KUWAIT: (From left) Dr Waleed Al-Dahi, Consultant Endocrine & Diabetes, Mubarak Al-Kabeer Hospital, Prof Dr Nabila Abdella, Professor of Medicine & Consultant Diabetologist, Mubarak Hospital, Dr Thaier Almuaili, Consultant Internist & Diabetologist, Al-Amiri hospital and Dasman Diabetes Institute and representative from AstraZeneca.

KUWAIT: An innovative new class of medicines for type 2 diabetes (T2D) will soon be available to patients in Kuwait MoH and provides a much-needed alternative treatment option for people with the disease. T2D is a common disease on the increase. Recent figures from the International Diabetes Federation show that almost 37 million people in the MENA region have diabetes, which if left unchecked is predicted to nearly double by 2035. Kuwait has the second highest comparative prevalence in the region, with an estimated 20% of the population affected.

Dr Waleed Al-Dahi (Consultant Endocrine & Diabetes, Mubarak Al-Kabeer Hospital), Prof Dr Nabila Abdella (Professor of Medicine & Consultant Diabetologist, Mubarak Hospital) and Dr Thaier Almuaili (Consultant Internist & Diabetologist, Al-Amiri hospital and Dasman Diabetes Institute), three experts in the field, said that in the early stages T2D is often managed with oral treatments combined with lifestyle modifications that include increasing physical activity and following a healthy diet.

Best control

"Unfortunately diabetes is a progressive disease and despite a person's best efforts, the reality is that most people will reach a stage when it is appropriate to consider an injectable therapy to get the best control of their disease," Prof Dr Nabila Abdella said.

"Until now this usually meant starting insulin therapy, which is a big step for many people," Prof Dr Nabila Abdella said. "A lot of different anxieties come up, including a fear of hypoglycaemia, which is when your blood sugar becomes dangerously low," she said. "People are also concerned about putting on weight," Prof Dr Nabila Abdella said.

Dr Waleed Al-Dahi welcomed the availability of the new injectable medicines - called glucagon-like peptide-1 receptor agonists (GLP-1 RA) - as an effective alternative to basal insulin therapy for those failing on oral therapy. "Each year brings new advances and we can now offer our patients an effective treatment with a very low risk of hypoglycaemia and unwanted side effects like weight gain," he said. "And this is with a weekly injection so the needle burden is much lower compared with insulin," he added.

Extensive experience

Following the MoH approval AstraZeneca, one of the world's leading pharmaceutical companies, will launch its Bydureon Pen, which is a unique pre-filled, single-use pen injector containing Exenatide, a medicine with extensive experience globally. In studies Bydureon has shown to significantly reduce HbA1c levels - a marker of how much sugar a person has in their blood - by up to 2% from an average starting level of 8.3%. Weight loss, as an additional benefit to diabetic patients, was also seen in the studies.

Dr Thaier Almuaili said if all the global experience with Bydureon was added together, it would equal around 3.8 million patient years of treatment since the medicine was first introduced. 'Patient years' is a representation of the total person-time on Bydureon in clinical trials, and is calculated by adding the number of patients in a group and multiplying that number with the number of years that patients are in a study.

"Bydureon provides a significant HbA1c reduction and, although not a weight loss medicine, has the additional benefit of weight loss for many people with diabetes," Dr Thaier Almuaili said. "An important factor knowing that over 40% of Kuwaitis in the general population are considered to be overweight or obese", he said.

The effectiveness of this class is also recognised by several global diabetes associations, with the American Diabetes Association (ADA) / European Association for the Study of Diabetes (EASD) putting it as the preferred treatment choice in second line after Metformin in their treatment guidelines for type 2 diabetes mellitus, much ahead of insulin .