How Diabetes Topics in the News Can Start to Feel Like a Game of “Telephone”

Diabetes Health writer Patrick Totty wonders if the Byetta “controversy” is largely a media creation. Has the threshold for controversy these days stooped so low to reach so high?

Oct 27, 2008

A recent Wall Street Journal article shows once again how misinformation about diabetes-related topics can be spread by even the most expert journalists.

The article, headlined "Eli Lilly to Pay for Right to Sell Diabetes Treatment Outside U.S.," begins, "Eli Lilly & Co. will pay Amylin Pharmaceuticals Inc. for the right to sell a controversial diabetes treatment outside of the U.S." (our italics)

The article discusses Lilly purchasing the right to sell a long-acting form of Byetta outside of the United States. Byetta, the brand name for exenatide, has approximately 700,000 users in the United States. Introduced in 2005, it is a proven means of controlling blood sugar levels in people with diabetes and helping many of them lose weight.

The version Lilly will sell abroad, called Byetta LAR and taken once weekly, is now undergoing the approval process by the U.S. Food and Drug Administration. 

The article jumps the track when it notes that when Amylin reported that Byetta performed well against a rival drug, Januvia, "that news came after recent reports of deaths from severe pancreatitis in patients on currently marketed twice-daily doses of Byetta. Amylin has repeatedly stated there is no proven relationship between Byetta and pancreatic side effects."

Those two sentences are the vaunted "balance" that journalists always talk about when they write a "he said/she said" piece.

Here's the problem with it:

  • The source of the "recent reports"-the FDA-is never identified.
  • The number of deaths from severe pancreatitis in patients taking Byetta is not mentioned (six).
  • The number of people taking Byetta who have also experienced severe, but not fatal, pancreatitis is not mentioned (30).
  • The total number of people taking Byetta is never mentioned (approx. 700,000).
  • The difference between correlation (taking Byetta and later getting severe pancreatitis) and causation (taking Byetta and therefore getting severe pancreatitis) is never mentioned or explored. 

Admittedly, the article's writer was probably facing space constraints and had to resort to the shorthand explanation above. The problem with that shorthand is it soon becomes an accepted stand-in for more thoughtful and thorough explanations of controversial topics.  

In fact, the "controversy" is largely a media creation. Even if Byetta could be proven as the cause of six fatal cases of pancreatitis among several hundred thousand users over a three-year period, we are talking about roughly one in every 116,000 users. 

Is the threshold for controversy these days that low?

Disclaimer: Contributing writer Patrick Totty has type 2 diabetes and takes metformin and a sulfonylurea. He has never taken Byetta. He has no investments in and no personal or professional relations with Amylin or Lilly. He dislikes junk science and hates to see it repeated in a good newspaper like the Wall Street Journal.

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Categories: Blood Sugar, Byetta, Community, Diabetes, Diabetes, Food, Losing weight, Politics, Type 2 Issues

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Posted by Anonymous on 28 October 2008

Good article. One point to keep in mind is that this is not unusual for the media. This is not to make an excuse for them, but it is fairly standard operating mode even in writing about non-technical topics.

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