# New type II diabetes drug **URL:** \ **Category:** In My Humble Opinion\ **Created:** [January 28, 2012, 9:08pm UTC](https://boards.straightdope.com/t/new-type-ii-diabetes-drug/611020 "2012-01-28T21:08:34Z")\ **Posts on this page:** 14\ **Page:** 1
**Author:** ![teela\_brown](https://avatars.discourse-cdn.com/v4/letter/t/d9b06d/32.png) [@teela\_brown](https://boards.straightdope.com/u/teela_brown)\ **Post date:** [January 28, 2012, 9:08pm UTC](https://boards.straightdope.com/t/new-type-ii-diabetes-drug/611020/1 "2012-01-28T21:08:34Z")
Disclaimer: I own a bit of stock in this company. The company’s Amylin, and they just got a new drug approved by the FDA. Right now, there are a couple of drugs a type II diabetic can inject, but the injections must happen on a daily basis. One is Victoza, of Paula Deen fame. This newly approved one only needs to be injected once a week, a big improvement IMO. It’s called Bydureon, and it’ll be available in pharmacies in February. I thought it’d be more expensive than Victoza, but according to this Marketwatch [article](http://www.marketwatch.com/story/fda-approves-amylins-bydureon-diabetes-drug-2012-01-27), it’ll be priced cheaper. My sister is a type II diabetic, and with the family history I’m leery of becoming one myself, so this event is doubly awesome to me. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [January 28, 2012, 11:41pm UTC](https://boards.straightdope.com/t/new-type-ii-diabetes-drug/611020/2 "2012-01-28T23:41:13Z")
Type II diabetes runs in my family and with my physique it is probably only a matter of time (though I try to do things to delay it). I have seen several articles saying that obesity surgery can put it into remission 80%+ of the time. [http://www.msnbc.msn.com/id/22787261/ns/health-diabetes/t/obesity-operation-may-cure-diabetes-many/#.TySGDFxSSHM](http://www.msnbc.msn.com/id/22787261/ns/health-diabetes/t/obesity-operation-may-cure-diabetes-many/#.TySGDFxSSHM) Then there is this saying type II diabetes may be a disorder of the upper parts of the small intestines. > **[Diabetes May Be Disorder Of Upper Intestine: Surgery May Correct It](https://www.sciencedaily.com/releases/2008/03/080305113659.htm)** > > Growing evidence shows that surgery may effectively cure Type 2 diabetes -- an approach that not only may change the way the disease is treated, but that introduces a new way of thinking about diabetes. The upper intestine of diabetic patients may be... Instead of doing a surgery, one possible tool is to insert a 1-2 foot long sleeve into the small intestines via the mouth to prevent absorption of food in the duodenum and part of the jejunum. > **[PRIME® Continuing Medical Education](https://primeinc.org/?utm_medium=mptcme)** > > PRIME Education is an accredited provider of continuing medical education but doing that will likely cause diarrhea. Can’t win them all. ---
**Author:** ![Chimera](https://avatars.discourse-cdn.com/v4/letter/c/8e8cbc/32.png) [@Chimera](https://boards.straightdope.com/u/Chimera)\ **Post date:** [January 28, 2012, 11:53pm UTC](https://boards.straightdope.com/t/new-type-ii-diabetes-drug/611020/3 "2012-01-28T23:53:08Z")
Daily injection? No thanks. That’s at least the saving grace of my being insulin resistant. No shots. It was bad enough when my doc sent over a 3 month prescription for Januvia and the Pharmacist stopped and said “Before I fill this one, I wanted to let you know that it would be $700”. My answer was “Then don’t fill it. I can’t afford that.” For next week’s appointment, I will be having a chat with my doctor about his not listening to me about financial matters. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [January 29, 2012, 11:42pm UTC](https://boards.straightdope.com/t/new-type-ii-diabetes-drug/611020/4 "2012-01-29T23:42:07Z")
You know, research has pretty clearly shown that all these new diabetes drugs really are no more effective at getting diabetes under good control than the holy trinity of metformin, sulfonylureas, and insulin. But they sure are from 10 to 500 times as expensive as those meds. QtM, who treats a LOT of diabetics. ---
