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Health & Medicine for Senior Citizens

Elderly Diabetes Patients Have Less Hypoglycemia in Januvia Study

Comparison data with sulfonylurea to be presented at the American Diabetes Association 72nd Annual Scientific Sessions that opened yesterday

June 9, 2012 – Senior citizens – those age 65 or older – with type 2 diabetes will cheer the analysis results announced today by Merck that its drug Januvia (sitagliptin) achieved similar blood sugar reductions as those produced by sulfonylurea but with “significantly” less low blood sugar (hypoglycemia). Merck says it may suggest fewer falls for seniors.

"The general effects of aging complicate the treatment of diabetes in the elderly; in particular, hypoglycemia is of greater concern in this population and may lead to dizziness and accidents or falls, which are more likely to be dangerous in the elderly," said Barry J. Goldstein, M.D., Ph.D., Vice President and Therapeutic Area Head, Diabetes and Endocrinology, Merck Research Laboratories. "Therefore, careful consideration of treatment options for older patients is important."

 

Related Archive Stories

 
 

Type 2 Diabetes Patients Can Add Cancer of the Blood to Their List of Worries

Researchers say preventing diabetes can lower the incidence of leukemia, lymphoma, myeloma - see video - June 5, 2012

Links to more archived stories below this news report


 
 

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Hypoglycemia can be more of a challenge in elderly patients and recognition of the symptoms of hypoglycemia may be diminished. Symptoms that may be caused by low blood sugar include: nervousness or anxiety, shakiness, sweating, tiredness, confusion, hunger and dizziness.

Nearly 26 million people in the United States (8.3 percent of the population) have diabetes, and 90 to 95 percent of diagnosed cases of diabetes are type 2 diabetes. According to the American Diabetes Association, of those with diabetes, 10.9 million people are age 65 years or older.

About Sulfonylureas Drugs

U.S. Food and Drug Administration

How do they work?
These pills help your body make more insulin.

Brand Name

Other Name

Amaryl

Glimepiride

Diabeta

Glynase

Glyburide

Diabinese

Chlorpropamide

Glucotrol

Glucotrol XL

(extended release)

Glipizide

*

Tolbutamide

*

Tolazamide

Some Things To Think About

   ● Before you start taking this drug, tell your health care provider if you have heart, liver, or kidney problems.

   ● Older adults and people with kidney or liver problems may be more likely to have low blood sugar when taking these medicines.

Common Side Effects

   ● Hypoglycemia (blood sugar that is too low)
   ● Weight Gain
   ● Headache
   ● Dizziness

>> Check the FDA website for the latest facts on each product.

>> More about type 2 Diabetes at FDA

Januvia is prescribed, as an adjunct to diet and exercise, to improve glycemic control in adults with type 2 diabetes mellitus. The Merck says Januvia should not be used in patients with type 1 diabetes or for the treatment of diabetic ketoacidosis.

Januvia is a selective, once-daily DPP-4 inhibitor that increases active GLP-1 and GIP hormones, part of a natural body system called the incretin system to help regulate blood sugar. Januvia inhibits the DPP-4 enzyme over 24 hours. Januvia is the first approved compound in the DPP-4 inhibitor class of oral treatments. Januvia has been approved in more than 107 countries, and to date, more than 42.5 million prescriptions have been dispensed for the sitagliptin family of products worldwide.

About the post-hoc analysis

This post-hoc analysis pooled data of elderly patients that completed trials through 30 weeks from three double-blind clinical studies of sitagliptin 100 mg/day (as monotherapy and in combination with metformin) compared to sulfonylureas (in titrated doses; glipizide or glimepiride).

The analysis compared the effects of Januvia 100 mg once daily or a sulfonylurea (in titrated doses) on change from baseline in A1C, fasting plasma glucose, body weight and the proportion of patients that experienced one or more episodes of symptomatic hypoglycemia.

In two studies, patients on diet alone or metformin were randomized to receive Januvia 100 mg/day (as a monotherapy or in combination with metformin) or the sulfonylurea glipizide (as a monotherapy or in combination with metformin) for 104 weeks, and in the third study patients were randomized to receive Januvia or the sulfonylurea glimepiride for 30 weeks.

