Letters to the Editor

May 2006

May 1, 2006

Why Can’t Diabetes Get Better Coverage?

Last October was Breast Cancer Awareness Month. For nearly every day of that month, there were numerous and extensive reports on both local and network news broadcasts pertaining to virtually every aspect of breast cancer: research and recent developments, treatments, statistics, charities and personal stories, to name a few. A major road in my community was closed for a breast cancer walk.

Finally in November, Diabetes Awareness Month arrived. But on the news shows, I saw reporting on—breast cancer. I did not see one single report or item regarding diabetes. I know from reading literature in the diabetes community that there have been tremendous strides in the care and treatment of the disease. At the same time, however, diabetes continues to be a deadly disease.

Statistics from the U.S. Centers for Disease Control and Prevention (CDC) in 2002 reported that diabetes was the sixth leading cause of death listed on death certificates. These death certificates reflected that diabetes was the underlying cause of 73,249 deaths, and that diabetes contributed to 224,092 deaths.

The CDC reported that in 2002, breast cancer accounted for 133.6 deaths per 100,000 people, and the American Cancer Society (ACS) estimates that breast cancer will account for 40,410 deaths in 2005. My view may not be politically correct, and no one is denying that breast cancer is a horrible and deadly disease, but I do not understand why a disease that causes more deaths, not to mention devastating complications, is given minimal media and public attention.

Lane R. Zbar
Frederick, Maryland

Attention Should Be Paid for Test-Strip Costs

I am writing in hopes that we can get some media attention to the costs of glucose test strips for the major manufacturers of testing devices. They nearly give the devices away, but what good does that do if one is not able to afford the test strips? I see many celebrities [in your pages] who tell diabetics to check their blood glucose often. Most of these celebrities don’t have the financial restrictions that a lot of Americans have who can’t afford health insurance, let alone testing supplies.

There are not a lot of people out there who can help you if you are financially unable. What we need in this country is someone to take the war to the manufacturers to bring down the price for test strips. I mean, there are how many diabetics in the United States alone? You would think that someone like Wilford Brimley or another celebrity might lend their name not just to telling people to test more often but would go head-on with the companies that charge an outlandish amount for the strips to make it impossible for the majority of diabetics to test as often as they should.

Thanks for listening.

Robert Ross
Waldo, Arkansas

Dr. Edelman Calls Foul on Insulin Article

I felt compelled to write to you about the sidebar article, “Can Insulin Cause Cancer?” in the February 2006 issue of Diabetes Health.

Below are some of my points:

  1. This is very old news, published over five years ago. The alleged issue of mitogenicity stems from a June 2000 issue of the journal Diabetes in a study conducted by Peter Kurtzhals. The data were earlier reviewed and discounted at that time by major researchers and found to be “irrelevant” by the European Medicines Evaluation Agency (EMEA). The article gives the impression that these are, in fact, newly released findings. The data have never been duplicated in any other laboratory and there have been no recent publications at all that would even ignite the issue again. In addition, this rat model has been shown to be prone to cancer and not appropriate to simulate what happens in a human model. It is a stand-alone finding not seen in any other study or animal models. Do you even know what a cell line is? It is not even in a live animal!
  2. Major researchers have long disputed and refuted the data, including study author Kurtzhals, who claimed, “These findings were made in cell lines, and there is no experience to project these findings to risk in humans.” Nancy Bohannon claims the rats used in the studies were “very prone to certain types of cancer” and added that the “researchers were using specially bred rats that didn’t have insulin receptors”—a near-impossible occurrence in humans.
  3. Lantus is an analogue similar to Humalog and NovoLog and has been used in clinical practice for over five years in more than one million patients—as well as in more than 2,000 patients in clinical trials before its approval by the FDA—without any reported incidence of cancer. This does not include the numbers of users worldwide. A drug’s true side effect profile always comes out after it has been released to the open market for several years.
  4. The title of the article is clearly intended to incite and drive patients in to [see] their physicians, causing entirely unnecessary concern. In addition to creating fear and angst among people who depend on these insulin analogues, the article also has the potential to create a drain on scarce and costly healthcare resources, requiring physicians, diabetes educators and nurses to spend valuable counseling time reassuring patients. With managed care and the limited eight-minute-per-patient average visit, it is really inappropriate.

I do not understand what was the driving force behind [publishing] this old, irrelevant, irreproducible negative report in cell lines from cancer-prone rats about an insulin analogue that has been used safely worldwide in millions of people with diabetes with no evidence of cancer whatsoever.

Steven Edelman, MD
Professor of Medicine
University of California, San Diego
Veterans Affairs Medical Center
San Diego, California

Editor’s note: We really appreciate this letter. This article was thoroughly researched and fact checked and the personal and scientific sources are all credible. The data cited was the most recent data available to support the claims of the sources. If newer data becomes available supporting or refuting the claims of the sources, we will publish that as well.

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