THE NEW ALPHABET SOUP OF DIABETES

If ever a malicious disease existed, one that often goes unnoticed while causing irreversible damage to many of the body's most vital systems, it would be diabetes. As the fifth deadliest disease in the United States, diabetes affects 18.2 million people in this country and kills approximately 400,000 each year, according to the American Diabetes Association (ADA). Yet, at the same time as its incidence is on the rise, especially in the younger population, new government findings suggest that the rate of diabetes control is on the decline.

An estimated 90% of all patients with diabetes are not controlling it enough to prevent diabetes-related health risks, including blindness, amputation, kidney failure, heart attack, and stroke. According to new guidelines set forth this year by the American College of Endocrinology (ACE) and the American Association of Clinical Endocrinologists (AACE), doctors need to test suspected patients right away for the condition and treat early and aggressively following diagnosis.

According to the company, pramlintide is not meant for all diabetes patients and should be used only in combination with insulin to help lower blood sugar during the first three hours after meals. The FDA has required a Risk Minimization Action Plan (RiskMAP) and a medication guide to be distributed to patients receiving pramlintide, in part because of the high risk of hypoglycemia associated with the drug. A higher risk exists for Type 1 patients and those with gastroparesis, or delayed emptying of the stomach. The company expects the drug to be commercially available this month.

Who would have thought today's reptiles would serve a greater purpose than to remind us of the creatures that came before us? Enter Byetta (exenatide, Amylin), a drug derived from the saliva of the Gila monster lizard. It is the first in a new class of drugs called the glucagon-like peptide 1 (GLP-1) agonists-also known as incretin mimetics (see related story ). Scientists isolated the compound after discovering the lizard ate only four times a year, at which time it secreted exendin-4 in its saliva to "switch on" its pancreas.