Another drug approved by the U.S. Food and Drug Administration may increase the risk of heart attacks and deaths. Avandia, a medication that has been used to treat diabetes for eight years now, and has been prescribed for six million people worldwide, has come under attack in light of recent reports. The implications for the healthcare and health insurance industries are huge, particularly in Texas, where the rate of diabetes is high.



More than one million Americans still take Avandia. Adding this to the international Vioxx scandal, an arthritis medication known to increase similar cardiovascular risks and also approved by the FDA, is not helping the organization's safety reputation. Texas is particularly vulnerable to these mistakes, where in 2004, over 500,000 statewide -- from Austin, to Dallas, to Houston -- already suffered from diabetes, with more expected to be diagnosed.

The state's propensity to obesity, hypertension, diabetes, heart disease, and cancer doesn't help. The prevalence of diabetes in the U.S. increased a staggering 49% between 1990 and 2000, and Texas was hit hard, possibly linked with an obesity rate hovering just above 60% of the adult population. Thirty-five percent of children are now clinically obese statewide, and Houston boasts a population in which 86% of its residents are either overweight or obese. This is significant due to the problems that often accompany the condition, including heart disease, stroke, certain cancers and, of course, type 2 diabetes.

The complications experienced by diabetic patients are, in and of themselves, significant. The top secondary threats include vascular, kidney and nervous system diseases, heart disease, high blood pressure, stroke, and blindness. Diabetes is the leading cause of kidney disease and blindness in adults ages 20 to 74, and is the sixth leading cause of death.

No outstanding research is necessary to conclude that a certain percentage of that majority population in Texas who are obese are also diabetic. It's also no mystery, then, that a certain number of these diabetic, obese patients are also taking Avandia. Add together the complications experienced by the obese, the diabetic, and those dependent on the medication in question, and we have a dangerous health cocktail, indeed.

Now, to make it even more complicated, over 25% of the population in Texas is also completely uninsured, the highest percentage in the nation. Such chronic conditions as obesity and diabetes, or a double whammy, for an uninsured individual could prove catastrophic. Not only would suffering a serious complication be detrimental financially, but a report released earlier this month by the Commonwealth Fund directly stated that the uninsured may not receive quality care. There is a "strong link," the report stated, between access to health coverage, particularly health insurance, and high quality care.

For Texas, none of this is good news. With one-quarter of the state going without health insurance, 60% of the population obese, and over half a million diabetic, any problem affecting a large number with any of these conditions could completely overload the already stressed system. A flood of Avandia patients coming in with complications, uninsured, and possibly suffering from other conditions as well, just might send the healthcare system of Texas into meltdown.

Much of the problem, it would seem, stems from the FDA itself, which is slowly but surely nurturing a reputation of extreme negligence into maturity. Once a drug is approved, its actual effects on the population are not as closely monitored as they should be, according to many in the industry.

Dr. Jerry Avorn, of Harvard Medical School, believes that such problems with the FDA will continue to exist until we are able to get a better system of drug approval and surveillance. That's a powerful statement, considering that this is precisely what the FDA is supposed to do.

It's a wakeup call, really. While it shouldn't be as a result of government agency negligence, in all reality, we should be more responsible for our health on an individual basis -- going for annual physicals, asking our doctors as many questions as we need in order to feel comfortable with a diagnosis or prescription, and doing what we can to take care of ourselves. Simple, common sense principles of nutritional eating and exercise may cut off many conditions requiring drugs before they even have a chance to exist.

Until the nation's health catches up with better habits, however, make sure to keep up with the latest recalls.