Developments in Diabetes Treatment 2008

A new group of medications has recently become available for the treatment of type 2 diabetes. These medications take advantage of discoveries on the workings of hormones naturally made by the intestines known as incretins. These hormones are made by special cells in the intestine in response to eating. Incretins stimulate the release of insulin from the pancreas and insulin enters the circulation where it regulates the amount of sugar in the blood. Some incretins also stop the release of glucagon which is another hormone which interferes with insulin action.

The first of these medicines receiving FDA approval is exenatide (Byetta). Byetta is given by subcutaneous injection twice daily just before eating. This medicine appears to have a secondary benefit of reducing appetite and assisting with weight loss efforts.

Sitagliptine (Januvia) is another FDA approved medication taking advantage of the incretin system. It is an oral medication taken once daily and has been shown to be effective at lowering blood sugar levels in type 2 diabetics.

These prescription drugs should only be used with the advice and monitoring of your health care professional.

A cure for type 1 (juvenile) diabetes is still a distant hope. The main focus for curing or delaying type 1 diabetes focuses on the immune system. The immune system normally protects us against viruses, bacteria and cancer cells. In type 1 diabetes a person’s own immune system appears to attack the insulin producing cells in the pancreas leading to the disappearance of this vital sugar controlling hormone. Studies in humans are now taking place which use artificially created antibodies to stop this immune attack on the pancreas. Using these experimental substances, delays of up to 18 months in the onset of type 1 diabetes have been achieved. Many more studies of this type are being planned hopefully paving the way for even better results.

Gary Pepper, M.D.


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