The HumaPen Memoir (Eli Lilly & Company, Basingstoke) is an insulin delivery device with a digital memory, capable of remembering the previous 16 doses and the time and date that the dose was delivered.
The device was launched on 5 March at the Diabetes UK Annual Professional Conference in Glasgow and promises to help increase the user’s adherence to their insulin regimen. The last dose, and the date and time that is was delivered, can be seen at the push of a button.
The pen has a simple ‘dialling’ system to enable users to set the correct dose – shown in the display window – which can be adjusted in increments from 1–60 units.
Poor adherence to treatment regimens, whether as a result of forgetfulness or reluctance, is a major barrier to achieving good glycaemic control. It is helpful to people with diabetes and healthcare professionals, as the memory function enables the healthcare professional to monitor whether the individual is taking the correct dose at the correct time and then discuss this with them.
The Director of Care, Information and Advocacy Services for Diabetes UK, Simon Grant, said: ‘For many people with diabetes, taking insulin is an essential element of their treatment. We welcome the development of any device which helps to make this part of their life easier to manage.’
Sitagliptin approved as add-on therapy with SU alone or SU plus metformin
On the 21 January 2008, Merck Sharp & Dohme (Hoddesdon) announced that sitagliptin had been approved by the European Commission as an add-on therapy in combination with a sulphonylurea alone when the maximally tolerated dose fails to provide adequate glycaemic control, or with a sulphonylurea plus metformin when diet and exercise combined with these agents fails to provide adequate glycaemic control.
Sitagliptin should be taken at a dose of 100mg daily, with or without food. Those with mild to moderate hepatic insufficiency or mild renal insufficiency (creatinine clearance ≥ 50ml/min) need no dose adjustment. The use of sitagliptin is not recommended in those with severe hepatic insufficiency or moderate to severe renal insufficiency in people under 18 years of age. It should also not be used in people with type 1 diabetes, those with DKA or those who are pregnant or breast feeding.
The approval was based on phase 3 clinical trials with glimepiride alone or glimepiride plus metformin, showing that the addition of sitagliptin significantly reduced fasting plasma glucose levels and HbA1c while being generally well tolerated.
ADVANCE with intensive glucose lowering
The preliminary findings from the Action in Diabetes and Vascular disease: preterAx and diamicroN mr Controlled Evaluation (ADVANCE) study indicate that intensive lowering of blood glucose does not increase risk of death, contrasting with the recently published interim data from the ACCORD trial.
The study involved 11 140 high-risk individuals with type 2 diabetes who were receiving an intensive intervention (sulphonylurea plus a range of drugs for those not reaching target levels) to reduce HbA1c below 6.5%.
The final results of the glucose lowering arm of the study will be published in September this year.
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