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Various New Treatment Diabetes Mellitus
So many people with diabetes mellitus (DM) worldwide, making the researchers continue to develop the treatment of disease. In recent years, many studies conducted related to the disease diabetes.
These studies must be done to find the best treatment for DM. These studies, including the successful discovery of an artificial pancreas and beta cell transplantation.
Beradasarkan to the National Diabetes Statistics 2011, the prevalence of DM has been estimated 8.3 percent of the population of the United States, and most are DM Type II as reported from Epharmapedia, Wednesday (09/07/2011).
Various treatments have been developed and DM has been applied to many patients with type 2 diabetes. However, treatment in patients with Type II diabetes related to several mechanisms, among others:
1. Insulin sensitizer
Insulin sensitizers can improve the ability of cells to recognize a variety of insulin, and then to improve insulin action by promoting glucose into it, thus lowering blood glucose levels. Insulin sensitizer main Biguanides such as metformin and glitazones.
2. Secretagogues
These drugs include drugs that force the pancreas to increase the amount of insulin, thereby lowering blood glucose levels. These medications include sulfonylureas, meglitinides, incretin mimetic (Exenatides) and inhibitors of dipeptidyl peptidase IV (DPP IV inhibitors), such as sitagliptin.
3. Other mechanisms
Other mechanisms, such as alpha-glucosidase inhibitors, and amylin analogue. Acarbose is an alpha-glucosidase inhibitor which prevents degradation of carbohydrates in the gut, and thus prevent the absorption of glucose obtained from food. Pramlintide is an analog of a hormone called amylin, which is produced from the same cells that produce insulin. Amylin slows stomach and creates a sensation of fullness that helps to regulate glucose uptake and prevent the rapid rise of blood glucose concentrations after meals
Several new treatments for diabetes, among others:
1. Exenatide once a week
Some exenatides have been introduced as a daily injection, and has been approved as an auxiliary treatment for diabetes mellitus type II.
2. SGLT-2 Inhibitors
Kidney is the organ that is quite conservative when accosted glucose, because it works to reabsorb glucose load that may try to come out with urine. Sodium-glucose cotransporter-2 (SGLT-2) are normally found in the proximal renal tubules to reabsorb most of the glucose and return to the bloodstream with the help of the sodium gradient.
Dapagliflozin is the first drug developed to inhibit the SGLT-2 and hence increase the loss of glucose in urine. Glucose-lowering drugs with the ability is related to renal glucose excretion. The effect depends on the amount of glucose that is filtered through the glomeruli and not dependent on insulin secretion. The method of action to minimize the risk of hypoglycemia. But it also makes dapagliflozin less effective when glomerular filtration rate decreased due to development of renal impairment.
In two studies, dapagliflozin (5 mg or 10 mg) were evaluated in combination with metformin XR and compared with monotherapy. Both studies were conducted for 24 weeks, and at the end of the study a higher proportion of patients treated with combination therapy achieved lower HbA1c and glycemic control better. In the group Dapagliflozin also reached more weight loss than the metformin group. The main side effects reported were urinary tract infection.
Food and Drugs Administration (FDA) on July 19, 2011 against recommending approval for this new drug because it can cause increased risk of breast cancer and bladder cancer.
3. Dual PPAR agonists
Glitazones is PPAR-gamma agonists, and through the activation of specific nuclear receptors, can make the body's tissues respond to insulin. A new group of drugs called dual PPAR agonists, because of its ability to activate PPAR-gamma and alpha at the same time. Interestingly, PPAR-alpha agonism should be a mechanism of action of fibrates that reduce triglycerides and increase HDL. So should that dual PPAR-agonists will continue to benefit from the glitazones and fibrates.
A Phase II trial examining a new dual PPAR agonist, namely aleglitazar,. Tests showed that therapy with these agents reduce hyperglycemia and normal levels of HDL-C and triglycerides with acceptable safety. Aleglitazar currently being studied in large-scale clinical trial to assess whether it will be able to reduce cardiovascular risk (death, myocardial infarction, or stroke) among patients with diabetes and coronary artery disease.
4. Glucokinase activator
Glucokinase is an enzyme that may limit intracellular step in glucose metabolism.
There is no doubt that diabetes is a potential target for many researchers and scientists to reduce the prevalence of diabetes. Advances in the understanding of the pathophysiology is expected to lead researchers to develop a more radical treatment and progress. But unfortunately, many new treatments for diabetes that has been discovered by researchers may not be obtained and used widely in developing countries
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