Many of us are always interested in learning and are on a constant search to find new products, medications, modalities, foods, vitamins or supplements to improve our health especially when we have diabetes. While doing your research, you can be sure that for every positive piece of advice you learn, you may find opposite viewpoints on that very same information. Try to obtain your information from a reliable source and know that even things you are certain to be real may change with the next study. An example that comes to mind is drinking caffeine can blunt blood sugars and lower your risk of diabetes, followed by a study that states “caffeine causes insulin resistance especially in the morning and could increase your future diabetes risk”. The best way to get confirmed information is to ask your health care provider questions, attend organized health seminars, go to support groups where relevant information is shared and do your own research on sites with a valid and secure reputation. Put all of this information together and use what applies to you.
Let’s review some new medications which may have an impact on your health, with or without diabetes.
- Toujeo- Toujeo is a new basal or long acting, flat line insulin which was FDA approved in February 2015.It is made by Sanofi, a company which has manufactured multiple diabetes products. Their other basal insulin which is a leading seller is Lantus. A competing brand of basal insulin is called Levemir. Toujeo is already marketed in Europe and should be available in the US by the late spring. It is generally prescribed as a once daily injection either in the morning or at bedtime. Many physicians may recommend splitting the dose when more than 60 units are required per day. It is available in a disposable pen but contains 450 units of insulin which is 150 units more than in a Lantus pen. This will be a big improvement to those requiring higher insulin doses. Toujeo will come with a “full team support system” from Sanofi. After trials “Toujeo was found to be safe and effective and better at lowering A1C levels”. It still caused hypoglycemia and weight gain similar to Lantus. Eventually, Toujeo will be combined into one pen with Lixisenatide- a GLP-1 agonist, to help reduce A1C levels even more along with offering increased satiation, slower gastric emptying and possible weight loss due to the GLP-1.Combination pens offer more convenience and better pricing. Presently, the only insulin/GLP-1 agonist combination is Victoza/ Tresiba.
- Saxenda- or Liraglutide, made by Novo-Nordisk, is a new GLP1-agonist, approved for “chronic weight management along with a reduced calorie eating program and added exercise plan. It is considered a new therapeutic approach for helping patients achieve and maintain a healthier weight”. It will be prescribed for patients with a BMI or 30kg/m2 with one co-morbidity such as hypertension, diabetes, elevated cholesterol or triglycerides or with a BMI of 27kg/m2 and 2 co- morbidities. It also comes in a disposable pen and is given daily at the same time regardless of food timing. The approved dosage is 3 mg daily but must be titrated up slowly over weekly increases to reduce severe side effects. It should not be given with insulin, with another GLP-1 agonist or to treat type 2 diabetes, when weight is not an issue. As with other GLP-1 agonists, it should not be taken with a personal or family history of meduallary thyroid cancer. Side effects may include acute pancreatitis, acute gall bladder disease, renal impairment, increased heart rate and hypoglycemia when given with insulin. Adverse side effects may include nausea, headache, vomiting, diarrhea or other abdominal symptoms.
- Glyxambi – was recently approved by the FDA. It combines 2 existing diabetes medications into a single pill. It is a combination of Empagliflozin, a SGLT [sodium glucose co-transporter 2]-2blocker and Linagliptin, a DPP-4 inhibitor. Empagliflozin works thru the kidneys by forcing sugar out with the urine and Linagliptin increases insulin production after eating. It was proven superior in controlling blood sugars compared to each pill independently when combined with diet and exercise. It is a once daily pill taken in the morning and not related to timing of food. It should not be taken with severe kidney function impairment. Glyxambi is available in 10/5mg tablets or 25/5 mg tablets. The most common side effects are urinary tract infections, upper respiratory infections and vaginal yeast infections. The combined pill increases convenience and a better price.
These are just a few new products on the market for those with diabetes or requiring weight management that has recently been approved. As always, working on lifestyle goals consisting of weight reduction, improved eating habits and increased physical activity along with diabetes medication is your quickest way to diabetes control.
NOTE: Consult your Doctor first to make sure my recommendations fit your special health needs.
She is a member of the American Diabetes Association as well as the South Florida Association of Diabetes Educators. She worked with the education department of NBMC to help educate the hospital's in-patient nurses about diabetes. She practices a healthy lifestyle and has worked as a personal fitness trainer in the past.
She was one of the initiators of the North Broward Diabetes Center (NBMC) which started in 1990 and was one of the first American Diabetes Association (ADA) certified programs in Broward County, Florida for nearly two decades. Robbie has educated patients to care for themselves and has counseled them on healthy eating, heart disease, high lipids, use of glucometers, insulin and many other aspects of diabetes care. The NBMC Diabetes Center received the Valor Award from the American Diabetes Center for excellent care to their patients. Robbie has volunteered over the years as leader of many diabetes support groups.
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