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New drugs for diabetes



Please explain about PrandiMet what pluses & minuses do you see in comparing to Janumet. How soon it will be available for prescription. Also: Onglyza, application went to FDA recently, how soon it will be available, is thia a new type of drug or similar to some other? Thanks


Prandimet is a combination of Prandin (repaglinide) and metformin.  Janumet is a combination of Januvia (sitagliptin) and metformin.  Onglyza is the proposed brand name for saxagliptin.  Hence the first two pills are each combinations of two medications with one drug, metformin, in common, while the third pill is a drug in the same class as one of the component medications of Janumet.  Repaglinide is a drug which acts directly on the pancreas to increase the amount of insulin released into the blood stream.  Sitagliptin and saxagliptin are both drugs which raise the blood level of insulin in the same way which is more indirect - they block the breakdown of another hormone called GLP-1 (glucagon-like peptide 1) which stimulates insulin secretion.  I have not seen data on or used saxagliptin.  There may be some difference between Prandimet and Janumet in how potently they lower blood sugar and conversely what the risk is of a low blood sugar (hypoglycemia) but I would be surprised if a direct comparison has been performed.  There may also be some differences in side effect profiles and the situations where one would be less safe than the other.

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Response by:

Robert M Cohen, MD Robert M Cohen, MD
Professor of Clinical Medicine
College of Medicine
University of Cincinnati