Diabetes and osteoarthritis have long been bedfellows. Statistically, people who have been diagnosed with diabetes have twice the likelihood of developing osteoarthritis. The FDA recently issued an urgent warning that diabetics taking a whole class of diabetic medication to keep their blood sugar under control are at risk for severe and disabling joint pain. Huh? This class of diabetes drugs causes severe joint pain, yet the drugs are being prescribed to diabetics already at risk for osteoarthritis?

Creating medications that do what they’re intended to do without doing other things as well seems to be beyond the scope of current pharmaceutical development. To use a metaphor, if we think of our medical problems as equivalent to a squeak on a car door, to fix that squeak what is needed is a can of WD-40 with one of those neat straws in the spray nozzle. What the pharmaceutical companies are suggesting is that we dump the car into a vat of WD-40. This is because it has not been possible to isolate, identify, and control specific protein-to-protein interactions, the result of which are the “sledge-hammer drugs” that flood the market. In addition, the skills needed to place medications specifically at certain sites are not widely available. That’s why when you see prescription medications advertised on TV, you get the creepy voice-over at the end, warning of such things as suicidal tendencies, stroke, depression, heart attacks, etc. Combine that with the fact that it takes upwards of $1.3 billion to take a drug from invention to your local pharmacy. This involves a symbiotic relationship between universities, pharmaceutical companies, and the FDA, and once the millions are raised by Wall Street, drugs tend to get approved and side effects are downplayed.

The class of drugs in question are DPP-4 inhibitors. These are marketed under the names of Januvia, Janumet, Janumet XR, Onglyza, Kombiglyze XR, Tradjenta, Glyxambi, Jentadueto, Nesina, Kazano, Oseni.  DPP-4 is a hormone secreted by the body to stop the secretion of another hormone, GLP-1 which limits insulin secretion. The problem is, of course, that’s not all the DD-4 inhibitors do. The human body is incredible in that it uses things for many purposes. The GL-1 is not only inhibited in the blood-sugar-control system, but GL-1 also is a hormone used by the body to control inflammation. Out of control joint inflammation equals osteoarthritis and severe joint pain.

There will always be a place for prescription medication. Whether we’re talking prescription medications or relying on surgery, it’s always better first to make the lifestyle changes needed and to use your own biologics to allow your body to heal itself than it is to introduce drugs and their predictably unintended side effects into your system.

“Diabetes Drugs Cause Severe Joint Pain” first appeared as a post on the Regenexx blog.