THESE DRUGS NEED TO BE IN THE WATER SUPPLY!!
Before you read further, read Doug’s recent post about statins:
https://authenticmedicine.com/2022/03/the-statin-wars-this-is-going-to-be-fun/
To summarize a key point from his post: Statins may not be as wonderful as we believed.
Every several years, my specialty society releases something called MKSAP (Medical Knowledge Self Assessment Program). It is an intimidating stack of more than twelve volumes of topic review and self-assessment questions. Most Internists shy away from the sheer size of the program, but, since I finished Residency 34 years ago, I have been religious at doing the full program. It gives a comprehensive update and reviews older, but still valid, information.
The current session is the 19th version of the program. Every session has an identifiable theme. In the past, such a theme focused on an exhausting and mind-numbing discussion on the genetics of malignancy. In other years, HIV treatments were reviewed with enough detail to make my brain explode.
This year was different. Diabetes and heart disease were the themes. Specifically, the text and questions focused on the two newest diabetes drug classes: DPP-4 Inhibitors and SGLT2 Inhibitors.
Suddenly, we are being inundated with data that claims we should start these drugs on anything even remotely like diabetes, no matter how good the control.
BUT WAIT! THERE’S MORE!! THEY ARE NOT JUST FOR DIABETES!!!
Heart failure? Absolutely. Not prescribing these drugs is little more than malicious manslaughter.
Coronary Artery Disease risk reduction? Definitely. Get everyone in your practice on these drugs ASAP!
Kidney disease? DO IT!!! Start those SGLT2 drugs now!
Did you recently eat some funnel cake? GOOD HEAVENS!! GET ON THESE MEDICINES NOW, NOW, NOW!!!
Since our patients may forget to take them every day, we should tell them to just take the whole bottle now!
Full speed ahead! We have data! We have the power of the pharmaceutical industry here to save our patients from the ravages of heart disease, kidney failure, heart failure and whatever else!
Dang! WE’RE NOT DOING ENOUGH!!! We need to put these drugs in the water supply!
Here I am, not yet on these medicines, and I FEEL POSITIVELY NAKED!!!!
I know what you’re thinking: Only one month of just one of these drugs costs as much as a luxury car payment, but… ISN’T YOUR LIFE WORTH THAT MUCH!!
QUICK!!!! RUN TO YOUR DOCTOR NOW AND DEMAND THEY GIVE YOU THESE MEDICINES!!!
Your stock portfolio will thank me.
The side effects and warnings for the SGLT2 drug class are nothing short of frightening. Ketoacidosis, urosepsis, amputation. Amputation!
https://www.fda.gov/drugs/drug-safety-and-availability/fda-revises-labels-sglt2-inhibitors-diabetes-include-warnings-about-too-much-acid-blood-and-serious
As a RN for 43 years, I have watched these big Pharma dramas unfold. My mother suffered from polypharmacy for many years (I blame commercials). At one point I discovered that she was on 2 statins! Most of these drugs are just means for a patient to continue bad behavior and eat what they want. (This coming from a life-long fat person on the brink of diabetes who refused to take those drugs). Great article.
The MKSAP is being renamed to CMPDAK – make a note of it – corporate medical propaganda disguised as knowledge. In the old days, there were a small number of arduously reviewed publications vetted for substantive and credible knowledge of importance to the physician, published by societies directed by and beholden to the physician.
Yah. Rilly.
Now, the primary research is hidden behind massive paywalls (Pay #35.00 to read this publication) and is corporately congealed into factlets like the MKSAP. When I dropped the ABIM, I breezed past MKAP untouched. I recall MKSAP classes which stated, well, this really isn’t so, but it’s the correct answer on the examination.
Then the ABIM got bagged selling examination “answers” to the testing “experts.” If you don’t know the ABIM-approved (but wrong) answer, you might not pass the (rigged) examination and rent your board certification for another few years.
The people that are targeted in ads and run to the doctor demanding these expensive drugs have insurance that gets everything covered in full
Government employees
Medicaid
Medicare HMO advantage
Large companies
The costs then get passed on making insurance unaffordable for those who pay themselves.
PS. You forgot…Don’t want to wear a condom, demand taxpayers pay 20k a year for your right to be promiscuous and protected by our drug.