Diabetes Drugs Associated with Heart Failure! Is there another way?

Recently the FDA has issued an alert about the possible connection between some diabetes medications and heart failure. The drugs in question, Onglyza and Nesina, are relatively new diabetes medications that have surged in popularity. These medications are among a class of dipeptidyl peptidase-4 inhibitor (DDP-4) drugs. 

The FDA is warning that these drugs may increase the risk of heart failure especially in those that are already vulnerable, namely those with existing cardiovascular or kidney disease. There are also combination medicines (Kombliglyze and Kazano) that have these medicines in them. 

This announcement follows the review of two cardiovascular-outcomes trials. In one of the trials there was a 27% increase in the rate of the first hospitalization for heart failure and possible increase in all-cause mortality. A third trial involving another DPP-4 inhibitor called Januvia appears to not show the same issue although I would be skeptical of prescribing that medicine as well considering it is in the same class of medicines.

This announcement re-emphasizes that need for patients to seek alternative means of treating their diabetes.

However, the real focus should be on prevention. Insulin resistance and elevated insulin levels precede the development of diabetes by many years. See the chart below. 

From the illustration above we can see that significant elevations of glucose are not seen until it is almost too late which is well after someone has had significant elevations in insulin and insulin resistance for 10-20 years.

The key is to get properly screened. Unfortunately, most physicians are not screening their patients appropriately. A simple blood sugar test or A1C is not enough as significant elevations in these tests don't happen until someone is well down the road already. 

The fact is that simple measurements of a person's insulin level and various other factors when they are younger can help tell us if someone is going down the wrong path. Based on the results of those tests changes can be easily made in someones dietary habits to stop this disease in its tracks. And Diabetes is not just about insulin. Consistently elevated blood sugar adversely effects nearly every organ in the body.  

If you have not been screened properly for insulin resistance or diabetes I would urge you to do so as soon as possible. There is no reason to suffer the terrible consequence of diabetes. 

For those that want to get screened for insulin resistance and or be treated for diabetes without dangerous drugs feel free to reach out to me for more information. 

Of course, each individual case is different and the advice in this post should not be a substitute for getting a consultation with your doctor. ​​