**Author:** ![Misnomer](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/misnomer/32/14897_2.png) [@Misnomer](https://boards.straightdope.com/u/Misnomer)\ **Post date:** [January 30, 2012, 3:53pm UTC](https://boards.straightdope.com/t/new-type-ii-diabetes-drug/611020/5 "2012-01-30T15:53:09Z")
I’m a type II diabetic who has been using metformin since being diagnosed (about 3.5 years ago): my doc seems happy with the results – though he’s even happier about my recent weight loss – and, except for insulin, I never even knew there _were_ injectable drugs for treating type II! > [@Qadgop\_the\_Mercotan](#): > > You know, research has pretty clearly shown that all these new diabetes drugs really are no more effective at getting diabetes under good control than the holy trinity of metformin, sulfonylureas, and insulin. So the other drugs are merely alternatives, and not “escalation” meds? ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [January 30, 2012, 8:54pm UTC](https://boards.straightdope.com/t/new-type-ii-diabetes-drug/611020/6 "2012-01-30T20:54:58Z")
**QtM** , what about detemir (Levimir)? It may not make much of an improvement in A1c levels, but it does seem to result in fewer hypoglycemic episodes and improved weight management, at least compared to NPH and Lantus as basal insulin control. ---
**Author:** ![Bijou\_Drains](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bijou_drains/32/2814_2.png) [@Bijou\_Drains](https://boards.straightdope.com/u/Bijou_Drains)\ **Post date:** [January 31, 2012, 3:30am UTC](https://boards.straightdope.com/t/new-type-ii-diabetes-drug/611020/7 "2012-01-31T03:30:42Z")
as the article notes, it’s actually an existing drug, Byetta. The difference is they changed the dosage to once a week, instead of twice a day. I’ve never heard of a new brand name for a drug based on dosages but maybe there are some other examples. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [January 31, 2012, 4:03pm UTC](https://boards.straightdope.com/t/new-type-ii-diabetes-drug/611020/8 "2012-01-31T16:03:27Z")
> [@DSeid](#): > > **QtM** , what about detemir (Levimir)? It may not make much of an improvement in A1c levels, but it does seem to result in fewer hypoglycemic episodes and improved weight management, at least compared to NPH and Lantus as basal insulin control. Which makes it a lot like metformin, except not as good at lowering A1c as metformin is. Don’t get me wrong, it’s useful to have a greater variety of tools in the toolbox. But I wouldn’t call any of them breakthroughs in the management of diabetes. Throw in the fact that they’re high-priced and I don’t see them bringing any great advantage to 95% of the diabetics out there. **Misnomer** , I’m not sure what you mean by “escalation meds”. ---
**Author:** ![Hari\_Seldon](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/hari_seldon/32/5173_2.png) [@Hari\_Seldon](https://boards.straightdope.com/u/Hari_Seldon)\ **Post date:** [January 31, 2012, 4:44pm UTC](https://boards.straightdope.com/t/new-type-ii-diabetes-drug/611020/9 "2012-01-31T16:44:57Z")
I take metformin twice a day. That is simple and cheap and I’m sure as hell not going to spend a lot of money to get a high price injection even once a week. If it were reasonably priced and lasted a month, then maybe. But I am not about to jump on this bandwagon. Especially if, as QtM said, it controls A1G less well. ---
