The U.S. Food and Drug Administration has approved the drug for 1) treating high cholestrol, and 2) treatment of type 2 diabetes in combination with insulin or oral antidiabetes medications. So, it’s not a diabetic medication to be used by itself. The most common side effects are constipation and dyspepsia.
I see very few patients using Welchol for treatment of diabetes, and I’m not entirely sure why. It may be related to the interference with absorption of other drugs. Many people with diabetes are on multiple oral medications. Another reason is that, since it cannot be used alone, it adds a layer of complexity to treatment. Some physicians would be tempted to use it in a diabetic with high cholesterol: the old “kill two birds with one stone” trick. However, it’s unknown whether such use acturally reduces cardiovasular disease and mortality. Statin drugs – the market leaders in lowering cholesterol – do reduce cardiovascular disease rates and mortality.
By my count, we how have 10 classes of drugs to help us fight diabetes, compared with three or so when I started my medical career.
Steve Parker, M.D.
Additional information: FDA Prescribing Information.