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New diabetes drug offers hope for Scottish patients

A NEW treatment for people with diabetes is being launched offering hope for hundreds of thousands of Scots patients.

Tresiba (Insulin degludec) is the first long-acting insulin that allows patients to manage blood glucose levels with a daily injection that can be taken at any time of day. It means the risk of blood sugar dropping to dangerous levels during the night should be greatly reduced.

The drug is launched today by Danish pharmaceutical firm Novo Nordisc but a decision has yet to be made on its approval for use by the NHS.

Conventional treatment involves an injection of basal insulin that should be taken at the same time every day, or patients may run the risk of hypo-glycaemia, where blood sugar drops too low. This causes unpleasant symptoms and confusion and can sometimes be dangerous, resulting in coma and seizures.

Half of all severe hypo- glycaemic episodes occur at night and often are undetected because the person is asleep. In a clinical trial involving 7000 patients with type 2 diabetes, the new insulin reduced the risk of night hypoglycaemia by up to 36%, compared to the standard basal insulin.

Around 90% of adults with diabetes have type 2 diabetes, where the body does not produce enough insulin to control blood sugar.

Patients with type 1 diabetes, which usually develops in childhood or young adulthood, are unable to produce any insulin, and in this type of diabetes the new insulin reduced the risk of night time hypoglycaemia by up to 26%.

It comes amid warnings Scotland is facing a public health epidemic of diabetes. New figures show a record three million people have been told they have the disease in the UK, with 250,000 of those in Scotland.

The number of known Scots' diabetes cases is increasing by 10,000 every year and the cost to the NHS is £300 million.

The Scottish Medicines Consortium (SMC) will make an announcement on whether the new drug is approved for widespread use on the NHS next month, a year ahead of NICE in England. However, the cost of the treatment may affect the decision to approve its use. It is under- stood to be up to 70% more expensive than the standard injection.

Without careful, continued management of blood sugar, research shows diabetic patients are at risk of reduced life expectancy of between six and 20 years as well as an increased risk of other health complications.

Professor Brian Frier, honorary professor of diabetes at Edinburgh University, said: "It is a much longer acting insulin than we have had before.

"The benefits are that it results in fewer 'hypos' at night, there is greater stability of blood sugar and the timing of the injection is not critical. It has a long plateau and no peak action which means it lasts longer in the blood with less fluctuation of the blood sugar during the day.

"In people with type 1 diabetes, half of all hypoglycaemic episodes occur during sleep. This is a big problem. Anything which is going to reduce the risk of that is an advantage.

"I would be very surprised if the SMC doesn't approve it. The biggest problem in terms of getting it prescribed will be the cost. As well as one daily injection of insulin, patients who suffer from type 1 diabetes must also take 'short' acting insulin before meals."

Around 10% more men in Scotland suffer from diabetes than women (54.5% men compared with 45.5% women), with diabetes prevalence in Scotland ranging from 4% to 4.2% of the population across different NHS boards.

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