**Author:** ![Athena](https://avatars.discourse-cdn.com/v4/letter/a/35a633/32.png) [@Athena](https://boards.straightdope.com/u/Athena)\ **Post date:** [January 31, 2012, 5:51pm UTC](https://boards.straightdope.com/t/new-type-ii-diabetes-drug/611020/10 "2012-01-31T17:51:43Z")
> [@Qadgop\_the\_Mercotan](#): > > You know, research has pretty clearly shown that all these new diabetes drugs really are no more effective at getting diabetes under good control than the holy trinity of metformin, sulfonylureas, and insulin. > > But they sure are from 10 to 500 times as expensive as those meds. > > QtM, who treats a LOT of diabetics. Do docs also get kickbacks or some sort of benefit from prescribing some of those high priced drugs? I ask because I had one endocrinologist go apeshit on me when I asked why I’d want to take Januvia instead of Insulin (this was back when they were figuring out my diagnosis and thinking I was type 2 instead of type 1 thus the Januvia prescription). The guy pretty much just started yelling about how Januvia was safe and fine but if I were THAT convinced I wanted Insulin or sulfonylureas or anything else he couldn’t stop me and yadda yadda yadda. It was around then that the need for another opinion on just what was going on with me became very apparent. His reaction was downright bizarre - I wasn’t confronting him or asking him to change my prescription, I just wanted to understand why Januvia was a better choice for me than Insulin. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [January 31, 2012, 7:14pm UTC](https://boards.straightdope.com/t/new-type-ii-diabetes-drug/611020/11 "2012-01-31T19:14:50Z")
> [@Athena](#): > > Do docs also get kickbacks or some sort of benefit from prescribing some of those high priced drugs? I sure never did. I’m unaware of any of my colleagues who have in recent decades either. Even in the old days, about all we primary care docs could expect from drug companies was an occasional dinner or golf outing. ---
**Author:** ![DoctorJ](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/doctorj/32/2904_2.png) [@DoctorJ](https://boards.straightdope.com/u/DoctorJ)\ **Post date:** [January 31, 2012, 10:27pm UTC](https://boards.straightdope.com/t/new-type-ii-diabetes-drug/611020/12 "2012-01-31T22:27:38Z")
> [@Athena](#): > > Do docs also get kickbacks or some sort of benefit from prescribing some of those high priced drugs? Drug reps can’t even give us pens anymore. The basal insulins (Lantus and Levemir) were the last real breakthrough in DM management. Pretty much everything else is just an excuse to dick around for a while longer before starting the damn insulin. The stuff like Januvia and Byetta might be useful for patients who are maxed out on metformin and glipizide and diet control but their A1C is still just a point or so high; I just never, ever see those patients. Mine are all either controlled or double digits. ---
**Author:** ![panache45](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/panache45/32/64_2.png) [@panache45](https://boards.straightdope.com/u/panache45)\ **Post date:** [January 31, 2012, 10:48pm UTC](https://boards.straightdope.com/t/new-type-ii-diabetes-drug/611020/13 "2012-01-31T22:48:19Z")
> [@Bijou\_Drains](#): > > I’ve never heard of a new brand name for a drug based on dosages but maybe there are some other examples. It’s a sneaky way of keeping a drug from going generic. And if this “new” drug is the same as Byetta, include me out. I was taking it a few years ago, and had a side effect of nausea and gagging. I’ll stick with my two-per-day injections of U-500 insulin. ---
**Author:** ![Misnomer](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/misnomer/32/14897_2.png) [@Misnomer](https://boards.straightdope.com/u/Misnomer)\ **Post date:** [February 1, 2012, 6:15pm UTC](https://boards.straightdope.com/t/new-type-ii-diabetes-drug/611020/14 "2012-02-01T18:15:12Z")
> [@Qadgop\_the\_Mercotan](#): > > **Misnomer** , I’m not sure what you mean by “escalation meds”. Sorry! I meant meds that get prescribed when the usual suspects don’t control your condition well enough. Like, if someone newly diagnosed wouldn’t start with drug xyz but they could be “escalated” to it if metformin doesn’t do the trick. (Is there a term that the medical profession uses for what I’m talking about?) On further reading of the thread, I pretty much meant this: > [@DoctorJ](#): > > The stuff like Januvia and Byetta might be useful for patients who are maxed out on metformin and glipizide and diet control but their A1C is still just a point or so high