The Daily Tonic: Can A Diabetes Drug Cause Cancer?

We covered diabetes in a newsletter just last week, but let’s do a quick recap of some of the statistics, as that will provide some useful context for today’s topic. 

Approximately 1 out of every 10 U.S adults suffers from diabetes according to the most recent CDC statistics. That’s over 37 million people. Then there are an additional 96 million Americans that qualify as “prediabetics,” which means they are well on their way to a full diagnosis in the coming years. The most alarming statistic? The death rate for diabetes jumped 14% between 2019 and 2020. 

Now that we are all caught up on the gravity of the diabetes crisis, let’s move on to today’s topic.

In typical American fashion, we deal with type 2 diabetes the same way we deal with every other preventable lifestyle disease in this country—good ol’ pharmaceuticals. One of the drugs used to treat diabetes is a drug called sitagliptin, which also goes by the name Januvia and Janumet, marketed by the good people over at Merck. 

Just last week, the Food and Drug Administration (F.D.A) said that traces of a potential carcinogen have been found in samples of sitagliptin. More specifically, the F.D.A. found traces of an impurity labeled NTTP, which belongs to a family of nitrosamine compounds that have recently been found in a number of popular medications. 

A good way to avoid taking diabetes drugs is to avoid developing diabetes

Now, this is hardly the first time this has happened. Since 2018, nitrosamine contamination has been found in samples of the heartburn medication Zantac, the antibiotic rifampin,  and the smoking-cessation drug Chantix. 

But here is the part that doesn’t seem to make much sense. Even though the F.D.A. is the agency that has labeled NTTP as a probable carcinogen, officials have said they will continue to allow Merck to sell their diabetes drug, regardless of the contamination that has come up on recent samples. 

Their reasoning? The F.D.A. says that the additional cancer risk is “minimal” and outweighed by the immediate medical needs of diabetes patients. 

The key takeaway? Should anyone really be taking a drug that poses an additional risk for developing cancer, even if that risk is “minimal”? It depends, I guess. There are very real risks associated with leaving blood sugar levels unchecked for diabetes patients. If sitagliptin can effectively regulate those blood sugar levels and the increased cancer risk is indeed “minimal,” then maybe the pros do outweigh the cons. 

After all, we are not experts or doctors. We are just writers with way too many Google tabs open at one time. If the experts say sitagliptin is good to go, then it must be good to go, right? 

But what we should all agree on is the fact that preventable, lifestyle diseases are… well… preventable. We should all be doing our part to make sure we never end up having to weigh out the pros and cons between leaving diabetes untreated or taking a drug with a “minimal” increased risk of developing cancer.