DOCSLIB.ORG

Pdb9 Direct and Indirect Costs and Resource

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Pdb9 Direct and Indirect Costs and Resource View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Elsevier - Publisher Connector Abstracts A61 OBJECTIVES: Racial disparities in diabetics exist in diabetes months of 2004. It was assumed that if the anti-diabetic agents control, as well as complications associated with diabetes. Such were not substituted by pioglitazone, patients would still be disparities could lead to difference in likelihood of hospitaliza- using them for one year. The effect of drug substitution in 2002, tion among different races. This study examined the association 2003 and 2004 were NT$ 14.4 million, 61.4 million and 41.4 between patients’ race and hospitalization in type 2 diabetes million, respectively. The order of substitution by expenditure of patients newly starting oral antidiabetic therapy. METHODS: pioglitazone was rosiglitazone, acarbose and metformin. Sub- This was a retrospective cohort study of Medicaid insured tracting the substituted expenditure, the reimbursement of patients with type-2 diabetes newly starting oral antidiabetic pioglitazone only burdened insurer NT$ 22.8 million, NT$ medication (metformin, sulfonylureas, thiazolidinediones). A 169.7 million and NT$ 318.0 million in 2002, 2003 and 2004, cohort of type 2 diabetes patients was identified using ICD-9 respectively. The cost effect of adverse drug reactions is difficult code (250.xx) and 1 National Drug Code for antidiabetic med- to evaluate in the retrospective data analysis. CONCLUSION: ication. Information for demographic factors (race, age of The financial burden of introducing the new drug to a health patient, gender of the patient), clinical factors (severity of dia- insurance program should not consider only the expenditure of betes, number of comorbidities), medication related factors the new drug itself. The substitution effect should be deducted (number of medications consumed), and access to care (number in the budget impact analysis. of diabetes related physician visits) was extracted from the data- base. Patients’ race was categorized as African Americans, PDB8 Whites and Others. Hospitalization was measured as a categor- COST-BENEFIT ANALYSIS OF INHALED INSULIN: A ical dichotomous variable. Patients were followed up for one CANADIAN PERSPECTIVE year after the index date of new medication. Multiple logistic Sadri H regression for three cohorts was performed to assess the associ- University of Toronto,Toronto, ON, Canada ation patients’ race and likelihood of hospitalization adjusting OBJECTIVES: To conduct a cost-benefit analysis (CBA) for for above mentioned factors. RESULTS: Among metformin users inhaled drug delivery system for insulin (INI). METHODS: Pre- (n = 215), there was no difference in the likelihood of hospital- viously, we reported the average monthly willingness-to-pay ization between races. Among sulfonylureas users (n = 1171), (WTP) for INI from diabetic patient (Cdn$153.70 ± $99.90) there was no difference in the likelihood of hospitalization and general population (Cdn$68.59 ± $44.65) perspective in between races. Among thiazolidinedione users (n = 1751), Canada. This study estimates the net benefit and cost-benefit African Americans were associated with 39% increased likeli- ratio for INH from both patient and general population per- hood of hospitalization as compared to whites (OR: 1.39, 95% spective. The average cost of insulin therapy using subcutaneous CI: 1.07–1.81). Number of medications and comorbidities were insulin injection (SCI) was calculated equal to Cdn$32.40 per found to be significant predictors in each of the analyses. CON- month based on average 40 units daily usage of rapid acting CLUSION: Racial differences in hospitalizations among thiazo- insulin for bolus insulin supplement. The cost of self-injection lidinediones users should be investigated to understand other was approximately Cdn$8.40. One form of INI is available using factors that contribute to hospitalization in this group. Avoiding powder form of insulin and a liquid inhaler is under develop- hospitalization among these patients would generate consider- ment. The average daily cost of inhaled delivery system for able cost savings. insulin is approximately 40% higher than SCI. Using the same price premium ratio we estimated the average monthly cost of DIABETES—Cost Studies INI in Canada equal to Cdn$45.36 (when being available). The