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It seemed that every time we gave something a try and it didn’t quite work out, Mom and Dad always had a cliché at the ready to cushion the blow.
But what would Mom and Dad have to say about the AtLast alternate-site meter?
Or the GlucoWatch?
Or those needleless “jet” injectors?
For Every Good Innovation, There’s a Clunker
Ask any long-term diabetic what having the disease used to be like, and you’ll hear a laundry list of anecdotes that will make you look with a whole new light at your rapid-acting insulin, your designer type 2 drug or your meter that requires only a tiny speck of blood.
But not every innovation has been a boom.
In fact, there has been a fair share of busts.
We asked Diabetes Health readers to tell us what they thought were some of the biggest disappointments in the world of diabetes. Their responses were as interesting as they were varied.
The American Diabetes Association’s (ADA) Exchange Diet
For many people with diabetes, this was, and still is, the first dieting concept introduced to them upon diagnosis.
The ADA Exchange Diet advocates a diet low in fat, limited in protein and higher in carbohydrates.
“This is a recipe for unstable blood sugars,” says Carl Hanson of Grantham, New Hampshire.
Ann Armstrong, a reader with type 2 from Zionsville, Indiana, agrees. “Now, as we know, carb counting is far more important than was once thought, and diabetics used to be told to eat way more carbs per day than is now acceptable for good blood glucose control.”
Phil Snell, a type 2 from Salt Lake City, Utah, says that prescribing a diet of 180 to 200 carbohydrate grams per day is “the biggest disservice being done to those of us with diabetes.”
“If I did that, my blood glucose would be much higher than it is, and I would undoubtedly have to be on insulin.”
Vicki Abbott of Portland, Oregon, says the ADA exchange plan has caused more harm to people with diabetes than practically anything else she can think of.
“All this [diet plan] does is make BGs rise, with the need for more medication to stay in control.”
Only a few years ago, Cygnus’s GlucoWatch was supposed to be the greatest thing to hit the diabetes industry since the sliced bread recommended by the ADA exchange plan.
At diabetes conferences, lines to the Cygnus booth ran out the door as curious diabetics and healthcare professionals tried to get a glimpse of the wristwatch device that would measure blood glucose in the interstitial fluid and alert users to lows and highs with its alarms.
Then, in May 2002, the GlucoWatch was granted FDA approval, but there was also a hefty price tag for the watch and pads. In addition, reports of inaccuracies and skin irritation came out of the woodwork.
One reader calls the GlucoWatch “too cumbersome, irritating, expensive, inaccurate, painful and overhyped.”
People seemed to stop caring about the GlucoWatch, and Cygnus is rarely represented at diabetes conferences today.
The GlucoWatch is still sold, however, and on August 13, 2004, the Cygnus financial report stated that the company had only $47,000 in total revenues for the fiscal quarter ending June 30, 2004. Cygnus also posted a net loss of $2.4 million for the same time frame.
Needleless “Jet” Injectors
Designed for needle-phobic people, these jet injectors force a tiny stream of insulin through the skin by pressure rather than puncture.
The devices were large and cumbersome and sometimes caused bruising at the injection site. Even though the devices were needle-free, jet injector users would sometimes wonder if the pain of inconvenience was better than the pain of a syringe.
Daniel Barcus of Chicago, Illinois, says the jet injectors of the early 1980s needed to be wound up to be pressurized, loaded with insulin and pressed against the skin, where insulin would shoot in a very thin stream through the skin with almost no pain.
“Yeah, right,” says Barcus. “And if there was any little problem, such as not holding the device (which was really heavy) at a perfect 90-degree angle, then only some of the insulin would go in to you. The rest would spray all around the room. There was also no way to know how much insulin had been delivered and how much sprayed.”
Barcus adds that often the insulin from the needleless injector would make it only past the top layer of skin, and it would form a visible bubble right below the skin.
This drug for type 2 diabetes came on the market in 1997 and was hailed by type 2s and healthcare professionals for its ability to lower blood glucose and A1Cs by decreasing insulin resistance in the muscle cells.
Then, in 1998, reports began to surface that Rezulin (troglitazone) was causing liver damage in some users. After intense media scrutiny and more deaths as a result of liver failure, Rezulin was pulled from the market in March 2000.
Constance Etter of Winchester, California, calls Rezulin the biggest diabetes bust.
“It kept my blood glucose perfectly in line, but it could have killed me eventually,” she says. “What a letdown, after almost a year on it, and feeling good.”
Melissa Ford calls Rezulin the biggest diabetes bust for 63 reasons: “63 deaths!”
While Rezulin was the first drug in the new class of thiazolidinediones (TZDs, glitazones) to be approved by the FDA, it was then followed by the two currently approved TZDs, Actos (pioglitazone) and Avandia (rosiglitazone), which offer the benefits of decreasing insulin resistance without the high risks associated with Rezulin.
In the works for many years now, several companies are championing inhalable insulin. At present, there exists much favorable data demonstrating its ability to lower BGs in people with types 1 and 2 diabetes.
Unfavorable data, however, have surfaced in the past.
The December 2002 issue of Respiratory Medicine found that children with type 1 have an increase in airway resistance, and that “progressive abnormalities in lung function might interfere with the promising results of treatment with intrabronchial administration of insulin.”
Scott Strumello of New York City considers inhalable insulin to be a bust.
“How much money has been [wasted] away on this concept?” asks Strumello. “It is not better for treatment, it is merely designed to sell insulin to millions of type 2 patients who refuse to take insulin because they’re afraid of needles. Above all, at least in the first versions being studied, it does not provide basal coverage, so millions will still need to rely on shots.”
Strumello argues that if the money allotted to inhalable insulin research had been spent on “legitimate” research, “we would have a cure by now.”
Flawed Terminology for Diabetes
Pat Shermer of Livingston, Montana, offers a different take on the diabetes bust concept. She thinks that our diabetes terminology is a bust.
“I believe that the biggest wrong is that type 1 and type 2 diabetes are called by the same name,” says Shermer. “They are two very different diseases with some similarities. Very few people, in this world, even know there is a difference.”
Promises of a Cure
Surprisingly, many readers felt the biggest diabetes bust is the endless promises of a cure that have come down over the years.
The list, it seems, goes back as far as there has been a diagnosis for diabetes:
Gail Trenhaile of Omaha, Nebraska, was diagnosed with type 1 in 1980 and has been told ever since that time that a cure is “just around the corner” or “only 10 years away.”
“Do the math,” says Trenhaile. “Holding out false hope is cruel, especially for families with children with diabetes, and it is very defeating for fundraising purposes.”
Toni Fraser of Saint Regis Falls, New York, is the parent of two sons with type 1. She, too, agrees that promises of a cure are a bust.
“Diabetes is a mega-money-maker for the healthcare and pharmaceutical industry,” says Fraser. “Why would they want to cure it? They come up with more and more devices because those things can be sold. A cure will put an end to the cash flow.”
The 17 Biggest Diabetes Busts According to Diabetes Health Readers
Tell Us Your Diabetes Busts
Okay, we know you’re going to read this and ask, But what about . . .? and what about . . ?
We would love to hear your “what abouts.” Drop us a line and let us know. We’ll publish some of them in a future article.
Jan 1, 2005
Diabetes Health is the essential resource for people living with diabetes- both newly diagnosed and experienced as well as the professionals who care for them. We provide balanced expert news and information on living healthfully with diabetes. Each issue includes cutting-edge editorial coverage of new products, research, treatment options, and meaningful lifestyle issues.