In the Houston Chronicle, People's Pharmacy columnists Joe Graedon and Teresa Graedon remember a drug scandal from 1970 that mirrors today's Avandia troubles almost exactly. Orinase, a popular diabetes drug was found to be increasing the very heart trouble it was designed (and marketed) to prevent.

Orinase's active ingredient is tolbutamide, a substance that stimulates the pancreas to produce insulin. According to the Graedons, the heart damage being caused by Orinase-takers was first revealed by the University Group Diabetes Program in 1970 following an extensive analysis of diabetes care in the US. Like the Avandia controversy, experts also debated the results of the University Group's conclusions on Orinase, yet it was more or less eventually accepted as fact that drugs belonging to the class sulfonylureas, including tolbutamide, do indeed increase the likelihood of heart problems. I say "more or less" because many authorities still hedge their bets. Example? The health site Drugs.com copies info on Orinase provided by Thomson Healthcare/Micromedix. According to that source, sulfonylureas, have been "reported, but not proven in all studies, to increase the risk of death from heart and blood vessel disease." [My emphasis.] This, thirty-seven years after the release of the study demonstrating such risk!

Orinase is still prescribed in certain situations. Is Avandia destined to end up sidelined, yet still on the market, like Orinase? Seems to be headed that way. In the meantime, the unfortunate reality is that new drugs will continue to be rushed to market and serious side effects discovered (or made public) only after they have been prescribed to thousands of people. The fact is, today's high-tech (and high-priced!) wonder drugs all come with a dose of risk.

Several commonly used drugs have adverse effects on glucose metabolism. Among these drugs are: aspirin, and an antibiotic.

Aspirin is a commonly used drug to relieve minor aches and pains, to reduce fever, as an anti-inflammatory and as a blood-thinner. However, studies show it leads to glucose metabolism impairment in insulin-sensitive tissues. A 3g daily dose of aspirin was administered over a three-day period. Although insulin release increased after the aspirin, the glucose remained unchanged. Despite the increased insulin, the body seemed to decrease cellular sensitivity to insulin in the aftermath of aspirin.

A healthcare facility in Scottsdale, AZ advises doctors to avoid giving gatifloxacin to patients with diabetes. They suggest selecting an antibiotic other than a fluoroquinolone for an elderly patient with diabetes, especially those taking sulfonylureas. Beyond elderly diabetics, any person who has recently undergone treatment with an antibiotic in the fluoroquinolone family should raise questions if they are diagnosed with diabetes or deemed pre-diabetic. Drugs included in this family are: Cipro, Ciproxin, Enroxil, Penetrex, Megalone, Maxaquin, Noroxin, Quinabic, Janacin, Floxin, Oxaldin, and Tarivid.

A new survey reveals that most people prefer to treat diabetes by changing their diets, rather than using medicines.

According to a survey of 1,022 adults (515 women and 507 men), 69% of Americans would prefer to try a dietary approach, whereas only 21% preferred treating diabetes with medicines. The survey reinforces results from clinical research on diabetes, which has consistently found that people with diabetes adapt well to low-fat vegetarian diets and gain important health benefits. A dietary approach to diabetes based on scientific research shows that a low-fat vegan diet can lower high blood sugar levels three times more effectively than oral medications.

Among the results: women are even more likely than men to prefer food changes over pills. People with more education and higher incomes were especially likely to favor a diet approach. For the financially savvy - this makes a lot of sense. You MUST buy food. You might as well buy healthier foods and curtail your Rx costs. Furthermore, Americans aged 45 to 64 were more enthusiastic about diet changes, compared with older Americans. I'll bet it's the convenience factor. A little less medication, a little more supper, please. The most pill-happy generation was the 18- to 24-year-olds. Don't look at me like that - I'm 28 and favor the flavor over medication, any day. Bon appetit!