Exploring new mechanisms of action and a patient-centered approach
Categories: For Healthcare Professionals, [Diabetes, Drug development, Glycemic control]
As of 2014, about 422 million people are living with diabetes, and an increase to 592 million is predicted by 2035.
There is a wide range of approved treatments available for type 2 diabetes (T2D), which may lead people to believe that it is an easily managed condition. However, medicated patients can still suffer from the gradual loss of glycemic control, which indicates that prescribed medicines may become less effective over time. On average, every 3 to 5 years, a different medicine needs to be prescribed to obtain or retain good glycemic control. It is estimated that only 1 in 2 patients achieves good glycemic control with existing treatment options, and, in many cases, a combination of medicines needs to be used to address the multiple pathophysiological abnormalities of T2D. However, prescribing a combination of medicines can also impede treatment success because it increases the risk of side effects and consequently decreases the patient’s long-term adherence to treatment. Therefore, to achieve effective treatments for people living with T2D, we need to develop new drugs with novel mechanisms of action that can either replace or act in combination with current therapies. We need to aim for better long-term glycemic control and to overcome the side effects of current therapies.
Current clinical efforts are focusing on potential new drugs that offer different mechanisms of action compared with approved treatments, such as peroxisome proliferator-activated receptor agonists/modulators, glucokinase activators, glucagon receptor antagonists, and anti-inflammatory compounds. In addition, recent research findings suggest that a new classification system for diabetes would be a powerful tool to identify the patients with the greatest risk of complications and to focus on individual treatment regimens. The research proposes that there may actually be 5 different types of the disease: severe insulin-resistant diabetes, severe insulin-deficient diabetes, severe autoimmune diabetes, mild age-related diabetes, and mild obesity-related diabetes. This perspective opens the gate for an important switch to a patient-centered treatment approach requiring precision medicine in diabetes.
Promising areas to explore for the future treatment of T2D include potential drugs with new mechanisms of action, the effects of different drug combinations, and the patient-centered approach. You can make an important contribution by referring your patients to take part in IQVIA-managed diabetes clinical trials.