Medical Breakthroughs 2013: Cutting-Edge Drugs Fight Diabetes

One of the Hudson Valley’s top medical breakthroughs in 2013

A new type of drug with a tongue-twisting name — sodium-glucose co-transporter 2 inhibitors — offers new hope in treating type 2 diabetes.

Also known as SGLT2 inhibitors, “They’re the hottest drug class out there,” says Robert Busch, M.D., of the Endocrine Group in Albany.

While most diabetes drugs focus on how the body deals with insulin — a key factor in the disease — such as helping reduce insulin resistance, increase insulin secretion, and/or generally lower too-high glucose levels in the body, SGLT2 inhibitors take a different approach.

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This oral medication works to control glucose in patients by blocking the mechanism that reabsorbs extra glucose back into the kidneys, causing extra blood sugar to instead be flushed out in the urine.

“And, while some current medications create side effects such as gastrointestinal issues, weight gain, and hypoglycemia (low blood sugar), this hasn’t been seen in most patients using SGLT2 inhibitors,” says Dr. Busch. The most common downsides of the new medication are urinary tract and yeast infections, which in most cases can be easily treated.

In late March, the FDA approved one type of SGLT2 inhibitor known as canaglifozin, marketed as Invokana, while requiring additional studies by its maker, pharmaceutical giant Johnson & Johnson. Other forms of the medication are also now in the testing phase by U.S. manufacturers.

Dr. Busch says, “The drug was approved on Good Friday, and I started prescribing it the next week. We’d known about it for a while, and couldn’t wait for it to come out.” He prescribes SGLT2 inhibitors to patients when appropriate; it is not, however, a recommended treatment for patients with type 1 diabetes, or type 2 patients with severe kidney disease or certain other issues.

“SGLT2 inhibitors are an exciting, promising new treatment, but there’s still no one magic bullet that will ‘cure’ diabetes. All medication should be used in conjunction with other factors in dealing with diabetes, including a healthy diet and moderate exercise,” Dr. Busch says.

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“However,” he adds, “we’re really fortunate to have a growing number of effective ways to help control diabetes.”

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