As much as 40 percent. patients treated with type 2 diabetes are afraid of life-threatening hypoglycaemia, i.e. hypoglycaemia, associated with the applied therapy. Meanwhile, the latest drugs, the so-called incretin, they pose almost no such risk, argue doctors.
Several incretin drugs have already received a positive recommendation from the Agency for Health Technology Assessment (AOTM), but they have not yet been included in the reimbursement list.
As emphasized by the diabetologists present at the conference, incretin drugs meet the criteria of an ideal drug for diabetes to the highest degree – they are safe, practically do not cause hypoglycaemia, and in addition do not cause weight gain or even promote weight loss. We would like to be able to use them in patients – emphasized the president of the Polish Diabetes Society, prof. Władysław Grzeszczak during the Friday press conference in Warsaw.
Diabetes can generally be described as a disorder in glucose metabolism that manifests itself with too much glucose in the blood. There are several types of disease. 85-90 percent type 2 of diabetes is caused by a decrease in tissue sensitivity to insulin – a hormone that regulates glucose metabolism in the body – and is closely related to lifestyle, ie too caloric diet, overweight or obesity, lack of exercise.
Type 1 diabetes mainly affects children and adolescents. It is caused by the destruction of insulin-producing beta cells by the pancreatic beta cells by the immune system. While type 2 diabetes treatment begins with lifestyle changes and oral medications, type 1 diabetes requires insulin dosing from the start.
As prof. Grzeszczak, a frequent complication of diabetes therapy is hypoglycaemia, i.e. hypoglycaemia. It is primarily a risk for patients using insulin, but its risk is also associated with most oral medications taken by patients with type 2 diabetes.
Hypoglycemia is diagnosed when the blood glucose level drops below 54 milligrams per 1 deciliter (ie 100 ml) of blood in an adult and below 50 mg / dc in a child. The early symptoms of hypoglycaemia include restlessness, nervousness, irritability, pallor, sweating, dilated pupils, and an increase in heart rate of up to 120 beats per minute. Later, there are disorientation, motor coordination, speech problems, convulsions, loss of consciousness and coma. Hypoglycemia can ultimately lead to death, but it always causes irreversible damage to some cells in the brain and increases the risk of heart problems, Prof. Grzeszczak.
Therefore, it is very important that diabetics always have some source of simple sugars on hand – preferably a sweet drink or a few candies. As assessed by prof. Edward Franek from the Central Clinical Hospital of the Ministry of Interior and Administration in Warsaw, chocolates or bars, although also sweet, often contain fats that may slow down the absorption of glucose into the blood.
According to the specialist, hypoglycemia occurs, among others, if the patient takes too much insulin in relation to the planned physical activity or does not eat a meal after administering insulin.
A statistical patient with diabetes experiences 100 episodes of hypoglycemia per year, of which 1 to 2 are assessed as severe – said Prof. Grzeszczak. A 2010 study of more than 400 type 2 diabetic patients from five European countries found that one sixth of them went to the emergency room because of hypoglycaemia, and a third required third-party assistance.
New drugs, the so-called incretin are divided into two groups. One is the so-called GLP-1 analogs that mimic the action of incretins, hormones secreted in the gut by food and stimulating insulin production in the pancreas. It is administered subcutaneously. The second group are inhibitors of DPP4 or gliptin, which inhibit the degradation of natural human incretins. The first drug in this group, sitagliptin, can be used in combination with other diabetes medications and with insulin.
Joanna Morga (PAP)