Tuesday, December 13, 2005

Pharmaceutical companies are exploring new and different ways of enabling people who need to take insulin to control their diabetes, according to a report issued today by the Association of the British Pharmaceutical Industry (ABPI).

At the same time, the report reveals that more than 50 new compounds to combat the condition are in various stages of development.
Companies are actively researching delivery methods that include:

• Inhaled insulin powder.
  
• Liquid insulin inhaler system.
  
• Insulin spray, to be delivered as a fine mist to the mouth.
  
• At least two types of oral insulin, using different delivery technologie
• Transdermal patch.

"The discomfort of self-injection is thought to deter many people with diabetes from starting insulin treatment that they may need. This has led companies to explore alternative methods of 'delivering' the medicine to patients," said Dr Richard Barker, Director General of the ABPI.

"Diabetes has been diagnosed in as many as two million people in the UK, with many more believed to have the condition but not yet diagnosed. While it can be kept relatively stable in the majority of patients, it does require careful attention to regulating the condition, both through lifestyle changes and medication."

Type 1 diabetes occurs when the body's immune system attacks and destroys cells in the pancreas that make insulin, a vital hormone that regulates glucose in the body. It forms about ten per cent of the total number of diabetes cases.

Type 2 diabetes typically emerges in middle or later life because of growing resistance to the action of insulin, often related to the development of obesity. At first, there are often no clear symptoms, which is why so many people are thought to be undiagnosed. In its advanced stages, type 2 diabetes may need to be treated with insulin injections, like type 1.

"The UK-based pharmaceutical industry is putting great effort into finding new and improved answers to both types of diabetes, with large numbers of potential medicines at various stages of development, and there are some exciting prospects for finding alternatives to injections," said Dr Barker.

"This area exemplifies the value of progressive, incremental innovations in bringing costly, long-term conditions under control."

The new delivery methods that are being researched, together with further details about the condition and the developments in the pipeline, are detailed in a new booklet, Target Diabetes, published by the ABPI.

The many different types of medicine under development include new compounds that reduce insulin resistance, others that reduce glucose release into the blood, and a synthetic version of a naturally occurring hormone found in the venom of the Gila monster, a poisonous lizard found in the south-western USA and Mexico.

Diabetes accounts for up to nine per cent of NHS expenditure, and that is estimated to grow by between 20 and 30 per cent by the year 2040. Complications of advanced diabetes, such as heart attacks, strokes, blindness and kidney disease, account for a large part of this NHS expenditure and greatly worsen survival and the quality of life of those affected.

Two clear priorities are identified for the coming years:

• Preventing the development of new cases of type 2 diabetes.
• Managing both forms of diabetes as well and cost-effectively as possible, in order to prevent or delay the development of complications.

While it is possible to slow or prevent the onset of type 2 diabetes by a combination of medicines and lifestyle changes, the damage is not reversible in type 1 diabetes because the cells that have been destroyed do not readily regenerate.

This means that people with this form of diabetes have to keep taking insulin for the rest of their lives unless they are given a transplanted pancreas or islet cells. In type 2 diabetes, the use of medicines is additional to necessary lifestyle changes such as increasing physical activity, reducing calorie intake and improving diet quality.

Target Diabetes points out that the economic and health costs of diabetes are enormous and escalating. While medicines are the mainstay of treatment, public awareness of the vital importance of a healthy lifestyle and balanced diet could make a real contribution to avoiding and managing diabetes.

"The pharmaceutical industry has a key role to play developing innovative and effective new treatments for diabetes - the future will see how we can all benefit from these efforts," the report says.

Target Diabetes has been written by Dr Stephen Bartlett.
To obtain a copy please contact ABPI Publications, 12 Whitehall, London, SW1A 2DY;
phone 020 7747 1466 or by email:publications@abpi.org.uk. Copies are free.