Spotlight on New Diabetes Treatments

Over the past three years, three diabetes treatments with entirely new modes of action were approved: Byetta (for people with type 2 diabetes), Symlin (as an add-on to insulin therapy for people with type 1 diabetes or type 2 diabetes) and Januvia (also for people with type 2 diabetes). "New is not necessarily better, but these are additional weapons in the armament," says Nora Saul, M.S., C.D.E., R.D., L.D.N., who educates Joslin Diabetes Center patients on blood glucose management.

Some diabetes medications help the pancreas release more insulin (if you have type 2 diabetes), others help cells use insulin better, and others keep the liver from releasing too much glucose. The three new treatments focus action on hormones called ‘incretins’. The two given by injection—Byetta and Symlin—have an added bonus of promoting weight loss.

With more options, treatments can be better tailored to an individual. Since type 2 diabetes is progressive, what works for some people for a period of time may lose effectiveness. For example, some people with type 2 diabetes may start treating the chronic disease with oral medications, and then subsequently discover that insulin would give them more control.

Here are the three new medical options that enhance blood glucose control for people with type 1 or type 2 diabetes:

Byetta
(generic: exenatide)

• by injection twice a day at mealtime
• for those with type 2 diabetes who have been unable to control blood glucose with oral medicines
• improves blood glucose control by mimicking incretin hormones, stimulating insulin and slowing stomach-emptying
• leads to weight loss (feel full faster, so people feel satiated faster and stop eating)
• can cause nausea

Symlin
(pramlintide acetate)

• for those with type 1 or type 2 diabetes who use insulin
• by injection at mealtime
• must never mix Symlin and insulin in one syringe; also means an additional injection
• better control, reduces spikes in blood glucose, reduces food intake (leads to weight loss)
• can cause nausea; hypoglycemia (dangerously low blood sugars)

Januvia
(sitagliptin)

• by pill once a day
• for type 2 diabetes
• does not promote weight gain
• often used in combination with metformin
• very little, if any, side effects
• slows the breakdown of incretins, so insulin is released over a longer period of time

Click here for more information about Patient Education at Joslin Diabetes Center.