Thursday, September 7, 2017

New medicine for Type II diabetes shows considerable promise

The global pharmaceutical company Novo Nordisk has announced that its new drug semaglutide had reduced blood glucose levels and lowered body weight to a statistically significant degree more than those treated with the competing drug dulaglutide.
The Danish global pharmaceutical company Novo Nordisk claimed that its late stage trial had met its main goal of reducing glucose (BG) levels in a trial involving about 1,200 patients over a forty-week period. Both those using Eli Lilly's dulaglutide and Novo's semaglutide also used metformin pills.
There was also a significant reduction in body weight among participants as well. Some diabetes medications are associated with a risk of increasing body weight. Novo Nordisk hopes that its new drug will become a standard therapy for treating type 2 diabetes. Novo Nordisk is headquartered in Bagsvaerd Demark but has production facilities in 8 different countries and affiliates or offices in 75 countries. Its key products include diabetic medicines and treatment devices.
Type 2 diabetes is contrasted with Type 1 which requires insulin injection for treatment from the beginning. Unlike Type I type 2 usually begins in middle-aged or older patients especially those who are obese and do not exercise, but there are also often generic factors involved. The incidence of type 2 appears to be increasing among younger people. Early treatment often involves just proper diet and exercise but as the disease progresses pills are used and often insulin injections are needed.
Wikipedia describes type 2 as follows:Diabetes mellitus type 2 (also known as type 2 diabetes) is a long-term metabolic disorder that is characterized by high blood sugar, insulin resistance, and relative lack of insulin.[6] Common symptoms include increased thirst, frequent urination, and unexplained weight loss. Symptoms may also include increased hunger, feeling tired, and sores that do not heal.[3] Often symptoms come on slowly.[6] Long-term complications from high blood sugar include heart disease, strokes, diabetic retinopathy which can result in blindness, kidney failure, and poor blood flow in the limbs which may lead to amputations.[
Type 2 accounts for more than 90 percent of all diabetes cases. Although there was some concern that the drug may have caused more retinopathy leading to vision loss, Novo Nordisk said that the number of patients reporting on increased retinopathy was low and the two drugs had similar rates.
Both semaglutide and dulaglutide belong to a class of drugs called GLP-1 (Glucagon-like Peptide 1). They "imitate" an intestinal hormone that stimulates insulin production and helps to lower blood glucose levels. One advantage of these drugs over insulin is that the dosage can be administered weekly. Eli Lllly's Trulicity has already been approved some time ago. However pricing and side effects are a problem.
The cost of 4 pens with each pen containing a weekly dose is around $700 US and that is with discount coupons. Presumably, Novo Nordisk pricing will be in the same ball park. This is much higher than the cost of conventional insulin treatment along with other medications which may work just as well in many cases. There also can be severe side effects of taking the medicine. While many effects may be less bothersome after longer use, other effects are so severe that the patient must stop using the medicine altogether. Many patient reviews of the effects of Trulicity can be found hereWikipedia describes some of the side effects:The most common side effects include gastrointestinal disorders, such as dyspepsia, decreased appetite, nausea, vomiting, abdominal pain, diarrhea.[6] Some patients may experience serious adverse reactions: acute pancreatitis (symptoms include persistent severe abdominal pain, sometimes radiating to the back and accompanied by vomiting), hypoglycemia, renal impairment (which may sometimes require hemodialysis). The risk of hypoglycemia is increased if the drug is used in combination with sulfonylureas or insulin.[7][8]
While this may make one wonder why anyone would take the drug, there are many users who find that the drug has worked when everything else has failed and many may have only mild if any negative side effects of its use. Being able to inject just once for a whole week of treatment will appear as a large plus to those who now must inject insulin several times a day. The control of blood glucose levels is essential in avoiding complications from diabetes. Any new drug to do that will be a plus for many patients.


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