What is Diabetes?
There are 3 common types of diabetes:
1. Type-1 Diabetes
Also called insulin-dependent diabetes, is the genetic form of diabetes.
Type-1 diabetes is an autoimmune condition in which the body attacks its own pancreas with antibodies, restricting the pancreas’ ability to produce insulin.
The body is unable to produce enough insulin to properly regulate an individual’s blood-sugar levels.
It is caused by a genetic predisposition, or as the result of faulty beta cells in the pancreas.
Type-1 diabetes is the much less common form of diabetes and is not preventable.
However, it is treatable with medications that maintain glucose levels.
2. Type-2 Diabetes
Also called adult-onset diabetes, is the non-genetic form of diabetes.
It is much more common than type I diabetes, accounting for 95% of diabetes cases in adults.
Unlike type-1 diabetes, type-2 diabetic patients are able to produce insulin.
However, the body is unable to efficiently use the insulin that it produces in order to control the individual’s blood sugar level.
Unlike type-1 diabetes, type-2 diabetes is completely preventable.
Type-2 diabetes is most commonly a result of obesity and poor lifestyle habits.
Obese people have insulin resistance, meaning the pancreas has to work much harder to produce insulin, although the amount produced still is not enough to control blood-sugar levels.
There is no cure for type-2 diabetes. However, it is treatable.
3. Gestational Diabetes
Is a form of diabetes that is developed during a women’s pregnancy.
It is a temporary form of diabetes, resulting from the body’s inability to produce proper insulin levels.
Insulin resistance is can in pregnancy but is often not recognized until the later trimesters.
Only 2% – 10% of pregnant women suffer from gestational diabetes.
It is treatable and is addressed a quickly as possible to ensure both the health of mother and child.
What are Common Diabetes Drugs?
As previously mentioned, the four (4) common types of drugs used to treat diabetes are:
- Incretin Mimetics
- DPP-4 Inhibitors
- SGLT-2 Inhibitors
- Thiazolidinediones
1. Incretin Mimetics
Incretin Mimetics, or incretin hormones, are produced naturally in the pancreas as a response to eating.
Incretins jump-start the pancreas’ production of insulin to regulate blood-sugar levels.
Incretin mimetics work to mimic the effects of incretin hormones in the pancreas, which in turn increases the amount of insulin produced to control blood sugar.
Incretin mimetics can also work to limit the amount of glucagon – a form of incretin – that is produced in the pancreas.
When produced, glucagon causes the liver to release excess stored glucose into an individual’s bloodstream, causing a spike in blood-sugar levels.
The most popular brands of incretin mimetics are:
In 2013, the FDA released a drug safety communication after a number of studies found that incretin mimetic drugs could potentially increase the risk of pancreatitis in users.
Further studies suggested that incretin mimetics also could potentially increase the risk of pancreatic cancer in users.
At the time, no brand name incretin memetics carried warning labels making patients aware of these increased risks.
As a result, a number of incretin mimetic lawsuits have been filed on behalf of individuals prescribed incretin mimetics and who developed pancreatic or pancreatic cancer as a result.
These cases were consolidated into a multi-district litigation (MDL) filed in the Southern District of California.
2. DPP-4 Inhibitors
DPP-4 inhibitors, also called gliptins, are a type of Incretin Mimetic and act to block DPP-4, an enzyme that acts to deactivate incretins.
DPP-4 inhibitors stop DPP-4 enzymes from deactivating the incretins, therefore increasing the level of incretins, which in turn increases the production of insulin in the pancreas.
Similar to incretin mimetics, DPP-4 inhibitors also work to limit the amount of glucagon produced in the liver.
DPP-4 inhibitors also slow down the digestive process and decrease the user’s overall appetite.
The most popular brands of DPP-4 inhibitors include:
A number of scientific studies have linked DPP-4 inhibitors to an increased risk of developing pancreatitis, pancreatic cancer, and thyroid cancer.
In 2017, the FDA reported that DPP-4 inhibitors may be linked to renal failure as a result of rhabdomyolysis – a life-threatening medical condition characterized by the depletion of skeletal muscle.
No brand name DPP-4 inhibitors carried warning labels making patients aware of these increased risks.
As a result, a number of DPP-4 inhibitor lawsuits have been filed on behalf of individuals who were prescribed DPP-4 inhibitors and developed pancreatitis, pancreatic cancer, or renal failure as a result.
3. SGLT-2 Inhibitors
SGLT-2 (sodium-glucose cotransporter 2) inhibitors are medications intended to treat Type 2 diabetes and work to limit the resorption of glucose into the kidneys by inhibiting the SGLT2 proteins that aid the kidneys in the resorption process.
SGLT-2 inhibitors cause the kidneys to pass that extra glucose through urine in order to maintain blood-sugar levels.
SGLT-2 inhibitors also work to increase the uptake of glucose by muscle cells and increase the body’s sensitivity to insulin.
The most popular brands of SGLT-2 inhibitors include:
In 2015, the U.S. Food and Drug Administration released a drug safety warning for Invokana and Invokamet, warning users of a potentially increased risk of bone fractures.
The FDA required these drugs to carry black-box warnings for these increased risks.
These findings were supported by a number of scientific studies.
In 2015, the FDA released a drug safety warning for SGLT2 inhibitors, warning users of a potentially increased risk of developing diabetic ketoacidosis – a disease that, if gone untreated, can be life-threatening.
The FDA required these drugs to carry a black-box warning for these increased risks, as well the additional increased risk of developing urinary tract infections.
These findings were supported by a number of scientific studies.
In 2016, the FDA released a drug safety warning for SGLT2 inhibitors, warning users of a potentially increased risk of suffering from kidney injury, after the agency received more than 100 adverse event reports linking SGLT2 inhibitors to kidney injury – some life-threatening, including kidney failure.
A number of scientific studies have found similar links.
In 2017, the FDA issued a warning for Invokana and Invokamet, warning users of a potentially increased risk of leg and foot amputations.
The FDA required these drugs to carry a black-box warning for these increased risks.
These findings were supported by a number of scientific studies.
In 2019, scientific studies indicated a possible link between SGLT-2 inhibitors and a potentially increased risk of developing necrotizing fasciitis – genital gangrene, commonly referred to as Fournier’s Gangrene. No brand name SGLT-2 inhibitors carried warning labels making patients aware of these increased risks.
As a result, a number of SGLT-2 inhibitor lawsuit have been filed on behalf of individuals who were prescribed SGLT-2 inhibitors and developed ketoacidosis, necrotizing fasciitis, or suffered from an amputation(s).
4. Thiazolidinediones
Thiazolidinediones are a category of treatment where the drugs increase cell responsiveness to insulin.
The primary types of thiazolidinedione medication are pioglitazone (Actos), pioglitazone & metformin (Actoplus Met), and pioglitazone and glimepiride (Duetact).
The most popular brands of SGLT-2 inhibitors include:
- Actos
- Avandia
- Actoplus Met
- Duetact
In 2010, the FDA released a drug safety warning for Actos, warning users of a potentially increased risk of developing bladder cancer.
This claim was supported by a 10-year scientific study of the medication.
Scientific studies and FDA warnings have also linked Actos to the following adverse effects and injuries:
- Bone fracture
- Congestive heart failure
- Chronic kidney disease
- Macular edema
As a result, a number of thiazolidinedione lawsuits have been filed on behalf of individuals who were prescribed thiazolidinediones and developed bladder cancer, suffered from bone fracture, congestive heart failure, chronic kidney disease, or macular edema.
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