Alternatives to diabetes medication Avandia

NEW YORK

Avandia for diabetes control is now under restriction by the Food and Drug Administration for use only if other drugs fail.

Arthur Lewis uses Actos right now. It is in the same family of drugs as Avandia, but has no heart risk. But like Avandia, Actos retains fluid.

"It put a lot of weigh on, probably about 15 pounds," said Lewis.

Actos can also increase the risk of bone fractures, and the extra fluid can cause heart failure in people with weak hearts.

Dr. Steven Nissen, of the Cleveland Clinic, knows these drugs. He did the studies that found Avandia's heart risks.

"There are about 12-13 classes of drugs to reduce blood sugar that don't have evidence of doing harm to the heart," Nissen said.

Mr. Lewis takes a pill from one of these classes of drugs - Januvia. Januvia and Onglysa are in the same class - drugs that increase insulin and reduce sugar release in the body. They can be taken with older drugs such as Metformin.

"They're fairly new drugs and we don't know what going to happen in 8-10 years, as we saw with Avandia," said Dr. Stuart Weiss of the NYU Langone Medical Center.

Side effects are minimal, perhaps a runny nose.

Two drugs to control blood sugar are used by injection - and they are not insulin- but they reduce blood sugar, and even better, curb appetite.

Victoza and Byetta may be good news for overweight patients who must drop pounds to control diabetes.

And patients now on Avandia? Dr. Nissen has some advice.

"There are risks with stopping these drugs cold turkey, they can cause a spike in blood sugar," Nissen said. "But a good talk with your doctors- that is the right course of action."

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