Monday, 1 April 2013

2 April, 2013


USFDA approves safer diabetes drug which acts on kidneys
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A novel anti-diabetic drug that lowers blood glucose levels by acting on the kidneys, instead of the liver or the pancreas, has been approved by the USFDA.
The drug, Invokana (Canagliflozin), works by blocking the reabsorption of glucose by the kidney, increasing glucose excretion and lowering blood glucose levels in diabetics. Its safety and effectiveness were evaluated in nine clinical trials involving over 10,285 patients with type 2 diabetes.
However, FDA has asked for some more safety data from the drug company, Janssen Pharmaceuticals, including a cardiovascular outcomes trial, an enhanced pharmacovigilance programme to monitor for malignancies, serious cases of pancreatitis, severe hypersensitivity reactions/photosensitivity reactions, liver abnormalities, and adverse pregnancy outcomes. It has also asked for a bone safety study.
While there are concerns about the cardiovascular and other side-effects of Canagliflozin, the uniqueness of its mechanism of action is expected to spawn a few more of its kind over the next few years.
While marvelling at the uniqueness of Canagliflozin, doctors in India are cautious in their prognosis for its future not just because of the side-effects but also because some of them feel the action through the kidneys is in itself a limiting factor in the efficacy of the drug.
It is only in combination with other drugs with different modes of action that it may achieve good results, they say. However, the possibility of combination drug therapy means that at least some diabetics who are on insulin can take a break from the daily needle pricks.
"Canagliflozin acts through the kidneys and therefore also has a role in weight loss which is vital for diabetes patients. In normal circumstances, kidneys resist removal of glucose from the body until the blood sugar reaches a very high level," said Dr Anoop Misra, chairman of Fortis C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology.
"This drug modifies that mechanism and enables excretion of glucose even when blood glucose level is relatively low. In combination with existing drugs, it may help get at least some patients off insulin therapy but it elevates chances of urinary infection," he said.
02.04.2013


Vitamin D may lower diabetes risk in obese kids
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Vitamin D supplements can help obese children and teens control their blood-sugar levels, which helps stave off diabetes, scientists say.
Being obese puts individuals at greater risk for developing Type 2 diabetes, a disease in which individuals have too much sugar in their blood.University of Missouri researchers studied 35 pre-diabetic obese children and adolescents who were undergoing treatment in the MU Adolescent Diabetic Obesity Programme.
"By increasing vitamin D intake alone, we got a response that was nearly as powerful as what we have seen using a prescription drug," said Catherine Peterson, an associate professor of nutrition and exercise physiology at MU.
"We saw a decrease in insulin levels, which means better glucose control, despite no changes in body weight, dietary intake or physical activity," Peterson said.
All of those in the study had insufficient or deficient vitamin D levels and had similar diets and activity levels. Study participants randomly were assigned either a high-dose vitamin D supplement or a placebo that they took daily for six months.
Those who took the supplement became vitamin D sufficient and lowered the amount of insulin in their blood. "The vitamin D dosage we gave to the obese adolescents in our study is not something I would recommend for everyone," Peterson said.
Vitamin D helps maintain healthy bones, muscles and nerves and enters bodies through sunlight exposure, diet or supplements. Vitamin D insufficiency is common; however, it can be more detrimental to those who are obese, Peterson said. "What makes vitamin D insufficiency different in obese individuals is that they process vitamin D about half as efficiently as normal-weight people," Peterson said.
Adding vitamin D supplements is a natural, inexpensive way to help obese children and teens decrease their odds of developing diabetes and avoid the side effects that might come from taking prescriptions to control their blood sugar, Peterson said. The study was published in the American Journal of Clinical Nutrition.
02.04.2013







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