• Guest - w'd love to know what you think about the forum! Take the 2025 Survey »

Which reference says that antidiabetic drugs do not reduce mortality and morbidity?

Rabdos

Well-Known Member
Messages
404
Type of diabetes
Type 2
Treatment type
Diet only
Hello

I read here and there that antidiabetic drugs do not actuallly reduce mortality and morbidity and thus, while they do reduce HBA1c, they do not have an actual health benefit.

Is there a conclusion for this or is it a debate?

Are there any strong references that show the inefficacy of the antidiabetic drugs?

Thanks!
 

Hi there, which drug in particular?, I would have thought the actual lowering of your hb1ac IS a health benefit otherwise why are we all bothering? x
 

Hi,

Could you provide links refferencing to where you read this..?
 
Well, personally, and tongue in cheek because I'm T1 and I know you mean T2, I would have died 50 years ago without insulin, so I'm a big fan of that anti-diabetic drug.

I agree with @KK123, anti-diabetic drugs reduce hba1c so at least in the short (and medium?) term they do help. The issue for many T2s is that they are part of a treatment for a slowly deteriorating condition. Without the drugs, the patients would be sicker and dead sooner, so the drugs do improve mortality. (Remember, we all end up dead eventually, even if it's the age of 110 after running a marathon in record time.) It's not that they make things worse, it's that reducing carbs can make things so much better. And you've got to remember that there are a lot of folk out there who do fine by reducing their carbs a bit and taking the medication.

I am an advocate to the T2 low carb approach (just ask my dad who's off T2 meds after ten years) but it's not for everyone and there's nothing wrong with getting some medication help. Some people need insulin even if they go low carb (you can argue about whether they are misdiagnosed T1 or whether there insulin producing cells are worn out), and I don't think anyone should be made to feel inferior because they still need a bit of medical help. It's a metabolic disorder, everyone's metabolism is a bit different, what works for one person does not necessarily have the same result for another.
 
Rabdos said:
I read here and there that antidiabetic drugs do not actuallly reduce mortality and morbidity and thus,
Click to expand...

Obviously my one observation isn't proof of anything, but my father, a skinny individual until his diabetic diagnosis, was type II for the last 40 years of his life. He passed away last year at the age of 93 because he asked for palliative care only having developed pneumonia while in hospital after a very minor stroke.
 
Jason Fung provides a referenced top level discussion of the diabetes drugs (The Good, The Bad, THe Ugly) in his book The Diabetes Code. He is biased towards low carb/fasting as a better option because as a nephrologist he has seen how ineffective many drugs are for type 2.
The bar for these drugs being allowed onto the market is low e.g. they must show only a tiny reduction in HBA1c to prove efficacy.
Prior to the discovery of a way to get insulin extracted from dogs' pancreases in 1922, diabetics were given low carb diets. Insulin saved lives of type 1s but doctors noticed that both types of diabetics still died early of kidney and heart disease or other co morbidities so it has been known that insulin alone tends to inrease the root cause of type 2 - insulin resistance whilst simultaneously treating the symptom - high blood sugar. The same applies to the drugs which help the pancreas produce yet more insulin. This was shown in various trials about 10 years ago when they monitored the effects of very tight control using drugs compared to normal monitoring (Accord study). Those taking plenty of drugs and getting very tight control of their blood sugars did not better than patients who had an hba1c of 10+ yet doctors still focus on blood sugars as the marker of success in treating type 2s.
The newer classes of drugs have better outomes with regards to the diabetic complications because they work on the basis of eliminating glucose from the body via the kidneys nut as has been pointed out surely the better way to achieve the same result is not to eat the glucose in the first place.
Fung's analogy is that if your house is flooding (your cells are overflowing with glucose) you turn off the ta ( (cut carbs or fast). You don't tinker with widening the drain (taking drugs)! Yes I know there are better drugs such as metformin and the sglt2 inhibitors but these surely have to be taken as an adjunct to diet.
 
I'd not imagine there is such a thing as an 'antidiabetic drug', I inject insulin to replace the stuff my body stopped making, insulin's a protein not a drug and without it I'd have died within a month of diagnosis and that was nearly 36 years ago so does seem to have reduced my mortality somewhat....

 
porl69 said:
Anti diabetic drug? hmmmm the only ones I am aware of are Insulin, Metformin and Gliclazide.
Any references to the other "miracle" drugs??
Click to expand...
I take bydureon and Dapagliflozin (as well as metformin) There is also victoza and probably quite a few others
 

Hi Rabdos,

What you are looking for is probably the ACCORD trial. This was a trial done on T2s to see if lowering average blood sugars (HbA1c less than 6% rather than 7 to 7.9%) by intensifying the adminstration of blood glucose lowering drugs leads to a lower incidence of cardiovascular disease. What they did find, however, was that in the intensive treatment group mortality increased compared to the control group.

Here's a link: https://www.nejm.org/doi/full/10.1056/NEJMoa0802743
 
Thank you, this trial seems to be the basis of what I am reading.

However, what is the latest status of the debate? Is there a review of what is currently believed that antidiabetic drugs achieve and what not? In terms of mortality and morbidity?
 
You must log in or register to reply here.
Menu
Log in
Register
Cookies are required to use this site. You must accept them to continue using the site. Learn More.…