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ShareMumbai: As per industry estimates, the anti-diabetes drugs market globally is valued at around $21 billion per annum. In India, it was worth $430 million in 2007, growing at 16-20% per year.
Due to its high prevalence, diabetes is considered the most important among lifestyle disorders. But an unhealthy trend brewing in the diabetes market is off-label use of anti-diabetic medication, including insulin.
Off-label use refers to using a drug for an indication not originally intended by the manufacturer, and for which no clinical trials were conducted to approve of its use.
According to pharma experts, diabetes medications like insulin, metformin, and repaglinide are being used by several people in the country for indications that have not been clinically proven by the manufacturer.
According to SK Wangnoo, senior endocrinologist at Apollo Hospital, about 5-10% of metformin, which is used for type II diabetes and also leads to weight loss, is being overused as a weight-loss pill. "Several overweight diabetics take more than the prescribed dose of metformin, holding the view that it may reduce their weight drastically," says Wangnoo.
Insulin, which leads to weight gain, is being overused for gaining weight. Wangnoo says about 2% of the total insulin consumed in India is used in excess by diabetics to gain weight. An overdose can lead to hypoglycemia, or low blood sugar, which can in turn lead to irritability, seizures, coma, and even death. And an overdose of metformin can lead to vomiting and gastric upset.
According to Ashok Jhingan, chairman of the Delhi Diabetic Research Centre, repaglinide, a short-acting oral diabetes medication, is another drug that is grossly misused. "People usually misuse repaglinide during fasts, by taking it before several small meals, or by not taking it during prolonged fasts," says Jhingan. The side effects of repaglinide misuse are nausea, anxiety, cold sweats and coma.
The latest diabetic drug in the league is Byetta, an injectible launched globally four years ago, and in India in 2007. Byetta is extensively used as a "diet pill" as it is known to reduce weight in type II diabetics by up to 30 kg (an average of 5-6 kg loss over 4-6 months). According to its innovator company, byetta is not a diet pill and has not been studied as a weight loss agent in people with normal blood sugar.