Since the third study was 30 weeks in duration, the analysis focused on results at or close to 30 weeks and included the 373 elderly patients who completed the trials through this time point.

Elderly patients taking Januvia 100 mg/day (n=178; 0.73 percent LS mean A1C reduction from a baseline of 7.5 percent) achieved similar blood sugar reductions as patients taking a sulfonylurea (n=195; 0.78 LS mean percent A1C reduction from a baseline of 7.5 percent).

Of the patients taking a sulfonylurea, 28.2 percent experienced one or more episodes of symptomatic hypoglycemia, compared to 6.2 percent of patients taking Januvia.

Prescribing Information and Medication Guide for Januvia are available at http://www.merck.com/product/usa/pi_circulars/j/Januvia/Januvia_pi.pdf and http://www.merck.com/product/usa/pi_circulars/j/Januvia/Januvia_mg.pdf

About Merck (company statement)

Today’s Merck (NYSE: MRK) (known as MSD outside the U.S. and Canada) is a global healthcare leader working to help the world be well. Merck is known as MSD outside the United States and Canada. Through our prescription medicines, vaccines, biologic therapies, and consumer care and animal health products, we work with customers and operate in more than 140 countries to deliver innovative health solutions. We also demonstrate our commitment to increasing access to healthcare through far-reaching policies, programs and partnerships. For more information, visit www.merck.com and connect with us on Twitter, Facebook and YouTube.


Links to Archived Reports on Diabetes

Should YOU be tested for diabetes?

Anyone 45 years old or older should consider getting tested for diabetes. If you are 45 or older and overweight-see the BMI chart -getting tested is strongly recommended. If you are younger than 45, overweight, and have one or more of the risk factors, you should consider getting tested. Ask your doctor for a fasting blood glucose test or an oral glucose tolerance test. Your doctor will tell you if you have normal blood glucose, prediabetes, or diabetes.

   ● Among U.S. residents ages 65 years and older, 10.9 million, or 26.9 percent, had diabetes in 2010.

   ● Diabetes affects 25.8 million people of all ages - 8.3 percent of the U.S. population
       > DIAGNOSED - 18.8 million people
       ●> UNDIAGNOSED - 7.0 million people

   ● About 215,000 people younger than 20 years had diabetes—type 1 or type 2—in the United States in 2010.

   ● About 1.9 million people ages 20 years or older were newly diagnosed with diabetes in 2010 in the United States.

   ● In 2005–2008, based on fasting glucose or hemoglobin A1C (A1C) levels, 35 percent of U.S. adults ages 20 years or older had prediabetes - 50 percent of adults ages 65 years or older. Applying this percentage to the entire U.S. population in 2010 yields an estimated 79 million American adults ages 20 years or older with prediabetes.

   ● Diabetes is the leading cause of kidney failure, nontraumatic lower-limb amputations, and new cases of blindness among adults in the United States.

   ● Diabetes is a major cause of heart disease and stroke.

   ● Diabetes is the seventh leading cause of death in the United States.

Heart Disease, Stroke Deaths Drop for People with Diabetes: Often Seniors

Healthier lifestyles, better disease management are helping people live longer; Among U.S. seniors 65 and older, 10.9 million, or 26.9% had diabetes in 2010. - May 23, 2012

Older Adults with Diabetes Live Long Enough to Benefit from Interventions

‘…with the exception of patients over age 76 with the poorest health status, all showed strong survival rates’ - U-M study - May 2, 2012


Lifestyle Changes Reduced Type 2 Diabetes Risk 58%; Highly Effective for Seniors

Over 10 years, the lifestyle and metformin interventions resulted in health benefits and reduced the costs of inpatient and outpatient care and prescriptions…

March 22, 2012


Diabetes Drug TAX-875 Improves Glucose Control Without Increasing Hypoglycemia

Researchers say it is as effective as glimepiride with lower risk of drop in blood sugar - good news for about 11 million seniors with type 2 diabetes

