It's amazing to me how quickly best practices change in how we manage some of the most common diagnoses today. For years we've been placing type 2 diabetics on insulin sensitizers like Avandia or Actos to help normalize their blood glucose levels. We did it because the evidence pointed us in that direction.  But now the Food and Drug Administration (FDA) is currently reviewing the insulin sensitizer, Avandia manufactured by Glaxo SmithKline. Avandia has recently been linked to an increase risk of heart attack as compared with other antidiabetic drugs however, the research is not sufficient to indicate that Avandia increases the chance of death. For many of us who have used Avandia for years to help control our patient's diabetes, this information may come as a surprise.  So what are healthcare professionals to do? For many patients, this class of drug works well for them. Do we take our patients off this drug due to this latest information?  

As with all areas of healthcare, we need to be careful that one study does not change the way we practice. Instead we need to make sure that a rigorous systematic review was done to develop the practice recommendations that drive our care.   For starters, we can follow the recommendations from the American Diabetes Association, the Endocrine Society, and other well known and respected diabetes associations in addition to the FDA. It's important we stay up to date with latest advances in evidence-based care and bring those interventions to our our patients, not interventions based on  anecdotal findings. We need to view this issue with Avandia as an opportunity to take another look at the evidence and then decide what we should do with our patients.   

One thing is certain - diabetes care is constantly changing.

By Anne Dabrow Woods, MSN, RN, CRNP, ANP-BC