diabetes pic 224.88.
(photo credit: Courtesy 'Diabetes Voice')
The Health Ministry has approved the marketing of Byetta, an injectable drug for patients with type 2 diabetes whose blood sugar levels are not well controlled with oral drugs and who do not take insulin.
The drug - also known as "Lizard Spit," since the original protein from which Byetta was synthesized was found in the saliva of the Gila monster, a poisonous North American lizard - was endorsed by the Israel Diabetes Association (IDA) on Sunday as a major advance in the control of diabetes.
IDA chairman Dr. Julio Weinstein said Byetta, made by the Eli Lily and Amylin pharmaceutical companies and known generically as exenatide, works in a different way than pills or insulin, as it helps the diabetic's body produce the right amount of insulin at the right time, minimizes damage to insulin-producing beta cells in the pancreas and even restores some of the damaged cells.
Unlike numerous types of oral medications, he said, it does not cause diabetics to gain weight, but actually helps them reduce. There is also no danger of sudden drops in blood sugar (hypoglycemia), unlike with synthetic insulin therapy, and it can be taken in conjunction with oral diabetes medication.
Weinstein said Byetta is injected twice a day using a special "pen" just under the skin in a standard dose not dependent on the type of meal eaten or the patient's exercise regimen.
The IDA is pushing the ministry to include it in the basket of health services so that it will be covered by the health funds at minimal cost. A month's supply today costs approximately NIS 800, but health funds already offer the drug at a significantly reduced charge for eligible diabetic members who have taken out supplementary health insurance policies.
"When a healthy person eats carbohydrates, a glucagon-like protein is released in the intestine," said Prof. Itamar Raz, head of the diabetes unit of Jerusalem's Hadassah-University Medical Center in Ein Kerem and head of the National Diabetes Council. "This protein reaches the brain and suppresses appetite, slows the emptying of the stomach and causes a feeling of satiety, as well as causing the pancreas to boost insulin production and suppress the release of glucagon, which works against insulin. Type 2 diabetics have inadequate release of insulin compared to non-diabetics."
However, Byetta causes a significant decrease in blood sugar levels and a drop of five to six kilos in the patient's weight, said Raz.
"It is meant for diabetics who no longer react to glucophage and other drugs and [who] otherwise need synthetic insulin," he said.
As Byetta can cause nausea in some patients, lower initial doses are recommended and then gradually raised. A clinical trial of 100 diabetics at Hadassah showed significant improvements and satisfaction among almost all the patients; only two dropped out because of side effects.
There are some 200 million people with type 2 diabetes around the world, and some 400,000 diagnosed in Israel (many have diabetes but have not yet been diagnosed).
If blood sugar is not controlled, it can cause serious complications affecting vision, blood vessels, kidneys, the heart and the brain.