Diabetes is one of the fastest growing epidemics globally. Statistics rolled out by World Health Organisation predicts that globally people suffering from this aliment would double to 300 m by 2025. Incidentally, India has one of the fastest growing diabetes patientís worldwide, thanks to rapid expansion of urbanization and consequent stress levels.
Considering the data, there is an urgent need for research in this area. Let us understand what exactly the ailment is and how is therapeutic research moving in the insulin segment.
Insulin is a hormone secreted by the pancreas and it is needed to metabolise sugar i.e. push glucose into the cells. When this process is upset it results in increased blood/ urine sugar. This condition is known as diabetes. Diabetes can be caused by inadequate insulin secretion (insulin sensitivity) or by the insulinís inability to metabolise sugar (insulin resistively).
The domestic market size for anti-diabetes therapy is estimated to be over Rs 2 bn, growing over 30% yoy. Of the total anti-diabetes market, half the market is for insulin formulations with demand growing in the range of 25-30%. The balance of the market comprises of formulations of other anti-diabetic drugs.
Dependent on the insulin shortfall in a personís body, there are two types of diabetes. Type I diabetes is a chronic condition when there is a severe lack of insulin in the body because auto-immune reactions have destroyed most or all of the insulin- secreting beta cells in the pancreas. Type I diabetes usually occurs in children and adults under the age of 30. However, Type I diabetes accounts for only 5-10% of the total market for anti-diabetes therapy.
Type II diabetes is again a chronic condition that occurs when there is imbalance between the amount of insulin that can be produced by the beta cells and the bodyís need for insulin. The body may still be able to produce some insulin, though not enough for its needs, and / or the insulin produced in the body does not work properly due to insulin resistance. Type II diabetes is generally on account of genetic susceptibility and external / environmental factors.
Over time beta cells in patients with Type II diabetes tend to produce decreasing quantities of insulin. Blood glucose control may be further compromised by increasing resistance to the actions of insulin, particularly in people who are overweight. In the first instance, the treatment aims at preserving or improving beta-cell function and insulin sensitivity. Globally, there is tremendous amount of research being conducted for improving insulin sensitivity. Let us further understand what does one mean by insulin sensitivity.
Insulin resistance occurs when people with Type II diabetes produce large amounts of insulin, but their tissues do not respond appropriately to the action of the insulin. This often happens because the person is overweight and has fats and liver cells do not respond well to the insulin. Also, as people age, their cells lose some of their ability to respond to insulin in a psychological manner. Insulin resistance is often linked to high blood pressure and high levels of fat in the blood and several other disorders.
Insulin sensitisers could offer a simple solution for various IRADís (Insulin resistance associated disorder). Different sensitisers offer solutions for different combinations of IRADís. Dr. Reddyís molecule, Ragaglitazar ĎDRF 2725í, which has been currently suspended from clinical trials by Novo Nordisk was a dual acting sensitiser for lowering blood glucose levels and putting a favorable effect on patientís lipid profile.
Research in anti-diabetes area holds good potential. Globally, there is tremendous amount of research also being carried out on the delivery system for injecting insulin in the body. Oral insulin and insulin inhalers are two prominent areas.