Interview
New developments in diabetes care
Dr Riccardo Perfetti is speaking on ORIGIN
Dr Riccardo Perfetti, an endocrinologist and scientist is currently the Vice President of Medical Affairs of the Global Diabetes Division team at Sanofi-aventis, one of the leading pharmaceuticals manufacturing drugs for diabetes. Recently, he paid a short visit to Bangladesh to unveil the results of ORIGIN (a type of Insulin called Glargine), the world's longest and largest randomised clinical trial in pre- and early diabetes that shows there are no adverse effects of this insulin that increase the risk of heart disease. He talked with the Star Health on new drugs and insulin delivery methods to combat diabetes. What are the factors driving the development of diabetes in emerging countries?The incidence of Type 2 diabetes is increasing due to the changes in eating habits and lifestyle. Diabetes is worse in emerging countries where changes in lifestyle are even more rapid than in so-called developed countries. If you look at the map of obesity and the map of Type 2 diabetes, it overlaps with a time-lag of ten years. So, obesity seems to be a precondition for developing Type 2 diabetes in many of us. Again, there is typically much more physical activity in the countryside than in cities, and urban lifestyles tend to be far less energy-consuming than rural lifestyles. What are the new drugs coming up that will improve control of blood glucose?
There are many researches going on to improve the action of drugs, produce better drugs or insulin to control diabetes effectively. The combination of insulin is the next revolution in pharmaceutical industry. Basal insulins provide sustained insulin levels for the entire day, providing good control of fasting and in between meal glucose levels. However, compared to short-acting insulins, basal insulins provide limited control of glucose for a certain period after meal. Therefore, the addition of insulin named a glucagon-like peptide-1 (GLP-1) which controls glucose effectively after meal is a potentially attractive solution to this problem for some patients with type 2 diabetes. The combination is in the pipeline and might be available in next 2 years. How can we improve the insulin delivery into the body as many people have needle fear?
Interestingly, surveys have showed that physicians fear the needle more than their patients. Most patients are quite compliant with the delivery of insulin through needle if the physician or the counsellor advocate for it. Instead of just a plain needle, there is insulin pen available in the market that has better patient compliance. Oral insulin, intranasal spray, sub-lingual delivery of insulin — all are exciting new ideas but none of these are yet to show any promising results. Scientists are pinning their hope to develop newer exciting methods in future.
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