Thriving in a Rock Crevice

Longer Lives with Weight-Sparing Diabetes Care

A quiet revolution is taking shape in the form of weight-sparing diabetes care that helps people live longer. Yesterday new data were simultaneously published in the New England Journal of Medicine and presented at the American Diabetes Association (ADA) Scientific Sessions. The LEADER study showed that people treated for type 2 diabetes with liraglutide (Victoza) were 15% less likely to die when followed for an average of 3.8 years, compared to standard treatment.

Unlike many older drugs for diabetes, liraglutide and a host of other new drugs actually cause a little weight loss instead of making people gain weight. Earlier in the day, researchers presented new details on data that show a mortality benefit for empagliflozin (Jardiance) in people treated with it for type 2 diabetes. So now we have strong data for two very different weight-sparing diabetes drugs that show a survival benefit over standard treatments.

Simon Heller, a professor of clinical diabetes at the University of Sheffield, commented on the significance of these studies:

I think we are in a different era now. People die from hypoglycemia, whether by insulin or sulfonylureas. We shouldn’t forget that.

These drugs [liraglutide and empagliflozin] don’t cause hypoglycemia and have other effects that may be beneficial. I agree absolutely we need to confirm with other studies, but I think we’re definitely going to see a shift toward modern therapies.

It has not been long since drugs that cause weight gain were mainstays of treatment for type 2 diabetes. Both sulfonylureas and short acting insulin can cause weight gain. Glitizones, such as Avandia and Actos, can also cause weight gain and have fallen out of favor for safety reasons. Thought leaders in diabetes care are increasingly favoring therapies that help people with both diabetes and obesity. The ADA recently endorsed the use of bariatric surgery to help reverse type 2 diabetes in patients with obesity.

So at the same time that new drugs are coming forward to treat obesity, treatments for type 2 diabetes are evolving to spare patients the weight gain that older drugs can cause.

It’s about time.

Click here to read LEADER study and here to read more from MedScape. Click here to read the press release from the ADA.

Thriving in a Rock Crevice, photograph © 陈文 / flickr

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June 14, 2016