NEW DIABETES DRUG FOR TYPE II INSULIN USERS

Troglitazone (trade name Rezulin, from Parke-Davis), is the first of a new class of oral medications, the thiazolidinediones, for treatment of type II (NIDDM) diabetes. Where the sulfonylureas, the traditional oral diabetes medications, stimulate the failing pancreas to produce more insulin, Rezulin directly attacks the problem of insulin resistance, the increasing inability to process insulin, that is the chief component of type II diabetes. In tests, Rezulin therapy enabled many insulin-using type II diabetics to reduce volume and frequency of insulin injections. A few were able to discontinue insulin injections entirely.

As with other oral diabetes medications, Rezulin's effectiveness depends on the presence of insulin. If sufficient insulin is not present, it must be injected, and Rezulin therapy will not change that fact. Where insulin supply rather than insulin resistance is the issue, Rezulin therapy offers nothing.

As per who may benefit from use of this medication, Parke-Davis states:

"Rezulin is indicated for use in patients with type II diabetes [who are] currently on insulin therapy, and whose hyperglycemia is inadequately controlled (HBA1C >8.5%) despite insulin therapy of over 30 units per day, given as multiple injections... Rezulin should not be used in type I diabetes or for the treatment of diabetic ketoacidosis."

Published data state that although degree of renal insufficiency has no effect on Rezulin dosage, persons with hepatic (liver) disease should exercise caution. Other data suggest that in premenopausal anovulatory women, Rezulin therapy may result in resumption of ovulation, and risk of pregnancy. There is further recommendation to proceed with caution if the individual is taking antirejection drugs such as cyclosporine or tacrolimus.

The arrival of a new diabetes medication is always a time of great excitement. Rumors abound, and what we don't know about the new drug can lead us to wild speculation, then disappointment. For more information, consult your doctor.