There are millions of Americans that suffer from diabetes (#diabetes). Whether we are discussing type 1 or Type 2, those that suffer need diabetes medications to regulate sugar in the body. It is not only those that are overweight who suffer but also those who have a genetic predisposition. As we get older, we will rely more heavily on diabetes medications. The prescription drugs below can be summarized into 4 main categories of treatment. First there are those that impact insulin. Next we have those that impact DPP-4 receptors, followed by GLP-1 receptors. Finally there are those diabetes medications that impact SGLT2 receptors. I will explain each one.
Four Impact Areas Of Diabetes Medications
For most that suffer from diabetes, insulin is the primary concern. Insulin is a hormone produced by the pancreas that regulates the metabolism of carbohydrates, fats and proteins. It does this function by promoting the absorption of, especially, glucose from the blood into fat, liver and skeletal muscle cells. When you don’t have enough insulin, you blood sugar level shoots up. At that point you have inject insulin to compensate for what your body can’t do. Next is the DPP4 receptor plays a major role in glucose metabolism. The pancreas releases a hormone called glucagon when the concentration of glucose in the bloodstream falls too low. Glucagon causes the liver to convert stored glycogen into glucose and releases it into the bloodstream. The DPP-4 receptor is responsible for starting this action.
The GLP-1 receptor is a human gene which is found in chromosome number 6. The protein encoded by this gene is a member of the glucagon receptor family. GLP-1 receptors are found and expressed in pancreatic beta cells. These are responsible for increased insulin production and release. Finally we have the SGLT2 which is a member of the sodium glucose transporter family. It is found in the kidney and is responsible for filtering and reabsorbing (moving) glucose into your blood from your kidneys. Your body does not like to waste glucose.
Lantus (insulin glargine injection) is a long-acting insulin that starts to work several hours after injection and keeps working evenly for 24 hours. It targets adults with type 2 diabetes and adults and children 6 years and older with type 1 diabetes for the control of high blood sugar. Manufactured by Sanofi with $3.9 billion in sales.
Januvia (Sitagliptin) is a once-daily prescription pill that, along with diet and exercise, helps lower blood sugar levels in adults with type 2 diabetes. Januvia targets DPP-4 receptors which release glucagon and hence glucose into the blood stream. Manufactured by Merck with $2.3 billion in sales.
Victoza (Liraglutide injection) is an injectable prescription medicine that may improve blood sugar (glucose) in adults with type 2 diabetes mellitus, and should be used along with diet and exercise. Victoza target GLP-1 receptors in 3 ways. It slows food leaving your stomach, prevents your liver from making too much sugar and helps the pancreas make more insulin. Manufactured by Novo Nordisk with $2.1 billion in sales.
Levemir (insulin detemir [rDNA origin] injection) is a basal insulin injection that improves glycemic control in adults and children with diabetes mellitus. It is a form of extended release insulin designed to remain soluble both before and after injection. Manufactured by Novo Nordisk with $1.8 billion in sales.
Humalog (insulin Lispro injection) is a fast-acting insulin (mealtime insulin) taken immediately before or after meals. As you eat, your blood sugar naturally goes up, or “spikes”. Humalog is used to manage those blood sugar spikes and may help keep your sugar levels in balance. It is used to treat adults and children with diabetes mellitus, type 2 diabetes in adults and type 1 diabetes in adults and children who are at least 3 years old. Manufactured by Eli Lilly with $1.7 billion in sales.
Novolog (insulin aspart Injection) is a fast-acting insulin (mealtime insulin) that helps lower mealtime blood sugar spikes. It is used to help lower blood sugar in adults and children with type 1 diabetes (aged 2 years and older) and adults with type 2 diabetes. Manufactured by Novo Nordisk with $1.6 billion in sales.
Invokana (Canagliflozin) is a once-daily pill that works around the clock to lower blood sugar medication for patients with type 2 diabetes. Invokana works with your kidneys to help you lose some sugar through the process of urination by inhibiting SGLT2 transport. Manufactured by Johnson & Johnson with $1.3 billion in sales.
Janumet (Sitagliptin & Metformin HCl) is an oral prescription medicine that, along with diet and exercise, helps lower blood sugar in adults with type 2 diabetes. Janumet is a DPP-4 inhibitor and targets 3 areas. First, it helps your pancreas make more insulin and helps your body more effectively use the insulin that it makes. Next it helps decrease excess sugar that your liver makes. Manufactured by Merck with $1.0 billion in sales.
Humulin (insulin human injection) is an insulin that is used to control high blood sugar in adults and children with diabetes mellitus who need more than 200 units of insulin in a day. Manufactured by Eli Lilly with $0.9 billion in sales.
Trulicity (Dulaglutide) is a once-weekly injectable prescription medicine to improve glucose in adults with type 2 diabetes mellitus. It works like the GLP-1 hormone in your body by helping your pancreas release insulin when your blood sugar is high. It can also limit how much sugar goes into your blood from your liver, and it slows the emptying of food from your stomach. Manufactured by Eli Lilly with $0.7 billion in sales.
As you can see, diabetes medications are big business for pharmaceutical companies. Sales should continue to grow over time considering that obesity in the population is increasing.
If you have diabetes, which medication is working for you?