The BMJ (British Medical Journal) and Channel 4 programme Dispatches are posing questions on
whether some diabetes medications might be, in the long run, harmful to
patients’ pancreases. Specifically, the journal, along with the television
programme, is concerned about the group of drugs called incretins and incretin
mimetics. This cluster includes both dipeptidylpeptidase-4 inhibitors (DPP-4)
and glucagon-like peptide-1 (GLP-1) agonists. Both types of medication have an
impact on glucagon and insulin production.
The BMJ and Dispatches
are citing Peter Butler, a researcher from the University of California, who
found that animals’ pancreases are negatively affected when GLP-1 is administered.
His research also highlights the possibility of a higher pancreatic cancer
risk. Our understanding is that Professor Butler accepts that his research has
limitations and should be interpreted with caution. The manufacturers believe
that an unwarranted public health scare could ensue.
Both the Food and Drug Administration (FDA) and the European
Medicines Agency (EMA) have stated that the evidence cannot be interpreted as
proving a definite causal link. The research does not establish that the risk
of pancreatic cancer, or other pancreatic damage, is caused by the incretins
and incretin mimetics rather than any other factors, such as the diabetes
itself. All the pharmaceutical companies involved in producing the drugs have
also said that they constantly monitor the situation and are continually
gathering long-term, detailed data. It
is our understanding the European Medicines Agency is due to review more data
on this group of medicines later in the summer.
What should be stressed is that the evidence being presented
is based on rodent studies. There does not appear to any evidence of pancreatic
cancer in human studies, although doctors are asked to be alert to the possible
symptoms of pancreatitis.
The medication is used by people with type-2
diabetes who do not respond, up to certain standards, to the first line of
medication and Liraglutide is also prescribed off-label as a weight loss aid. If
you are currently taking this kind of medication and you are worried about
taking it, you should speak with your doctor. You should definitely not stop
taking the medication without seeking medical advice. Also remember to report any side effects that you
experience to your healthcare provider. You can read BMJ’s full article here.