TRANSLATIONAL MEDICINE AND ITS IMPACT ON DIABETES DRUG DEVELOPMENT

• Published in: Translational Medicine and Drug Discovery pp. 35 - 61
• Main Authors: Calle, Roberto A., Taylor, Ann E.
• Format: Book Chapter
• Language: English
• Published: Cambridge University Press 31.01.2011
• Subjects: Pharmaceuticals; Pharmaceuticals, Cosmetics & Toiletries
• ISBN: 9780521886451; 9781107435940; 1107435943; 0521886457
• DOI: 10.1017/CBO9780511976087.004

IntroductionType 2 diabetes is one of the largest medical burdens in the United States. At present it is estimated that 23.6 million people in the United States have diabetes (7.8% of the population) of which 5.7 million remain undiagnosed. Of this total, approximately 95% have type 2 diabetes. In addition to insulin, eight different drug classes are available for the treatment of type 2 diabetes. In spite of all these drugs being available, many of them generic, only 49.8% of patients reach the American Diabetes Association–recommended targets for glucose control. Moreover, many patients require the addition of a second therapy to maintain glucose control. Thirty-six percent require a second therapy with a mean time to failure from start of initial therapy of 1.51 years. Thus, many patients require multiple medications and often eventual insulin replacement. Furthermore, many of the existing drugs have characteristics and potential adverse effects that make them less than ideal.Macrovascular and microvascular complications continue to take a heavy toll on patients with diabetes. An estimated 57.9% of people with type 2 diabetes have one or more complications. As a nation, the United States spends $57.1 billion a year in health care related to diabetes and its complications. With an estimated 57 million people now having prediabetes, this metabolic pandemic can only be expected to grow unless serious steps are taken at the public health and drug development levels. Therefore, the need for better drugs for type 2 diabetes is now stronger than ever.