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Most clinical studies of new drugs are conducted primarily on white men, whether or not they are most affected by the disease the drug is intended to treat. African Americans, for example, are 1.6 times more likely to have diabetes than non-Hispanic whites. Why should we assume that what works for white males will also be effective for African Americans, Hispanics, Asians, or, for that matter, women?
It seems, however, that we may finally be on our way to testing new treatments on the populations most affected by the disease. At the National Medical Association Annual Convention and Scientific Assembly, researchers from Novo Nordisk reported on a Phase 3 clinical trial that actually studied the effects of a new drug on African Americans with type 2 diabetes. The treatment in question, liraglutide, was found to reduce both their blood sugar and their weight.
"Obesity is a major medical risk factor for type 2 diabetes and a significant issue in the African-American community, as they are 1.4 times as likely to be obese as non-Hispanic whites," said the lead author of the study, Dr. Shomali, in a press release. "For these patients in particular, even modest weight loss can make a significant difference in the management of their diabetes, which makes liraglutide a potentially important treatment option."
Liraglutide is a glucagon-like peptide-1 (GLP-1) analog, so called because it is a synthetic version of GLP-1, a natural gut hormone. It stimulates insulin release by beta cells in the pancreas and decreases glucagon secretion. Liraglutide is naturally broken down in the body, stimulates the release of insulin only when blood sugar is high, and slows gastric emptying (making a person feel full for a longer period of time), leading to weight loss.
So how does liraglutide differ from exenatide (Byetta), another GLP-1 analog? The difference is that exenatide is a synthetic version of a hormone found in the saliva of the Gila monster. Liraglutide, on the other hand, is the first human GLP-1 analog. Although it is a synthetic version of the human hormone, it stays active after subcutaneous injection much longer than the natural gut hormone, with a half-life of 10 - 15 hours after injection as opposed to an hour. Liraglutide, therefore, is expected to be much more effective as a therapeutic.
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