Promising drug for Type 2 diabetes

Type 2 diabetes patients who don’t respond to metformin, the most widely used medication for the disease, may get significant benefit from a new second-line drug, a new study has claimed.

The new drug, linagliptin, results in significantly less weight gain than the most common second-line drugs currently used, and may even carry a smaller risk of cardiovascular events such as heart attack and stroke, according to the study published in The Lancet.

Though metformin is the most commonly prescribed drug to treat diabetes, which affects almost 10 per cent the world’s population, it can become ineffective in the long-term for many patients. Those who do not respond to metformin alone are offered an additional drug known as sulphonylureas.However, sulphonylureas can lead to hypoglycaemia, or low blood sugar levels, and weight gain, raising the risk of heart attack and stroke.

“Since hypoglycaemia have substantial negative clinical consequences in terms of cognitive function, mortality... and quality of life, its prevention is a crucial component of any diabetes management programme,” said study author Prof Baptist Gallwitz of Tubingen University Hospital in Germany.

The new drug, linagliptin - a class of drugs called DPP-4 inhibitors or “gliptins” — works in a different way by blocking an enzyme known as dipeptidyl peptidase-4 which is involved in glucose metabolism.

This allows the body to increase the amount of insulin it secretes in a glucose-dependent manner, resulting in a very low risk of hypoglycaemia, the researchers said.

Conducted over two years in 16 nations, the study looked at the effects of linagliptin versus glimepiride, one of the most commonly used sulphonylureas, in more than 1,500 patients with Type 2 diabetes who had not achieved normal glucose regulation through the use of metformin alone.

While the two treatments produced comparable improvements in patients’ glucose regulation, the study showed side effects of linagliptin were considerably less severe than those with glimepiride, with just seven per cent of patients treated with linagliptin experiencing hypoglycaemia, compared to 38 per cent of patients treated with glimepiride. The group treated with linagliptin also experienced fewer cardiovascular events such as heart attacks or strokes compared to those treated with glimepiride, the authors said.

However, they stressed that further studies are needed to confirm this, as the study was not long enough to provide reliable evidence that linagliptin results in reduced cardiac risk compared to glimepiride.

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