People who take pills for type 2 diabetes may find themselves in an unexpected "good news-bad news" medical predicament.
Good news: Those diabetes-buster pills worked. Blood sugar levels have dropped to normal. Your risk of a heart attack and other health complications also has declined.
Bad news: You've mysteriously gained still more weight.
Remember, most people with type 2 diabetes got the disease mainly because they were overweight. That extra fat throws a wrench in the body's machinery for using insulin, causing blood sugar levels to rise. More fat they don't need.
Weight gain is an unwanted side effect of a popular family of anti-diabetes drugs called the glitazones. It has been such a well-kept secret that patients, suddenly fatter, often express utter disbelief that the medicine had such an effect.
Glitazone drugs are sold under the brand names Avandia and Actos. Another, Rezulin, was taken off the market two years ago because it sometimes caused liver damage.
Studies show that patients taking glitazone drugs experience weight gains averaging 2 to 12 pounds. Some individuals have gained 5 percent of their body weight. Weight gain can be rapid, occurring within a few months. In some patients, it continues as long as they're on medication.
Drug researchers even describe weight gain as the "glitazone paradox." Obesity is the leading cause of type 2 diabetes. Yet drugs used to control type 2 diabetes cause more weight gain.
The drugs work by making body cells respond better to insulin. But in doing so, cells also start sucking up and storing more fatty material from the blood.
Type 2 diabetes, also called adult-onset diabetes, occurs because cells lose the ability to respond to insulin, the hormone that allows the body to use sugar as fuel. Type 2 is the most common kind of diabetes, and is increasing at an epidemic pace around the world.
In contrast, type 1 diabetes usually begins during childhood or adolescence because the body stops making insulin. It requires insulin injections.
New government estimates say that 17 million Americans have type 2 diabetes, 8 percent more than the previous estimate. Another 16 million have elevated blood sugar levels, or "pre-diabetes," which sometimes is treated with pills.
People with type 2 diabetes should know that taking those pills may require more attention to diet and exercise than ever before to avoid gaining more weight.
Have your doctor explain the side effects before taking that first pill. Other drugs commonly used by diabetics also may cause weight gain.
Losing weight may be the treatment to try first. Even a 10- to 15-pound loss may drop your blood sugar to normal, eliminating the need for pills.
Michael Woods can be reached at mwoods@nationalpress.com or 1-202-662-7072.
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