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Type 2 Diabetes

Diabetes is a group of diseases characterized by high blood glucose levels that result from defects in the body’s ability to produce and/or use insulin. Glucose is the type of sugar that the cells of the body use for energy. Insulin is a hormone produced in the beta cells of the pancreas, which plays a central role in transporting glucose from the blood stream into cells.

There are two forms of diabetes, type 1 and type 2:

• type 1 diabetes (commonly referred to as juvenile-onset diabetes): the body has lost the ability to produce insulin and therefore is dependent on injections of insulin or modified forms of insulin (insulin analogs). 
• type 2 diabetes (commonly referred to as adult-onset diabetes): a chronic disease which begins when the body cannot produce adequate levels of insulin or loses the ability to respond to insulin (insulin resistance). This type affects an estimated 90 to 95% of those suffering from diabetes.

Both type 1 and type 2 diabetes are complex, chronic and progressive disorders that, left untreated, can lead to long-term health complications and shortened life expectancy. High blood glucose levels increase the risk of cardiovascular diseases such as high blood pressure, heart disease and stroke. Prolonged elevation of blood glucose can result in permanent damage to the kidneys, the eyes, the sensory, motor and autonomous nerves, as well as the extremities. Both high blood glucose levels (hyperglycemia) and low blood glucose levels (hypoglycemia) are undesirable and present serious health hazards.

Of the various risk factors involved in contracting type 2 diabetes, including lifestyle and age, one of the most important is obesity. Obesity plays a central role in insulin resistance and the progression of type 2 diabetes. The majority of the type 2 diabetic population is either overweight or obese, and there is a high level of demand for new classes of drugs that can address this issue. Body weight loss significantly reduces diabetes-related morbidity and mortality while improving other health parameters such as blood pressure and cholesterol levels. Studies have indicated that a modest weight loss of just 5% to 10% of initial body weight is sufficient to produce benefits with respect to diabetes prevention and cardiovascular risk reduction. 

Current treatment
The first line of treatment for a patient with type 2 diabetes is to modify diet and exercise. If these lifestyle changes are insufficient to naturally regulate blood glucose levels, then commonly available oral antidiabetic treatments (called OADs) such as metformin or sulfonylureas are typically introduced. If blood glucose can no longer be adequately controlled by OADs, patients must start insulin or insulin analog treatments. Most pharmaceutical treatment options tend to cause weight gain and increase the risk of hypoglycemia which, if left untreated, can be fatal.

A new class of diabetes treatments, employing GLP-1 analogs or GLP-1 receptor agonists, has entered the market and attracted much attention from diabetes specialists. A number of drugs in this class have recently been approved by the FDA as a first line treatment in addition to diet changes and exercise. GLP-1 is released naturally from cells in the gut after ingestion of food and acts to cause the pancreas to secrete and release insulin in the presence of high blood glucose. In turn, insulin acts to control the transport of blood glucose into cells, reducing the risk of hyperglycemia. This is the normal mechanism of insulin’s release and action in the body. GLP-1 based peptide drugs are artificially produced forms of the naturally occurring GLP-1. Using GLP-1 analogs or GLP-1 receptor agonists as a drug for type 2 diabetes appears to more naturally mimic the body’s natural process of stimulating insulin production compared to administering insulin directly as a drug. In addition, using GLP-1 analogs or GLP-1 receptor agonists as a drug also appears to have positive effects on the gut, enhancing satiation following a meal, resulting in weight loss, a desirable outcome in patients with diabetes. Finally, there is evidence in published preclinical studies that GLP-1 helps to preserve the functioning of beta cells that produce insulin and thus may slow the general progression of type 2 diabetes.

Home   Legal Disclaimer   Updated: 31.1.2012