[acb-diabetics] new study shows better control for type 1

Sat Jun 25 19:18:08 EDT 2011

You must have read my thoughts, Mike.  I see my endow next week and am going
to ask him.  I don't know what my A1C is as they don't do it on dialysis
patients.  It is too inaccurate.  But, I am bouncing around a lot more than
I used too.  Very irritating 

-----Original Message-----
From: acb-diabetics-bounces at acb.org [mailto:acb-diabetics-bounces at acb.org]
On Behalf Of Mike Freeman
Sent: Saturday, June 25, 2011 4:00 PM
To: 'Discussion list for diabetics and/or ACB issues'
Subject: Re: [acb-diabetics] new study shows better control for type 1

Regrettably, you're probably correct. But we could both be wrong in that
Victosa is at least already on the market so that all it would take would be
for FDA to approve an expansion of the group for whom its use is "on-label".
Come to think of it, I wonder if an adventurous or forward-thinking endo
could be persuaded to prescribe Victosa for his/her Type 1 patients as an
experiment?

Mike Freeman

-----Original Message-----
From: acb-diabetics-bounces at acb.org [mailto:acb-diabetics-bounces at acb.org]
On Behalf Of Patricia LaFrance-Wolf
Sent: Saturday, June 25, 2011 3:39 PM
To: 'Discussion list for diabetics and/or ACB issues'
Subject: Re: [acb-diabetics] new study shows better control for type 1

Me too.  But I think it is wishful thinking on my part to hope that it will
be in my lifetime.  I have been type 1 for 66 years!

-----Original Message-----
From: acb-diabetics-bounces at acb.org [mailto:acb-diabetics-bounces at acb.org]
On Behalf Of Greg Wocher
Sent: Saturday, June 25, 2011 8:31 AM
To: Discussion list for diabetics and/or ACB issues
Subject: Re: [acb-diabetics] new study shows better control for type 1

Hello,
This article is great.  I have been a type one diabetic for nearly 32 years.
I hope this new medicine will work in the larger study.
Sincerely,
Greg W.

On 6/24/2011 9:27 PM, Patricia LaFrance-Wolf wrote:
> 22-Jun-2011
>
> June 2011 - Results of a small, observational study conducted at the 
> University at Buffalo suggest that liraglutide, an injectable 
> medication used to treat type 2 diabetes, also helps type 1 diabetics 
> on insulin achieve optimal control of their blood glucose levels.
>
> If the findings are confirmed in a larger, prospective, randomized 
> study now being planned by the UB researchers, they could mean the 
> first significant, new treatment for type 1 diabetes since insulin was 
> discovered and made available in the 1920s.
>
> The research has been published online here 
> <http://www.eje-online.org/content/early/2011/06/06/EJE-11-0330.abstra
> ct>
in
> the European Journal of Endocrinology. It also was recently presented 
> at the annual meeting of the Endocrine Society in Boston, where it 
> received recognition as one of the most outstanding abstracts 
> presented and the best in the field of diabetes.
>
> "Since the development of injectable insulin, there has been nothing 
> definitive in terms of a significant advance in type 1 diabetes 
> treatments," says Paresh Dandona, MD, PhD, UB distinguished professor 
> of medicine in the School of Medicine and Biomedical Sciences and 
> senior author on the study. "That is the tragedy of the type 1 diabetic.
>
> "This study shows that liraglutide can provide even well-controlled 
> type
> 1 diabetics with additional benefits that help them achieve even 
> better blood glucose levels," says Dandona.
>
> The patients on liraglutide, which is marketed as Victoza, also saw a 
> reduction in appetite and food intake and the paper reports that body 
> weight significantly fell in patients who took the drug for 24 weeks.
>
> The unfunded study was a retrospective analysis of data. It was 
> conducted at Kaleida Health's Diabetes-Endocrinology Center of Western 
> New York, which Dandona directs.
>
> At the start of the study, all 14 patients had hemoglobin A1C levels 
> of under 7, which is considered optimal. They were characterized in 
> the paper as "well-controlledÂ
meticulous and disciplined" in terms of 
> their ability to control their blood glucose levels with insulin.
>
> Nevertheless, Dandona notes, even well-controlled type 1 diabetics 
> still experience "glycemic excursions," fairly wide swings in their 
> blood glucose numbers ranging from the hyperglycemic, from 150 
> milligrams per deciliter to 250 mg/dl or higher to the hypoglycemic, under
70 mg/dl.
>
> "The addition of liraglutide to insulin therapy in these 
> well-controlled type 1 diabetics resulted in a significant and rapid 
> reduction in glycemic excursions and, as a consequence, a rapid 
> reduction in the amount of insulin they needed to take," Dandona explains.
>
> Several figures in this presentation by Dandona clearly demonstrate 
> this effect.
>
> These improvements occurred rapidly, within 1-2 days of beginning 
> treatment with liraglutide and they reversed just as rapidly when 
> treatment was discontinued, signifying that it was the drug that was 
> responsible for these beneficial effects.
>
> The mechanism behind these improvements is not well-understood but 
> Dandona and his co-authors suggest that liraglutide may be suppressing 
> the post-meal increase in glucagon, the hormone that raises glucose 
> levels, in type 1 diabetics.
>
> Dandona and his colleagues are now planning a much larger, multicenter 
> study of liraglutide in type 1 diabetics.
>
> "We will be investigating in detail the hypothesis that it is 
> liraglutide's ability to suppress glucagon that significantly reduces 
> the wide swings in blood glucose levels that type 1 diabetics -- even 
> those with very good glucose control -- live with everyday," says Dandona.
>
> The retrospective study involved 14 adult type 1 diabetics who took 
> liraglutide for periods ranging from one week to 24 weeks.
>
> Co-authors with Dandona are: Ajay Varanesi, endocrinology fellow; 
> Natalie Bellini, honorary research fellow; Deepti Rawal, MD, UB 
> medical resident; Mehul Vora, clinical assistant instructor; Sandeep 
> Dhindsa, assistant professor of medicine; Antoine Makdissi, assistant 
> professor of medicine; and Ajay Chaudhuri, MD, associate professor of
medicine.
>
> Source: University at Buffalo, The State University of New York
>
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