by Daniel Trecroci
The type 2 diabetes
epidemic has reached an estimated 125 million people worldwide. This number is expected to increase to 220 million by the year 2010. The main reasons for this steep increase include reduced physical exercise
, dietary changes and a higher incidence of obesity.
The world's pharmaceutical businesses compete fiercely for a part of the U.S. type 2
market of 14 million people. With this increasing prevalence, more and more type 2 medications
have been approved by the U.S. Food and Drug Administration or are currently being designed to treat type 2 diabetes.
Type 2 medications run the gamut. Some drugs treat insulin resistance
, in which the pancreas produces an adequate amount of insulin
, but they can't properly use it. Other drugs slow carb
ohydrate digestion there by lowering drug sugars.
Types of Type 2 Drugs
Glyburide, Glucotrol XL, DiaBeta and others (see chart on pg. 50) are drugs that make the pancreas work harder to produce more insulin.
Avandia and ACTOS (see chart) are generally prescribed for people with insulin resistance.
Glucophage (see chart) slows the liver's production of sugar during the night and tends to make the muscles a little more sensitive to the glucose uptake.
Precose and Glyset work in the intestines on carbohydrate
digestion so that after-meal blood sugars
do not shoot up drastically.
Know Your Body
Since no two type 2s are alike, there is a different prescription for different type 2s.
Knowing your own body and the drug's specific function can help you understand your doctor's prescription, and lead to better treatment of your diabetes.
Side Article 1
Good To Go?
FDA Reviews Weight-Loss Drug That May Help Treat Type 2s
On May 22 that the U.S. Food and Drug Administration announced that it will review the weight-loss drug orlistat (Xenical) to determine if it is a suitable treatment for type 2 diabetes. If given FDA approval, Xenical, which works by preventing about one-third of the fat in the food consumed from being absorbed, will be the first weight-loss drug indicated for the treatment of type 2 diabetes.
Xenical maker Roche submitted a supplement
al new-drug application to the FDA on March 19, requesting approval of Xenical for the treatment of diabetes based on the results of new clinical trials conducted in overweight and obese patients with type 2 diabetes.
"The clinical trial data show that patients treated with Xenical plus a mildly reduced calorie diet lost more weight than those patients treated with placebo plus diet, and also had significantly greater and sustained decreases in (HbA1c
) and fasting plasma glucose," read a May 22 Roche statement. "É In addition, patients with type 2 diabetes treated with Xenical were able to reduce their daily doses of É sulfonylureas, insulin and [Glucophage]."
In seven large, multi-center, randomized, placebo-controlled trials involving 2,600 patients with type 2 diabetes, Xenical demonstrated:
•clinically significant improvements in blood-sugar control
•an ability to aid type 2s in reducing the dose of, or even discontinue, their anti-diabetic
•a weight loss
of up to three times more weight than diet alone in overweight and obese patients with type 2 diabetes
• an improvement in certain risk factors for cardiovascular disease, such as total cholesterol
levels and blood pressure.
In addition, Xenical's notorious gastrointestinal side effects, which include gas with oily discharge and increased bowel movements-including an urgent need to have them and an inability to control them-occurred less often among Xenical patients with type 2 diabetes. Also, Xenical's inhibiting effect on the absorption of some vitamins
was also observed less frequently in people with type 2 diabetes.
Xenical received FDA approval for the treatment of obesity, including weight loss and weight management, in April 1999. The FDA also cleared Xenical for use in reducing the risk of regaining weight.
Side article 2
Drug Company Reprimanded for False Advertising
Novo Nordisk Pharmaceuticals of Denmark violated federal regulations for inaccurately representing the type 2 drug Prandin (repaglinide) in promotional materials, according to the U.S. Food and Drug Administration (FDA).
In a May 1 statement, the FDA announced that the drug manufacturer understated the risks of Prandin and inflated its efficacy in advertising paraphernalia such as posters, sales aids and professional exhibits.
The FDA asked that Novo Nordisk immediately discontinue those materials and any others making such claims.
In an interview with Reuters Health, Novo Nordisk spokeswoman Susan Jackson denied that the company violated FDA regulations.