Tag Archives: hazard

Chubby Neck Becomes the New Normal


After reading the latest research on the metabolic hazards associated with chubby necks I am more sensitive to the size of people’s necks then ever. Of course I look at the size of my patient’s neck but people who I pass in the street or supermarket may find me staring. Watching TV a few days ago I was startled by a series of people in one commercial for Quicken Loans who definitely qualify for the metabolic high risk category based on neck chubbiness. One after another the characters in this commercial walk on, outdoing each other in this physical trait. Has the chubby neck become the new normal? If so, the incidence of diabetes and heart disease is sure to continue to rise.

Let me know if you agree with my impression, or am I biased by being an endocrinologist?

Gary Pepper, M.D.
Editor-in-chief, Metabolism.com

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Old, Old News About Diabetes Medicine Danger Makes Headlines Again


In 2007 I published an article entitled, “Old News About Avandia and Actos Makes Front Page New York Times”. This article criticized the media for publishing an old story about the potential danger of Avandia, then a popular diabetes medication. Even in 2007 the potential hazard of Avandia was a story which had been beaten to death by experts with the conclusion that the hazard of using this drug was probably exaggerated by a few vocal critics. Since then much more information has come to light supportive of the safety of using Avandia. Just a week ago the whole issue again made front page news, making it seem as if something new had come to light on the safety issue. Close inspection of the reports show this to be virtually the same information that existed in 2007 without the benefit of more recent information, but now rehashed by a congressional committee. So here we have it…old, old news making headlines again but unenlightened by the passage of another 3 years.

Here is the original story about “old news” which I published at metabolism.com in 2007

Old News About Avandia and Actos Makes the Front Page NY Times

Today’s NY Times carries a front page article about the dangers of Actos and Avandia, two popular diabetes medications. The reason behind the news story is that the FDA has finally required the two companies that make these diabetes drugs to carry a “black box” warning (the strongest labeling warning that can be applied) about the potential for congestive heart failure (overload of fluid in the heart and lungs) in diabetics using these drugs. Is this warning really news? Not to doctors.

I have been to numerous seminars on the use of these two diabetes drugs and have been paid by the companies that manufacture these drugs to educate other health care professionals about the use and hazards of these drugs. Both companies gave all representatives and speakers the strictest instructions regarding their obligation to carefully mention the potential for fluid overload and congestive heart failure associated with the use of these drugs. I know that my colleagues, particularly the cardiologists (heart doctors) and endocrinologists (diabetes doctors), have been acutely aware of this information for years.

Did you know that the type of drugs known as sulfonylureas that have been used to treat diabetes since the 1960’s and remain popular today carry a “black box” warning since the 1970’s about the potential for causing heart disease? This class of drug include Diabinese, Orinase, DiaBeta, Micronase, glyburide, and glipizide. Why are these drugs still in widespread use, and where are the stories notifying the public about this? What’s the big deal about the black box warning on Actos and Avandia?

I think I smell some politics going on. The Commissioner of the FDA, Dr. von Eschenback, was appointed by President Bush in 2005. The harshest critics of the FDA on this issue are the Democrats on the House Panel. Coming out of the woodwork are various “injured” parties who were criticised by company representatives for speaking out against these drugs in 1999. These stories warrant a separate column in The Times today.

Are there real risks to taking Actos and Avandia in the treatment of diabetes. Of course there are, just as there is a real risk of treating diabetes with just about any drug. It is up to the medical profession to remain vigilant and educated about these risks and to balance them with the benefits. Inflammatory front page news stories which create an atmosphere of mistrust and hysteria may serve only narrow political purposes.

This blogged comment at metabolism.com is not intended to convey medical advice. Diabetics are encouraged to contact their own healthcare professional about advice about what to do at this time. Most authorities encourage the public not to panic and to wait instructions from their physician before altering their medical treatment.

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