New Diabetes Treatments Show Promise
Inhaled Insulin, Lizard-Saliva Drug Offer New Options
Editor's Note: The FDA approved the inhaled insulin drug Exubera in 2006,
but in October 2007 the drug company Pfizer said it was halting sales of the
drug because of financial reasons.
Oct. 17, 2005 -- Two new diabetes treatments appear to control blood sugar
in people with type 2 diabetes who do not achieve glucose control.
Newly published studies highlight the strengths and weaknesses of the two
treatments -- a long awaited inhaled version of insulin and a novel injected
drug derived from the saliva of the American Southwest's venomous lizard, the
"Both of these new therapies hold promise, but also uncertainty,"
American Diabetes Association president Robert Rizza, MD, tells WebMD.
"They will increase the options for people with diabetes."
Improving Blood Sugar
People with type 2 diabetes progressively lose their ability to make and use
their own insulin, an important hormone that the body needs to process sugar.
The aim of treatment is to improve impaired blood sugar control to reduce the
risk of diabetic complications.
This might be possible with diet and exercise alone early in the disease
process, or a single medication to either enhance insulin secretion or help
increase insulin sensitivity like the drug Metformin.
Later on, patients may be put on a combination of diabetes drugs, but
eventually many need daily injections of insulin to control their blood sugar
The two new treatments were tested in people with type 2 diabetes whose
blood sugar could no longer be controlled with a combination of these pills for
Both studies are published in the Oct. 18 issue of the Annals of
Weight Gain, Weight Loss
Unlike most other medications used to treat type 2 diabetes, including
insulin, the new drug exenatide, made from the saliva of the Gila monster, does
not cause weight gain. In fact, most patients lose some weight while taking the
In a 26-week study comparing twice-daily injections of exenatide to
long-acting, once-daily injections of insulin, patients on both treatments
achieved similar blood sugar control. On average, those taking exenatide lost
an average of 5 pounds, while those on insulin gained about 4.
But the exenatide group reported much higher rates of gastrointestinal side
effects, with 57% reporting nausea, compared with 9% of the insulin patients,
and 17% reported vomiting, compared with just fewer than 4% of those on
Overall, roughly 19% of the patients taking exenatide withdrew from the
study because of side effects vs. just under 10% of those on insulin.
Patients receiving exenatide showed more improvement in blood glucose level
after meals compared with the long-acting insulin (glargine), yet those taking
long-acting insulin showed a greater reduction in fasting blood sugars compared
Both drugs similarly improved overall blood sugar control in people with
type 2 diabetes with less than adequate control with a combination of oral
diabetes medications, concludes the study.
The study was funded by exenatide manufacturer Eli Lilly and Co., a WebMD