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lupinepublishers-ado · 4 years ago

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Bromocriptine - A Novel Therapy in Type-2 Diabetes

Lupine Publishers| Archives of Diabetes and Obesity

Abstract

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Bromocriptine is used in treatment of diabetes mellitus. It acts by increasing dopaminergic activity in hypothalamus and lowers HbA1c by 0.6 to 0.9%. It is not to be used in type 1 diabetes and DKA.

Keywords:Bromocriptine; Hypothalamus; Contra indicators; Infarction; Combination therapy; Quick release bromocriptine

Introduction

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Bromocriptine mesylate is a new modality of treatment for type-2 diabetes. The drug increases dopaminergic activity in the hypothalamus. It lowers HbA1c by 0.6 to 0.9% compared to placebo when added to other oral anti-diabetic agents. It regulates metabolic rhythm. The drug increases insulin sensitivity [1]. There is 24% increase in insulin mediated glucose disposal. Reduces fasting and post prandial hyper insulinemia by 30-70%. Body fat stores and insulin action are controlled by temporal interactions of circadian neuro-endocrine oscillations. Bromocriptine modulates neurotransmeter action in the brain and has been shown to improve glucose tolerance and insulin resistance in obesity and diabetes. Bromocriptine improves glycemic control and glucose tolerance in obese type-2 DM. Both fasting and post prandial blood glucose are reduced. This is due to enhanced maximally stimulated insulin mediated glucose disposal [2]. No change in body weight or BMI occurred with this therapy. Mechanism of Action is unclear. It resets the circadian rhythm at hypothalamic level [3,4]. Preclinical data suggest that decreased hypothalamic dopaminergic tone may be involved in the pathogenesis of insulin resistance. The normal circadian cycle that results in a leaner body in the summer and heavier body in winter is disrupted in humans because of abundant caloric intake year-round resulting in the absence of a lean phase. Stimulation of the hypothalamus promotes the release of several hormones that respond to the traditional shift in caloric intake and storage. Quick-release bromocriptine (D2 against), given once in the morning, stimulates the hypothalamus to release cortisol, growth hormone, and prolactin, allowing a reset of the circadian clock permanently stuck in a winter rhythm. This means there occurs resetting of abnormally elevated hypothalamic drive for increased plasma glucose, triglyceride and free fatty acid levels in fasting and postprandial states in insulin-resistant patients. Other mechanisms, including α-1 antagonist, α-2 agonist, and serotonin and prolactin modulator, may also help to explain bromocriptine’s glucose-lowering effects (Table 1). Bromocriptine quick release (Cycloset) was added on to various antidiabetic agents and studied for 52 weeks safety trial and was found to be useful as add on therapy [4].

Table 1: 24 weeks trial (245) subjects with type-2 diabetes (summary) [3].

Dosage

To be given within 2 hours are waking with food. Starting dose is 0.8 mg. Recommended dose is 1.6 to 4.8 mg.

Side Effects

Can cause nausea. Taking with food minimise nausea. Can produce hypotension, somnolence, headache, fatigue, vomiting, diarrhea, constipation and dizziness. Loss of consciousness during migraine may reflect dopamine receptor hypersensitivity [5,6].

Contraindications [5,6]

a. Hypersensitivity to Ergot

b. Syncope is potentiated

c. Inhibits lactation, hence, not to be given in lactating mothers

d. Type-I DM or diabetic ketoacidosis

e. Not to be given during pregnancy

f. Syncopal migraine

Interaction [5,6]

Interact with dopamine receptor antagonist, clozapine, olanzapine and reduces the effectiveness. Increases serum levels of Salycilates, Sulfonamide, Chloramphenicol and Probenecid due to its high protein binding character. Avoid using concomitantly with other Dopamine antagonist such as neuroleptics. They diminish the effectiveness of Bromocriptine.

Storage

Store at 25°C and protect from light and moisture.

Conclusion

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Bromocriptine mesylate is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type-2 diabetes mellitus. It may be used as monotherapy or as adjunctive therapy to metformin/sulfonylurea. It should not be used to treat type-1 diabetes or diabetic ketoacidosis.

