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    Five Treatments Turning the Tide on Diabetes

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    Individuals diagnosed with diabetes incur an average of $7,900 more in medical expenses annually, the American Diabetes Association (ADA) reports. Diabetes costs add up to a whopping $245 billion in direct medical costs and $69 billion in reduced productivity annually, according to an ADA study based on 2012 numbers. The largest components of medical expenditures are hospital inpatient care (43% of the total medical cost), prescription medications to treat the complications of diabetes (18%), antidiabetic agents and diabetes supplies (12%), physician office visits (9%), and nursing/residential facility stays (8%).

    Given the large amount of people who have diabetes and the high costs associated with it, finding better ways to treat it are vital. Here are five new advances in disease management—including promising treatments in the pipeline.

    Double-duty medications

    Poorly controlled diabetes is associated with an increased risk of heart disease, says Roger Kulstad, MD, associate clinical professor of medicine, Division of Endocrinology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin. A study published in British Medical Journal estimated that every 1% increase in HbA1c above 6% is associated with a 14% increase in risk of heart attack.

    Two classes of diabetes medications (SGLT2 inhibitors and GLP-1 receptor antagonist) show cardiovascular benefits for patients with diabetes at high risk for heart disease. The hope is that the medications may also help prevent or delay cardiovascular disease, says Anders L. Carlson, MD, medical director, International Diabetes Center.

    One SGLT-2 inhibitor, empagliflozin (Jardiance), for instance, makes patients excrete sugar, salt, and water, says Robert S. Busch, MD, director of clinical research, Albany Med: The Endocrine Group, Albany, New York. It has been shown to lower cardiac death by 38% and heart failure by 35%. A GLP-1 antagonist, liraglutide (Victoza), a daily GLP-1, has been shown to lower cardiac death by 22%.

    Furthermore, several GLP-1 therapies that only need to be administered weekly with a simplified pen are now on the market. Another advantage is that they do not cause hypoglycemia (low blood glucose) when used alone or with other drugs that don’t cause hypoglycemia. “This is a big concern when using insulin or other standard pills for diabetes (e.g., sulfonylureas) which may cause hypoglycemia and weight gain,” Busch says. These drugs facilitate weight loss as well as lower blood sugar by a variety of mechanisms including increasing insulin from the pancreas only if sugar is high, decreasing appetite, and delaying stomach emptying.

    Next: More effective insulin 

     

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