Survey: One-Third Of Hispanic Patients Exhibit Warning Signs Of Diabetes
- Volume 19 - Issue 12 - December 2006
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Proteomics has been defined as the study of large-scale protein expression patterns in cell/tissue and is the “new genomics,” according to David G. Armstrong, DPM, PhD, the Director of CLEAR. CLEAR partners with the renowned Midwest Proteome Center under the direction of Marc J. Glucksman, PhD. The center partners with numerous other institutions, including the Argonne National Laboratories.
As Dr. Armstrong explains, proteomics identifies the various proteins that genes code for. He says this process is “highly intricate, and at the same time, highly practical for identifying meaningful proteomic fingerprints.”
What are the practical implications of proteomics? Seminal questions in the wound healing field include which patients will heal quickly, which will not heal quickly, and how practitioners can rapidly discover who will heal quickly, according to Dr. Armstrong. He notes that DPMs often ask why one patient receiving a certain wound healing therapy healed while the other patient did not.
Dr. Armstrong, a Professor of Surgery, Chair of Research and Assistant Dean at the William M. Scholl College of Podiatric Medicine, says his team strongly believes that “work in (proteomics) can shed some light on these questions and do so in a way that brings a great deal of positive attention to this field. Our unit has renamed this highly directed area ‘podiomics.’ We will see where it leads.”
Furthermore, Dr. Armstrong says work on proteomics may spur the development of an area of molecular diagnostics delivered either at the point and time of the initial care or continuously, such as in negative pressure wound therapy. As Dr. Armstrong notes, clinicians could then pay further attention to patients who fail therapy by modifying either the technology they are using or their approach, and accordingly target these therapies to those who need it the most.
FDA Approves Januvia For Type 2 Diabetes
By Brian McCurdy, Senior Editor
The first in a new class of dipeptidyl peptidase-4 (DPP-4) medicines recently garnered FDA approval to treat type 2 diabetes. Sitagliptin phosphate (Januvia™, Merck) is indicated as a monotherapy or as combination therapy with either metformin or thiazolidinediones to improve glucose control in patients with type 2 diabetes who struggle to achieve glucose control with diet and exercise alone, according to the company.
Januvia addresses both reduced insulin due to beta-cell dysfunction and the liver’s uncontrolled production of glucose due to alpha-cell and beta-cell dysfunction, according to the company.
In two double-blind, placebo-controlled studies of a total of 769 patients with mild to moderate baseline A1C levels, Merck says 100 mg of Januvia once a day demonstrated significant mean differences in A1C from the placebo. The FDA cautions that clinicians should not use Januvia in patients with type 1 diabetes or to treat diabetic ketoacidosis. Merck notes that Januvia will cost $4.86 per tablet and the recommended dosage is 100 mg once a day.
“Januvia may become a revolutionary medication for the management of hyperglycemia,” says Eric Feit, DPM. He cites initial studies showing that the drug is effective in lowering HgA1c levels as a monotherapy and that it may be even more effective as a complementary medication to metformin and pioglitazone.
Although he feels Januvia shows promise, Dr. Feit says more long-term studies are needed to further define the drug’s safety profile. Furthermore, although Januvia is designed for patients who have difficulty controlling blood glucose with exercise and diet alone, Dr. Feit cautions that some patients may use Januvia “as an excuse not to eat well or exercise enough.”