ADA 2015: diabetes is still the world's major disease, calling for breakthrough drugs / outcome evidence

Source: American Chinese medicine source / passerby C 2015-06-08 [news event]: the 75th annual meeting of American Diabetes Association (ADA) is held in Boston this weekend Unlike ASCO, which has attracted much attention, 2015 ADA has hardly had much heated report and discussion Although diabetes is one of the biggest chronic diseases in the population, the whole industry seems to have little interest in such a common and serious chronic disease Compared with cancer, diabetes is less attractive to pharmaceutical companies and investors [drug source analysis]: diabetes is a chronic disease that affects the most people in the world According to aslikan, it is estimated that 8.3% of the world's population has diabetes Hyperglycemia and hyperlipidemia are not diseases in themselves, but the main risk factors of cardiovascular and microcirculation diseases Diabetes is the first risk factor for kidney failure, amputation and blindness in the United States The annual direct and indirect cost is 250 billion US dollars, higher than the 170 billion US dollars of cancer 11% of the world's medical costs are spent on diabetes treatment There are several factors that make diabetes drug development less popular than anticancer drugs One is that it is a chronic disease and does not die immediately Second, many cases of this disease are caused by lifestyle, which can be avoided if you pay enough attention At a time when obesity is not so common in the United States, type 2 diabetes is a relatively rare disease Third, there are many drugs According to the algorithm, there are now 12 or 3 kinds of antidiabetic drugs Fourth, the development process of diabetes drugs is long and expensive After the 2008 rosiglitazone event, all new diabetes drugs must have cardiovascular safety experimental data, which is a huge burden Because of the slow death and disability of the disease itself, and a large number of existing drugs, FDA is not eager to approve more new drugs As far as I know, there is no breakthrough drug status for diabetes medicine Another factor that makes it difficult for new diabetes drugs to grow is the effect of insulin on diabetes Unlike other diseases, there is a magical hormone called insulin The vast majority of drugs are difficult to compete with insulin in efficacy In 2013, seven of the top ten diabetes drugs were insulin for various purposes, and three were GLP drugs (one GLP receptor agonist, two DPP4 inhibitors) Coupled with the world model metformin, although the population of diabetes patients is huge, but the market for new drugs is limited Unlike lipid-lowering drugs, the lower the blood sugar, the better In fact, hypoglycemia is the most serious side effect of all non glucose related hypoglycemic drugs (if there are more serious side effects than hypoglycemia, it is difficult to approve now) This also set obstacles for the development of new diabetes drugs Although diabetes is a major risk factor for many serious diseases, most hypoglycemic drugs do not show that they can reduce these risks, which needs to be answered sooner or later Diabetes drugs need to be used for life, but due to the improvement of needle technology, patients do not seem to have much resistance to injecting drugs Eight of the top ten best-selling drugs are injections, while the newly launched inhaled insulin affrenza is not selling well In the future, new hypoglycemic drugs must be Glucose dependent, and ultimately show a reduction in the risk of complications, rather than no increase in new risks But according to the current investment layout of the pharmaceutical industry, such drugs are unlikely to appear in 20 years This may also be one of the reasons why ADA has received less attention than ASCO.