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aliciathelucario · 6 years ago

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Diabetes management Leslie Greenberg’s Blog

Drugtext.nl – Informatief over drugs, medicijnen en gezondheid klachten

Diabetes management! Ik heb onlangs een lezing bijgewoond over diabetesmanagement. Hier zijn de moeren en bouten … Er zijn drie pijlers van diabetesmanagement … Het is het beste om de # 1 en # 2 maximaal te gebruiken, of u en uw arts moeten de weg van # 3 afleggen.

# 1. Dieet. Een belangrijke strategie is 45-60 gram koolhydraten per maaltijd. Beperkte gezoete dranken en geconcentreerde koolhydraten. Eet een "consistent koolhydraatdieet". Mediterraan dieet, DASH, plantaardige voeding. Om af te vallen, heb je een tekort van 500 tot 750 kcal / dag.

# 2. Oefening. Minimaal 150 minuten per week met matige intensiteit aëroob, waarbij de hartslag op 50-70% van de maximale hartslag wordt gehouden. Krachttraining van 2-3 keer per week is nuttig voor patiënten ouder dan 50.medicijnen Diabetes beïnvloedt 8 verschillende orgaansystemen. Alvleesklier is bijvoorbeeld betrokken bij insulinesecretie en glucagon-secretie, de hersenen worden beïnvloed door de eetlust, de nier wordt beïnvloed door glucose-reabsorptie, de spier heeft veranderingen in glucose-opname. De ADA heeft december 2017 een nieuwe richtlijn (zie link onderaan), die ons laat weten welke medicatie te starten afhankelijk van hemoglobine A1c. Metformine is de belangrijkste medicatie.

Wanneer moet insuline worden gestart? Als de patiënt 3 orale medicaties gebruikt met de maximale dosis EN nog steeds niet op het HbA1c-doel, is de patiënt aan het wachten voor insuline. # 3 Medicijnen. En nu de lijst met medicijnklassen met hun in-class medicijnnamen en de details.

sulfonylureumderivaten. Verlaagt A1c met 1,5%, maar het leidt tot een geleidelijke afname van de bètacelfunctie. Dit is hierdoor uit de gunst geraakt. Binnen 3 jaar hebben meer patiënten tweede anti-diabetica nodig.

