Type 2 diabetes is also known as noninsulin-dependent or adult onset diabetes. Currently, adult onset diabetes represents 90% of all newly diagnosed cases of diabetes. Type 2 diabetes is a disease of concern in the United States because more than 1/3 of the population is considered obese. The populations with the highest rates of type 2 diabetes are the overweight and the elderly.
In contrast with type 1 diabetes, type 2 is a disease of insulin resistance. This means that the beta cells of the pancreas continue to secrete insulin, but the cells in the body are unable to respond to insulin and take up glucose from the blood. The three main cell types affected by insulin resistance are liver, muscle and fat cells. As the demand for insulin increases, the beta cells in the pancreas eventually are unable to keep up with body's increasing insulin demands. As a result of the impaired glucose uptake, individuals diagnosed with type 2 diabetes are hyperglycemic; meaning that they have high blood sugar levels.
Due to the insulin resistance, most diagnosed patients must take exogenous insulin or other medications aimed at lowering their hemoglobin A1C levels. One of the newer medications aimed at controlling hemoglobin A1C levels is Victoza. Victoza is a non-insulin injection that allows for tighter control of blood sugar levels by increasing insulin secretion from beta cells in the pancreas, reducing glucagon secretion and by delaying gastric emptying. The delayed gastric emptying can lead to weight loss in patients because they will feel full for a longer period of time and are likely to eat less.
Another benefit of Victoza compared to other medications is that it acts in a glucose dependent manner. This means that Victoza will only work properly if blood glucose levels are sufficiently high. The glucose dependency of Victoza results in reduced risk for hypoglycemia and allows for much tighter blood glucose control.
References:
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001356/
http://www.cdc.gov/diabetes/pubs/statsreport14/national-diabetes-report-web.pdf
http://www.cdc.gov/obesity/data/adult.html
http://www.mayoclinic.org/diseases-conditions/type-2-diabetes/expert-answers/byetta/faq-20057955
Hey Charlie. I like your topic choice--obesity, and the downstream consequences, are important issues facing healthcare, especially in the United States. Do you know whether Victoza has any other associated side effects? I thought it was interesting that this drug is most effective when blood glucose levels are high. Does this mean it is administered after meals? After a little extra research, I found that measuring hemoglobin AC1 levels show the trend/correlation of sugar levels over a period of time, because the sugars can stick to RBCs, and levels are elevated in patients with diabetes. Does anyone know how Victoza might act to control these levels?
ReplyDeleteCharlie, thank you for bringing up the topic of new medications to treat type 2 diabetes. There are a lot of new medications that are currently in clinical trials or have recently been approved by the FDA that are improving the quality of life for many diabetics. Another new medication that been approved by the FDA is called Afrezza. Afreeza is an insulin medication that is inhaled through the nose before eating a meal. An insulin medication for diabetics that does not involve an injection is rare. Afrezza does need to be paired with other oral anti-diabetics medications, similar to insulin injections. Type 2 diabetes is becoming more prevalent in young children and this medication may be a good option for children who are afraid of needles.
ReplyDeleteUnfortunately, many of the new medications are incredibly expensive. A 2-pack 18 mg/3 ml pen of Victoza costs $1302.56 at Costco. Afreeza is not currently for sale in the pharmacy setting yet, so the cost is unknown though it is expected to be slightly more expensive than a typical insulin pen injection. These new medications are paving the way for a greater quality of life for a large population in the United States, though the cost pay prevent most from attaining them.
Source: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm403122.htm