So many people with diabetes mellitus (DM) in the world,
led researchers to continue to develop the treatment of the disease. In recent
years, much research was done associated with 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 data from the National Diabetes Statistics 2011, the prevalence of diabetes has been estimated at 8.3 percent of the population of the United States, and most of it is DM Type II as reported Epharmapedia.
Various treatments have been developed diabetes and has been applied in many patients with type 2 diabetes. However, the treatment in patients with Type II diabetes related to several mechanisms, among others:
1. Insulin sensitizer
Insulin sensitizers may increase the ability of cells to recognize a variety of insulin, and then to enhance the action of insulin to push the glucose into them, thereby lowering blood glucose levels. Insulin sensitizers, namely Biguanides such as metformin and glitazones.
2. Secretagogues
These drugs include drugs that force the pancreas to increase insulin, thereby lowering blood glucose levels. These medications include sulfonylureas, meglitinides, incretin mimetic (Exenatides) and dipeptidyl peptidase IV inhibitor (DPP IV inhibitors), such as sitagliptin.
3. Other mechanisms
Other mechanisms, such as alpha-glucosidase inhibitors, and amylin analog. Acarbose is the alpha-glucosidase inhibitor that prevents the degradation of carbohydrates in the intestine, thereby preventing the absorption of glucose from food. Pramlintide is an analogue of a hormone called amylin, which is produced from the same cells that produce insulin. Amylin slows stomach and create a sensation of fullness that helps to regulate glucose uptake and prevent a rapid increase in blood glucose concentrations after meals
Several new treatments for diabetes, among others:
1. Exenatide once a week
Some exenatides been introduced as daily injections, and has been approved as an adjuvant treatment for type II diabetes.
2. SGLT-2 Inhibitors
The kidney is the organ that is quite conservative when accosted glucose, because it works to reabsorb glucose load may be trying to come out with urine. Sodium-glucose cotransporter-2 (SGLT-2) that are normally found in the renal proximal tubule will reabsorb most of the glucose and returns to the bloodstream with the help of the sodium gradient.
Dapagliflozin was the first drug developed to inhibit SGLT-2 and therefore increases the loss of glucose in the urine. Glucose-lowering drug is related to the ability of the renal glucose excretion. The effect depends on the amount of glucose that is filtered through the glomeruli and not dependent on insulin secretion. Method of action to minimize the risk of hypoglycemia. But it also makes dapagliflozin less effective when glomerular filtration rate decreased due to the 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 over 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 dapagliflozin groups also achieve weight loss more than the metformin group. The main side effects reported were urinary tract infection.
Food and Drug Administration (FDA) on July 19, 2011 against recommending approval for a new drug can cause increased risk of breast and bladder cancer.
3. Dual PPAR agonists
Glitazones are agonists of PPAR-gamma, 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 it should be double that PPAR-agonists will continue to have the benefit of glitazones and fibrates.
A phase II trial examining a novel dual PPAR agonists, which 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 a large-scale clinical trial to assess whether it will reduce cardiovascular risk (death, myocardial infarction, or stroke) among patients with diabetes and coronary artery disease.
4. Glucokinase activator
Glucokinase are intracellular enzymes that can be limiting 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 understanding the pathophysiology is expected to lead the researchers to develop treatments that are more radical and forward. But unfortunately, many new treatments for diabetes that has been discovered by researchers may not have been available and widely used in developing countries.
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 data from the National Diabetes Statistics 2011, the prevalence of diabetes has been estimated at 8.3 percent of the population of the United States, and most of it is DM Type II as reported Epharmapedia.
Various treatments have been developed diabetes and has been applied in many patients with type 2 diabetes. However, the treatment in patients with Type II diabetes related to several mechanisms, among others:
1. Insulin sensitizer
Insulin sensitizers may increase the ability of cells to recognize a variety of insulin, and then to enhance the action of insulin to push the glucose into them, thereby lowering blood glucose levels. Insulin sensitizers, namely Biguanides such as metformin and glitazones.
2. Secretagogues
These drugs include drugs that force the pancreas to increase insulin, thereby lowering blood glucose levels. These medications include sulfonylureas, meglitinides, incretin mimetic (Exenatides) and dipeptidyl peptidase IV inhibitor (DPP IV inhibitors), such as sitagliptin.
3. Other mechanisms
Other mechanisms, such as alpha-glucosidase inhibitors, and amylin analog. Acarbose is the alpha-glucosidase inhibitor that prevents the degradation of carbohydrates in the intestine, thereby preventing the absorption of glucose from food. Pramlintide is an analogue of a hormone called amylin, which is produced from the same cells that produce insulin. Amylin slows stomach and create a sensation of fullness that helps to regulate glucose uptake and prevent a rapid increase in blood glucose concentrations after meals
Several new treatments for diabetes, among others:
1. Exenatide once a week
Some exenatides been introduced as daily injections, and has been approved as an adjuvant treatment for type II diabetes.
2. SGLT-2 Inhibitors
The kidney is the organ that is quite conservative when accosted glucose, because it works to reabsorb glucose load may be trying to come out with urine. Sodium-glucose cotransporter-2 (SGLT-2) that are normally found in the renal proximal tubule will reabsorb most of the glucose and returns to the bloodstream with the help of the sodium gradient.
Dapagliflozin was the first drug developed to inhibit SGLT-2 and therefore increases the loss of glucose in the urine. Glucose-lowering drug is related to the ability of the renal glucose excretion. The effect depends on the amount of glucose that is filtered through the glomeruli and not dependent on insulin secretion. Method of action to minimize the risk of hypoglycemia. But it also makes dapagliflozin less effective when glomerular filtration rate decreased due to the 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 over 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 dapagliflozin groups also achieve weight loss more than the metformin group. The main side effects reported were urinary tract infection.
Food and Drug Administration (FDA) on July 19, 2011 against recommending approval for a new drug can cause increased risk of breast and bladder cancer.
3. Dual PPAR agonists
Glitazones are agonists of PPAR-gamma, 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 it should be double that PPAR-agonists will continue to have the benefit of glitazones and fibrates.
A phase II trial examining a novel dual PPAR agonists, which 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 a large-scale clinical trial to assess whether it will reduce cardiovascular risk (death, myocardial infarction, or stroke) among patients with diabetes and coronary artery disease.
4. Glucokinase activator
Glucokinase are intracellular enzymes that can be limiting 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 understanding the pathophysiology is expected to lead the researchers to develop treatments that are more radical and forward. But unfortunately, many new treatments for diabetes that has been discovered by researchers may not have been available and widely used in developing countries.
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