Alfa-glucosidaseremmers (merknamen: Acarbose en Miglitol). Verlaagt A1c met 0,5 tot 0,8%. Van deze klasse geneesmiddelen is niet bekend dat ze de gewichtstoename verhogen en ook veroorzaakt het geen hypoglykemie. Deze medicijnen helpen de patiënten de snelheid van koolhydraatvertering te verminderen. Dit kan maagkrampen en gasvorming veroorzaken. biguaniden (Metformine). Dit verlaagt de GI glucose glucose-absorptie en vermindert de eetlust en verlaagt de glucoseproductie van de lever. Dit helpt de nuchtere glucose in de ochtend te brengen. Verlaagt A1c met 1,5% Dit is een veilig medicijn voor patiënten met een goede lever- en nierfunctie. Als patiënten een CT-scan krijgen, moeten ze dit medicijn 2 dagen vóór het gebruik van het contrast stoppen. meglitiniden (merknamen – Starlix en Prandin). De meeste artsen gebruiken deze medicijnklasse niet vaak. Deze geneesmiddelen kunnen hypoglykemie veroorzaken. Kan A1c verlagen met 1-1,5 Thiazolidinedionen (TZD) -Merknaam: Actos en Avandia. Verlaag A1c met 0,8 – 1%. Lagere bloedsuikers zonder hypoglykemie. Een paar jaar geleden was er een blaasontsteking. Dit is veranderd om aan te tonen dat blaaskankerpatiënten in rokers waren. Dit kan de centrale adipositas doen toenemen. Dipeptidyl peptidase 4-remmers (DPP4s)-Brand namen: Januvia, Onglyza, Tradjenta. Verlaagt A1c van 0,5 – 0,8%. Veroorzaak geen hypoglykemie vaak. Kan in combinatie met andere orale middelen worden gebruikt. Kan buikpijn of hoofdpijn of heupzenuwpijn veroorzaken. Gebruik dit niet met GLP1-medicijnen. Tradjenta wordt slechts in één dosis gedoseerd en er zijn geen aanpassingen nodig voor patiënten met nierfalen. Galzuur Sequestranten (merknaam: Welchol). Verlaagt A1c 0,5 – 0,6%. Verlaagt zowel het A1c- als het LDL-cholesterol. Dopamine Agonist (merknaam: Cycloset). Reset de biologische klok en kan. Het verlaagt A1c van 0,3 – 0,5%. Natriumglucose Co-transporter 2 (SGLT2) merknamen Invokana, Farxiga, Jardiance, Steglatro. Blokkeert de reabsorptie van de glucose door de nieren. Verlaagt A1c 0.7-1.0%. Kan ook gewichtsverlies veroorzaken. Er is een laag risico op hypoglykemie. Het kan gistinfecties verhogen bij zowel vrouwen als onbesneden mannen. SGLT2 kan leiden tot vermindering van botvorming. Invokana kan de amputatiegraad verhogen. En, een zeldzame bijwerking van deze klasse van geneesmiddelen is gangreen van Fournier. Jardiance kan helpen om cardiovasculaire gebeurtenissen te verminderen. Glucagon-achtige peptide-1 receptoragonist. GLP-1 (Byetta en Victoza en Adlyxin en Bydureon en Trulicity en ozempic) zijn verantwoordelijk voor de incretwisselveranderingen. Het verlaagt A1c met 0,6 – 1,4%. Kan misselijkheid, braken en stekende tijdelijke hoofdpijn veroorzaken. Kan gewichtsverlies veroorzaken en minder kans op cardiovasculaire gebeurtenissen. Kan gebruiken met metformine. Niet gebruiken met DPP4s. Dit kan de proliferatie van bètacellen en eilandjescellen bevorderen. Byetta wordt tweemaal per dag gedoseerd. Victoza wordt eenmaal per dag gedoseerd. Adlyxin is nieuw in 2016. De injectieplaats kan als een knoop onder de huid aanvoelen. Dit is normaal en bedoeld. Bydureon wordt eenmaal per week gedoseerd. De echtheid wordt ook eenmaal per week gedoseerd. Ozempic is in 2017 door de FDA goedgekeurd en wordt eenmaal per week gedoseerd. Deze klasse wordt goed getolereerd. Insuline. Het doel is om de patiënt te starten met een therapeutische dosis. 0,2 eenheden / kg patiëntgewicht. Snelwerkende insulines werken in 15 minuten en piek in 30-90 minuten en de duur is 3-5 uur. Dit is gekoppeld aan hun eten. Timing van insuline-injectie is belangrijk. Langdurig werkende insuin (levemir en lantus) met aanvang 1-2 uur met een piek van 3-9 uur met een duur van maximaal 24 uur. Basaglar is biosimilar voor lantus en vereist 25-50% meer insuline dan levemir en lantus. Toujeo is glargine U-300. Duur is 36 uur. Tresiba heeft een duur van 42 uur. Dit kan nuttig zijn bij patiënten die vergeten hun dagelijkse insulinedosis te nemen.

Heb je gehoord van een geïnhaleerde insuline? Het heet Afrezza. Dit wordt niet vaak voorgeschreven, heeft een goede werking van de longen nodig en kan alleen in een niet-roker worden gebruikt. Wil meer weten? De beste algehele look is de richtlijnen van de American Diabetes Association 2017. http://bit.ly/2vHOdie

Over drlesliegreenberg

Ik heb meer dan 20 jaar als huisarts gewerkt, zowel als opvoeder van artsen als clinicus. Van kleutertijd tot ouderen, ik verricht verloskunde en algemene geneeskunde. Ik hou van mijn carrière en ben gepassioneerd door mijn kennisgebied en mijn patiënten. Volg mij op Facebook op Leslie Md Greenberg Medical Disclaimer De inhoud van deze website is alleen bedoeld voor algemene informatieve doeleinden en is niet bedoeld als, en mag niet worden beschouwd als, een vervanging voor, professioneel medisch advies. Gebruik de informatie op deze website niet voor het diagnosticeren of behandelen van medische of gezondheidsproblemen. Neem onmiddellijk contact op met uw professionele zorgverlener als u een medisch probleem heeft of vermoedt.

