Dr Weng Sam Type 2 Diabetes Medication Interview

Dr Weng Sam Type 2 Diabetes Medication Interview

A new medication that reduces blood glucose levels to help control type 2 diabetes is now subsidised by the Federal Government.

The once daily medication, Trajenta® (linagliptin) will be available under the Pharmaceutical Benefits Scheme (PBS) for the treatment of type 2 diabetes in combination with one of two existing medications, metformin or a sulphonylurea therapy.

Trajenta® works by blocking the breakdown of hormones produced by the gut after a meal called incretins, which in turn prime the pancreas to produce more insulin when blood glucose levels are high. The medication also reduces the amount of glucose made by the liver. Together, these processes reduce blood glucose levels to help control type 2 diabetes.

Professor Mark Cooper, Deputy Director, Baker IDI Heart and Diabetes Research Institute, explained that Trajenta® can be used in patients with type 2 diabetes.

'An estimated 787,500 Australians have type 2 diabetes. Given the size of the diabetes problem it's pleasing to see new therapies being made more readily available," he said.

Experts call for improved kidney function screening in diabetes patients

Medical researchers warn that type 2 diabetes is now the leading cause of chronic kidney disease in Australia and are calling on diabetes patients and their doctors to give urgent priority to kidney function testing as well as ensuring stricter control of blood sugar levels.

Kidney Health Australia says that around half of Australians with type 2 diabetes suffer from chronic kidney disease, yet most patients do not have their kidney health routinely tested and many live with blood sugar levels that accelerate the loss of kidney function.

'Chronic kidney disease and type 2 diabetes are strongly interrelated, with each accelerating the progression and complicating the treatment of the other," said Dr Tim Mathew, National Medical Director, Kidney Health Australia.

'Too many patients with diabetes are not having their kidney function tested regularly enough" said Dr Mathew. 'This leaves them at increased risk of serious complications."

Kidney Health Australia has called for all type 2 diabetes patients to have their kidney function tested annually and for chronic kidney disease and diabetes to be treated in tandem where they co-exist.

Trajenta® (linagliptin) is reimbursed for type 2 diabetes in combination with either metformin or a sulphonylurea, in patients whose HbA1c is greater than 7%with either metformin or a sulfonylurea and where a combination of metformin and a sulphonylurea is contraindicated or not tolerated.

The safety and efficacy of Trajenta® has been established in an international clinical trial program involving more than 4,500 patients.

Trajenta® belongs to a class of medicines called DPP-4 (dipeptidyl peptidase-4) inhibitors. Trajenta is indicated in adult patients with type 2 diabetes mellitus to improve glycaemic control in conjunction with diet and exercise, as add on to metformin, sulphonylureas or metformin plus sulphonylureas.

Precautions: Trajenta® is not to be used in patients with type 1 diabetes or diabetic ketoacidosis and those who are pregnant, lactating or under 18 years of age.

Interview with Dr Weng Sam

Dr Weng Sam is the Endocrinologist associated with the Diabetes Centre at St Vincent's Hospital.

Question: Can you talk about the correlation of type 2 diabetes and chronic kidney disease in Australia?

Dr Weng Sam: People with diabetes are prone to developing a few complications and one of them is chronic kidney disease. We know that after having years of diabetes, if the blood sugar levels remain uncontrolled and that is high and high blood pressure the kidneys will be strained and kidney disease will develop and for some it will lead onto chronic kidney disease needing dialysis.


Question: What are the systems of type 2 diabetes?

Dr Weng Sam: Unfortunately type 2 diabetes is very mild and some people will not have any symptoms however if someone has a strong family history of diabetes and particularly if they're overweight they need to go to the doctor to do a simple blood test to make sure they don't have diabetes.

For those who have already developed diabetes, most will not be aware that they have kidney disease. In Australia the data shows that approximately 50% of patients with diabetes will have some form of kidney disease. If you look at the data there is approximately one million diabetics in Australia and half a million people with diabetes will have some form of kidney disease, which is quite staggering.