Just
recently a close relative was sent to the emergency room, because her
sodium level went very low due to a change of her diabetic medications-
to a diuretic. Her Na/K level is good now, but this incident reminded me
of an article about diabetes and available drugs in the market that I
wrote a few years ago.
Today, some of the older drugs
are cheap but the new ones are expensive. You need to inquire in how to
save on your prescription drugs from your
carrier insurance and from the supplier of the drug.
The
following article I wrote last August, 2010. A recent incident however
inspired me to re post this. Every year before we leave for the
Philippines for our winter sojourn, we request that our physician give
us a 90 day supply prescription for all our drugs via a vacation over
ride. One drug that I take as a type 2 diabetic is metformin, 1000mg
once a day. For my 90 day supply, my co-pay is only $2.00. This drug
maintains my sugar level from around 120 to 130 reading. Last week
during my pre-snowbirding check up, the doctor suggested I take 1000mg
extended release metformin for better control of my blood sugar. I
consented to try it.
However, when I ordered this drug,
my insurance told me it will cost me $250 dollars for a 90 day supply. I
was shocked and I can not believe the difference. I insisted that the
pharmacist call my insurance why this extended release formulation is
over 100 times more expensive than the basic metformin. I was told this
is considered a new drug thus much more expensive than the generic
version I am currently taking. I know that new drugs are more expensive
than generic drugs, perhaps 5 to 10 times but not over 100 times in this
case. Needless to say, I did not buy the extended release metformin
formulation. A lesson learned from this experience is to talk to your
physician about drug prescription which can saved you money.
Here's a repost of my article about Diabetic drugs published in this site August 22, 2010.
My
wife and I are type 2 Diabetic. Having work for new drugs development
at FDA for a number of years, my interest in drugs has not diminished
even though I have been retired from FDA since 2002. The following
article is a reference for new, and old diabetic drugs for Type 2. This
is a must read of you are a type 2 diabetic. It was compiled by Debra
Manzella, R.N., former About.com Guide and updated May 2, 2010.
"It's
been an exciting time for diabetes treatment - in the past year or so,
several brand new medications have been approved to treat type 2
diabetes. These are not just new meds, they're completely new categories
of drugs. What does that mean? These new medications work in completely
different ways than the standard medications.
But does
that mean that science is giving up on the old stand-by drugs? No, it
doesn't. The oldies-but-goodies still do a good job, and coupled with
the new kids on the block, blood glucose levels can stay even closer to
normal and tighter control may be easier to maintain.
New Classifications and Medicines
DPP-4 Inhibitors:
These drugs block an enzyme (DPP-4) that normally deactivates a protein
(GLP-1) that keeps insulin circulating in the blood. Slowing the
deactivation process helps reduce sugar production, lowering blood
glucose levels.
*
Januvia
(sitagliptin phosphate): The first of the DPP-4 inhibitors to be
approved by the Food and Drug Administration. Januvia is an oral
medication which is taken once a day, either alone with diet and
exercise, or in combination with other oral diabetes medications.
Incretin Mimetics:
These mimic the action of incretin hormones which help the body make
more insulin. They also slow the rate of digestion so that glucose
enters the blood more slowly. People on incretin mimetics feel full
longer, which reduces food intake, which helps some people lose weight
while on the medication.
*
Byetta (exenatide):
Byetta is an injectable medication that is used in combination with
other oral diabetes medications. It is not an insulin and it does not
take the place of insulin. It is used for type 2 diabetes only and
cannot be given with insulin. Byetta comes in a pre-filled injector pen.
The dose is 5 mcg. to start, twice a day within 60 minutes prior to
your morning and evening meals. Your doctor may increase the dose to 10
mcg. based on your results.
Antihyperglycemic Synthetic Analogs:
These are medications that are created as synthetic versions of human
substances, in this case a human hormone called amylin, which is used by
the pancreas to lower blood glucose levels.
*
Symlin
(pramlintide acetate): Symlin is an injectable medication which is used
with insulin for tighter blood glucose control. Symlin can increase the
risk of severe hypoglycemia, therefore patients who are put on Symlin
are selected carefully and monitored closely by their healthcare
providers.
Older Classifications and Medicines
Sulfonylureas:
These medications are the oldest of the oral diabetes drugs, and until
1995 they were the only drugs available for managing type 2 diabetes.
Sulfonylureas stimulate the pancreas to release more insulin into the
blood stream. Hypoglycemia can be a side effect of these drugs.
Sulfonylureas can also sometimes stop working after a few years.
There
are several "generations" of this classification of medicines. Second
and third generations are more widely prescribed today.
* First generation: Orinase, Tolinase and Diabinese
* Second generation: Glucotrol (glipizide), Glucotrol XL (extended-release glipizide), Micronase or Diabeta (glyburide)
* Third generation: Amaryl (glimepiride)
Biguanides:
These lower the production of glucose that is made in the liver. It
also makes the body more sensitive to insulin. Cholesterol levels may be
lowered as well.
* Glucophage, Glucophage XR
(metformin): There is very little risk of hypoglycemia when metformin is
used alone. Lactic acidosis can be a rare but serious side effect.
Alpha-Glucosidase Inhibitors:
These delay the conversion of carbohydrates into glucose during
digestion. This prevents blood glucose levels from peaking too high.
* Precose (acarbose)
* Glyset (miglitol)
Thiazolidinediones: Sensitizes muscle and fat cells to accept insulin more easily.
* Avandia (rosiglitazone)
* Actos (pioglitazone)
As
of May 21, 2007, the FDA has issued a safety alert regarding the
possibility of heart attacks or other fatal cardiovascular events when
taking Avandia. Please call your physician to discuss alternative
medications for managing your diabetes.
* Avandia May Cause Risk of Heart Attack and Death
* Avandia Linked to Increased Heart Attacks
Meglitinides:
These stimulate insulin production when there is glucose present in the
blood. If blood sugar is low, the drug does not work as well.
* Prandin (repaglinide)
* Starlix (nateglitinide)
If
you are not a chemist( I am a chemist), the above names of drugs are
hard to pronounce and spell, but I hope after reading this article, you
did learn a little knowledge how these drugs regulate blood sugar in
your body.
Also remember drugs is not everything! Watch
out for your diet, exercise a little bit and avoid stress if you want
to live longer in spite of your diabetes.
Attached below are new drugs for the treatment of diabetes
https://www.drugs.com/article/new-diabetes-treatments.html
 |
| Trulicity-One of the newest and expensive drug for Diabetes |
The cost for Trulicity
subcutaneous solution (0.75 mg/0.5 mL) is around $800 for a supply of 2
milliliters, depending on the pharmacy you visit. You need this drug
once a week. Prices are for cash paying customers only and are not valid with insurance plans.
