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What are the most exciting advancements against diabetes?
![]() Gary Pepper, M.D., FACP
A new group of medications has recently become available for the treatment of type 2 diabetes. These medications take advantage of discoveries on the workings of hormones, known as “incretins,” which are naturally made by special cells in the intestines in response to eating. Incretins stimulate the release of insulin from the pancreas into circulation where it regulates the amount of sugar in the blood. (Some incretins also stop the release of glucagon, which is another hormone that interferes with insulin action.) The first of these medicines receiving FDA approval is exenatide (Byetta). Byetta is given by subcutaneous injection twice daily just before eating. This medicine appears to have a secondary benefit of reducing appetite and assisting with weight-loss efforts. Sitagliptine (Januvia) is another FDA-approved medication taking advantage of the incretin system. It is an oral medication taken once daily and has been shown to be effective at lowering blood sugar levels in type 2 diabetics. As with all prescription medications, only a health care professional can determine if a drug treatment is appropriate for each individual. A cure for type 1 (juvenile) diabetes, though, is still a distant hope. The main focus for curing or delaying type 1 diabetes focuses on the immune system. The immune system normally protects against viruses, bacteria and cancer cells. In type 1 diabetes a person’s own immune system appears to attack the insulin producing cells in the pancreas, leading to the disappearance of this vital sugar-controlling hormone. Studies in humans are now taking place which use artificially created antibodies to stop this immune attack on the pancreas. Using these experimental substances, delays of up to 18 months in the onset of type 1 diabetes have been achieved. Many more studies of this type are being planned—hopefully paving the way for even better results. |
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