Newer Diabetes Medicines | Stay Updated

As we all know it, there is no cure for diabetes. The chronic nature of this disease and the associated complications makes it a costly affair for one and all. According to IDF (International Diabetes Federation), the number of Indian people with diabetes is expected to cross the ten crore mark by 2030.

Currently, diabetes is managed by healthy lifestyle and medications. Various pharmaceutical companies have invested millions in launching newer drugs in the market that can help to achieve better glycemic control in patients with diabetes.

Of all the recent innovations, two latest drugs discoveries which have been in the limelight are:

Latest Drugs Discoveries

1. Oral Semaglutide (Rybelsus)

It is the first oral pill in its class of drugs – which makes it unique. Before this oral form, the drug had to be injected (injectable form – Ozempic).

The drug was developed by Novo Nordisk, a Danish Pharmaceutical Company and got USFDA (US Food and Drug Administration) approval in September 2019. Since then, patients have a new option for managing their blood sugars – that too, without injections!

Class: GLP-1 RA (Glucagon-like peptide receptor agonist)

Indication: Type 2 diabetes, in combination with diet and exercise.

Mechanism of action: GLP-1 is a normal hormone produced in the body; it is found in low levels in patients with diabetes, like GLP-1, oral simaglutide acts by slowing digestion and by preventing the liver from making too much glucose. It also helps the pancreas to produce more insulin and thereby lowers blood glucose levels.

Advantage:

Available as oral dosage form in 3mg, 7 mg and 14 mg strength.

Can be used in patients where other oral therapy options have failed.

ADA (American Diabetes Association) recommends the use of a GLP-1 RA, such as semaglutide over initiating insulin for patients in whom oral therapy treatments have failed in achieving target blood glucose levels.

Can be used as monotherapy when metformin is considered inappropriate.

Can be used in combination with other drugs for the treatment of type 2 diabetes.

Limitations of use:

Not considered as first-line therapy for patients with type 2 diabetes.

Limited studies to support its use in patients with pancreatitis.

Cannot be used in patients with type 1 diabetes or with diabetic ketoacidosis.

Availability in the Indian market:On 31st January 2020, the Committee for Medicinal Products for Human Use (CHMP) under the European Medicines Agency (EMA) gave market authorisation for the use of oral semaglutide in managing type 2 diabetes along with diet and exercise. However, its launch in the Indian market is still awaited.Semaglutide injectable (Ozempic) which was approved by USFDA in 2017, is readily available in various pharmacies across India.

2. Liraglutide (Victoza)

It is an injectable drug developed by the same Danish pharmaceutical company that developed semglutide – Novo Nordisk.Injectable liraglutide was approved to treat adult patients with type 2 diabetes since 2010. It was in June 2019 – last year, that liraglutide got approval to treat type 2 diabetes in children.

After metformin was approved for pediatric use in 2000, liraglutide is the first non-insulin drug to get approval in managing type 2 diabetes in children.

Class: GLP-1 RA (Glucagon-like peptide receptor agonist)

Indication:

Type 2 diabetes in patients with more than 10 years of age as an adjunct to diet and exercise.

Type 2 diabetes with increased risk of cardiovascular disease in adults.

Mechanism of action: It lowers blood sugar levels by working similarly as GLP-1. It slows digestion, prevents the liver from making too much glucose and stimulates the pancreas to produce more insulin. This overall results in reduced blood glucose levels and thereby better glycemic response.

Advantage:

Expanded indication in pediatric patients with type 2 diabetes, thereby provides an additional treatment option. It is available as a single-patient-use pen that delivers doses of 0.6 mg, 1.2 mg, or 1.8 mg.

Can be used in adult patients with type -2 diabetes and increased risk of major adverse cardiovascular events.

Limitations of use:

Has not been studied for use in combination with prandial insulin.

Cannot be used in patients with type 1 diabetes and diabetic ketoacidosis.

Availability in the Indian market:Novo Nordisk had launched liraglutide in the Indian market in 2013 for use in adults patients with type 2 diabetes in an injectable form.

These two drugs, with their new place-in-therapy, offer promising treatment options for patients with diabetes. Science of diabetes is continuously evolving, and with the advent of the latest drugs improved health outcomes are expected.