SF | ENDOCRINOLOGY
January 2022 | Vol. 22 No. 1
This article was independently sourced by Specialist Forum.
Photo credit: Shutterstock.com
www.medicalacademic.co.za
Novo Nordisk launches once-weekly semaglutide in South Africa Once-weekly semaglutide, a human glucagon-like peptide 1 receptor agonist (GLP1‑RA), was launched in South Africa on 21 August 2021. Semaglutide provides superior and clinically meaningful reductions in blood glucose and weight, in addition to proven cardiovascular (CV) benefits in people living with type 2 diabetes (T2DM).1-7
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ccording to the 9th edition of the International Diabetes Foundation (2019), an estimated 463 million people globally have diabetes (type 1 and T2DM combined). T2DM accounts for the vast majority (around 90%) of cases.8,9 The number of people living with T2DM is projected to increase to 700 million in 2045. The greatest increase will be seen in Africa. In 2017, an estimated 16 million South African adults (>25-years) were living with T2DM, of which 69% were unaware of their status.1 Dr Zaheer Bayat, head of the Department of Endocrinology at Helen Joseph Hospital in Johannesburg, said the main reasons why so many South Africans remain undiagnosed are:1 Patients are hesitant to get tested Lack of access to healthcare (many live far from hospitals and clinics) Denial (do not want to accept diagnosis)
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Availability of therapies in the public versus the private sector. The situation is not unique to South Africa, noted Dr Bayat. Similar scenarios are prevalent in other African countries as well as the Middle East. Education and awareness about the diagnosis of T2DM and the availability of effective treatments are needed to overcome these challenges.1
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Keynote speaker presentations A number of international and local experts presented at the launch of semaglutide. This article summarises some of the presentations.
Incretin-based therapies: How do they work?
Dr Daniel Drucker, LunenfeldTanenbaum Research Institute, Mount Sinai Hospital, University of Toronto (Canada) The first incretin hormone, glucosedependent insulinotropic polypeptide,
was isolated in the 1970s. In 1985 a GLP-1, GLP-1 amide was characterised and was shown to have insulinotropic properties. In 1987 the GLP-1 sequence was discovered. This discovery revealed that GLP-1 was an insulin-stimulating glucoregulatory hormone.10 In 1993, researchers demonstrated that in patients with poorly controlled T2DM, a single exogenous infusion of GLP-1 increased insulin levels in a glucosedependent manner.10 It has subsequently been recognised that GLP-1 is degraded by the ubiquitous protease dipeptidyl peptidase-4 (DPP-4), and thus that GLP-1 not only stimulates glucose-mediated insulin secretion but also has inhibitory effects on glucagon secretion, gastric emptying, and enhancing satiety, facilitating weight loss.10 Pivotal studies in patients with T2DM resulted in the approval of the first GLP1RA in 2005. Today, multiple GLP-1RAs are approved for the treatment of T2DM.10 Once-weekly semaglutide was
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