Bio Tech Today
Tuesday, July 21, 2009
Different Diseases, Diabetes Types I & II, Part II
By John Rambosek, Ph.D.
Life Sciences Editor, GAIN-WIki
July 21, 2009
In a previous post, I discussed alternative markets for new therapies and technologies. I focused on the Kuwaiti market for diabetes therapies. Here I give a brief background to this disease, complications, and current treatments for the disease.
THE DISEASE
Type I and type II diabetes are fundamentally different diseases, although the symptoms and complications may be quite similar. Type II diabetes is the most prevalent form of the disease, accounting for 90 to 95% of all diabetes cases. Most people with type II diabetes are still able to produce insulin at diagnosis. However, the insulin they produce is unable to perform its primary job, which is providing energy in the form of glucose to the muscle, fat, and brain. Type II diabetes is more common in adults aged 50 and older, although it can occur in children and adolescents as well.
Being overweight or obese and leading a sedentary (i.e., non-active) lifestyle are major risk factors for developing type II diabetes, as is having a family history of the disease. Type I diabetes is an autoimmune disease that occurs when the insulin-producing beta cells within the pancreas are gradually destroyed and eventually fail to produce insulin. Type I diabetes is usually diagnosed early in life (often referred to as juvenile diabetes) but may occur at any time. In either form of the disease, glucose can't be absorbed by the cells, and builds up in the bloodstream instead, resulting in high blood glucose.
CURRENT TREATMENTS FOR DIABETES
There are treatments, though no cures for both types of diabetes. Type I diabetics do not produce insulin and must take insulin, almost invariably in the form of shots. There are many types of insulin available, the most popular being recombinant human insulin and genetically modified recombinant human insulin. The modified insulins have various novel properties that are advantageous in the long-term maintenance of blood sugar levels. A cure for type I diabetes is only likely to come from reintroduction of viable beta cells into the body of the patient.
Treatments for type II diabetes are varied, but, because type II diabetes is usually associated with obesity and a sedentary life style, diet management and exercise are usually front line treatments. It is often necessary to combine exercise and weight management with medication therapy. There are a number of drugs that can be used to treat type II diabetes. These work by different mechanisms; for example, stimulating the pancreatic beta cells to produce more insulin, decreasing the amount of glucose produced by the liver, reducing the amount of glucose released by the liver. or by inhibiting the breakdown of starch and some sugars in the intestine. These classes of medications may be combined (mixed and matched) to produce to increase overall effectiveness.
COMPLICATIONS ARISING FROM DIABETES
Managing the complications associated with diabetes is large part of the expense of the disease. These complications include heart disease and stroke, atherosclerosis, high blood pressure, high cholesterol, kidney disease, diabetic retinopathy, neuropathy and nerve damage and foot complications. Therapies addressing any of these would be ideal candidates for the Kuwaiti market. Of course, cures for either type of diabetes would be greatly welcomed by this market.
Consider Non-Traditional Markets for Bio-Related Technologies
By John Rambosek, Ph.D.
Life Sciences Editor, GAIN-WIki
July 19, 2009
Technology transfer marketing largely focuses on developed western countries. This may be a consequence of limited marketing funds or the tendency to do what has worked well in the past, however, considering the widespread economic downturns of the past several years, it is time to question this thinking. I foresee alternative markets growing in importance as testing grounds for successfully licensing and developing new biotechnologies.
The most desirable alternative markets are ones where a strong link exists between a particular biotechnology and a population with a specific medical need. Let's look at Kuwait as an example. Kuwait is a non-traditional market where it may be possible to introduce and develop new diabetes therapies using licensing and/or sponsored research funding.
The medical demand for new diabetic therapies in Kuwait
Type II diabetes is extraordinarily widespread in Kuwait compared to western nations. Type II diabetes afflicts about 25% of Kuwaitis as compared to 6% of the US population. If we consider the rate of type II diabetes in the US to be epidemic, what level can we possibly assign to Kuwait where it is four times higher?
Not only is type II diabetes inordinately represented in Kuwait, but the incidence of type I diabetes is extremely high as well. Records show that 270 out of 100,000 Kuwaitis suffer from type I diabetes. Looking at the rest of the world, we find that an incidence of 20 cases per 100,000 is considered very high and populations with more than 36 cases per 100,000 are almost unknown.
The economic demand for new diabetic therapies
The costs associated with both types of diabetes are large and will continue to grow. That said, type I diabetics are disproportionately costlier to treat than type II diabetics. They are typically diagnosed much earlier in life, tend to have more severe complications leading to higher disability, work loss and premature mortality.
In the US, where diabetes is the 7th leading cause of death, the American Diabetes Association attributed $174 billion in direct and indirect expenditures to diabetes in 2007. With rates of type I and type II diabetes running about 6 and 10 times higher in Kuwait than in the US, the future economic burden of diabetes on Kuwait is disturbing.
I believe that economics and medical necessity have come together to create a new reality. Alternative markets like Kuwait can and should not be ignored by those among us who are licensing and developing emerging biotechnologies.