cost of basal insulin and self blood-glucose monitoring was con- PDB7 sidered equal. RESULTS: In the base-case scenario, the net BUDGET IMPACT ANALYSIS OF PIOGLITAZONE FOR benefit of INI when compared to SCI was Cdn$90.74 per month DIABETES IN TAIWAN:A RETROSPECTIVE DATABASE from the diabetic patient perspective and Cdn$5.63 from the ANALYSIS general population perspective. The cost-benefit ratio (CBR— Tang SL1,Tarn YH2 calculated as ÄCost/ÄWTP) from the patient (0.12) and the 1Tri-Service General Hospital,Taipei,Taiwan, 2College of Pharmacy, general population (0.69) perspective were <1, suggestive of a Taipei Medical University,Taipei,Taiwan positive CBR for INI. Extensive sensitivity analysis was per- OBJECTIVES: To determine: 1) the utilization and expenditures formed by changing variables (set apriori) including INI price of pioglitazone after the decision of drug reimbursement, and 2) (+10%, 20%) and daily usage of insulin units (±10%, 20%). the addition (adding of pioglitazone to the treatment) or substi- Results of the analysis were robust to the changes in variables. tution (switching from other anti-diabetic agents to pioglitazone) CONCLUSION: This analysis demonstrated that the benefits of effect of pioglitazone introduction. METHODS: Retrospective inhaled delivery system for insulin for control of blood glucose database analysis was carried out from the payer’s (BNHI) per- levels in diabetic patients are greater than the costs, therefore spective. Overall treatment resource from 5-year BNHI claimed- The rapy provide a positive net benefit from both patient and database of diabetic patients (ICD-9-CM: 250.XX), including general population perspective and is a good investment for OPD and hospitalized data from January 2000 to December money. 2004, were extracted. However, only pharmaceutical expendi- tures of anti-diabetic agents were analyzed. Drug prices were PDB9 BNHI reimbursed prices, and discount rate was not considered. DIRECT AND INDIRECT COSTS AND RESOURCE RESULTS: Five-year database contains population of 0.92, 0.98, UTILIZATION ASSOCIATED WITH PHOTOCOAGULATION 1.02, 1.05 and 1.14 million people from 2000 to 2004 respec- AND VITRECTOMY PROCEDURES AMONG EMPLOYEES WITH tively in Taiwan with diabetes (including type 1 and type 2 DM). DIABETIC RETINOPATHY In 2002, the expenditure of pioglitazone reimbursed by BNHI Yu AP1, Cahill KE1, Birnbaum HG1, Lee LJ2, Oglesby AK2,Tang J1, was NT$ 37.2 million (1.02% of total anti-diabetic agents), and Qiu Y1 it increased significantly in 2003 (NT$ 231.2 million) and 2004 1Analysis Group, Inc, Boston, MA, USA, 2Eli Lilly and Company, (NT$ 359.4 million) but approached saturation at last few Indianapolis, IN, USA A62 Abstracts OBJECTIVES: This study examined resource utilization and tute in Mexico City (n = 311). Costs included emergency, out- direct, indirect, and procedure-related costs associated with pho- patient and inpatient services, drugs, comorbidities procedures, tocoagulation and vitrectomy procedures among employees with etc. Costs and LYG were discounted 5% annually. One-way and diabetic retinopathy (DR). METHODS: Health care utilization probabilistic sensitivity analyses were performed and acceptabil- and costs of DR employees age 18–64 were examined using ity curves were constructed. RESULTS: Expected costs for claims from 17 large self-insured U.S. employers (1999–2004). patients using inhalable insulin resulted in US$17,997, followed Indirect costs (work loss, absenteeism) were estimated using dis- by NPH insulin (US$19,433), glargine insulin (US$20,338), ability claims and absenteeism information. The study sample NPH insulin + metformin (US$19,642) and pioglitazone + met- included employees who had at least one diagnosis of DR based formin (US$25,258). LYG per patient resulted in 8.13yrs with on ICD-9 codes and were enrolled continuously for 12 months. inhalable insulin vs. 8.05 yrs with the other therapies in average. Cost outcomes were examined over a randomly chosen 12- ICERs for inhalable insulin against other therapies resulted month (study) period following the DR diagnosis. Annual total within the range US$2213–US$3141. Results were robust to (i.e., health care plus indirect) costs (2005 USD) were compared Monte Carlo first order sensitivity analysis and acceptability between DR employees who did and did not undergo a proce- curves showed that inhalable insulin was the option most cost- dure. Utilization and costs were measured on the procedure date effective with a 69.9% of certainty. CONCLUSION: Despite its and during the 30-day follow-up period. RESULTS: The study higher cost in the Mexican market, inhalable insulin was in the sample consisted of 2,098 DR employees. The average age was long term the most cost—effective option for the treatment of 51 years; 67.4% were male and 64.7% had type I diabetes. DM2 patients who didn’t reach metabolic control. Approximately 11.8% (n = 247) of DR employees received pho- tocoagulation procedures during the study period; 2.1% (n = 44) PDB11 received vitrectomies. DR employees with photocoagulations THE COST-EFFECTIVENESS OF VACUUM ASSISTED had average total costs that were approximately
