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The Landscape of Diabetes is Changing with New Medications

The diagnosis of Diabetes has been around for decades, and often, there were a handful of medications that were options. However, in the last decade, numerous new and improved medications have been approved by the FDA. It is clear that Diabetes Type 1 and Diabetes Type 2 are different causes/results with relation to blood sugars and treatments. Insulin continues to be the mainstay for Type I, but for Type II – a bunch of new injection and oral medications are not available.

Let’s take a look at some of the available medications:

Mounjaro – Tirzepatide

– This is a once-a-week injection for Type II diabetes that can help lower blood sugars and can also help with weight loss.
– This is the first in a new class of medications, and it has been shown to lower hemoglobin A1C more than any other medication.
– It is being used off-label to help patients with diabetes specifically target weight loss.
– This is a GLP-1 medication – which will be discussed later.

Tzield – Tepizumab

– This medication can delay the onset of Type I diabetes in children over the age of 8.
– It is the first treatment to change the course of this autoimmune disease.
– It was approved in 2022.

SGLT2 inhibitors

– This class of medications prevents the kidneys from reabsorbing glucose, which allows glucose to be eliminated in the urine.
– This can improve blood sugars, contribute to weight loss, and slightly lowers blood pressure.
– Some potential side effects include UTI’s and vaginal yeast infections.
Examples:
.  Farxiga – Depagliflozin
.  Jardiance – Empagliflozin
.  Invokana – Canagliflozin

GLP-1 – Glucagon-like peptide 1

– These medications provide glycemic control by helping to affect the feeling of fullness in the stomach in those with Type II
– They help improve blood sugar control and help with weight loss.
– They can have side effects that affect the stomach such as nausea, vomiting, and diarrhea.
– Each medication is unique in their schedule, dosing, and administration requirements.
Examples:
.  Byetta – Exenatide   (Given twice a day)
.  Victoza – Liraglutide  (Given once a day)
.  Bydureon – Exenatide ER  (Given once a week)
.  Tanzeum – Albiglutide  (Given once a week)
.  Trulicity  –  Dulaglutide  (Given once a week)
.  Adlyxin – Lixisenatide  (Given once a day)
.  Rybelsus – Semaglutide (Given twice a day – by mouth)
.  Ozempic – Semaglutide (Given once a week)

DPP-4 – Dipeptidyl peptidase-4

– These medications attempt to lower blood sugars without causing Hypoglycemia
– These medications can help the pancreas make more insulin which is helpful in most Type II diabetes patients.
Examples:
.  Nesina – Alogliptin
.  Kazano – Alogliptin + Metformin
.  Tradjenta – Linagliptin  
.  Jentadueto – Linagliptin = Metformin 
.  Onglyza –  Saxagliptin  
.  Kombiglyze – Saxagliptin   + Metformin  
.  Januvia – Sitagliptin 
.  Janumet – Sitagliptin  + Metformin
.  Juvisync – Sitagliptin + Simvastatin