How do I weigh up taking a diabetic medication that could cause cancer?

[Wraakian]

The diabetic doctor has offered to put me on pioglitazone but I have recently read that this has been linked to bladder cancer? My understanding is that the control of my diabetes far outweighs the risk of taking pioglitazone but I would still worry about such a trade off. I would like to ask what do other diabetics who are on this medication think about it?

 

[Bluetit1802]

Perhaps go back to your doctor, ask why he has put you on this, and discuss the possible side effects. I can't say I'd be very happy. It isn't the only drug to help you control diabetes. Diet helps just as much.

https://bnf.nice.org.uk/drug/pioglitazone.html

 

[lindijanice]

Hey Wraakian, not knowing if you are well controlled or not, what other diabetes meds you may be on, I would have to agree with Bluetit1802 that there are many other drugs that could be tried. Yup, a call or trip back to see your Doc, I would say! When there are known links like that with a drug, it boggles my mind that it would be suggested....Cheers/L

 

[DCUKMod]

The diabetic doctor has offered to put me on pioglitazone but I have recently read that this has been linked to bladder cancer? My understanding is that the control of my diabetes far outweighs the risk of taking pioglitazone but I would still worry about such a trade off. I would like to ask what do other diabetics who are on this medication think about it?

Wraakian, at a recent presentation an Endocrinologist stated there are over 400 options for diabetes medications. To be clear that's 400, including combinations and variants, but what that says to me is that it's unlikely the addition of Pioglitazone is the only option for you.

One thing I would say is if the risks of developing cancer were significant, it would not be authorised in this country. That said, insignificant os no consolation to the person finding themselves inpacted by it.

Sounds like another chat with your Doc could be helpful.

Good luck with it all.

 

[Guzzler]

I found this BMJ article which mentions an alternative drug of the same class. After reading this I am not sure that I would be comfortable with taking Pioglitazone either even though the risk is very small.

http://www.bmj.com/content/352/bmj.i1541

 

[Dark Horse]

This meta-analysis from last year states that "there is no link between long-term use of pioglitazone and bladder cancer" and that "the explanation of hypothetically increased risk of bladder malignancy should be attributed to other factors".
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5544610/

This systematic literature review and meta-analysis,also from last year, "observed a small but statistically significant association between ever (vs. never) use of pioglitazone and bladder cancer risk; however, causality is not established and one cannot rule out alternative explanations". They went on to say, "Importantly, when studies without adjustment for lifestyle factors were excluded, the effect size was not statistically significant."
http://www.encepp.eu/encepp/openAtt...WESKC_xFVrqaOVJU4oKu6oBv2XA3oQ0l6Lc!298584184

 

[Wraakian]

The diabetic doctor has offered to put me on pioglitazone but I have recently read that this has been linked to bladder cancer? My understanding is that the control of my diabetes far outweighs the risk of taking pioglitazone but I would still worry about such a trade off. I would like to ask what do other diabetics who are on this medication think about it?

 

[Wraakian]

Thanks guys, This change of medication is due to my being diagnosed with having a rare type of diabetes and not the type 2 that I had been told I had 30 years ago! My diet is low carb and very healthy and apart from diabetes I am officially very healthy and fit for my age as my annual GP review came out excellent and I exercise regularly. I am awaiting a letter from the hospital diabetic doctor with more details but as I am now coming up to 71 years of age going onto pioglitazone isn't something I'm looking forward to. I will take a look at other similar drug alternatives that do the same job but might be safer. I also realise that some reports can be over the top where heart or cancer episodes are of little or no risk but it still plays on your mind if you have to go on such drugs! Thanks again everyone ... Much appreciated!

 

[DCUKMod]

Thanks guys, This change of medication is due to my being diagnosed with having a rare type of diabetes and not the type 2 that I had been told I had 30 years ago! My diet is low carb and very healthy and apart from diabetes I am officially very healthy and fit for my age as my annual GP review came out excellent and I exercise regularly. I am awaiting a letter from the hospital diabetic doctor with more details but as I am now coming up to 71 years of age going onto pioglitazone isn't something I'm looking forward to. I will take a look at other similar drug alternatives that do the same job but might be safer. I also realise that some reports can be over the top where heart or cancer episodes are of little or no risk but it still plays on your mind if you have to go on such drugs! Thanks again everyone ... Much appreciated!

Hi again, Wraakian - What sort of diabetes have you been diagnosed with? It's always good to understand the variants, and there certainly seem to be a few!

 

[Wraakian]

Hi again, Wraakian - What sort of diabetes have you been diagnosed with? It's always good to understand the variants, and there certainly seem to be a few!

