 |
Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2021, vol. 27, issue3
Subject Area: Medicine
-
DOI: 10.5272/jimab.2021273.3885
Published online: 17 August 2021
Original article
J of IMAB. 2021 Jul-Sep;27(3):3885-3892
NEW APPROACHES IN THE TREATMENT OF TYPE 2 DIABETES - TRANSITION FROM GLUCOSE-CENTRED TO PATIENT-CENTRED MODEL
Antoaneta Tsvetkova
, Silvia Mihaylova,
Medical College, Medical University - Varna, Bulgaria.
ABSTRACT:
Objective: The high prevalence of Type 2 diabetes mellitus (T2D) all over the world cause a high demand of searching for new antidiabetic drugs. The present study aims to identify the consumption of three new classes of antidiabetic drugs (DPP-4 inhibitors, GLP-1 receptor agonists, and SGLT-2 inhibitors), analyzing the use of these drugs prescribed for the treatment of T2D. In this retrospective observational study, we analyzed consumption data for the period 2015–2020, obtained from National Health Insurance Fund (NHIF) database only.
Results: The NHIF expenditure of DPP-4 inhibitors, GLP-1 receptor agonists, and SGLT-2 inhibitors in Bulgaria for the period 2015-2020 is increasing. Although last introduced into clinical practice, SGLT-2 inhibitors were preferred by clinicians, over GLP-1 agonists, during the considered period.
Conclusions: DPP-4 inhibitors, GLP-1 receptor agonists, and SGLT-2 inhibitors consumption in Bulgaria indicates progressive changes in the prescription of antidiabetic drugs. We have highlighted the market uptake of drugs approved during the last 15 years. To ensure the optimal benefits to the patient, we feel it is necessary to implement guidance to assist prescribers in choosing the most appropriate therapy based on drug and patient characteristics. Further monitoring of the effect of the pharmacotherapeutic changes on additional cardiovascular and renal benefits of these drugs is needed.
Keywords: type 2 diabetes, NHIF, PRAC, DPP-4 inhibitors, GLP-1 receptor agonist, SGLT-2 inhibitors,
- Download FULL TEXT /PDF 1016 KB/
Please cite this article as: Tsvetkova A, Mihaylova S. New approaches in the treatment of Type 2 diabetes - transition from glucose-centred to patient-centred model. J of IMAB. 2021 Jul-Sep;27(3):3885-3892. DOI: 10.5272/jimab.2021273.3885
Correspondence to: Antoaneta Tsvetkova, Medical University - Varna, Medical College – Varna; 84 Tsar Osvoboditel Blvd , Varna, Bulgaria; E-mail: antoaneta.tsvetkova11@gmail.com
REFERENCES:
1. Defronzo RA. Banting Lecture. From the triumvirate to the ominous octet: a new paradigm for the treatment of type 2 diabetes mellitus. Diabetes. 2009 Apr;58(4):773-95. [PubMed]
2. Verspohl EJ. Novel therapeutics for type 2 diabetes: incretin hormone mimetics (glucagon-like peptide-1 receptor agonists) and dipeptidyl peptidase-4 inhibitors. Pharmacol Ther. 2009 Oct;124(1):113-38. [PubMed]
3. Deacon CF. Circulation and degradation of GIP and GLP-1. Horm Metab Res. 2004 Nov-Dec;36(11-12):761-5. [PubMed]
4. Adelhorst K, Hedegaard BB, Knudsen LB, Kirk O. Structure-activity studies of glucagon-like peptide-1. J Biol Chem. 1994March 4;269(9):6275-8. [PubMed]
5. Eng J, Kleinman WA, Singh L, Singh G, Raufman JP. Isolation and characterization of exendin-4, an exendin-3 analogue, from Heloderma suspectum venom. Further evidence for an exendin receptor on dispersed acini from guinea pig pancreas. J Biol Chem. 1992 Apr 15;267(11):7402-5. [PubMed]
6. Barnett AH. Lixisenatide: evidence for its potential use in the treatment of type 2 diabetes. Core Evid. 2011; 6:67-79. [PubMed]
7. Knudsen LB, Lau J. The Discovery and Development of Liraglutide and Semaglutide. Front Endocrinol (Lausanne). 2019 April 12;10:155. [PubMed]
8. Ahrén B. DPP-4 Inhibition and the Path to Clinical Proof. Front Endocrinol (Lausanne). 2019 June 19;10:376. [PubMed]
9.Cai W, Jiang L, Xie Y, Liu Y, Liu W, Zhao G. Design of SGLT2 Inhibitors for the Treatment of Type 2 Diabetes: A History Driven by Biology to Chemistry. Med Chem. 2015; 11(4):317-28. [PubMed]
10. Pearson S, Kietsiriroje N, Ajjan RA. Oral Semaglutide In The Management Of Type 2 Diabetes: A Report On The Evidence To Date. Diabetes Metab Syndr Obes. 2019 Dec 2;12:2515-2529.[PubMed]
11. PRAC concludes that diabetes medicine canagliflozin may contribute to risk of toe amputation. EMA. February 10 2017. EMA/76661/2017. [Internet]
12. Bailey CJ, Day C. The future of new drugs for diabetes management. Diabetes Res Clin Pract. 2019 Sep;155:107785. [PubMed]
13. Davies MJ, D’Alessio DA, Fradkin J, Kernan W, Mathieu C, Mingrone G, et al. Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2018 Dec;41(12):2669-2701. [PubMed]
14. FDA News Release. FDA approves new treatment for a type of heart failure. May 05, 2020. [Internet]
15. Marso SP, Daniels GH, Brown-Frandsen K, Kristensen P, Mann JF, Nauck MA, et al. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2016 July 28;375:311-22. [PubMed]
16. Marso SP, Bain SC, Consoli A, Eliaschewitz FG, Jуdar E, Leiter LA, et al. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med. 2016 Nov 10;375:1834-44. [PubMed]
17. Hernandez AF, Green JB, Janmohamed S, D’Agostino RB, Granger CB, Jones NP, et al. Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomized placebo-controlled trial. Lancet. 2018 Oct 27;392:1519-1529. [PubMed]
18. Gerstein HC, Colhoun HM, Dagenais GR, Diaz R, Lakshmanan M, Pais P, et al. Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): double-blind, randomized placebo-controlled trial. Lancet. 2019 July 13;394(10193):121–130. [PubMed]
19. Zinman B, Wanner C, Lachin JM, Fitchett D, Bluhmki E, Hantel S, et al. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med. 2015 Nov 26;373(22):2117–2128. [PubMed]
20. Neal B, Perkovic V, Mahaffey KW, de Zeeuw D, Fulcher G, Erondu N, et al. Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes. N Engl J Med. 2017 Aug 17;377(7):644-657. [PubMed]
21. Wiviott SD, Raz I, Bonaca MP, Mosenzon O, Kato ET, Cahn A, et al. Dapagliflozin and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2019 Jan 24;380(4):347-357. [PubMed]
22. Tankova T, Borisova AM, Orbetzova M.[Recommendations for Good Clinical Practice in Diabetes Mellitus.] [in Bulgarian] Bulgarian Society of Endocrinology. 2019. p.96. [Internet]
23. Buse JB, Wexler DJ, Tsapas A, Rossing P, Mingrone G, Mathieu C, et al. 2019 Update to: Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2020 Feb;43(2):487-493. [PubMed].
Received: 02 February 2021
Published online: 17 August 2021