Once-Daily Pill Lowers Blood Sugar and Cholesterol in Diabetics

Therapy could simplify treatment for many with the disease, experts say

SUNDAY, June 12, 2005 (HealthDay News) -- A drug that could simplify pill-taking for many Americans with the most common form of diabetes has shown promise in clinical trials, researchers report.

The drug is muraglitazar, which mounts a two-pronged attack against high blood sugar and high cholesterol, the major problems faced by people with type 2 diabetes, in which the body gradually loses its ability to metabolize insulin.

"Further, muraglitazar achieved these goals with only one pill a day, which makes it easier for people with type 2 diabetes to manage multiple health problems and may enhance patient compliance," Dr. David Kendall, medical director of the International Diabetes Center in Minneapolis, said in a statement.

Kendall was to present the findings Sunday at the American Diabetes Association's annual meeting in San Diego.

Muraglitazar produces its twin effect because it acts on cell receptors for both insulin and fats such as cholesterol. Existing diabetes drugs such as metformin act only on insulin receptors, the researchers said.

A first trial of 985 people given different daily doses of muraglitazar established that the most effective dose was 5 milligrams a day. The researchers followed 88 of the participants taking the 5-milligram doses and found very tight control of blood sugar levels.

A larger trial included 1,159 people with type 2 diabetes who were taking metformin. They all continued to take that drug. Half were randomly assigned to take either muraglitazar or a different drug, pioglitazone, which acts only on insulin receptors. After 24 weeks, blood sugar levels were 1.14 percent lower in the muraglitazar group, compared to 0.85 percent lower in the people taking the other drug.

Blood levels of LDL cholesterol, the "bad" kind that clogs arteries, were 5.9 percent lower in the muraglitazar takers, compared to 1.2 percent lower in those taking the other drug. And levels of "good" HDL cholesterol were markedly higher in those taking muraglitazar

Those results are in line with previous large-scale trials of muraglitazar, said Dr. Nathaniel Clark, national vice president for clinical affairs of the American Diabetes Association, and are important for a large percentage of people with type 2 diabetes.

"The important point is that most people with type 2 diabetes have problems with both blood sugar and blood cholesterol," Clark said. "This pill, taken once a day, helps with both problems."

But the dream of controlling diabetes with just one pill a day probably will not come true for many people, Clark said. It's likely that a number of people with type 2 diabetes will continue to take other medications even if muraglitazar works as hoped for them because many have other problems that require drug therapy, such as high blood pressure.

Muraglitazar was developed by Bristol-Meyers Squibb, which has signed a marketing agreement with Merck. An application for approval was submitted last December to the U.S. Food and Drug Administration, said Janet Skidmore, a Merck spokeswoman.

"It is very encouraging that a number of drugs for diabetes are coming on the market or being studied," said Clark.

Another such drug is rimonabant, which not only lowers blood sugar levels but also promotes weight loss. Studies have shown that rimonabant can have a direct effect on physical appearance, by taking fat off the waistine.

Such a study, done in Europe, was reported Sunday at the conference by Dr. Andre Scheen of the University of Liege in Belgium. Persons who took the drug for a year lost an average of 11.7 pounds, trimmed more than 2 inches off their waistline and had lower blood fats and higher HDL cholesterol readings than those taking a placebo, Scheen reported.

According to the American Diabetes Association, 18.2 million people in the United States have diabetes. While 13 million people have been diagnosed with the disease, 5.2 million people don't know they have it.

More information

To learn more about type 2 diabetes, visit the American Diabetes Association.

SOURCES: Nathaniel Clark, M.D., national vice president for clinical Affairs, American Diabetes Association, Alexandria, Va.; Janet Skidmore, spokeswoman, Merck, Whitehorse Junction, N.J.; June 12, 2005, presentations, American Diabetes Association, annual meeting, San Diego
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