Diabetes and weight loss.
People are talking about the new diabetes drug, Byetta (exenatide), for weight loss...even in people who do NOT have diabetes.
It's all over the internet...even though this drug is still investigational in Canada...even for diabetes patients.
Some call it "Gilly" or "Lizzie"...because it's derived from Gila monster, or lizard, saliva.
Byetta is an incretin mimetic for type 2 diabetes.
It improves glycemic control by INCREASING insulin and decreasing glucagon when glucose levels are elevated. It also seems to reduce hunger...and slows stomach emptying which might help patients
feel full faster and longer.
People taking Byetta do LOSE weight...instead of GAINING weight like with insulin or sulfonylureas. The average loss is only about 2.3 kg...but some lose 20 kg or more.
Byetta is not recommended for weight loss yet.
From 2006 Canadian Pharmacist's Letter (May 2006)
pharmacist.
Insulin pumps to be funded
Families with children who have juvenile, or Type 1, diabetes are getting a boost from Ontario's budget.
A new program worth $12 million in 2006-07, and growing to $30 million by 2008-09, will help families purchase insulin pumps and supplies.
Ontario will now pay the $6,000 price of an insulin pump and the nearly $2,400 a year for supplies to run one. Who will gain access to the program is yet to be defined by the health ministry. There are about 6,500 children in Ontario with Type 1 diabetes.
Finance Minister Dwight Duncan said of all the things announced in yesterday's budget, he is most proud of this provision for insulin pumps for young people with diabetes. Once Ontario does this, he said, perhaps every other jurisdiction in Canada will follow.
Source: Tanya Talaga- Health Reporter (March. 24, 2006)
Levemir (insulin detemir) is now available in Canada.
It's a basal insulin similar to Lantus (insulin glargine). It's used in combination with a short- or rapid-acting meal-time insulin... Novolin ge Toronto, NovoRapid, etc.,
Levemir has a more predictable glucose-lowering effect than Lantus or NPH insulin (Novolin ge NPH, etc). It also causes less nighttime hypoglycemia than NPH insulin in patients with type 1 diabetes. It lasts up to 24 hours and is given either once or twice daily.
evemir's slow absorption and prolonged effect are due to self-aggregation at the injection site and binding to albumin. But it doesn't interact with other drugs that bind to albumin.
Levemir is only available in 3 mL penfill cartridges...not vials.
(From Pharmacist letter-Feb' 2006)
The new inhaled insulin, Exubera, is getting Type I diabetics excited.
Some may try to get it early from across the border...when it comes out later this summer in the U.S. It will be an alternative to short-acting mealtime insulin.
It has a fast onset like Humalog or NovoRapid...but a longer duration like regular insulin (Humulin R, etc). Exubera won't totally replace injectable insulin. Many patients will still need a long-acting insulin for basal control.
Exubera is also approved only for adults...not for children.
Exubera's downside.
Exubera will be a rather large dry powder inhaler. The insulin will come in 1 and 3 mg blister packs. This works out to be equivalent to about 3 and 8 units of injectable insulin. Some patients will need multiple inhalations.
Two big concerns are that Exubera can decrease lung function... plus decreased lung function can affect insulin absorption. Patients will need pulmonary function tests before starting Exubera.
Patients cannot use Exubera if they smoke...or for 6 months after they quit. Exubera is also not recommended for patients with chronic lung disease such as asthma or COPD.
(From Pharmacist Letter March 2006)
