sorry for the rant - reading about this drug made me feel quite angry.

Seems crazy to me and somewhat unethical, but it makes me wonder how many prescribing doctors would actually discuss this drugs risks with their patients. It's not unusual for patients to never read the info that comes with a drug because their doc prescribed it, so it must be the right thing to do.

 

[bulkbiker]

prescribing doctors would actually discuss this drugs risks with their patients.

I'm guessing that few if any would know enough about it to be in a position to explain the risks.... they'll simply parrot what the rep has told them..

 

[Tophat1900]

I'm guessing that few if any would know enough about it to be in a position to explain the risks.... they'll simply parrot what the rep has told them..

Quite true. Reps are very good at promoting a new drug....

 

[Krystyna23040]

Because people are desperate and easy lead.
Novo figure they can make a profit and some bean counter somewhere has figured out the cost in law suits form side effects is easily outweigh by the profits and bonuses they can pay themselves.

Do you not know how business works?

That is so true - but isn't it a shame that they cannot act more ethically.

 

[Krystyna23040]

Seems crazy to me and somewhat unethical, but it makes me wonder how many prescribing doctors would actually discuss this drugs risks with their patients. It's not unusual for patients to never read the info that comes with a drug because their doc prescribed it, so it must be the right thing to do.

In my experience they don't discuss the side effects. But that is only my experience and it may not be true of all doctors.

 

[Tophat1900]

In my experience they don't discuss the side effects. But that is only my experience and it may not be true of all doctors.

Oh I've experienced that myself too.... I can't recall ever being told about side effects or risks. I've even been prescribed stuff I'm allergic to, luckily I caught it. I missed it once because it was part of an antibiotic treatment containing a mix of things... spent 2 weeks barely being able to walk from extreme pain in the Achilles tendons, but that's what happens when they don't look at the allergic list. :***:

 

[Mbaker]

Should this even be available with those risks. If I were newly diagnosed and had to choose between this drug and a week or 2 of Keto flu (or should I say carbohydrate withdrawal), I think there is an obvious choice.

 

[Tophat1900]

Should this even be available with those risks. If I were newly diagnosed and had to choose between this drug and a week or 2 of Keto flu (or should I say carbohydrate withdrawal), I think there is an obvious choice.

Drug companies aren't going to make a profit recommending keto... as you know.

 

[TriciaWs]

Hi. All of the previous 'xxxxtide' drugs of which there are several have side effects and are probably best avoided if possible. As usual LCHF plus Metformin are typically the best start point.

If recently diagnosed and unless HbA1c is through the roof why take metformin? My HbA1c went from 53 to low 40s within the first three months just by low carbing.
Some might take longer, but early diagnosis appears to be the key to a fast reduction without drugs?