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Times of India
28 May 2010
By Jayashree Nandi
Bangalore, India

If you’re a diabetic and obese, then this new group of drugs might kill both these conditions.

A new set of GLP1 agonist group of drugs is set to hit the market in June. The new drugs reduce weight and suppress appetite to a great extent and is specially suited for obese diabetics who are not yet on insulin.

One of the agents of the tobe–released drug –Liraglutide –is already available in the market. Exenatide drugs are popular in the US as the population of obese people is higher. Both drugs are usually prescribed to patients who have not started on insulin, but are in the early stages of diabetes and are obese.

“It is usually combined with a rigorous discipline of diet and exercise. They are associated with lowering of blood pressure and decrease in visceral fat. We’ve a thin fat population. Even though Indians are not very obese, the visceral fat levels are quite high,”said consultant endocrinologist, Usha Srinivasan.

Consultant endocrinologist at Fortis Hospital, Dr C V Harinarayan Sharma, says the advantage is marginal.“Patients try to avoid insulin because it is injected regularly; these drugs are also injectible, so it doesn’t make much difference. They are expensive and weight loss cannot be the only reason for a diabetic to use this drug,”he said.

How Does IT Work?
The two GLP 1 drugs are called incretin mimetics. They mimic the two intestinal hormones –glucagon–like peptide–1 (GLP 1) and gastric–inhibitory polypeptide (GIP). These hormones are secreted in response to food. In type–2 diabetes, the secretion is decreased and only about 50% of it reaches the pancreas where beta cells are stimulated to create insulin. According to consultant diabetologist, Karnataka institute of Diabetology, Dr Anil Kumar, GLP1 drugs mimic the action of the hormones, but not so much is destroyed while reaching the pancreas; so the insulin secretion is higher.

“Liraglutide can be given once daily. The results can be seen in a couple of months. My patient lost 6 kg in two months. It’s particularly suitable for type–2 diabetes patients with obesity. Side effects like nausea are seen in some patients. The FDI has given a safety warning against chances of pancreatitis. However, it is effective in diabetes management before oral insulin comes into the market,”Dr Anil added.

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