Load more

Recommended publications
  • Molecular Basis of Blood Glucose Regulation Asma Ahmed and Noman Khalique
    Chapter Molecular Basis of Blood Glucose Regulation Asma Ahmed and Noman Khalique Abstract Blood glucose level is regulated by multiple pancreatic hormones, which regulate it by different pathways in normal and abnormal conditions by expressing or suppressing multiple genes or molecular or cellular targets. Multiple synthetic drugs and therapies are used to cure glucose regulatory problems, while many of them are used to cure other health issues, which arise due to disturbance in blood glucose regulations. Many new approaches are used for the development of phytochemical- based drugs to cure blood glucose regulation problems, and many of the compounds have been isolated and identified to cure insulin resistance or regulate beta cell function or glucose absorption in the guts or GLP-1 homoeostasis or two/more pathways (e.g., either cure hyperglycemia or raise insulin resistance or cure pan- creatic beta cell regeneration or augmentation of GLP-1, production of islet cell, production and increased insulin receptor signaling and insulin secretion or decreased insulin tolerance or gluconeogenesis and insulin-mimetic action or pro- duction of α-glucosidase and α-amylase inhibitor or conserve islet mass or activate protein kinase A (PKA) and extracellular signal regulated kinases (ERK) or activate AMPK and reduce insulin sensitivity or suppress α-glucosidase activity and activate AMPK and downstream molecules or prevents cell death of pancreatic β-cell and activates SIRT1 or lower blood glucose due to their insulin-like chemical structures or decrease lipid peroxidation. Keywords: genes, molecular and cellular targets, hormones, pathways 1. Introduction Blood glucose is regulated by the pancreatic hormones alone or in combination with other endocrine glands and all this is controlled by one or more gene or cellular or molecular targets.
    [Show full text]
  • Inhaled Insulin: the Solution for Suboptimal Diabetes Control?
    I EDITORIALS Inhaled insulin: the solution for suboptimal diabetes control? Stephanie A Amiel Stephanie A Amiel For nearly a century, we have been using insulin to action comparable to human soluble (regular) BSc MD FRCP, treat diabetes. Until recently, that insulin has been insulin rather than fast-acting analogues.10 In trials, RD Lawrence given by injection. In 2006, the first inhaled insulin, Exubera® is only ‘non-inferior’ to conventional (not Professor of Diabetic Exubera®, was licenced for use in Europe. The man- analogue) insulins, the latter not always used in Medicine, King’s ufacturers hoped for a warm welcome – the end of equivalent basal-bolus regimens11–14 and in type 2, College London School of Medicine injections and the dawn of a new era of enthusiastic slightly more effective than adding a second oral insulin takers with perfect diabetic control. The agent in very poorly controlled disease.15,16 It has not Clin Med National Institute for Health and Clinical Excellence been tested against fully flexible analogue regimens. 2007;7:430–2 (NICE) was more cautious and recommend that It is clear that inhaled insulin’s sole advantage over inhaled insulin only be used in the presence of diag- injected insulin is its route of delivery. nosed needle phobia (or severe intractable problems Exubera® has low bioavailability, minor and prob- with injection sites) and should be supervised by dia- ably reversible effects on lung function17 and a nat- betes specialists.1 True needle phobia is rare and ural lack of long-term safety data. Active smoking treatable by standard psychological techniques.2,3 On contraindicates its use because of increased bioavail- the NICE criteria, the market for inhaled insulin may abilty of inhaled insulin,18,19 while absorption may be small indeed.