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Het bericht Diabetes management Leslie Greenberg's Blog verscheen eerst op Drugtext.nl.

Source: http://bit.ly/2vNvqjw

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leonardogaga · 6 years ago

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Diabetes management Leslie Greenberg's Blog

Drugtext.nl - Informatief over drugs, medicijnen en gezondheid klachten

Over drlesliegreenberg

Meer lezen

Het bericht Diabetes management Leslie Greenberg's Blog verscheen eerst op Drugtext.nl.

Source: http://bit.ly/2vNvqjw

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freehealthguider · 6 years ago

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Does Breastfeeding Hormone Protect Against Type 2 Diabetes?

THURSDAY, Oct. 11, 2018 (HealthDay News) — The hormone prolactin — most commonly associated with breastfeeding — may play a role in reducing the risk of type 2 diabetes, a new study suggests.

Researchers found that women with the highest levels of the hormone, though still in the normal range, had a 27 percent reduced risk of developing type 2 diabetes compared to those with the lowest levels in the normal range.

“Prolactin is a multi-function hormone — it is not only related to pregnancy and breastfeeding, it also plays an important role in many other biological functions, like metabolism, immune regulation and water balance,” said study lead author Jun Li. She is a post-doctoral research fellow at the Harvard T.H. Chan School of Public Health in Boston.

Li said previous studies have shown that prolactin may affect insulin secretion and sensitivity. Insulin carries sugar from the bloodstream into the body’s cells to be used as fuel. People with type 2 diabetes don’t use insulin efficiently, and as a result, their blood sugar levels rise too high.

Although the study linked higher (but still normal) levels of prolactin to a lower risk of developing type 2 diabetes, Li said it’s not yet clear if there are any practical implications from these findings.

“It’s too early to tell if altering prolactin concentrations is a suitable way for diabetes prevention,” she said, adding that normally high prolactin levels are associated with a higher breast cancer risk. Plus, higher-than-normal levels can promote weight gain and increase insulin resistance, along with other adverse effects.

“Future studies are needed to find out the mechanism and come up with practical strategies,” Li said.

Diabetes expert Dr. Joel Zonszein said much about prolactin is unknown. “It’s a hormone made by the pituitary gland, and in women it goes up during lactation. But, we don’t really know what it does in men.”

What doctors do know is that prolactin levels normally vary a lot, he said. Zonszein is director of the clinical diabetes center at Montefiore Medical Center in New York City.

Zonszein also noted that a diabetes medication called Cycloset (bromocriptine mesylate) lowers prolactin levels at the same time it lowers blood sugar levels — an effect that would seem to contradict the new findings.

The study included more than 8,600 healthy American women whose health was tracked over time as part of a national study. Most were white and in their late 40s or 50s when the study began.

From that group, 699 women developed type 2 diabetes during an average follow-up period of 22 years.

The researchers adjusted the data to account for women’s menopausal status and other diabetes risk factors.

The findings showed that the higher the women’s prolactin levels (while still in the normal range), the less likely they were to develop type 2 diabetes.

But the study does not prove cause and effect.

The report was published Oct. 11 in the journal Diabetologia.

More information

Learn more about preventing type 2 diabetes from the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.

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#Breastfeeding #Diabetes #Hormone #Protect #Type

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connperinatal · 6 years ago

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Breastfeeding: Do’s and Don’ts

Breastfeeding moms are advised to eat healthy diets to increase milk production for their new borns. However, not every breastfeeding mother knows what they should eat and avoid at this stage henceforth a healthy diet should include:

Starchy

– foods like rice, wholemeal bread, pasta and potatoes.

Proteins

– such as egg, seeds, nuts, soya foods, fish and pulses, lean meat and chicken thus at-least 2 portions of fish per week is recommended which also includes some fish with oil.

Fruits and vegetables

– variety of fruits as well as vegetables on a daily basis. At-least 5-portions of the aforementioned. Vegetables and fruits are a great source of calcium, folic acid and iron. Calcium and iron contributes to your baby’s bone health.

