- The Washington Times - Wednesday, February 22, 2006

Gila monsters are giving new hope to diabetes patients.

A medication derived from enzymes found in the lizards’ saliva, recently approved by the Food and Drug Administration, could mean those with the chronic condition can lead healthier lives.

The drug, called Byetta, is just one of several advances for those with diabetes.

Roughly 18.2 million people in the United States suffer from the disease, according to the Centers for Disease Control and Prevention, and 1.3 million new cases are diagnosed annually in people ages 20 and older. It’s a chronic condition in which the body struggles to break down sugar in the bloodstream because of an inability or problem with producing insulin.

Dr. Michelle Magee, director of the Medstar Diabetes Institute with the Washington Hospital Center in the District, says Byetta is a breed apart from existing medications.

“It makes you feel like you’re full. It depresses appetite and slows down how the stomach empties,” Dr. Magee says.

Existing medications often result in weight gain, so the switch is significant for those with type 2 diabetes.

Type 1 diabetes means the patient has stopped making insulin, often during his or her childhood years. Type 2 typically occurs later in life, although with childhood obesity levels rising, it can occur earlier. Patients with type 2 diabetes can make insulin, but their bodies use it improperly or sometimes not at all. The condition typically is found in adults older than 50, says Howard Steinberg, CEO of DLife, a consumer resource for people with diabetes.

Mr. Steinberg, who learned he had diabetes at age 10 and has been aggressively fighting the condition for the past 37 years, says the current medical marketplace offers more hope for fellow patients than ever before.

“It’s a very liberating time,” Mr. Steinberg says.

From the invention of medical insulin in 1922 to the 1980s, few advances were made for diabetics, Mr. Steinberg says. The ‘80s, however, saw the development of analog insulin created through recumbent DNA, a move that allowed for faster-acting and longer-lasting treatments. The decade also featured the birth of home blood-glucose testing kits, which until then hadn’t been available to the public.

The ability to measure one’s glucose levels illustrates how diabetes is different from many other chronic conditions, Mr. Steinberg says. A diabetic’s health is completely dependent on self-measuring and modifying behavior, he says, adding that patients are only as good as the tools they have to do that.

Mr. Steinberg’s DLifeTV network, programming aimed at the diabetic community, produced a special called “The Story of Insulin,” which details the condition’s history. It will air at 7 p.m. Sunday on CNBC and at various times on both DirecTV and Dish Network. For the latter, check www.dlife.com for air times.

The Gila-inspired medicine is part of a new wave of drugs for type 2 diabetes patients called incretin mimetics, according to the American Diabetes Association. It’s a synthetic version of a naturally occurring hormone that lowers blood glucose levels by increasing insulin secretion.

The medication represents a collaboration between Amylin Pharmaceuticals and Eli Lilly and Co.

The medicine is injected roughly an hour before breakfast and dinner via a pen-type applicator.

Dr. John Holcombe, a medical fellow at Lilly research laboratories in Indianapolis, says a Bronx, N.Y., researcher named Dr. John Eng discovered the Gila connection through a laborious protein screening effort.

Dr. Eng’s research uncovered the enzyme with a marker for biological activity that helped regulate blood sugar levels, part of what he calls the “tedious work of a scientist.” Dr. Eng later applied the enzyme to diabetic mice and watched their blood sugar levels drop, Dr. Holcombe says. The enzyme helps stimulate insulin release when needed.

“Nature has given us lots of different drugs for use in people,” including anesthesia derived from periwinkle plants, Dr. Holcombe says.

Byetta isn’t for everyone. It’s specifically for type 2 patients, and in clinical trials, 20 percent of the patients studied didn’t see improvement in their glucose control.

Patients may experience “intermittent nausea,” but those side effects typically fade, Dr. Holcombe says. A small percentage of users during clinical trials reported that the nausea made them stop the medication.

For diabetes patients, keeping tabs on their blood sugar levels is an all-encompassing task.

A new gadget makes that task much easier.

The Guardian RT Continuous Glucose Monitoring System from the North Ridge, Calif.-based Medtronic Diabetes gives readings as frequently as every five minutes.

Before the device, patients had less advanced methods for taking those measurements, such as pricking their skin and placing a droplet of blood on a test strip, which was then inserted into a glucose meter.

Medtronic Diabetes spokesman Steve Sabicer says the monitoring device, made public in November, uses a sensor placed just beneath the skin to constantly read the patient’s glucose levels.

The sensor, a thin device affixed to the patient’s abdomen, transmits data to a small box — roughly the size of the insulin pumps Medtronic produces, Mr. Sabicer says. The collected information can be downloaded to a computer or e-mail system.

The technology allows for near-instant readings, but it also lets doctors track how the levels ebb and flow throughout the day.

“This gives you more significant data points,” Mr. Sabicer says. “A lot of people may be coming up with good numbers, but between those [reading] times, their glucose levels could be varying.”

The device sounds an alarm if the patient’s glucose levels reach dangerous spikes or lows.

For now, the data doesn’t go directly to one’s doctor, but Mr. Sabicer says work is under way to make that happen.

Until then, “whatever information you get from this device you share with your physician,” he says.

Mr. Steinberg says all the technological innovations could address a glaring need for diabetes patients — the ability to directly affect their own health.

“That’s the ultimate shame of this. If we can intervene and get patients to do what they need to do, all these unfortunate side effects, or even death, can be avoided,” he says.

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