New Type 2 Diabetes Drug Helps Lower Blood Sugar: Study

MONDAY, March 19 (HealthDay News) — A new type of medication for
type 2 diabetes helps to lower blood sugar levels when used in concert
with insulin and other diabetes drugs, new research suggests.

The medicine is called dapagliflozin, and average blood sugar levels
were lower in those taking the drug compared to those taking a placebo;
both groups in the trial also took insulin and other diabetes medications.
Daily insulin doses went down for those on the drug, and body weight
dropped slightly.

“This study looked at the effects of dapagliflozin treatment in people
with type 2 diabetes with high blood sugars despite insulin treatment, and
found it was effective at reducing blood sugar, body weight and blood
pressure,” said study author Dr. John Wilding, head of the department of
obesity and endocrinology at the University Hospital Aintree in Liverpool,
England.

“Possible disadvantages include a slightly higher risk of urine
infections and genital fungal infections, although most of these responded
well to standard treatment,” he added.

Results of the study are published in the March 20 issue of the
Annals of Internal Medicine. The study was funded by AstraZeneca
and Bristol-Meyers Squibb, two pharmaceutical companies who are
collaborating in the development of dapagliflozin.

Type 2 diabetes affects the way your body metabolizes sugar. In type 2
diabetes, the body either doesn’t use the hormone insulin effectively or
it doesn’t make enough insulin, according to the U.S. National Library of
Medicine. Insulin allows the body’s cells to convert sugar from food into
fuel. If it isn’t used well or there’s not enough insulin, blood sugar
levels will rise. High blood sugar levels can cause a number of serious
health consequences, including damage to the eyes, kidneys and blood
vessels.

In some cases, type 2 diabetes can be controlled with lifestyle
changes, such as losing weight and exercising regularly. However, most
people need medications to control their blood sugar levels, and many
people need a combination of medications to lower their blood sugar.

Dapagliflozin is from a new class of type 2 diabetes medications that
work by blocking the ability of the kidneys to hold sugar. This causes the
kidneys to release sugar as waste in the urine.

Numerous clinical trials have found dapagliflozin to be effective at
lowering blood sugar levels. Despite this beneficial effect, the U.S. Food
and Drug Administration recently decided not to approve dapagliflozin
until more information is available about its possible long-term side
effects. The most significant concern cited by the FDA was a potential
increase in the rates of bladder and breast cancer in people taking the
drug.

Although the current trial wasn’t long enough to look for longer-term
outcomes, such as cancer, Wilding said that the slight increase in bladder
and breast cancer was likely a chance finding. But, he said, because there
is concern, it’s important to continue surveillance for these cancers in
future trials.

The current study was designed to see how the drug would work in
combination with insulin and other type 2 diabetes medications.

The researchers enrolled just over 800 people with type 2 diabetes who
were already taking insulin to control their blood sugar levels. In
addition, the study volunteers could be taking up to two more blood
sugar-lowering medications.

Study participants were randomly assigned to one of four treatment
groups. They received either a placebo, or one of three doses of
dapagliflozin (2.5, 5 or 10 milligrams) daily.

After 24 weeks of treatment, people in the dapagliflozin group lowered
their average hemoglobin A1C level between 0.79 percent to 0.96 percent
compared with a 0.39 percent reduction in those on placebo. Hemoglobin A1C
is about a three-month average blood sugar level. People with diabetes are
advised to keep their levels below 7 percent.

Insulin use also dropped for people taking the medication, suggesting
more effective blood sugar control. And, body weight decreased between 2
pounds and 3.5 pounds for those taking the medication. Weight increased by
almost 1 pound for those on placebo, according to the study.

In addition, the researchers found that both systolic and diastolic
blood pressure levels went down more for those on the drug compared to
those on placebo.

“In this study, dapagliflozin seemed to improve glucose control and
lower the need for insulin, as well as cause some weight loss,” said Dr.
Sue Kirkman, senior vice president of medical affairs and community
information of the American Diabetes Association.

“This is an interesting study on a new medication that’s under
development. It has a novel mechanism of action, but there have been some
ongoing concerns about the safety of this class of medications, and none
has been approved by the FDA yet,” she noted.

More information

Learn more about type 2 diabetes and currently approved treatments from
the American Diabetes Association.

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