diabetes

Statistics of the World Health Organization indicate that a quarter of Saudi Arabia’s adult population suffers from diabetes, and that 13 per cent of those who suffer from diabetes have not been diagnosed yet, which puts these individuals at greater risk of developing complications from diabetes. These statistics are worrisome for health service providers at the Ministry of Health, who work to curb this disease in various ways, including health education campaigns that focus on healthy nutrition and exercise, in addition to searching for and adopting everything new in various medical treatments.

The company, "AstraZeneca" pharmaceuticals, launched a new drug compound that combines two drugs, namely: "Metformin" and "Dapagliflozin" in the form of long-acting pills taken by mouth, and used once a day. And both drugs in this compound have a different action by which they maintain a standard level of blood sugar, without causing a sharp in the level of sugar. The new drug was launched under the name "xigduo".

What are the advantages of this new compound? And has it been approved by the Saudi Food and Drug Administration?

Is it prescribed for both types of diabetes first and second? Do side effects combine the complications of the two drugs in the compound? Who is the right patient to take this new compound?

Medical symposium

Last week, a seminar and workshop was held in Jeddah for three days, in which international and local experts spoke, headed by Professor Paolo Buseli from the University of "Pio Medico de Roma" in Italy, Professor Sundar Modalyar from the "San Diego Medical Center" in California, and Professor Abdul Rahman Al-Sheikh, Professor of Internal Medicine and Endocrinology at King Abdulaziz University, President of the Saudi Scientific Society for Diabetes, and Professor Saud Al-Safari from Taif University, President of the Diabetes and Endocrinology Center at Al-Hada Hospitals of the Armed Forces in Taif. The challenges of diabetes and its complications, such as heart failure, vascular disease and others, were discussed, and what is in the interest of the Saudi diabetic, in light of the treatment developments. Where a "long-acting" drug was launched to treat diabetes, it was considered the first of its kind within the class of treatment drugs. The seminar was organized by the company «AstraZeneca».

Diabetes globally and locally

Prof. Dr. Abdel-Rahman Al-Sheikh, spoke to “Your Health” in “Asharq Al-Awsat”, confirming that the prevalence of diabetes has been increasing continuously in recent years Whether in the world or in the Gulf region, especially Saudi Arabia, it ranges between 6 - 12%, depending on the region and the country of the world. While reports of the World Health Organization and the latest studies in the Kingdom indicate that about 25 percent of the Kingdom''s population suffers from this disease, and the greater the age of more than 40-50 years, the higher the incidence rate. This is due to various reasons, foremost among which is the lack of physical activity and eating unhealthy food.

The incidence of diabetes complications is very high for us in the Kingdom, due to the lack of early detection of the disease immediately upon infection, despite the availability of specialized centers for diabetes, and also the availability of simple detection methods that can be made at home. This exposes the diabetic patient to complications problems that affect most systems and organs of the body, such as the heart, blood vessels, nerves, kidneys, eyes ... etc. Studies have shown that the better control of diabetes, the less complications.

Professor Al-Sheikh indicated that the Saudi Food and Drug Administration authorized the use of the drug. He praised the arrival of the new drug compound, which consists of two drugs currently used in the treatment of diabetes, namely the drug "metformin", which is old and has a good effect, and reduces the patient''s weight, and the drug "dapagliflozin", which works by the kidneys. The effectiveness of the new compound has been shown to be very excellent in controlling blood sugar level, and in reducing the cumulative rate of sugar, and it is a suitable option for the target group of patients compared to other treatments. It provides additional benefits beyond those found in the two drugs separately, as it not only lowers glucose, but also reduces the risk of heart disease, lowers blood pressure, and reduces weight without the need to use insulin. He is given one pill a day, instead of taking two medicines several times a day.

Professor Abdel-Rahman Al-Sheikh advised community members to engage in sports, to combat obesity, and to reduce fast food intake as much as possible.

