Diabetes still growing, but new treatments on the way

More systematic applications of new treatments for Types 1 and 2 diabetes should have a profound effect on glucose control and the complications of diabetes. So said William Herman, M.D., Stefan S. Fajans/ GlaxoSmithKline Professor of diabetes, professor of internal medicine and epidemiology, and director of the Michigan Diabetes Research & Training Center at the University of Michigan Medical Center in Ann Arbor. He spoke at a recent media press briefing in New York City sponsored by the American Medical Association.

Some treatments for Type 2 diabetes can target the following underlying causes of diabetes: decreased insulin secretion, increased glucose production, resistance to insulin, and altered absorption of food.

New hormonal treatments approved by the Food & Drug Administration in the past year include pramlintide (Symlin, Amylin) and exenatide (Byetta, Eli Lilly/ Amylin). Each has multiple mechanisms of action-reducing glucose production by the liver, altering the way food is absorbed, and suppressing appetite. They help lower glucose and A_1c levels and are associated with weight loss. The required injections two to three times a day can produce nausea and vomiting.

Inhaled insulin is on the horizon, Herman said, and "early clinical trials show it's as effective as injected insulin. The hope is that a lot of people who need insulin but aren't taking it may be willing to take inhaled insulin and achieve improved glucose control."

With the availability of new insulins that better mimic normal insulin secretion and new treatments that address all underlying causes of Type 2 diabetes, clinicians can better tailor treatments to individual patients, combining and adjusting treatments when a prior therapy is not working. In this way we should be able to improve glucose control and reduce the enormous burden of diabetes and its complications, Herman said.

Here are the latest figures on diabetes incidence from the Centers for Disease Control & Prevention:

For more information, visit http://www.cdc.gov/diabetes/.