New Red Wine Pill and Other Drug Notes

Lots of drug news coming out of the JP Morgan Healthcare Conference here in San Francisco last week. Among the presenters were Amylin, DexCom, Insulet (OmniPod), MannKind (developing inhalable insulin), and Biodel (developing fast-acting Viaject insulin).Red_wine_diabetes

The most intriguing news seems to come from Sirtris Pharmacueticals, a startup based in Cambridge, MA, that’s testing a new diabetes drug made from red wine. No kidding! Hey, if lizard spit can turn out to be effective, Cabernet may very well turn out to be the next big thing in treating diabetes. Seriously.

Sirtris is a formulation of resveratrol, a substance found in red wine, which is showing good results in helping Type 2s lower their blood sugar in early stage clinical trials. They’re also calling it an “anti-aging drug” because it is thought to mimic the life-prolonging effects of a very low-calorie diet. And so far, it has proved quite safe.

One never knows for sure until it hits the market, but this could give Avandia and Actos a run for their money, if it can help drop A1c levels without all the drawbacks: weight gain, edema, and potentially much more harmful side effects.

Speaking of side effects, what is up with Januvia? The posts here at DiabetesMine on that drug continue to attract dozens upon dozens of comments about muscle pain, nausea, headaches, constipation, and even risk of heart damage — crazy for a drug that was marketed as side-effect free!

Since Diabetic Investor David Kliff was in town for the conference, I asked him about it.

“Januvia is an accident an accident waiting to happen,” he said. Yikes!

He’s heard of side effects ranging from nightmares to cancer, but notes that if Januvia hits rock bottom, “it could be the worst thing to happen to diabetes ever.” This is because so many patients are already scared off oral drugs by the Avandia flap, so another like it would do irreparable damage to the treatment regimen doctors are already struggling to instill in Type 2 patients. Ugh!

btw, I learned that you can follow reported problems with medications closely yourself by checking out the FDA’s Adverse Event Reporting Program. Or report your own drug troubles HERE.

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3 Responses

  1. Jo
    Jo January 14, 2008 at 11:00 am | | Reply

    Would be cool if “wine” pill would help because I cannot stomach red wine to drink!

  2. Adam Becker Sr
    Adam Becker Sr January 14, 2008 at 11:21 am | | Reply

    Anecdotal reports don’t scare me much.

    Anecdotal reports accompanied by plausible physiological mechanisms scare me a lot more. Which is why the info in Jenny’s Januvia pages
    http://www.phlaunt.com/diabetes/18538604.php
    really concern me. Messing around with the incretins sounds like a good idea. Messing around with DPP-4 sounds not so good. DPP-4 is a protein with two faces. On one hand, it’s an enzyme that slices up proteins, disabling them. Januvia works by disabling DPP-4. That way, the incretins don’t get sliced up and they stay around longer. That’s good. But DPP-4 apparently disables a lot of other proteins, which are ill-characterized. That sounds less good; we don’t know what we’re monkeying with.

    Also, DPP-4 has another completely different role, sitting in the cell membrane and acting as a signaling site in the immune system. We really don’t understand what it’s doing there. Disabling it seems very much like “Hey, what happens if I push this button?”

  3. Laurie, RNP
    Laurie, RNP January 14, 2008 at 8:41 pm | | Reply

    Hi,

    My practice consists of all type 2′s (it just fell out that way because of the population that I care for by age). Although I have learned about these new drugs I have not rushed to use them. I have worked in this office for 4 years. When I started there fewer than 1/4 of my patients with diabetes had a HgbA1C less than 8%. Today 1/2 are under 6.5% and another 1/4 of them are between 6.5 and 8%. The vast majority of them are on a combination of an old sulfonyurea, Amaryl, and metformin. Those who need it also use the long-acting insulin glargine (Lantus). I like Amaryl because it matches pancreatic insulin stimulation/secretion to meal time glucose excursions, rather than pushing the pancreas to make more insulin all the time. I believe that this helps to spare the pancreas from constant stimulation, possibly extending it’s usable life. Metformin, of course, helps the body to use insulin more efficiently. Insulin is what the body makes naturally to control blood sugar, so one can hardly argue with it’s use. My point is that there are drugs available already that can give great blood sugar control, and we should not rush to try new meds when they come out, just because they are avaliable. Studies of medications are very controlled in their choice of participants in order to minimize the risk of side effects. This ensures that there will be many new side effects seen in the post-marketing tracking once a new drug is launched. Each person has to choose for themselves whether or not a new drug is right for them. If one can achieve good control with their current medications and an honest effort at good eating an exercise habits, they may choose not to try a new medication the minute it hits the market. Once a full safety profile has been documented and you need a new drug in yor arsenal, you’ll still be able to choose that medication, unless it has been ripped from the market by post-marketing outcomes. Then you’ll be glad you avoided it!

    Laurie

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