New pill for injection-free diabetes

A new pill on the market promises to change the life of some diabetics by stabilising their glucose levels and helping the body secrete insulin when needed.

This new class of daily drugs helps control Type 2 diabetes, the most common form that affects more than 53 million people in Europe and nearly 30,000 people in Malta.

Professionals are seeing it as "a very exciting new development", said Stephen Fava, head of the Diabetes and Endocrine Unit within Mater Dei Hospital.

It is particularly exciting because patients eligible for such drugs can do away with invasive insulin injections and control their condition with a pill.

Earlier this month Januvia, a drug in this class, was launched onto the local market, joining another one called Galvus.

While both are approved by the EU, Januvia is the only one to have a certification by the US Food and Drug Administration (FDA).

Both fall under the new class of prescription oral drugs known as enzyme inhibitors - or dipeptidyl peptidase IV inhibitors (DPP-IV) - that regulate the levels of insulin produced by the body after eating.

They work by blocking the DPP-IV enzyme that hinders the work of a naturally produced hormone that augments insulin secretion within the pancreas to control glucose levels.

"This class of drugs is a missing link... It is filling an existing gap and most diabetic specialists are excited about this new class of medicines. It adds an important arsenal in our fight against diabetes," said consultant endocrinologist Michael Zouvanis, who was in Malta for Januvia's launch earlier this month.

Dr Zouvanis, a Cypriot doctor who heads the Endocrinology Unit at Lito Private Hospital, stressed that Januvia must be complemented with a healthy lifestyle.

Agreeing with this, Dr Fava said that, while he believed such drugs would not completely do away with the use of insulin in treating Type 2 diabetics, there was a place for them in the Maltese market where it was estimated that about 95 per cent of the 30,000 diabetes patients in Malta suffer from this condition.

Type 2 diabetes is a condition in which the body does not make enough insulin and the insulin the body produces does not work as well as it should.

When this happens, glucose builds up in the blood and this can lead to serious medical problems. Dr Zouvanis explained that the small, brownish, round pill should be taken once a day before breakfast. Januvia is a prescription drug that can be given to adults with Type 2 diabetes and a remaining function of the pancreas, he said.

"Insulin production is one of the core causes of diabetes. Januvia, and drugs of its class, help the body produce and secrete insulin in a more natural way and when it is needed.

"It's a question of timing. You need to have the right amount of insulin at the right time. If the insulin comes 30 minutes early your sugar levels will go down and you'll get hypoglycaemia - or low sugar. If it comes too late then you'll have a very high peak of glucose that, over the years, causes damage to the vascular system. You want the insulin to be there at the exact second it is needed and the only thing that can do that is the body itself. Januvia helps the body do just that," he said.

The side-effect profile of the drug, which has been on the market for two years, has been positive as unlike other anti-diabetic drugs this one changes nothing in a non-diabetic, he said.

The most common side-effects reported include upper respiratory infection, stuffy or runny nose and sore throat and headache.