- A new drug for type 2 diabetes is the first of its kind to be available in pill form.
- It may give people a cheaper and easier option to manage their disease.
- Experts say the new medication raises the possibility of new, oral forms of other drugs currently available only as injections.
A new drug for type 2 diabetes can be taken orally rather than injected.
But the new medication is about more than just convenience.
Injections can be expensive. You need syringes. You need a sharps disposal and you need the right technique.
“[It’s] a huge psychological burden to have to take an injection once a day or once a week,” said Dr. Louis Philipson, a University of Chicago professor of medicine and current president for science and medicine at the American Diabetes Association.
“Many people do just fine but to have an alternative where you can just put a pill in your mouth is a big advantage,” Philipson told Healthline.
The Food and Drug Administration (FDA)
The drug is the first glucagon-like peptide (GLP-1) treatment that doesn’t need to be injected.
This type of treatment mimics a glucagon-like peptide receptor that stops the liver from making too much sugar. It also helps the pancreas make more insulin.
People with type 2 diabetes often don’t have enough of this protein. In some of those cases, doctors will prescribe a GLP-1 drug.
In its approval, the FDA stated that Rybelsus contains a boxed warning about the potential increased risk of thyroid C-cell tumors, among other possible side effects.
It also noted that Rybelsus, which is manufactured by Novo Nordisk, is “not recommended as the first choice of medicine for treating diabetes.”
Philipson said the new oral drug might point the way forward for the development of new, oral versions of other drugs.
He noted there are other types of pills available for patients with diabetes, but none of this type.
The drugs are usually destroyed by stomach acids, so it’s been necessary to inject the medication to actually get and keep the proteins in the body.
Philipson said since this new drug has a way of protecting the protein from stomach acids, maybe other drugs that are only available via injection could follow — even beyond diabetes drugs.
Rybelsus is just one of several new drugs to come on the market recently for diabetes treatment.
Three oral drugs for type 2 diabetes were approved in late 2017, although they use different mechanisms than GLP-1.
Some oral insulin sprays are also in development.
The market for new diabetes drugs is robust due to the demand for them.
“Type 2 (diabetes) is mostly silent and many people don’t know they have it until a few years in,” he said.
He added that it’s one of the leading causes of blindness, heart problems, and amputations.
Because it often crops up in middle age, “people at the top of their income potential are being struck down” — costing billions in lost productivity, on top of the health problems.
Giving those patients another treatment option may be important.
The FDA warns that Rybelsus isn’t recommended as a first-line treatment for diabetes and that there are several potential side effects in terms of increased risk of other health problems.
But Philipson noted that other diabetes treatments have potential side effects as well, including weight gain.
“So a drug like this that can be taken as a pill once a day with a favorable side effect profile is a big win,” he said.