This is a story about FDA approval for an inhaled form of insulin marketed as Exubera. The story discusses how this new form of insulin delivery may affect diabetics, possibly increasing adherence to blood sugar management by reducing the need for injected insulin. A cost comparison of the two forms of insulin is provided. There are appropriate caveats from medical professionals who specialize in diabetes care regarding the need for continued insulin injections for some diabetics. These warnings are contradictory to the story’s sub-headline which states that Exubera is an “alternative to daily injections”. (We realize that reporters don’t write headlines, but someone at AP is responsible for it.) Some diabetics, especially those with Type 1 diabetes, may need a longer-acting injected insulin and cannot rely solely on inhaled insulin. The story discusses some potentially serious side effects, such as a decrease in lung capacity in some people, however, there is no data on the incidence of this or other side effects. Overall, there is little quantitative information on the efficacy of the new form of insulin compared with the existing method of insulin delivery. While investors may be interested that this could be a “$1 billion a year seller for Pfizer”, diabetics who are considering inhaled insulin would appreciate quantitative information on the risks and benefits of Exubera.
Gives a cost comparison with injected insulin. Given that the article stresses the need for injected
insulin as an adjunct to inhaled insulin (in some cases), the cost would be higher.
No quantitative data presented. No information on the efficacy
of Exubera at controlling blood sugar as compared to existing methods of insulin delivery. No data on the side effects, or
how many people who did not have pre-pre-existing lung disease experienced inflammation due to Exubera.
No quantitative data
presented. No long-term data on the side effects, or how many people who did not have pre-existing lung disease experienced
inflammation due to Exubera.
No data from any Exubera trials. No
mention of study design or incidence of side effects.
Provides American Diabetes
Association statistics on prevalence. Does not appear to be disease mongering. Mentions that not all diabetics take insulin
and some people with Type 2 can manage with oral hypoglycemics, diet and exercise. There is some discussion that more
diabetics will take insulin if it is inhaled form, which may or may not be true.
Balanced. FDA, American Diabetes
Association, Juvenile Diabetes Foundation and diabetic patient perspective provided. No conflict of interest noted. (No
mention if anyone received research funding from Pfizer.)
Mention of alternative
treatment (i.e. injections alone) and possible treatment needed in conjunction with inhalable insulin. There is mention of
some of the side effects on the lungs (coughing or decrease in lung capacity) , and that the inhaled form of insulin is not
appropriate for all diabetics, especially those with asthma or poorly controlled lung disease. There is a reminder that
diabetics still need to check their blood sugar levels via needles, pens or pumps.
Mentions availability of treatment and that Exubera won’t replace injected insulin.
The story focuses on recent
FDA approval.
No clear evidence that the story relied heavily on a press
release; however, the financial information seems to be PR-driven. While investors may be interested that this could be a
“$1 billion a year seller for Pfizer”, people with diabetes who take daily insulin in this new form would appreciate
quantitative information on the risks and benefits of Exubera.
Systematic, Criteria-Driven
The tale of two “negative” studies. Or, how spin is applied to make research findings look more impressive. A must read. https://johnmandrola.substack.com/p/the-tale-of-two-negative-studies
The @nytimes chose to interview one of the editors of the @AnnalsofIM (publisher of this paper) who "gushed with extraordinary glee: It’s huge! There are very few things that reduce your mortality by 30%."
Turns out coffee is not one of those few things despite all that glee. https://twitter.com/garyschwitzer/status/1533202075928215558
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