Japan experimented with drugs to treat diabetes

Japan is experimenting with SGLT2 inhibitors that can treat diabetes completely to avoid potentially dangerous complications for patients.

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Glucose-filtered glucose will be reabsorbed back into the blood by sugar-salt transport proteins (SGLT2) . If SGLT2 is controlled, glucose will be excreted completely in urine and blood sugar will not increase. High blood sugar density will cause dangerous complications for nerves, retina and kidneys.

The new drug has a mechanism to treat inactivation and block SGLT2 protein, which is responsible for sugar absorption in the kidney.

So far, the types of drugs that increase the effectiveness of hormones and insulin still play a key role. However, the new drug will be based on the anti-reabsorption mechanism of excess kidneys and complete urinary excretion also contribute to weight loss in obese people.

Six drugs with the same mechanism are being tested in Japan and started to be recognized in European-American and Japanese countries.

In Japan, more and more of the 9.5 million patients switch to this new treatment option.

Reduce blood sugar

Basically, the kidneys have the function of maintaining a stable blood sugar level and under the action of SGLT2 protein in the microcosm, 90% of the sugar is excreted from the blood into the urine is absorbed again.

In the case of diabetics who have many sugars excreted in the urine, SGLT2 dysfunction drugs cause excess sugar to not be absorbed back into the blood and excreted entirely in the urine. Therefore, although the amount of sugar in the urine increases, blood sugar levels will decrease and high blood sugar will improve.

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In addition, the drug lowers blood sugar, which reduces the amount of sugar penetrating into the cell, which also helps to reduce body weight. Thanks to this effect, the effect of insulin also improves the burden on Langerhans island cells of the pancreas, creating hope to restore pancreatic insulin secretion.

However, it should be noted that the side effects of the new type may increase the bacteria in the urethra and genitals due to increased sugar levels in the urine.

Treatment scale increased sharply

The director of the Ueda Clinic, Dr. Nobuyuki Ueda, of the Japan Diabetes Research Association, who participated in the drug testing program, said: 'The current treatment for diabetes is mainly an increase in insulin to reduce the amount of sugar inside. blood, improve vision and increase insulin secretion. However, new drugs follow a mechanism that promotes excretion of excess sugar in the urine, so the effect of the drug is completely different, and it can be said that the scale of treatment has expanded. '

In about a year of participation in the trial, the patient's average HbA1c levels for 1-2 months improved to nearly 1% while the standard value was less than 7%. In a body mass loss of 2-3 kg, the amount of fat in the liver decreases and the γGTP index tends to improve.

Mr. Ueda stressed: "New drugs are basically for people with high blood sugar levels after eating, but the methods of exercise and abstinence do not improve obesity."

Evaluation of new drugs, Dr. Ueda said: 'I also want to discuss more about other side effects of new drugs such as making patients thin, having much calcium excretion causing dilution of the frost, causing electrolytes loss. or not?'

Testing was conducted since 2010

Of the current treatment for diabetes, there are three forms of promoting insulin secretion; improve insulin resistance; anti-sugar absorption from the intestine.

Recently, these drugs increase the effectiveness of incretin hormones that increase pancreatic insulin production, which is widely sold.

SGLT2 inhibitors are compounds called Phlorhizin extracted from apple roots and are thought to be closely related to diabetes.

The drug is divided into six categories based on chemical composition and began to be tested in many countries around the world since 2010.

In January 2014, besides a drug approved in Japan, two other drugs were approved for use in the United States.