New diabetes-related medicines being tested on patients

Four novel approaches to treat type 2 diabetes were discussed at the recent 69th Scientific Sessions of the American Diabetes Association.

All are in stage 3 clinical research trials right now. In other words, real patients are using these new treatments and their progress is being recorded and analyzed.

One treatment of great interest to anyone with diabetes is the possibility of taking insulin by mouth. New approaches have been developed to make this a reality. Until now, any insulin swallowed is damaged by the stomach acids. New discoveries allow the tissues inside the cheek to absorb insulin.

Another new category of anti-diabetic medicines called SGLT-2 inhibitors have been found to reduce blood sugars without the use of insulin. These drugs make the kidneys spill sugar into the urine. This has two potentially beneficial effects. First, it lowers blood sugar levels by helping the body eliminate high sugars faster. Second, the extra calories the sugar represents are lost. This helps the diabetic lose weight. Side effects seem to be minimal. Studies are under way to prove their value and effectiveness.

There is good evidence that the insulin-producing cells of the body are damaged and destroyed by inflammation in type 2 diabetics. That puts it in a similar category with other inflammatory diseases such as rheumatoid arthritis and gout. One new agent being investigated is called interleukin-2 (IL-2) beta receptor antagonist. Studies have shown the receptor plays a significant role in the death of the insulin producing cells. If this killer agent could be blocked, then insulin production would be preserved. Diabetes would be slowed or maybe even stopped.

Another anti-inflammatory agent being studied is Salsalate. Not only might this medication, which is chemically similar to aspirin, be helpful in preventing type 2 diabetes, but it also could protect against the damage to blood vessels so commonly seen in all diabetics. Salsalate is known to slow down overactive inflammatory pathways in type 2 diabetics. There is now good evidence that inflammation of blood vessels is closely associated with insulin resistance and impaired insulin secretion.

None of these medicines will be on shelves anytime soon. It’s important to study new medications for side effects and prove their value. Next, the FDA would need to evaluate these drugs and that process can take time before formal approval. Finally, like any other new medicines, don’t expect them to be inexpensive or covered by your health insurance.

As exciting as any new medicine may seem, the best management for any type of diabetes is carefully balancing food eaten, regular activity, and medications (only if needed). The Diabetes Prevention Program proved more than a decade ago that regular daily exercise combined with improved eating habits aimed at lowering weight by just 7 percent prevents diabetes better than any known medicine.