Type 2 Drug Victoza Helps Type 1s, Too

Victoza May Help Diabetics Control Their Blood Sugar

| Jul 11, 2011

Victoza, a drug aimed at type 2 diabetes, may turn out to be a boon for type 1 diabetes patients as well. A small clinical study shows that patients with well-controlled type 1 who took Victoza daily for just one week experienced a 15 percent drop in their blood sugar levels. Patients who took the drug over a full 24-week test period needed less and less insulin, decreasing their average mealtime dose by seven units and their all-day insulin requirement by eight.

Patients who continued with Victoza beyond the 24-week test lost an average of 10 pounds and lowered their A1c levels from 6.5% to 6.1%. Reduced appetite and food consumption were also continuing effects of the drug.

The study, conducted at the State University of New York at Buffalo, involved 14 patients who achieved tight control via use of insulin pumps. Because the study size was so small, it can only function as pointer to larger, more extended studies. Victoza's maker, Novo Nordisk, is already embarking on a more extensive study.  

Researchers were surprised by Victoza's effect on type 1s because it is not designed to address their primary problem, which is their lack of functioning insulin-producing cells. Victoza is a "GLP-1 receptor agonist," a drug that mimics the GLP-1 peptide, a natural secretion that increases insulin production in the pancreas after a meal.

For type 2s, the problem is that they produce insulin but can't use it efficiently-something that Victoza can help them do. Because type 1s lack the ability to produce insulin, Victoza would apparently have no effect on them. But Victoza has a secondary effect that scientists think may be the key to its success with type 1s: It lowers the level of glucagon, a liver-produced hormone that counteracts the effects of insulin. In doing so, it apparently allows type 1s to more efficiently use the insulin they take, even to the extent of allowing them to lower their customary doses.

The drug also is an appetite reducer, which means that it would probably not be good for thin type 1s who need to maintain weight. However, a significant percentage of type 1s are overweight, so the drug could have yet another beneficial effect.

Occasionally, endocrinologists make what is called "off-label" use of a diabetes drug that is intended for one type of patient but is helpful to another. However, that is done under strict supervision and close monitoring. So for now, Victoza and the other GLP-1 receptor agonist currently on the market, Byetta (exenatide), will remain type 2 drugs.


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Categories: A1c Test, Blood Sugar, Diabetes, Diabetes, Food, Glucagon, Insulin, Insulin Pumps, Losing weight, Novo Nordisk, Over weight, Type 1 Issues, Type 2 Issues, Victoza

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Posted by Hans on 14 July 2011

[quote]It lowers the level of glucagon, a liver-produced hormone[/quote]
Funny livers that you have there on the other side of the pond ;-)

Posted by cde on 31 July 2011

Good point to show how confusion or imprecision can be present in the minds of professionals and persons with DM. The Alpha cells of the pancreas produce glucagon, causing the liver to release glycogen. The sequence is not likely to function properly in DM1 after a few years with the condition, as the modulation of hypoglycemia (from excessive insulin dose) by glycogen is less than in those without DM.

But also striking is the statement that the drug led to "decreasing their average mealtime dose by seven units and their all-day insulin requirement by eight (units)." This means that their mealtime doses were probably greater than 8 units (I assume the number does not refer to the amount contained in basal insulin doses). Seven units of ultrarrapid insulin would be expected to result, in an adult, in a reduction of about 280 mg/dL in levels of BG (roughly the effect of about 56 grams of carbohydrate in the meal).

Dr. Stan De Loach
Mexico, Distrito Federal

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