Fibre

– plenty of fibre which can be found from eating wholemeal bread & pasta, rice, breakfast cereals, pulses such as lentils and beans, and vegetables and fruits. In some cases, after birth, some women develop bowel problems as well as constipation thus with proper intake of enough fibre into the body, this can help to solve these problems. In addition, they keep mothers fuller for longer periods and as well help you boost breast milk supply.

Dairy

– foods such as cheese, milk, butter and yogurt. They contain calcium and are great source of proteins as well which are vital in boosting your infant’s bone, teeth as well as muscle development. For more info regarding teeth development and dental treatments, kindly click on this link, www.doncastersupremedental.com.au.

Staying hydrated

– drinking plenty of fluids to keep you hydrated at all times and increase milk production.

What to Avoid when Breastfeeding

Not every food is consumed by breastfeeding moms are healthy, some of these foods as well as medicines can pass through to your breast-milk. Therefore, if it happens after consuming a certain food or drink, your baby becomes very unsettled, it is advised that you should talk to your breastfeeding counselor or health visitor at your local clinic though, it might be a coincidence however keeping a food dairy for yourself can help.

Here are certain foods and medicines to avoid when you’re breastfeeding;

Alcoholic drinks

Small amount of alcohol is most likely to pass into your breast-milk. Occasional drinks may not harm your baby but it’s best to limit or reduce alcohol drinks probably to less than 2-units a week. If you’ve established breastfeeding and you have introduced your baby to a bottle then you can express breast-milk for yor baby before a special occasion that’s before drinking alcohol.

In addition, it’s advised that all parents needs to stop or avoid being drunk that is, when caring for their baby and shouldn’t share a bed or even fall asleep with a baby.

Peanuts & other allergens

However, peanuts are not listed as on of the foods to avoid when breast-feeding by the Health department but for those who have a family-history of allergies, it’s recommended that you speak to paediatric allergy specialist or a GP.

Caffeinated drinks

When you take in Caffeine drinks, it passes through into your breast-milk and then acts as a stimulant to your infant. Caffeine can also be found in chocolate as well as in some medicine thus it’s advisable that you limit the amount of cold and hot drinks with caffeine that is, during the day.

In the USA, breastfeeding moms are recommended not to take more than 2-cofees or even fizzy drinks containing caffeine. Therefore, drinks that contain caffeine can affect your baby’s health; it may keep them awake thus you may drink caffeinated drinks occasionally while your baby is still young rather than on a daily basis.

Mercury

Though, it’s advisable for breastfeeding mothers to eat a diet rich in proteins and omega-3 fatty acids, fish being a vital source. However, nearly all fish contain certain traces of mercury which is a metal that naturally occurs in the environment and mostly is increased by industrial-pollution. Many people are not affected by these small amounts of mercury in fish but for the little ones, mercury can cause damages to their nervous system thus, that’s why it’s recommended for childbearing age, pregnant as well as lactating women to avoid taking fish that are highly concentrated in mercury such as king mackerel, shark, swordfish and tilefish.

Recommended fish to be eaten by breastfeeding moms that are contain less mercury include salmon, catfish, shrimp. canned light tuna and pollock fish. Check with your local advisories on safety of the fish to be eaten, if you like consuming fish that are caught in local waters. If the information are unavailable them limit or reduce your fish consumption to 6-ounces a week that is, about one meal.

Pseudoephedrine, methergine & bromocriptine

Some of the medicines greatly affect breastfeeding moms which includes;

Pseudoephedrine – it’s an active ingredient in Sudafed as well as in similar cold-medications

Methergine – mosly used to treat severe uterine-bleeding that happens after childbirth

Bromocriptine – brand names include Cycloset or Parlodel, they are used to treat a variety of issues such as hyperprolactinemia.

All these have shown or proven to have a negative side effect on breastfeeding women in regards to milk supply. Henceforth, if you are taking either of the listed medications and you’ve realized that your milk supply has dropped then, it’s advised that you ask your doctor for another alternative treatment. Therefore, with increased breastfeeding, supplementation with lactogenic foods and herbs as well as possibly additional pumping will greatly help you build-up your baby’s milk production yet again.

