Diabetes Patients Still Seek More Convenient Therapies. Pharma Isn't There Yet.

Implications: A recent Chicago-area study has made it clear that diabetics view the daily-injection routine as being equally as onerous as many of the long-term complications from the uncontrolled disease. In addition to multiple daily injections, diabetic patients usually take several concommitant medications every day. While patients greatly fear the most severe end-stage complications like blindness, kidney failure, and stroke, many indicated a willingness to give up years of life (or quality of life) to avoid daily treatments.

Analysis: Healthcare practicioners have always known that the most onerous part of treating newly-diagnosed diabetics is making the leap to insulin injections. The pharmaceutical industry has a variety of programs that are looking at alternate means of delivering insulin: oral, transdermal, intranasal, and of course, inhaled. At present, none of these alternatives would enable insulin-dependent diabetes to completely free themselves from daily injections.

The advent of GLP-1 analogs (exenatide, liraglutide, etc.) has certainly garned excitement in the medical community because of the excellent glucose control coupled with meaningful weight loss. Of course, these compounds are all administered with a needle, thus reducing the appeal to the patient.

Oral diabetes drugs, including the newly available DPP-IVs, aren't cures for diabetes, and pharma has an intense focus on coming up with therapies that not only control glucose, but preserve or restore pancreatic beta cell function, reduce the risk of neuropathy, retinopathy, and nephropathy, and provide a cardioprotective effect. Having a combination of these factors in only one or two drugs would be icing on the cake. My opinion is that a medium pill burden would still be far preferable to a daily injection for most patients.

Of course, the key to any diabetes treatment being successful is a patient who is compliant with their therapy and who makes the appropriate lifestyle modifications to ease the burden on their body. It's not a stretch to think that modern medicine can completely cure diabetes, but only if the causal factors are removed at the same time that the symptoms are treated. In many ways, the situation with diabetes is not unlike that experienced by HIV patients in the 90s. Once HAART made HIV a chronic, treatable disease instead of a death sentence, patients began to clamour for more well-tolerated and convenient therapies. Diabetics deserve the same thing.