The AP notes that the drug, dapagliflozin, is a “once-a-day pill designed to help diabetics eliminate excess sugar in their urine. That differs from older drugs that decrease the amount of sugar absorbed from food and stored in the liver.” Nearly all the FDA panelists praised dapagliflozin’s “innovative approach to lowering blood glucose, but a majority said they wanted more information on a host of safety concerns, including cancer, infections and possible liver toxicity.” Dr. Erica Brittain, a biostatistician with the National Institutes of Health, who voted against the drug, said, “The level of evidence about the cancer is fairly weak, but it’s just that the uncertainty is still there.”

Medscape reported, “Across the companies’ [Bristol-Myers Squibb and AstraZeneca] 11 clinical trials, there have been nine bladder cancers in 5,478 patients on the drug compared with one case in 3,156 controls; and there have also been nine cases of breast cancer in 2,223 women on the drug compared with just one in 1,053 female controls.” Also, panelists were concerned about “one case of liver damage that was thought to be caused by dapagliflozin.” FDA reviewer Somya Dunn, MD, said, “‘It is difficult to make this estimate based off one case,’ nonetheless estimated that one in 25,000 patients exposed to dapagliflozin for at least six months would develop serious liver injury.”

From the American Association for Justice news release.

By his own reckoning, a Navy electrician spent just eight hours in Vietnam, during a layover on his flight back to the U.S. in 1966. He bought some cigarettes and snapped a few photos.

The jaunt didn’t make for much of a war story, and there is no record it ever happened. But the man successfully argued that he may have been exposed to Agent Orange during his stopover and that it might have caused his diabetes — even though decades of research into the defoliant have failed to find more than a possibility that it causes the disease.

Because of worries about Agent Orange, about 270,000 Vietnam veterans — more than one-quarter of the 1 million receiving disability checks — are getting compensation for diabetes, according to Department of Veterans Affairs records obtained by The Associated Press through the Freedom of Information Act.

More Vietnam veterans are being compensated for diabetes than for any other malady, including post-traumatic stress disorder, hearing loss or general wounds.

Agent Orange was a dioxin-laden defoliant that was sprayed over jungles to strip the Viet Cong of cover. American forces often got a soaking, too, and Agent Orange was later conclusively linked to several horrific health ailments, including cancers. So Congress and the VA set up a system to automatically award benefits to veterans who needed only to prove that they were in Vietnam at any time during a 13-year period and later got one of the illnesses connected to Agent Orange.

The VA, interpreting that 1991 law and studies that indicated potential associations, has over time added ailments that have no strong scientific link to Agent Orange. The nonprofit Institute of Medicine’s biennial scientific analysis of available research, to which the VA looks for guidance, has repeatedly found only the possibility of a link between Agent Orange and diabetes, and that even a chance of a correlation is outweighed by factors such as family history, physical inactivity and obesity.

Disability benefits are a lot like workers’ compensation, providing income to veterans who incurred ailments from their active-duty service. The benefits can last a lifetime even if the veteran holds a full-time job. They often transfer to surviving family members when a veteran dies of the disability. They are paid in addition to any medical, education and pension coverage that veterans receive.

Many veterans have a combination of ailments that are crunched in a formula to determine their benefits. This makes it difficult to determine how much is being spent solely on diabetes.

Most veterans get a 20 percent disability rating for diabetes, which amounts to about $3,000 per year if it is their only ailment. Others get up to 100 percent. If each of the 270,000 Vietnam veterans got the minimum compensation for their diabetes, it would add up to $850 million every year.

Congress gave the VA the ability to deem ailments “presumptive” — automatically awarded — because of exposure to Agent Orange. The VA did that for five illnesses for which the Institute of Medicine found “sufficient evidence of an association,” such as leukemia, non-Hodgkin’s lymphoma and soft-tissue cancers. Those illnesses have risen dramatically in both Vietnam and the U.S. since the war.