Feb. 27, 2012


Older Women with Diabetes Have Greater Hearing Loss as They Age

Men lose even more hearing regardless of diabetes or age; women lose less if diabetes controlled

Jan. 26, 2012


Statins of Any Kind May Increase Risk of Diabetes in Postmenopausal Women

Researchers say current recommendations by diabetes association nor statin guidelines should change - Jan. 10, 2012


Diabetes Drugs, Blood Thinners Cause 2/3 of Senior Citizen Adverse Events, Hospitalizations

Almost half of cases are in elderly aged 80 plus; overdoses, stronger than expected effect most common causes - Nov. 26, 2011


Raising 'Good' Cholesterol Reduces Heart Attack, Stroke Risk in Diabetes Patients

And, risks of heart attack and stroke increase when 'good' cholesterol levels go down - Oct. 7, 2011


Dieting Beats Exercise for Diabetes Prevention in Older Women, Combo Is Best

Strengthening exercise appears to have greater benefits for insulin resistance than aerobic exercise - Sept. 2, 2011


Older Diabetes Patients with Very Low Glucose Have Slightly Higher Risk of Death

Well controlled blood sugar level lowers risk of heart attack, amputation, kidney disease - April 18, 2011


Senior Citizens Lead the Way as Diabetes Spreads to 26 Million in New U.S. Estimate

Estimates in U.S. have risen since CDC estimated in 2008 that 23.6 million (7.8) had diabetes and 57 million adults had prediabetes - Jan. 27, 2011


Older Women with Diabetes and Depression Have Twice the Risk of Death

Both problems linked to unhealthy behaviors such as smoking, poor diet and a sedentary lifestyle - Jan. 3, 2011


Fat Distribution Plays Key Role in Weight Loss Success in Patients at Risk of Diabetes

‘Abdominal and liver fat are the two most important factors in predicting whether a lifestyle intervention will be successful’

Aug. 24, 2010


An Old Antibiotic Appears to Reduce Stroke Risk, Injury for Diabetics

Almost 70% of Americans dying with diabetes found to show a major vascular event such as a stroke or heart attack as a cause of death

Aug. 23, 2010


Getting Fat After Age 50 Greatly Increases Diabetes Risk that Already Escalates for Seniors

‘Participants with a greater than 4 inch increase in waist size from baseline to the third follow-up visit had a 70 percent higher risk of type 2 diabetes…’

June 22, 2010


Study Pinpoints Atrial Fibrillation Risk at 40 Percent for Those with Diabetes, Maybe Higher

Nearly nine in 100 people over age 80 - have atrial fibrillation; risk rises by 3% for each additional year patients have diabetes – watch video

April 23, 2010


Considering Type 2 Diabetes Treatment, Experts Say 1 Size Does Not Fit All

International group recommends individualized therapies; Almost one of every four senior citizens has diabetes

April 5, 2010


Senior Women at High Risk of Bone Fractures After Taking Diabetes Drugs Avandia or Actos

TZDs have previously been linked to bone loss, increasing fracture risk; type 2 diabetes and insulin also increase risk for fractures

Feb. 10, 2010


Victoza (liraglutide) Gets FDA Approval as New Treatment for Type 2 Diabetes

Seniors aged 60 with type 2 diabetes are about one-third of all adults with this chronic disease

Jan. 27, 2010


Harvard Scientists Move Closer to Correcting Cellular Defects That Lead to Diabetes

Report says the G6PD protein, which produces essential antioxidant NAPDH, could prevent the death of pancreatic beta cells, the root cause of diabetes

Jan. 4, 2010


Seniors May Reduce Risk of Type 2 Diabetes by Half with More Exercise, Less Weight

Modest weight loss or taking anti-diabetic drug for 10 years lowers risk of type 2 diabetes in high risk people of all ages

Nov. 2, 2009


Diabetes Patients May Have Wrong Idea About Taking Insulin: Should be Front-Line Defense

Common fears of weight gain, developing low blood-sugar, decline in quality of life are largely unfounded, researchers find

Aug. 11, 2009

 

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