A medicinal compound

Dr. Saud Al-Safri, Professor of Internal Medicine at Taif University, head of endocrinology and diabetes departments at Al-Hada Hospitals for the Armed Forces, and one of the speakers at the symposium also spoke to “Your Health”, and explained that the treatment plan after the diagnosis of diabetes (type II) is always drawn up in agreement with The patient, taking into account his conditions in terms of his health and his age. He emphasized that the most important steps of treatment are the health system, then the appropriate daily movement of the patient, and then comes the ion of the appropriate medication, based on the patient''s needs, abilities and daily activity.

And he stated that the new treatment guidelines issued by the American Diabetes Association for the year 2018, call for the use of the new combination therapy, from the start, for patients who have high levels of diabetes (high cumulative diabetes rate). As it was approved a year ago by the US Food and Drug Administration (approved by the administration in 2014 - ed.).

Advantages

Prof. Dr. Al-Safri added that the new compound consists of two compounds in one pill: the first of them is "metformin", known for more than 60 years, for the treatment of type II diabetes and it is safe to use, and the second compound is "dapagliflozin", a drug that is considered a new family in Type 2 diabetes treatment.

Among the most important advantages of the new property are the following

Combine two medicines together into one tablet, to be taken once a day by mouth.

It helps reduce the amount of excess sugar in the body, and also helps to maintain the standard level of sugar without gaining weight.

Helps reduce weight for type 2 diabetes patients.

It helps reduce blood pressure from 2 to 3 millimeters of mercury, and it is considered a very safe drug.

This new compound is only used in the treatment of type 2 diabetes, and it is not permitted for use in the first type.

side effects

As for its side effects, Dr. Al-Safri explained that it is considered low compared to other medicines, and it may lead to an increase in some infections in some sensitive areas of the body, by 3 - 5 percent of people, and therefore it is advised not to use such a medicine and others except after consulting a specialist doctor. Where this drug is prescribed to patients with type 2 diabetes over 18 years of age, who do not suffer from impairments in kidney function of the severe type, and it is not prescribed to pregnant women.

Other than that, it is suitable for most type II patients, and it is preferable to use it with patients who suffer from obesity and high blood pressure. By virtue of that it leads to weight loss, as well as moderation in blood pressure.

Prevention of complications

Among the doctors participating in the symposium, Dr. Afaf Al-Shammari, a consultant of endocrinology and diabetes at the King Abdulaziz Medical City for the National Guard in Riyadh, spoke about the importance of the pre-diabetes stage, and that awareness of it is required, whether through the media or by The health sector, such as hospitals and health centers, in order to prevent diabetes or postpone the incidence of disease. She added that the aim of prevention is to change the wrong lifestyle that was the cause of the high incidence of diabetes in our society, whether by movement, walking and practicing sports, or changing food in quality, quantity and timing, combating obesity and monitoring weight gain by measuring the waist circumference, and making periodic medical examination, including measurement Blood glucose level and GPA check. Studies and research have proven that simply adhering to sports and diet can delay the onset of diabetes for more than five years.

She added that the human body is one system, and that high blood sugar is a negative indicator of the patient’s health and the possibility of complications, in the event of his lack of regularity in treatment, which affects all parts of his body. Whether the heart, veins, arteries, nerves, kidneys, eyes ... etc.

80% of patients who arrive at reference hospitals due to heart disease are diabetic, and diabetes is considered the number one cause of kidney failure, and also the main reason for the patient to reach the dialysis stage, and the second cause of eye disease complications. Accordingly, the goal of regulating diabetes is to reduce the complications of the disease, which studies indicate a high incidence among diabetics.

Finally, Dr. Ismail Shehadeh, General Manager of the "AstraZeneca" Company in Saudi Arabia, explained that the new compound has become available in pharmacies, and we expect that this will help control the level of diabetes, which will spare many patients the exposure to acute and chronic complications, as well as improving treatment management. Diabetes, as it is used "only once" a day, and its effect lasts for 24 hours, which increases the possibility of controlling the level of sugar in the blood.