Controlling blood sugar the natural way

MANILA, Philippines - Diabetes care pioneer Novo Nordisk has developed a novel type of medicine for type 2 diabetes that controls blood sugar the natural way.

“Liraglutide mimics the action of a hormone released from the small intestine after food intake. This hormone, a type of incretin called GLP-1, helps the pancreas control blood sugar more efficiently,” said Dr. Filip Knop, head of Diabetes Research Division, Gentofte Hospital, University of Copenhagen, Denmark.

“Liraglutide signals the pancreas to secrete more insulin to help lower blood sugar quickly. At the same time, it suppresses the pancreas from secreting too much glucagon, a hormone that releases glucose from the liver and raises blood sugar levels,” said Dr. Augusto Litonjua, consultant endocrinologist of Makati Medical Center.

The two experts spoke during a recent lunch symposium organized by Novo Nordisk at the Edsa Shangri-La Hotel in Mandaluyong City. Around 200 local internists, cardiologists, and endocrinologists attended the symposium.

Liraglutide belongs to a class of diabetes medicines called GLP-1 receptor agonists. Also called incretin mimetics, GLP-1 receptor agonists mimic the action of intestinal GLP-1. While the effects of GLP-1 only last for a few minutes, the half-life of liraglutide is about 10-13 hours.

Liraglutide is 97 percent similar to GLP-1. By acting like GLP-1, liraglutide helps make more insulin available in the bloodstream to help lower blood sugar levels quickly.

Beta cells

Liraglutide triggers important cells in the pancreas, called beta cells, to make insulin when blood sugar is high. This is important because, over time, beta cells stop working in people with type 2 diabetes. By the time of diagnosis, about 50 percent of beta cells are no longer working the way they should. Liraglutide helps beta cells work the way they should.

“Unlike other anti-diabetes medications — e.g. sulphonylureas — that stimulate insulin secretion all the time, liraglutide stimulates insulin secretion only when there is a need for it — after a meal when blood sugar levels are high,” said Knop. “Because of its unique mechanism of action, liraglutide does not cause hypoglycemia (low blood sugar), a dangerous condition associated with certain anti-diabetes medications.”

“GLP-1 receptor agonists such as liraglutide provide multiple benefits to patients with type 2 diabetes,” said Litonjua.

These include normalizing after-meal (postprandial) blood sugar levels, suppressing inappropriately high glucagon secretion, improving beta cell responsiveness and nighttime insulin secretion, decreasing appetite and weight, and significantly lowering HbA1c, a key measure of diabetes control.

Liraglutide is a once-a-day injectable medication indicated for the treatment of type 2 diabetes when diet and exercise alone are not enough to control blood sugar levels. It can be used together with other diabetes medications, such as metformin, sulfonylureas (e.g. glimepiride or glicazide), and pioglitazone.

Liraglutide comes in a pre-filled pen that is injected at any time of the day under the skin of the stomach, thigh or upper arm.

According to Knop, GLP-1 receptor agonists such as liraglutide play a major role in the management of type 2 diabetes patients in Europe and the United States. He said the number of patients using liraglutide is increasing in Asia and South America.