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Summer 2007

New Drugs Target Type 2 Diabetes

Three new drugs have become available for people with type 2 diabetes, who until recently had only limited options for medication to control their blood sugar.

“The availability of these new treatment options means many more patients can achieve good control of their diabetes than in the past,” says Andrew Drexler, M.D., director of the Gonda Diabetes Center at UCLA. “Just because one treatment option was not successful for them doesn’t mean one of these might not be.”
Exenatide, which is taken by self-injection, increases insulin secretion by replacing the levels of a hormone in the body, GLP-1, that is reduced in diabetics. In addition to lowering blood sugar, it acts as a natural appetite suppressant and has resulted in weight loss for a number of overweight patients, but not all, Dr. Drexler says.

A second drug, sitagliptin, also increases the level of GLP-1, but by a different mechanism, and does not appear to cause weight loss. It is taken as a once-daily pill. “We have known for many years that the lack of GLP-1 in the body contributes to diabetes, but we haven’t had any way of replacing it,” Dr. Drexler says. “These drugs do that, which is very exciting.” The drugs don’t produce low-blood-sugar reactions (hypoglycemia) because they act only in the presence of elevated blood glucose levels.

A third new medication, inhaled insulin, replaces injected short-acting insulin. It is inhaled 10 minutes before meals to control blood sugar levels. Dr. Drexler says patients should have a lung function test when starting inhaled insulin and after six months.

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