    [Show full text]
  • The Un-Design and Design of Insulin: Structural Evolution
    THE UN-DESIGN AND DESIGN OF INSULIN: STRUCTURAL EVOLUTION WITH APPLICATION TO THERAPEUTIC DESIGN By NISCHAY K. REGE Submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy Department of Biochemistry Dissertation Advisor: Dr. Michael A. Weiss CASE WESTERN RESERVE UNIVERSITY August, 2018 CASE WESTERN RESERVE UNIVERSITY SCHOOL OF GRADUATE STUDIES We hereby approve the thesis/dissertation of Nischay K. Rege candidate for the degree of Doctor of Philosophy*. Committee Chair Paul Carey Committee Member Michael Weiss Committee Member Faramarz Ismail-Beigi Committee Member George Dubyak Date of Defense: June 26th, 2018 *We also certify that written approval has been obtained for any proprietary material contained therein. Dedication This thesis is dedicated to my mother, Dipti, whose constant love and faith have never failed, to my father, Kiran, who taught me of the virtue of curiosity, and to my wife, Shipra, whose kindness and companionship have given me enough strength for eight lifetimes. i Table of Contents Dedication ..................................................................................................................................... i Table of Contents ......................................................................................................................... ii List of Tables ............................................................................................................................... v List of Figures ...........................................................................................................................
    [Show full text]
  • Maikawa STM 2021.Pdf
    SCIENCE TRANSLATIONAL MEDICINE | REVIEW DRUG DEVELOPMENT Copyright © 2021 The Authors, some rights reserved; Engineering biopharmaceutical formulations exclusive licensee American Association to improve diabetes management for the Advancement Caitlin L. Maikawa1, Andrea I. d’Aquino2, Rayhan A. Lal3,4,5, of Science. No claim 4,5 1,2,4,5,6 to original U.S. Bruce A. Buckingham , Eric A. Appel * Government Works Insulin was first isolated almost a century ago, yet commercial formulations of insulin and its analogs for hormone replacement therapy still fall short of appropriately mimicking endogenous glycemic control. Moreover, the controlled delivery of complementary hormones (such as amylin or glucagon) is complicated by instability of the pharmacologic agents and complexity of maintaining multiple infusions. In this review, we highlight the advantages and limitations of recent advances in drug formulation that improve protein stability and pharmacokinetics, prolong drug delivery, or enable alternative dosage forms for the management of diabetes. With controlled delivery, Downloaded from these formulations could improve closed-loop glycemic control. ENGINEERING OPPORTUNITIES TO IMPROVE DIABETES tive treatment with insulin alone is already highly burdensome and MANAGEMENT costly—requiring frequent glucose monitoring, mealtime insulin Over the past century, insulin replacement therapy has been impera- boluses, basal insulin delivery through infusion pumps or long-acting http://stm.sciencemag.org/ tive to saving lives and improving diabetes treatment outcomes. The analogs, and routine carbohydrate counting—and still does not truly administration of exogenous insulin prevents ketoacidosis, which recapitulate the complexities of metabolic control in nondiabetic was once a universally fatal condition. Although insulin has histor- individuals (Fig. 1B) (7).
