Study results presented at the Second International Conference on Advanced Technologies & Treatments for Diabetes in Athens suggest that the OmniPod Insulin Management System (a disposable, tube-free insulin delivery system similar to an insulin pump; Insulet Corporation, Bedford, MA, USA) delivers more accurate doses of insulin than “traditional” pumps, whose insulin delivery rates can be impacted by their position relative to the infusion set.
The manufacturers of the device suggest that this is important for people with type 1 diabetes as increased variations in insulin delivery make it difficult to consistently control blood glucose levels.
An earlier study from the same research team indicated that short-term interruption of continuous subcutaneous insulin infusion therapy can result in significant elevations in blood glucose levels (P<0.001). The OmniPod is worn for up to 3 days at a time and does not have to be disconnected at any time during its use.
Liraglutide appears to be superior to rosiglitazone when added to glimepiride
Data from the LEAD-1 (Liraglutide Effect and Action in Diabetes 1) study, published in Diabetic Medicine in January of this year, indicated that liraglutide (a glucagon-like peptide-1 analogue) provided improved glycaemic control and a favourable weight profile compared with rosiglitazone or placebo when added to glimepiride monotherapy in people with type 2 diabetes.
In the 26 week study involving more than 1000 participants, liraglutide in combination with glimepiride was shown to reduce HbA1c by 1.1 percentage points. This change was significantly greater than that in the groups who were assigned to placebo plus glimepiride or rosiglitazone plus glimepiride.
Addition of liraglutide to glimepiride also reduced fasting plasma glucose (FPG) and postprandial glucose (PPG) levels more than adding either rosiglitazone (P<0.006 for FPG, P<0.05 for PPG) or placebo (P<0.0001 for both).
As expected, significant weight gain was experienced in the rosiglitazone group, but liraglutide and placebo reduced weight slightly.
Interestingly, using the higher doses of liraglutide (1.8 or 1.2 mg/day), the proinsulin:insulin ratio, a marker of beta-cell function, was reduced compared with the rosiglitazone and placebo groups, thus indicating improved cell function. However, this was not significant when using the 0.6 mg/day dose.
An additional study published in Diabetes Care further supports the efficacy and tolerability profile of liraglutide in the treatment of type 2 diabetes, when added to metformin.
Expert Patient Programmes improve people’s outlook
Recent research has suggested that 75% of people with long-term conditions who attended an Expert Patient Programme felt more positive about their condition, and 78.4% felt they were managing their feelings better.
It also revealed that people living with long-term conditions significantly improved their relations with healthcare professionals after attending the programme, and were more likely to speak out (61%) and be more willing to say exactly what they wanted (71%). Furthermore, 60% said that they were coping with pain better and 55% were becoming less frustrated at the symptoms they were experiencing.
Launch of “motivational” blood glucose testing device
The Accu-Chek Aviva Nano, launched recently by Roche Diagnostics, is designed to motivate people with diabetes to self-manage their condition.
The blood glucose monitor reminds the user of the importance of pre- and post-meal testing, with meal markers indicating when measurements need to be taken. These readings help track longer-term patterns in the user’s daily testing and provide calculations to guide both the person with diabetes and the healthcare professional.
Orlistat cleared for over the counter sales in the UK
In January, GlaxoSmithKline Plc (GSK) was given the go-ahead to sell orlistat (in the form of Alli, a lower dose formulation of the drug) over the counter in Europe.
The approval from the European Commission had been expected, following a positive review by the European Medicines Agency. The drug has been available without prescription in the USA since 2007.
GSK plans to release the drug in all 27 member countries of the European Union and Norway. It is aimed at adults with a BMI of 28 kg/m2 or more.
In clinical trials, people lost 50% more weight when they used Alli with a reduced-calorie, lower-fat diet than by dieting alone. The drug enabled recipients to lose an extra pound for every two pounds they would lose if they dieted without taking the pill.
In the USA, the drug has “successfully helped millions of users lose weight gradually and steadily, and adopt a healthy lifestyle,” said Manfred Scheske, GSK’s European President of Consumer Healthcare. Alli is not intended to replace, but to enhance, the effect of dieting and exercise, said GSK.
Attempts to achieve remission, or at least a substantial improvement in glycaemic control, should be the initial focus at type 2 diabetes diagnosis.
9 May 2024