Research and innovation leading to better outcomes for Canadians living with diabetes

See original story here In August 1922, 13-year-old Elizabeth Evans Hughes, extremely weak at only 45 pounds, was one of the first patients treated with insulin. It saved her life. She went on to graduate from college, get married and have three children. She died when she was 73. Before insulin, diabetes led to death. The best treatment was a starvation diet, which allowed patients to live a few extra years—if they didn’t die of starvation first. When insulin was discovered in 1921, it forever changed what it meant to have type 1 diabetes. Today, people with the disease have an almost normal life expectancy and insulin is regarded as one of the greatest medical discoveries in history. But the pharmaceutical industry didn’t stop there. It has continued to advance diabetes treatment. Today, medications for type 2 diabetes that support cardiovascular health and weight loss, in addition to blood sugar control, are once again promising to change what it means to be diagnosed with diabetes. Good glycemic control is the hallmark of diabetes therapies, however according to Dr. Ronnie Aronson, we are now looking to effects beyond glucose-lowering when selecting medication. “There have been substantial changes in the last decade,” says Aronson, a general endocrinologist and founder and chief medical officer of LMC Healthcare, which has 11 diabetes and endocrinology clinics across Canada. “A movement arose for treatments that go beyond lowering blood sugar levels to ones that benefit overall health and help patients avoid early death.” Dr. Aronson says innovative new medicines currently being researched have been shown to both help with weight loss (often recommended for patients with type 2) and lower blood pressure, while another new class of drugs lowers blood sugar, leads to weight loss, and may even reduce the rate of heart attacks, stroke and hospitalization for heart failure. These studies are especially noteworthy as people with diabetes are three times more likely to be hospitalized with cardiovascular disease, according to Diabetes Canada. “The old question for a physician was, ‘How do I lower my patient’s sugar?’ Now, the question is, ‘What drugs should my patient be on to lower their sugar and optimize their survival?’” Dr. Aronson says. “Patients used to be on 11 pills. We can now reduce that to five or six and have better control and weight loss. This is because of the pharmaceutical industry—and it makes getting healthy easier.” Research is also changing how people with diabetes monitor their blood sugar. Traditionally, they’d prick their fingers several times a day, but today, a tiny sensor underneath the skin can transmit a reading every five minutes to a smartphone, showing how the body responds to insulin, food or exercise. This constant awareness can help patients avoid high or low blood sugar or allow for intervention before a situation becomes severe. However, lack of public funding and differences in private coverage means access to this technology is out of reach for many. This is the case for many diabetes medications, supplies and devices, where government coverage varies across jurisdictions “Access is often limited to paying out of pocket or to people with employee benefits that cover it,” says Dr. Aronson. “These drugs may be more expensive, but they save lives, improve productivity and reduce health care costs. Governments should factor these benefits into their relative cost planning.” Diabetes Canada estimates that diabetes costs the health care system $3.4 billion a year, a number that’s expected to rise to $5 billion by 2026. “The older, more affordable drugs carry the risks of weight gain and unwanted low blood sugar (hypoglycemia), which both translate to high costs in hospital emergency rooms,” says Dr. Aronson. “Those high costs could be reduced significantly with a movement to new types of therapy.” This story was created by Content Works, Postmedia’s commercial content division and Patient Diaries, on behalf of Innovative Medicines Canada (IMC) and an IMC member company]]>

Xultophy® approved in Canada for the treatment of adults with type 2 diabetes

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Once-daily Xultophy® has been shown to help patients achieve blood glucose targets

Novo Nordisk announced today that Health Canada has approved Xultophy®as an adjunct to lifestyle modifications, for the once-daily treatment of adults with type 2 diabetes mellitus to improve glycemic control in combination with metformin, with or without sulfonylurea, when these combined with basal insulin (less than 50 units daily) or liraglutide (less than or equal to 1.8 mg daily), do not provide adequate glycemic control.1
“Living with diabetes is a complex situation in itself especially for people requiring insulin therapy. Therefore, treatment options should ideally aim to reduce complexity,” says Dr. Stewart Harris, Clinical Diabetologist and Professor at the Schulich School of Medicine and Dentistry at Western University in London, Ontario. “Xultophy®, a new insulin combination treatment therapy, not only helps people with type 2 diabetes optimize their blood glucose targets, studies have also demonstrated the added benefits of a lower risk of hypoglycemia and potential weight loss when compared to other insulin intensification approaches where hypoglycemia and weight gain poses a significant clinical barrier to successful blood glucose control. Xultophy® does this in a simple, once-daily injection using a pre-filled pen.” Xultophy® (insulin degludec + liraglutide injection) is a fixed-ratio combination of a long-acting basal insulin (Tresiba®/insulin degludec) and a glucagon-like peptide 1 receptor agonist (GLP-1 RA) (liraglutide), in a once-daily injection. Xultophy® can be taken independent of meals, at any time of day – preferably at the same time of the day.1 “Insulin is, and has been, the mainstay for treating patients with longstanding type 2 diabetes,” says Dr. Jan Hux, President and Chief Science Officer of Diabetes Canada. “But insulin carries the risk of causing dangerously low blood glucose levels. When insulin is used in combination with other medications that don’t carry a risk of low blood sugar levels, it can help patients with type 2 diabetes reach their blood glucose targets more safely and with less insulin than they would otherwise need.” About the DUAL™ Clinical Development Program The approval of Xultophy® is based on efficacy and safety data from the DUAL™ (Dual Action of Liraglutide and Insulin Degludec in Type 2 Diabetes) clinical development program. In three DUAL™ trials involving 1,393 adults with type 2 diabetes, patients who were inadequately controlled on liraglutide or basal insulin therapy and switched to Xultophy®achieved significant reductions in HbA1c.1 For adults uncontrolled on basal insulin, Xultophy® demonstrated reductions in HbA1c from baseline of 1.81 per cent (vs insulin glargine) and 1.90 per cent (vs basal insulin therapies).1 The most frequently reported adverse reactions during treatment with Xultophy® were hypoglycemia and gastrointestinal adverse reactions, of which nausea was the most frequently reported and declined as treatment continued.1 About Xultophy® Xultophy® is a once-daily single injection fixed-ratio combination of long-acting insulin degludec and the GLP-1RA liraglutide in one pen. Insulin degludec lowers blood glucose by facilitating glucose uptake upon binding to insulin receptors on muscle and fat cells and simultaneously inhibiting hepatic glucose output.1 Liraglutide stimulates insulin secretion and decreases glucagon secretion in a glucose-dependent manner.1 About Novo Nordisk Novo Nordisk is a global healthcare company with more than 90 years of innovation and leadership in diabetes care. This heritage has given us experience and capabilities that also enable us to help people defeat obesity, hemophilia, growth disorders and other serious chronic diseases. Headquartered in Denmark, Novo Nordisk employs approximately 41,700 people in 77 countries and markets its products in more than 165 countries. For more information, visit novonordisk.caTwitterYouTube. References _________________________ 1 Xultophy® Product Monograph. Novo Nordisk Canada Inc. April 11, 2018. SOURCE Novo Nordisk Canada Inc. For further information: Media: Kate Hanna, 905-629-6612, kxyh@novonordisk.com
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