Hi and thanks for following up on this issue. I was supposed to have had a letter from the hospital 2 weeks ago from the diabetes doctor, my having had various blood tests to find out if I have a rare type of diabetes and not type 2 but this wasn't forthcoming. I rang 3 days ago and they said it was sent to myself and my GP. When I telephoned the GP they had not had any letter either? The hospital told me they would fax the details through to my GP and send me a copy letter. I have not had the letter yet so do not know what the results were but my GP has had the fax now and will be sorting me out soon with the new medication. It could be that the tests showed either type 2 or some rare kind of diabetes as the hospital diabetic doctor suspected, I will post the conclusion when I receive the letter.

 

[Wraakian]

Okay, I have at last received the letter which briefly states my pancreas is still making reasonable amounts of insulin. It gives my blood results as ;-

HbA1c 53 mmol/mol
Chol 2.9
eGFR 72
Hb 146 g/l
Gluc 10 mmol/l
C-pep 1103 pmol/l
GAD negative

I do not know what all this means as the hospital doc has not said if I am type 2 or not in the letter so I'm guessing I must be type 2 after all and do not have any rare type of diabetes?

The hospital diabetic doctor has taken me off Liraglutide as she doesn't think that was doing any good at all and put me on just 15 mg Pioglitazone per day along with my other diabetic meds. My readings within 2 days of stopping the Liraglutide and starting Pioglitazone have shot up to just under 15 mmol/l on a low carb diet. I am trying to keep my carbs even lower but have informed the clinic (via answerphone message) of the higher readings and awaiting their reply. It said in the letter that I am currently on just 80 mg of Gliclazide twice daily and to increase the dose to 120 mg twice daily if my figures are still high but they have it wrong as I have already been told to increase my Gliclazide to 120 mg twice daily and have been on that dosage for some time now. My Metformin is also at its highest permitted dose of 1000mg twice daily so I can only think that they will slowly increase the dosage of the Pioglitazone to a max of 45 mg a day if my readings remain high. I had low sugar baked beans with a little cheese this morning (without bread or toast) plus a coffee and for lunch had homemade vegetable soup with turmeric. I will stick to meat or fish for tea with a few sweet potato fries and possible peas and see what the end results are for the day, my readings may come down a little but I don't really think they will be under 10 mmol/l. Hopefully the diabetic team at the hospital will come back to me to let me know what I should do now?

 

[lindijanice]

Hey Wraakian, I can't comment on your insulin or other drugs as only on Metformin myself. Hope you get things sorted out. However, just seeing what you plan to eat today is Carb City - beans, sweet potatoe fries, peas, veg soup contain root vegs like carrots, parsnips, potatoes?? Please get yourself a Carb Counter book or go online and find a carb counter, so that you can begin to see that carbs are in loads of things that we may even think as "healthy" but for us diabetics, aren't!! It's a marathon and a ton of things to learn what works for us individually....some can tolerate more carbs than others, but with your numbers I would guess that you are too high in carbs to get the results you are looking for.....Blessings/L

 

[rmz80]

Was this diabetes doctor you saw a consultant Endocrinologist?

 

[johnpol]

I was on pioglitazone and Metformin together to combat my Insulin resistance, pioglitazone can take a few weeks to build up in the system, same goes when you come off it takes a while to leave it. I must admit that I did feel that it wasn't doing much for me, but when I stopped taking it as my insulin usage was slightly decreased, and readings ok, they both crept up so back on it. I was on them for a while and now been changed to a different drug all together.
not very helpful I know

 

[Wraakian]

Hey Wraakian, I can't comment on your insulin or other drugs as only on Metformin myself. Hope you get things sorted out. However, just seeing what you plan to eat today is Carb City - beans, sweet potatoe fries, peas, veg soup contain root vegs like carrots, parsnips, potatoes?? Please get yourself a Carb Counter book or go online and find a carb counter, so that you can begin to see that carbs are in loads of things that we may even think as "healthy" but for us diabetics, aren't!! It's a marathon and a ton of things to learn what works for us individually....some can tolerate more carbs than others, but with your numbers I would guess that you are too high in carbs to get the results you are looking for.....Blessings/L

Many thanks, usually low sugar baked beans don't raise my bloods and the soup veggies were mostly low carb content, I thought sweet potato chips were supposed to be better than normal chips but I will look at getting a carb counter book to help get a better handle on things. Thanks again ... much appreciated.

 

[Wraakian]

I was on pioglitazone and Metformin together to combat my Insulin resistance, pioglitazone can take a few weeks to build up in the system, same goes when you come off it takes a while to leave it. I must admit that I did feel that it wasn't doing much for me, but when I stopped taking it as my insulin usage was slightly decreased, and readings ok, they both crept up so back on it. I was on them for a while and now been changed to a different drug all together.
not very helpful I know

Every little helps John so thank you ... I will see what happens as the week progresses ... my bloods came down to 9.9 mmol/l tonight o though still high they're at least coming down a little. Thanks again John.

 

[Wraakian]

Was this diabetes doctor you saw a consultant Endocrinologist?

Yes, a very young but efficient and thorough one.