    [Show full text]
  • The Leading Source of Diabetes Business News It's Complicated
    The Leading Source of Diabetes Business News It’s Complicated January/February 2011 • No. 105 The diabetes business used to be fairly straightforward. It’s a lot more complicated now, but that’s not a bad thing. Take insulin. After it was commercialized in the early 1920s, the goal was clear: sell more insulin. But look at today’s three major insulin makers: Eli Lilly, sanofi-aventis, and Novo Nordisk. For all three, to be sure, insulin is still preeminent. The diabetes divisions of Novo Nordisk and Lilly draw most of their revenue from human insulin and rapid-acting analogs, while sanofi-aventis’ blockbuster basal analog Lantus, as well as its mealtime insulins, continue to drive the bottom line. But all three companies have also developed (or are developing) GLP-1 analogs, Lilly has invested in oral drugs for type 2 diabetes (most recently through a major partnership with Boehringer Ingelheim), and the companies are also developing new therapeutic approaches for different stages of disease progression. The evolution of the insulin makers reflects broader industry trends. As our understanding of diabetes has expanded – and we dig deeper into the molecular complexities of the disease – it’s clear that single- focus large companies can no longer prosper. Ours is an era of individualized treatment that mixes and matches different drugs and technologies that try to meet the unique needs of every person with diabetes. Toward that end, companies are forming partnerships to find complementary therapies and development efforts that will create
    [Show full text]
  • Various Emerging Trends in Insulin Drug Delivery Systems
    British Journal of Pharmaceutical Research 5(5): 294-308, 2015, Article no.BJPR.2015.029 ISSN: 2231-2919 SCIENCEDOMAIN international www.sciencedomain.org Various Emerging Trends in Insulin Drug Delivery Systems Yasmeen1, T. Mamatha1*, Md. Zubair1, Sana Begum1 and Tayyaba Muneera1 1Department of Pharmaceutics, Sultan-ul-Uloom College of Pharmacy, affiliated to Jawaharlal Nehru Technological University Hyderabad, Road No.3, Banjara hills, Hyderabad 500 034, Telangana, India. Authors’ contributions This work was carried out in collaboration between all authors. Author TM designed the study, Authors Y and SB wrote the protocol, and wrote the first draft of the manuscript. Authors Md. Z and TM managed the literature searches. All authors read and approved the final manuscript. Article Information DOI:10.9734/BJPR/2015/12528 Editor(s): (1) Rafik Karaman, Bioorganic Chemistry, College of Pharmacy, Al-Quds University, USA. (2) Alyautdin Renad N, The Department of Pharmacology, I. M. Sechenov MSMU, Russia. Reviewers: (1) Anonymous, Italy. (2) Anonymous, Spain. (3) Anonymous, Norway. (4) Wei Wu, School of Pharmacy, Fudan University, China. (5) Anonymous, Malaysia. (6) Anastasia Thanopoulou, Diabetes Centre and Department of Internal Medicine, National University of Athens, Hippokration General Hospital, Athens, Greece. Complete Peer review History: http://www.sciencedomain.org/review-history.php?iid=883&id=14&aid=7718 Received 4th July 2014 th Review Article Accepted 28 November 2014 Published 9th January 2015 ABSTRACT Lowering of blood glucose level in patients can be achieved by insulin therapy as it plays a key role in the control of hyperglycaemia for type 1 diabetes. Insulin delivery systems that are currently available include syringes, infusion pumps, jet injectors and pens.
    [Show full text]
  • The Prospect of Inhaled Insulin Therapy Via Vibrating Mesh Technology to Treat Diabetes
    International Journal of Environmental Research and Public Health Review A Review: The Prospect of Inhaled Insulin Therapy via Vibrating Mesh Technology to Treat Diabetes Seán M. Cunningham and David A. Tanner * School of Engineering, Bernal Institute, University of Limerick, Limerick V94 T9PX, Ireland; [email protected] * Correspondence: [email protected]; Tel.: +35-3612-141-30 Received: 18 June 2020; Accepted: 31 July 2020; Published: 10 August 2020 Abstract: Background: Inhaled insulin has proven to be viable and, in some aspects, a more effective alternative to subcutaneous insulin. Past and present insulin inhaler devices have not found clinical or commercial success. Insulin inhalers create a dry powder or soft mist insulin aerosol, which does not provide the required uniform particle size or aerosol volume for deep lung deposition. Methods: The primary focus of this review is to investigate the potential treatment of diabetes with a wet insulin aerosol. Vibrating mesh nebulisers allow the passive inhalation of a fine wet mist aerosol for the administration of drugs to the pulmonary system in higher volumes than other small-volume nebulisers. Results: At present, there is a significant focus on vibrating mesh nebulisers from the pharmaceutical and biomedical industries for the systemic administration of pharmaceuticals for non-traditional applications such as vaccines or the treatment of diabetes. Systemic drug administration using vibrating mesh nebulisers leads to faster-acting pharmaceuticals with a reduction in drug latency. Conclusions: Systemic conditions such as diabetes, require the innovative development of custom vibrating mesh devices to provide the desired flow rates and droplet size for effective inhaled insulin administration.
