House Calls, a popular newsletter written by the prestigious Dr. Inglis, highlights a very important question in light of the Avandia mishap: how many other potential whistle-blowers are out there who have been silenced into submission before the Big Pharma vultures?

A medical expert testified that he agreed to sign a statement that was meant to appease the company's investors. This is not the type of behavior anyone should expect or dismiss of a doctor, entrusted with a patient's life. In his defense, he did forward a letter with his concerns to the FDA, which means they also were aware of the same threat. This same doctor is the President-elect for none other than the American Diabetes Association. Isn't that special? The ADA -- my friend, my confidant, my utter supporter of the C-peptide crusade ... sense the sarcasm? So much for advocacy, when the president-elect of this organization so willingly swept those safety concerns under the table, when he should have been throwing a tantrum on top of it! And all over the threat of litigation from a drug company more concerned about its investors than patients.

The closing comments in Dr. Inglis' newsletter say it all: There are so many vultures out there waiting to pick the bones of the American public, it disgusts me. This example goes to show why I always recommend to you -- and to all of my patients -- that you always question everything when it comes to your health. I don't care if it's your doctor you've had for 50 years or one of these nonprofit organizations -- give them all hell.

Neuropeptide regulating appetite may help in developing new diabetes treatments. The neuropeptide called melanin concentrating hormone (MCH) plays a role in the growth of insulin-producing beta cells and the secretion of insulin. MCH is found in the brain and regulates energy balance and appetite.

A previous study conducted at Joslin found an association between high levels of MCH and an increase in the number of beta cells in mice. When we eat food, our body needs more insulin. When MCH induces appetite, it simultaneously increased insulin secretion. This calls upon the beta cells and enhances their growth. If the proteins that mediate the growth mechanism can be identified, it could lead to the development of new drugs that would enhance beta cell growth to treat type 1 and type 2 diabetes.

Sounds great! However, this sounds similar to the function of SYMLIN, which is the synthetic form of amylin. Amylin is a hormone secreted by beta cells at the same time as insulin. If you've heard of Byetta - you've heard of Amylin Pharmaceuticals, the makers of SYMLIN. The researchers at Joslin and the guys at Amylin should get together and do lunch. They might have a lot to discuss between this research and the development of yet another biotechnological blockbuster drug.

It hasn't gone unnoticed - the cost of healthcare is rising, diabetes diagnoses are rising, the pharmaceutical industry has dramatically increased its investment in research and development -- but that has not translated into more new treatments.

Between 1993 and 2004, funding for new drug applications submitted to the FDA increased almost a 150%. However, the number of new drug applications increased only 38%. Of those applications, only 7% were for innovative drugs with new ingredients. The Government Accountability Office (yes there is such a thing) says the reason for unimpressive returns on medical research funding dollars is due to the difficulty of developing new treatments, combined with marketplace pressure to produce blockbuster new drugs.

The phenomenon known as "me too" drugs (where companies produce drugs similar to drugs already on the market) has also become much more common. These drugs offer little in the way of innovation. However, despite the economic challenges of bringing new and innovative drugs to market, the pace of scientific discovery has increased substantially in the past 10 years - 56 diabetes drugs in development, alone. As the cost of discovering new medicines rises, it becomes more difficult for drug companies to recover these costs. It seems the research dollars are plentiful but ideas for new drugs can't compete with all the profit-decaying hurdles along the way. It's not a problem of interest until it's your own. I wouldn't wish diabetes on anybody-- even those who care more about the profit margin versus the quality of life of the person taking the pill.