The post Breastfeeding: Do’s and Don’ts appeared first on Connecticut Perinatal Association.

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#IFTTT #Connecticut Perinatal Association

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type2diabetestreatments-blog · 8 years ago

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ADA Conference 2011: Product Updates!!

New Post has been published on http://type2diabetestreatment.net/diabetes-mellitus/ada-conference-2011-product-updates/

ADA Conference 2011: Product Updates!!

We're officially conference-weary after running around the San Diego Convention Center for four days of ADA briefings, sessions, meet-ups and expo booth visits. We lugged home loads of material that will surely keep us post-happy here at the 'Mine for weeks. So what was super-new and hot? Spoiler Alert: Not all that much this year.

Our overall impression was that a lot of cool technologies we've already seen are stuck in the holding pen while FDA increasingly drags its feet on the approval process. Grrr.

Case-in-point: Intuity Medical's Pogo all-in-one meter including built-in lancing device and test strip cartridge. I believe this was the third year in a row we oggled the design in the company's booth, yet still nothing to market. It's just a glucose meter, for goodness sake — not some radical new therapy! *sigh*

Anyway, Intuity has had plenty of time to soup up their demo models. Check out this "race car" design:

Also, weirdly, some of last year's hottest prototypes were glaring absent this year. No booth for Debiotech, for example, which wowed us with their Jewel patch pump last year.

Some new stuff we did learn about:

* A company now called Spring (formerly NiliMEDIX) is working on a new "hybrid patch pump" that's kind of wacky, in a good way. It's in development and so far only lightly described on their website, but we snapped a brochure pic, below. The part that attaches to your body will be a "cradle" that allows you to disconnect the "pod" portion (as with the Roche / Medingo Solo pump design). But here's the wacky part: you can also switch to wearing it as a tubed pump whenever you like, just by popping off the "pod" portion and plugging the infusion set right into the cradle connector. Wow!

Look and feel? Currently the "pod" part is a 2x2-inch-looking white square. Yes, a SQUARE — and yes, I told them we don't like to wear sharp corners on our contoured bodies, right? The remote control looks like a slick white iPhone/iPod, complete with a color touch screen and scroll wheel for commands. Also:

the remote control has an integrated glucose monitor

you'll be able to bolus with or without the remote control

you can suspend the pump at the push of a button

the whole thing will be IPX 8 water-tight, which is BIG, and I'll tell you why...

Having taken another look at the Solo patch pump that Roche acquired from Medingo last year (which is still in the holding pen, btw), I discovered that it is NOT WATERPROOF. The Accu-Chek folks claim that in order to make it detachable, the device cannot be completely air sealed. Which means that the advantage of being able to disconnect is offset by the disadvantage that you are FORCED to remove it each time you shower, bathe, or swim. That's bad news, IMHO.

* On Friday, the folks at Spring submitted an application for European CE Mark approval of their "regular" Springâ„¢ Zone Insulin Delivery System, the updated version of their spring-driven insulin pump. We covered the details of this pump last year here.

As a reminder, once approved, the sporty-looking Spring would be the smallest tubed insulin pump on the market. Other advantages the company is touting are: that it doesn't use a motor, but rather draws energy from pressure created via a controlled-release mechanism — and this no-motor approach reportedly makes the system "virtually fail-proof" and very low-cost to manufacture. It also offers a highly sophisticated error sensing and alarm system.

Related to that last bit is the company's new SpringNow Universal Infusion Set, designed for the highest level of error protection. Its proprietary "Detach-Detect" mechanism actually triggers a blocking device that creates an occlusion in case any part of the infusion set base becomes detached from your body. It also features "high-transparency tubing (that) enables visual air-bubble detection." (Yes, I talked to them about the colored tubing idea, too!)

SpringNow is newly FDA approved, and compatible with all standard Luer Lock connectors (pretty much all pumps except Medtronics, which use their own proprietary connector.)

