PCOS-MEDICATION Messages for July, 2002: Re: Dianette

Re: Dianette

From: Victoria (anonymous@obgyn.net)
Wed, 3 Jul 2002 10:13:53 -0400

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> From: "Fergus" <ferg@islandnet.com>

> Thank you for the link to the study. I haven't had time to review that
> information yet. As for endometrial cancer, I have not made any comments
> about it. You raised it. I don't know what you think I found out about it.
> I have referred only to uterine cancer.

Is what you are referring to as uterine cancer not the same as endometrial cancer? That was my assumption, and if that was wrong, I apologize.

> Why any treatment? Surely the purpose of treatment is to achieve the best
> possible result. I am not convinced that diet and exercise alone achieve a
> better result than combining these sensible factors with Glucophage.

There has been at least one head to head Metformin vs. diet/exercise that showed Metformin prevented 31% of the time, 58% for diet and exercise. There was no test of Metformin with diet and exercise to find out if that beats each one alone. Theoretically that should be true, but who knows?

> I know of an old man who smoked multiple times a day for 75 years. He
> smoked cigars that smelled like burning tires and a pipe. He died at the
> age of 96 of unrelated causes. Should we conclude that smoking is not a
> health risk? Or is it more reasonable to interpret these anecdotes as an
> indication that one person proves nothing?

Kat Carney was being as an example. Not everyone who uses diet and exercise to keep problems at bay is going to say so. Tis the squeeky wheel who gets the grease. If that's the case, then some of Dr. Glueck's studies may have to be thrown out, as others.

> In statistics there is a precept. Many things achieve a "natural
> distribution", a bell-curve. If you roll a die once, you will not get a
> natural distribution. If you roll it a thousand times, you will. As you
> increase the size of your sample, your distribution will become increasingly
> normal. Likewise, it's valuable to consider what helps most people the
> most.

True. Which is why I go back to the study I was talking about.

> > What about those people who claim to not be IR? Glucophage can be
> effective in 50% to 90% of the population, depending on study.
>
> What about it?

If we do have a subset of those who aren't IR, or Metformin doesn't help, we would need to test for that, and provide alternatives. If the drug isn't effective for everyone, we need to provide options to people outside of Glucophage.

> Thinking critically is very important. I think it's a worthy aim. Are you
> claiming that you don't have a bias, though?

No. I made the statement because I've been publically accused before of not being 'for Metformin'. I do have people though, that do spread old wives tales on lists. Information that isn't accurate. I generally use research studies as a guide to think about some replies and what I say. For example, if I was a doctor, I would 100% want to prescribe Metformin, as of what I know today, for the first 3 months of PCOS womans' pregnancies. Not all docs do that or believe in it. I try not to say that in any of the posts I make when I answer those like that, and ask that people think and research their decision for Metformin during pregnancy at any length in time, based on data, not my words.

--
Victoria

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