    [Show full text]
  • 022472Orig1s000
    CENTER FOR DRUG EVALUATION AND RESEARCH APPLICATION NUMBER: 022472Orig1s000 CLINICAL PHARMACOLOGY AND BIOPHARMACEUTICS REVIEW(S) CLINICAL PHARMACOLOGY REVIEW NDA 22-472 Submission Date(s) October 13, 2013 Brand Name AFREZZA Inhaler Generic Name Insulin human [rDNA origin] inhalation powder Reviewers* Sang M. Chung, Ph.D. Manoj Khurana, Ph.D. Team Leader Lokesh Jain, Ph.D. OCP Division Clinical Pharmacology 2 OND Division Metabolism and Endocrinology Products Sponsor MannKind Corporation Submission Type Resubmission: Response to the Complete Response Letter dated January 18, 2011 Formulation AFREZZA is available as single-use cartridges Strength(s) of: 10 and 20 U strength** Indication To improve glycemic control in adults with type 1 or type 2 diabetes mellitus Dosage & Administration AFREZZA is administered via oral inhalation using the AFREZZA Inhaler. * Dr. Sang Chung is the primary reviewer for this application and Dr. Manoj Khurana performed the PK/PD analyses and simulations ** Afrezza dosing units as reported in the clinical pharmacology studies. Cartridge units that will be reported in the label have not been finalized. 1 Reference ID: 3509366 Table of Contents 1 Executive Summary............................................................................................. 5 1.1 Recommendation ................................................................................................. 5 1.2 Phase IV Commitments ....................................................................................... 6 2 Summary of Clinical Pharmacology
    [Show full text]
  • Advancements in Insulin Therapy: a Review Anila Abraham1*, K Krishnakumar2, L
    SAS Journal of Medicine ISSN 2454-5112 SAS J. Med., Volume-3; Issue-4 (Apr, 2017); p-69-71 Available online at http://sassociety.com/sasjm/ Review Article Advancements in Insulin Therapy: A Review Anila Abraham1*, K Krishnakumar2, L. Pannayapan2, Leo Mathew1 1Department of Pharmacy Practice, St James College of Pharmaceutical Sciences, Chalakudy, Kerala 2St James Hospital Trust Pharmaceutical Research Centre (DSIR Recognized), Chalakudy, Kerala *Corresponding author Anila Abraham Email: [email protected] Abstract: Glycemic control is required to prevent microvascular and macrovascular complications of diabetes. Insulin is an important part of therapy in diabetic patients. Insulins have to be injected which is inconvenient and cause many complications. Newer forms of insulin which are delivered through routes other than injections are developed by pharmaceutical companies. The efficacy, bioavailability, side effects of these are studied in various clinical trials and gained approval. This review focuses on the advancements in insulin therapy that helps to overcome the troubles caused by invasive insulin administration. Keywords: Diabetes, insulin, therapy. INTRODUCTION INHALABLE INSULIN Diabetes mellitus is a group of chronic The need for multiple daily injection and lack metabolic disorder characterised by hyperglycemia due of acceptance of injections made the query for another to defects in carbohydrate, lipid and protein metabolism route by which insulin can be administered to the body [1]. There are two types of diabetes mellitus- type I and for attaining glycemic control. Administration via the type II. Type I diabetes is caused due to destruction of pulmonary route provides a greater surface area for beta cells of langerhans of pancreas and type II diabetes absorption and is rapidly absorbed through alveoli [4, is caused due to decreased sensitivity and resistance of 5].