* Roche is also working on a system called the Accu-Chek Combo — a new competitor to the Animas Ping which uses Bluetooth technology to connect the meter and pump. What's special about the Combo is that you can control all pump features from the glucose meter, including basal rates and temp basals. You can also program in preset "add-ons" to your bolus calculations. For example, if you're dosing for a 45-gram-carb muffin and hit your preset "sick" rate, the system would automatically add 20% (or whatever increase you pre-programmed for "sick") to your bolus dose. Sweet! The Combo is not yet approved in the U.S., needless to say.

Roche has a few more pre-approval things up its sleeve, including the FastClix (pictured), an upgrade to the popular MutliClix lancing device, and the Accu-Check Aviva Expert, with a bolus calculator built into the glucose meter — designed for patients on shots. The Expert keeps track of boluses and insulin on board (IOB) too. That one's available in Europe already.

* CellNovo's new mobile-technology-enabled pump system was making a nice splash on display in that company's booth.

Earlier this year we published an in-depth conversation with the CEO, Bill McKeon. We were finally able to get an up-close and personal look at this quasi-patch pump. Why quasi? Because despite the fact that the pump can sit directly on your skin, there is still tubing to a set. In other words, it's almost like a patch pump that's attached to you with tubing.

There's a separate, wireless controller (the cool part that's got people excited), and you can choose to wear the reservoir "patch" portion either hanging off of long, standard tubing, or wear a velcro-like adhesive stuck to your body that will keep this portion in place. With the latter option, you would definitely be wearing two things stuck to your body.

Now, we at the 'Mine had a bit of a debate on this point. Allison, a long-time tubed pump user (Medtronic since 2000), is in favor of having a bit of tubing even if it means having a separate site, in case there's an issue with the insertion, or if the adhesive comes off. But I (Amy) thought it looked kind of like the worst of both worlds: you've got this tiny patch-like pump, but you still need tubing to use it, and your wear options are basically to tape it to your skin, or have it dangling off you with no good clip option that I could see.

CellNovo is still looking at a fall 2011 launch in Europe, but due to regulatory restraints at the FDA that have been discussed ad nauseum, the U.S. launch will be later — by late 2012 if they're lucky. Though at the rate the FDA is going, we wouldn't bet money on it...

* Two new type 2 drugs also seem quite hot.

Cycloset:

Most drugs for people with type 2 focus on the obvious: the pancreas (producer of insulin) or the liver (producer of glucagon). But this new drug from the folks at Rhode-Island-based VeroScience is making an attempt at managing diabetes starting in the brain. Their theory is that it stands to reason that the control center of the body would have some kind of impact on diabetes. They found that people with diabetes have lower levels of dopamine (yep, that feel-good hormone), and that if they could turn it up in the morning, it could have a benefit for people with type 2 throughout the rest of the day. In their clinical trial, people on Cycloset vs. a placebo saw a 1% drop in A1C over a year, and it was shown to be safe for the heart.

The downside: the average dose is between 3.2 mg and 4.8 mg, but the tablets are .8 mg because Cycloset needs to be titrated at an average of one pill a week. That means that by the time you're at the average dose, you're taking anywhere from 4 to 6 pills. They're small, about the size of an Advil, but you have to take all of them at one time at breakfast. Seems like an awful lot to gulp down with your oatmeal every day, or...?

SGLT2 Inhibitors:

This is an entirely new class of drugs that will be hitting the market real soon, we hear. A subsidiary of Johnson & Johnson called Janssen is looking at using the kidney to flush out sugar from the body. What SGLT2's essentially do is force the body to rid itself of the glucose through the kidney, excreting it via urine. One woman at the booth likened these drugs to diuretics in that they use the kidneys to flush sugar. Patients will basically "pee out" the extra sugar. Sounds kind of weird, but apparently it is safe. Janssen's formulation is currently in clinical trials so the reps had sealed lips on any more info about it, but we'll be sure to share more as soon as we hear.

In addition, there were many briefings about data results in closed-loop research (we wish the reality were closer), and some very positive data reported on type 2 patients successfully using CGM systems.

And of course, there was lots of aggressive marketing going on. Like this:

Oh yes, they did.

Disclaimer: Content created by the Diabetes Mine team. For more details click here.

Disclaimer

This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.

Type 2 Diabetes Treatment Type 2 Diabetes Diet Diabetes Destroyer Reviews Original Article

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