There's no such thing as a safe diabetes drug--just different degrees of risk.

While the spotlight has been on Avandia's heart risk, the FDA now says it's putting the drug's main rival, Actos, under review after new data linked it to an increased risk of bladder cancer.

And naturally, the feds are telling diabetics to make sure they keep right on taking this drug anyway.

In fact, they're sending some dangerously mixed signals: First, they say the interim analysis of data on 193,000 California diabetics collected between 1997 and 2008 did not show an increase in bladder cancer risk.

Second, they say that patients who took the highest cumulative dose for the longest periods did have a higher risk--one that reached statistical significance after just 2 years.

Confused? Don't be--because other studies have also found a link, including two clinical trials that found patients who took this med had a higher risk of bladder cancer than patients on other drugs.

In addition, rats given the rodent equivalent of a human dose have developed bladder tumors.

Not exactly encouraging... but the drug's maker, Takeda Pharmaceuticals, is urging caution, saying we're only halfway through a 10-year trial that should answer more questions.

But of course they'd say that.

They have drugs to sell, after all--and Actos has never been in a better position than it is now.

In fact, Actos is the unofficial "better than Avandia" choice for diabetics, since most of the studies that linked Avandia to heart risk compared it to Actos. And with Avandia sales now severely restricted, Takeda stands to earn a quick burst of cash before Actos faces generic competition next year.

But as I've written before, being "better" is not the same as being "good," so even if Actos is better than Avandia, that doesn't make it a good choice for you.

In fact, none of the diabetes meds are good choices, because they all come with risks--and those risks start with the illusion they create.

That's the illusion that a diabetic can take a pill, and then enjoy a slice of double chocolate pound cake.

But that's all it is--an illusion.

Do yourself a favor and take control of your diet, your body and your disease--because diabetics who commit to basic lifestyle changes--and I mean really commit to them, from a strict low-carb diet to daily exercise--find they no longer need dangerous drugs or even insulin.

And that's the best way to avoid the drug risks... and the illusions.