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Feature Diabetes Drugs

Has pancreatic damage from glucagon suppressing diabetes drugs been underplayed?

BMJ 2013; 346 doi: (Published 09 June 2013) Cite this as: BMJ 2013;346:f3680

Re: Has pancreatic damage from glucagon suppressing diabetes drugs been underplayed?

The British Medical Journal has dedicated 6 pages of print, 2 editorials, has worked with television in producing a programme on Channel 4 (Despatches) and produced a video, all on the topic of the dangers of using the incretin based treatments for management of diabetes. There are 2 major strands to this published material : firstly that the pharmaceutical companies involved have suppressed important safety data and secondly that these agents are unsafe. It is unclear which of these issues the editorial team is pushing so urgently.

There are several brief points to be made in the face of this barrage of comment.

Firstly, those of us in the field of clinical diabetes management have been aware of these issues from the outset, regardless of what the manufacturing companies may or may not have published. We recognise that new medications do not have extensive safety data behind them and advise patients accordingly. I note that the same issue of the BMJ has an item in the news section on a possible cancer risk associated with angiotensin receptor blockers, so we all know that new safety data accumulates with increasing patient exposure. There is no need to invoke conspiracy theories.

The second point is to question the editorial direction of the Journal. The published material comes from the Journal’s investigative journalist. Many of us are surprised that there is a role for such an entity on the staff of a scientific journal. There is a place for reviewing the safety of pharmaceutical agents in a balanced fashion, and there may be a place for discussion of the pharmaceutical companies’ obligation to publish all their data on file. What is surprising, however, is the launch of a very high profile and unscientific ‘campaign’ against a particular group of pharmaceuticals, with a failure to engage in a full discussion of risks and benefit. This has not been helpful to healthcare professionals or public. Does the British Medical Journal consider itself a scientific journal or has it become part of the lay press, without the need for balanced discussion and peer review ?

Competing interests: No competing interests

18 June 2013
Patrick S Sharp
Consultant Physician
Solent NHS Trust
Southampton General Hospital SO16