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Type 2
diabetes strongly featured During the EASD meeting in Barcelona much of the attention focused around NovoNormŽ and the publication of the UKPDS results. |
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Financial
highlights Summary of the Group. |
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Financial statement For the first nine months of 1998. |
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Latin
America poised for growth Since 1994 the Latin American region has gradually become one of the company´s growth centres. |
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Enzyme
Business´ multifaceted strategy Sustained market growth is to be achieved through implementation of a strategy which focuses on improved idea generation, research into new applications in existing industries, collaboration with customers, and new focus areas and markets. |
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The
vision is alive and well Novo Nordisk´s decision to stop the development of levormeloxifene has not weakened its ambition to remain an independant company. |
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Type 2 diabetes strongly featured
During the EASD (European Association for the Study of Diabetes) meeting in Barcelona much of the attention focused around NovoNormŽ and the publication of the UKPDS results
The great interest in the outcome of the UKPDS (United Kingdom Prospective Diabetes Study) must be seen as a consequence of the long-standing controversy about the long-term benefit of tight blood sugar regulation in Type 2 diabetes. Some have argued that the benefits were negligible, others that both life expectancy and quality of life would be increased. The UKPDS was seen as the study to end the controversy, as was the US-based DCCT (Diabetes Control and Complications Trial), which was completed in 1993, with respect to Type 1 diabetes.The UKPDS is the longest study ever conducted in the area of Type 2 diabetes and it involved 5.102 patients, making it also the largest. It was driven by professors Robert Turner, Rury Holman and David Mathews from Oxford University.
The study began in 1977 and its aim was to establish whether blood glucose control in patients with Type 2 diabetes reduced the risk of macrovascular or microvascular complications. Macrovascular complications include blood clots and stroke. Microvascular complications include blindness, kidney failure and amputations due to nerve damage. The main conclusions of the UKPDS are that intensive blood glucose control by either sulphonylureas or insulin "substantially decreases the risk of microvascular complications such as blindness, kidney failure and amputations, and causes a borderline decrease in myocardial infarction (heart attacks) in patients with Type 2 diabetes". Thus, insulin therapy is beneficial and should be initiated at an early stage. This means that combination therapy using different agents as well as more frequent use of insulin should be advocated, according to the study.
One meal, one dose - No
meal, no dose this is Novo Nordisk's answer to tight blood glucose regulation in Type 2
diabetes. |
The results of the UKPDS support Novo Nordisk’s current recommendations and strategies regarding treatment of Type 2 diabetes. Its conclusions are particularly favourable because Novo Nordisk has both insulins and an OAD (Oral Antidiabetic Drug) on the market. Furthermore, the results provide extra support for previous studies’ conclusions, as well as support the argument for early treatment to reduce diabetic late complications and consequently the strain on countries’ health budgets, while at the same time improving the quality of life.
NovoNormŽ introduced
Novo Nordisk used the EASD meeting in Barcelona to present NovoNormŽ (Prandin™ in
the US) to the delegates who came from all corners of Europe. At a satellite symposium,
which lasted for four hours, 1.600 participants heard about NovoNormŽ and its potential
advantages in the treatment of patients with Type 2 diabetes.
Great success
The experts invited to speak at the symposium stressed the concept of postprandial
hyperglycaemia. This means that blood glucose levels increase dramatically after a meal,
while insulin production - which is to normalise the blood glucose level - does not
increase at the same rate in people with Type 2 diabetes. The result is that blood glucose
levels are too high following a meal, and this may generate diabetic complications.
Experts agree that NovoNormŽ is particularly suitable for boosting the patients’ own
meal related insulin production - leading to good glycaemic control. This is called
prandial glucose regulation (PGR).
One of the most important objectives was to establish the concept of PGR since it is central to understanding the potential value of NovoNormŽ. To avoid hyperglycaemia as well as hypoglycaemia with one simple treatment was the challenge, when developing NovoNormŽ. And the concept of "One meal, one dose / No meal, no dose" is the simple and straightforward answer to a complicated question: How to allow individuals to eat on a flexible schedule, according to their lifestyles, while at the same time keeping a tight control of the blood glucose levels.
 This figure compares the normal mealtime insulin response with the insulin response in Type 2 diabetics. NovoNormŽ/Prandin™ (repaglinide) stimulates a rapid insulin response in Type 2 diabetes, when needed most - at mealtime. |
Next step
The symposium was the first step in the European launch this autumn. NovoNormŽ has right
now been introduced in the UK, Denmark, Sweden, and Germany.
During the initial phases of the launch intentions are to concentrate on providing further information about NovoNormŽ to endocrinologists and diabetologists. These experts are opinion leaders as regards the choice of drugs for the treatment of Type 2 diabetes. In this context, it is an advantage that Novo Nordisk has close relations with these experts from the company’s long-standing relationship in the field of insulin.
