I Told You So: A Work-Related Divergence

Some time in the future there will be a big story in the Press that I was warning everyone about for quite a while already.  Pharmaceutical Companies will be under scrutiny for withholding evidence of major side-effects of very popular drugs.

Not that that is new.  Happens all the time.  Side effects can occur with any medication.  But when evidence of significant side-effects are found, and the companies quadruple advertising for the drugs, something smells very fishy.  The rush to cash in on the incredible R&D costs of blockbuster drugs outweighs the risks of selling risky medications to a blind public.  And blindness may very well be an end result of the fiasco???  But that isn't my field.  I deal with the foot, which is incredibly complicated enough as it is.  And I have seen a substantial increase in the need for amputations in diabetic patients, especially those taking the newer diabetic drugs with their miracle lowering of A1C levels.  You've seen the ads on tv, with catchy songs and happy people...

In the preceding 10 years, I probably did a handful of amputations.  But so far this year I have done 9, with another one tomorrow.  Thare are other factors involved in this, but I feel the most important reason is the explosion in the use of the newer class of diabetic drugs which cause the kidneys to rid the bloodstream of glucose.  Unfortunately, a side effect of this has already been proven with one drug and the ambulance chasers of the world have already begun soliciting clients.

The side effect of these medications is that they thicken the blood, causing reduced blood flow in the "end organs", which happens to be the toes in my profession.  Combine that with the other effects diabetes bestows on patients and the end result is infections, osteomyelitis (bone infection) and the need for amputations in diabetic patients with "good" A1C levels.  Other targets of diabetic vascular problems are the eyes and kidneys.  I am not sure if problems are occurring in these specialties, but I will bet they are.

Here's another scary "end organ" problem with inceasing prevalence in those taking these medications...

Widely Used Diabetes Drug Can Cause Flesh-Eating Genital Infection

The mechanism of action is probably the same thickening in the blood causing sluggish circulation, but the bacteria involved is sometime markedly different!