Differentiating Between Type 1 and 2 Diabetes Mellitus

Introduction

Diabetes Mellitus is a disease of the endocrine system primarily differentiated between type 1 and type 2. Type 1 diabetes occurs when the pancreas is unable to produce insulin and was previously seen in the younger generation which is no longer the case.1 Type 2 diabetes is the more prevalent of the two types and involves elevated blood sugar levels due to the insufficient production of insulin. Risk factors that make an individual higher risk for type 2 diabetes include increasing age, obesity, family history, a sedentary lifestyle.1,2 Innovative drug therapies for type 2 diabetes remain important for the treatment and reduction of the disease.

The prevalence of diabetes according to the CDC is 26 million Americans currently diagnosed with diabetes, 79 million with pre-diabetes, and 7 million unaware they have diabetes.1 Diabetes is currently more prevalent in the western countries due to physical inactivity and obesity, but as more Eastern countries develop the western lifestyle it becomes an increasing worldwide epidemic.1 The risk for developing type 2 diabetes increases with age (especially after age 40), but is increasing most rapidly in the adolescent and young generation.1 It is therefore critical that education as well as drug therapies are implemented to decrease the rising prevalence of this illness.

The pathophysiology of type 2 diabetes is characterized by both insulin resistance and insulin secretion. Peripheral insulin resistance and inadequate insulin secretion by the pancreas due is due to beta cell dysfunction. The resistance results in elevated free fatty acids and inflammation which leads to an overall decreased amount of glucose taken up into the muscle, increased glucose production, and incr...

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...6 and Sitagliptin at week 52 (p <0.001). Canagliflozin 100 mg and 300 mg reduced body weight vs placebo (week 26: –3.7%, –4.2%, –1.2%, respectively; p <0.001) and sitagliptin (week 52: –3.8%, –4.2%, –1.3%, respectively; p <0.001). Both canagliflozin doses reduced FPG and systolic BP vs placebo (week 26) and sitagliptin (week 52) (p <0.001).5

Overall adverse effects (AE) and AE-related discontinuation rates were generally similar across groups, but higher with canagliflozin100 mg (5.2%). Genital mycotic infection and osmotic diuresis-related AE rates were higher with canagliflozin vs sitagliptin and sitagliptin/placebo. Hypoglycemia incidence was higher with canagliflozin over the 52 weeks (6.8%) clinical study. Urinary tract infections (UTIs) were similar across groups over 52 weeks. One death was reported in all treatment arms except for canagliflozin 100mg.5