    [Show full text]
  • Pharmacologyonline 1: 498-524
    Pharmacologyonline 1: 498-524 (2009) ewsletter Kakadiya and Rathod ORAL HYPOGLYCEMIC AGAGENTENT ––– OVEROVERVIEWVIEW Jagdish Kakadiya*, Shivkumar Rathod Pharmacy Department, Faculty of Technology and Engineering, The M.S. University of Baroda, Baroda-390 001, Gujarat, INDIA. ADDRESS FOR CORRESPOCORRESPONDENCENDENCE Mr. Jagdish L. KakaKakadiyadiya Pharmacy Department, Faculty of Technology and Engineering, The M.S. University of Baroda, BarodaBaroda----3900139001 Phone 09825882922 [email protected] 498 Pharmacologyonline 1: 498-524 (2009) ewsletter Kakadiya and Rathod Diabetes mellitus is a metabolic disorder characterized by hyperglycemia (high blood sugar) and other signs, as distinct from a single disease or condition. The World Health Organization recognizes three main forms of diabetes: type 1, type 2, and gestational diabetes (occurring during pregnancy) (1), which have similar signs, symptoms, and consequences, but different causes and population distributions. Type 1 is usually due to autoimmune destruction of the pancreatic beta cells which produce insulin. Type 2 is characterized by tissue-wide insulin resistance and varies widely; it sometimes progresses to loss of beta cell function. Gestational diabetes is similar to type 2 diabetes, in that it involves insulin resistance; the hormones of pregnancy cause insulin resistance in those women genetically predisposed to developing this condition. The prevalence of type 2 diabetes is showing is showing a rapid progression world wide. Type 2 diabetes currently affecting 5 % to 10 % of most population, has become the most frequently encountered metabolic disorder in the world. The global prevalence of type 2 diabetes will rise from 171 million in the year 2000 to 366 millions by the year 2030 and these figures are higher the earlier estimates (2).
    [Show full text]
  • Background Paper 6.4 Diabetes
    Priority Medicines for Europe and the World "A Public Health Approach to Innovation" Update on 2004 Background Paper Written by Warren Kaplan Background Paper 6.4 Diabetes By Warren Kaplan, Ph.D., JD, MPH February 8 2013 Update on 2004 Background Paper, BP 6.4 Diabetes Table of Contents 1. Introduction .......................................................................................................................................... 4 1.1 Types of Diabetes .......................................................................................................................... 5 1.1.1 Type 1 Diabetes (T1D): ............................................................................................................ 5 1.1.2 Type 2 diabetes: ........................................................................................................................ 7 2. What Are the Epidemiological Trends for Europe and the World? ................................................ 8 2.1 Type 1 Diabetes ............................................................................................................................. 8 2.2 Type 2 Diabetes: Increasing overall global burden ..................................................................... 9 2.2.1 The European burden of diabetes is increasing ................................................................. 13 2.3 Specific epidemiologic issues exist with the main types of diabetes ....................................... 16 2.3.1 Increases in Type 1 diabetes ................................................................................................
    [Show full text]
  • The Leading Source of Diabetes Business News Regulation Limbo
    The Leading Source of Diabetes Business News Regulation Limbo November/December 2010 • No. 104 Sometimes it seems like everyone is talking about the same thing. At this time of year, it’s how fast the holiday season is upon us or how it’s overtaken the radio airwaves. Last month, it was the election. Before that, it was the greatest World Series in recent memory (may apply to San Francisco only). In diabetes and obesity, we’ve spent the last several months at many different meetings, listening to nurses, executives, physicians, regulators, and researchers. But no matter who we hear from, we hear about the same thing: the risk-averse environment at the FDA. The FDA signaled a new era in diabetes therapeutic development in December 2008, when the agency released its new cardiovascular guidance that requires pre-approval outcomes studies for all type 2 diabetes drugs. The document came as a surprise even in the wake of Dr. Steven Nissen’s meta-analysis of Avandia (GSK’s rosiglitazone) and the FDA’s subsequent advisory committee meeting on July 30, 2007, which found evidence for increased CV risks associated with the drug. The FDA’s document, the only one of its kind that we’ve seen for an entire therapeutic area, did more than change the way companies and investors think about drug development. It also affected the existing pharmaceutical pipelines across the industry. Now that a phase 3 program for diabetes costs twice or three times as much as it did two years ago, small companies are scrambling to adapt or even to survive.
    [Show full text]