Insights into new treatments

Every year the "Late-Breaking Trials" present some of the most exciting news at Scientific Sessions, and this year was no exception.

Five late-breaking studies today report new drug approaches and insulin strategies to treat or slow the progression of diabetes:

• A study showed that when basal insulin alone is no longer enough, adding pramlintide (Symlin) instead of rapid-acting insulin gets more patients to target glucose levels without weight gain, and with a lower risk of hypoglycemia.

• The HEART2D study compared prandial insulin (a fast-acting insulin taken close to mealtime) versus basal insulin (long-acting insulin that is released slowly) on cardiovascular disease risks in 1,115 patients with type 2 diabetes who already had heart risk factors. They found no difference between the groups, showing post-meal glucose levels are not relevant in preventing heart attacks.

• The first proof that an anti-oxidant, anti-inflammatory agent can reduce the rate of progression to type 2 diabetes was reported in a clinical trial involving more than 6,000 people who have coronary artery disease. The study, ARISE (Aggressive Reduction of Inflammation Stops Events), was designed to see if the drug, now called AGI-1067 (succinobucol), had benefits when added to current therapies. Last year, researchers reported the drug reduced heart attack and cardiac death by 19%. Today they announced it brought about a 63% reduction in incidence of type 2 diabetes compared to placebo, and slowed the rate of progression to diabetes in people who had abnormal fasting glucose. In a poster presented this week, researchers reported in animal studies using AGI, the drug improves insulin sensitivity but unlike currently available TZDs, which do the same, the new one doesn’t cause weight gain.  A lot more  research will need to be done, however, before we can know whether this therapy is ready for widespread use in patients.

• Three diabetes drugs are known to help delay progression from impaired glucose tolerance (IGT) to type 2 diabetes. They are metformin, rosiglitizone (Avandia) and acarbose (Precose). Now, there’s a fourth: pioglitazone (Actos). In a study, 6.8% of patients taking a placebo developed diabetes compared to only 1.5% on pioglitazone. Pioglitazone reduced by 81% the conversion of IGT to type 2 diabetes, researchers said (The Diabetes Prevention Program, the gold standard of prevention trials, showed a 58% reduction through intensive lifestyle changes without medications). In addition, insulin sensitivity improved in the pioglitizone group, suggesting that the drug, one of the thiazoladinediones (TZDs), improved function of insulin-producing beta cells.

• A once-weekly version of exenatide, marketed as Byetta, produced the same glucose control and weight loss as the current twice-daily shots in a 30-week study involving 295 patients with type 2 diabetes. Both groups of patients lost nearly nine pounds during the study, but those who got once-a-week shots had greater improvements in long-term blood glucose levels measured by the A1C, and in fasting plasma glucose. Those improvements were sustained in a group of 120 patients who continued getting the weekly shots for 52 weeks. Lipid profiles, which measure blood fats such as cholesterol and triglycerides, improved in both groups after 30 weeks, but were even better in those who received the once-weekly version of exenatide.

Comments

[Ranches L Hall]

education is so important when it comes to being inform about your diabetes and every diabetic should take their health serious

[diabetes]

thanks for information....I love metformin before using insulin

[diabetic signs]

I think great combination are medicine for repairing recistency also secretion insulin, avandia+metformin and tzd ...all work for recistency insulin