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The BMJ (British Medical Journal) and Channel 4 programme Dispatches are posing questions on whether some diabetes medications might be, in the long run, harmful to patients’ pancreases. Specifically, the journal, along with the television programme, is concerned about the group of drugs called incretins and incretin mimetics. This cluster includes both dipeptidylpeptidase-4 inhibitors (DPP-4) and glucagon-like peptide-1 (GLP-1) agonists. Both types of medication have an impact on glucagon and insulin production.

The BMJ and Dispatches are citing Peter Butler, a researcher from the University of California, who found that animals’ pancreases are negatively affected when GLP-1 is administered. His research also highlights the possibility of a higher pancreatic cancer risk. Our understanding is that Professor Butler accepts that his research has limitations and should be interpreted with caution. The manufacturers believe that an unwarranted public health scare could ensue.

Both the Food and Drug Administration (FDA) and the European Medicines Agency (EMA) have stated that the evidence cannot be interpreted as proving a definite causal link. The research does not establish that the risk of pancreatic cancer, or other pancreatic damage, is caused by the incretins and incretin mimetics rather than any other factors, such as the diabetes itself. All the pharmaceutical companies involved in producing the drugs have also said that they constantly monitor the situation and are continually gathering long-term, detailed data.  It is our understanding the European Medicines Agency is due to review more data on this group of medicines later in the summer.

What should be stressed is that the evidence being presented is based on rodent studies. There does not appear to any evidence of pancreatic cancer in human studies, although doctors are asked to be alert to the possible symptoms of pancreatitis.

The medication is used by people with type-2 diabetes who do not respond, up to certain standards, to the first line of medication and Liraglutide is also prescribed off-label as a weight loss aid. If you are currently taking this kind of medication and you are worried about taking it, you should speak with your doctor. You should definitely not stop taking the medication without seeking medical advice. Also remember to report any side effects that you experience to your healthcare provider. You can read BMJ’s full article here.

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