Fresh hope for diabetes treatment with new insulin therapy
Diabetes is a growing health concern world-wide, with nearly 422 million people living with the disease.
In South Africa, 12.8% of adults have diabetes according to the International Diabetes Federation. Diabetes is one of the leading causes of death in South Africa.
What is Type 2 diabetes?
Diabetes is a chronic disease that has many long term effects. It occurs when either the pancreas does not produce sufficient insulin or when the body cannot effectively use the insulin it produces.
As insulin is the hormone that regulates blood glucose, or blood sugar; raised blood sugar (hyperglycaemia) is a common effect of uncontrolled diabetes.
Hyperglycaemia can lead to serious damage to many of the body’s systems over time, especially the nerves and blood vessels.
Treating Type 2 diabetes
The easiest ways to test for diabetes is to use the glycated haemoglobin (A1c) test. This tests the average blood sugar level of a person for the past two to three months.
Anything below 5.7% is considered normal, 5.7% to 6.4% is considered prediabetic, and 6.5% or higher on two separate tests indicates diabetes. If an A1c test is not available, a random blood sugar test, fasting blood sugar test or an oral glucose tolerance test can be conducted to test for diabetes.
Once diabetes is confirmed, the focus is on managing the disease to prevent long-term complications. One of the most important ways this is done is by maintaining and improving glycaemic control over time.
The most common methods used to treat diabetes include starting a diet and increasing physical activity in an effort to lose weight and lower blood glucose levels. It is also recommended that smokers quit in order to help avoid complications.
Blood sugar levels will need to be monitored to ensure that blood sugar levels stay within the target range.
If diet, exercise, and weight loss are not enough to maintain the targeted blood sugar levels, medication is the next step. This includes oral medications and injectable medications that assist in either improving insulin production or insulin function. Some medications focus on lowering glucose production or decreasing glucose absorption.
Insulin therapy is another important form of treatment for diabetes, however it is often delayed due to concerns from patients or health-care practitioners.
Some of the most common concerns around insulin therapy include fear of potential increased hypoglycaemia risk, weight gain, and treatment complexity. Delaying insulin treatment can lead to irreversible complications, so it is vital to escalate treatment to include insulin.
Novo Nordisk South Africa, is launching its new insulin therapy product in South Africa. The new, injectable insulin therapy is a fixed ratio combination of a basal insulin and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in a single formulation.
GLP-1 agonist medicines are a type of incretin-based medicine for Type 2 diabetes. This type of medicine is based on the action of hormones called incretins which help control how the pancreas works. GLP-1 is a type of incretin that causes the pancreas to produce more insulin after eating, and helps keep blood sugar levels within a normal range.
According to specialist physician Dr Adri Kok, a unique characteristic of the basal insulin and GLP-1RA combination is that fixed-ratio co-formulations are available.
Dr Kok says: “These are dosed once-daily and therefore allow treatment intensification without additional daily injections. This is important because a greater number of daily injections is associated with decreased adherence, poorer quality of life and clinical inertia”