S-I really would like to have your advice regarding two issues: first, as you know the RECORD study has reassuring results regarding the use of rosiglitazone. Do you think that it would be better if we replace it with pioglitazone as we have an offer to supply the hospital with Actos with comparable price to that of Avandia, given the adverse publicity of Avandia?
The second issue is again regarding the recent observational studies about the possible association between Lantus and some cancer. Do you think switching to Detemir would be safer or shall we continue with lantus till we get more information. what is the NICE and the UK standpoint of this issue.
Dr.Yahya Al Zaman,MD,FRCP(UK) ,Cert.(RCP)(Endocrinology&Diabetes), Salmaniya Medical Hospital, Ministry of Health, Kingdom of Bahrain.
Thank you for your email.
1. I think that Actos and Avandia are equivalent and you can use either. If you feel that your patients will be more comfortable taking Actos, then I would use it.
2. I think that the data concerning Lantus and cancer are weak at best and there are no data on Detemir and cancer. At my institution we are making no changes in the treatment of our diabetics. Sincerely, Ira D. Goldfine MD