The worldwide occurrence of type 2 diabetes

Type 2 diabetes is now a serious global pandemic. It is the most common form of diabetes and in developed countries it accounts for up to 95 Percent of all cases.¹ It now affects 285 million people globally – and without effective prevention and management the number of cases is predicted to rise to 440 million people by 2030.¹

Diabetes is a chronic condition that requires continuing medical care and ongoing patient self-management, education and support to prevent acute complications and to reduce the risk of long-term problems. Diabetes care is complex and requires that many issues, beyond glycaemic control, be addressed.² Patients who do not control their blood sugar levels over time have a higher risk of developing serious, damaging complications that are a major cause of death and disability and lead to a reduced quality of life.³

The long-term complications of diabetes include:

• Declining renal function leading to kidney failure
• Impaired eyesight
• Damage to nerves, leading to loss of feeling
• Poor wound healing
  
• Reduced blood circulation, especially to the feet
  
• Increased risk of stroke
  
• Increased risk of myocardial infarction (heart attack)
  

The overall objective of type 2 diabetes management is to achieve and maintain blood glucose control, and reduce the risk of long-term complications. It nearly always begins with diet and exercise, aimed at helping to reduce a patient’s bodyweight and control blood sugar. However, because the condition gets worse over time, additional treatments will be required to control blood sugar levels, blood pressure, and fats (lipids) in the blood like cholesterol and triglycerides.

Not achieving control with diabetes treatment over time can damage the kidney’s filtering systems and is a leading cause of kidney (renal) failure. About one third of all people with diabetes will eventually develop long-term, impaired kidney function4 which itself carries a greater risk of diabetes-related death and disease. For this reason, kidney function should be seen as a key aspect of type 2 diabetes treatment, ideally being considered at diagnosis and taken into account when deciding treatment options.

DPP-4 inhibitors are a modern type of medication used to treat type 2 diabetes to effectively reduce blood sugar levels, both before and after eating food.^5–7 However, some of the currently available DPP4 inhibitors may have to be prescribed with dose adjustments in case of kidney function impairment, or with caution in case of cardiac heart failure.^5–8

At Boehringer Ingelheim, we understand the ongoing need to research and develop newer, targeted medications that are specifically designed not only to provide effective, long-term reductions in blood sugar levels, but also avoid the limitations and tolerability issues of the current treatments.

Trajenta®

Trajenta^® (linagliptin) is an inhibitor of the enzyme DPP-4 (dipeptidyl peptidase-4) which is involved in the inactivation of the incretin hormones GLP-1 and GIP (glucagon-like peptide-1, glucose-dependent insulinotropic polypeptide). Linagliptin glucose-dependently increases insulin secretion and lowers glucagon secretion thus resulting in an overall improvement in the glucose homoeostasis. Linagliptin is a prescription medicine that is used along with diet and exercise to lower blood glucose in adults with Type 2 Diabetes.^2,3  Linagliptin is not for people with Type 1 Diabetes or for people with diabetic ketoacidosis (increased ketones in the blood or urine).^1,2

^{[1] Trajenta® (linagliptin) tablets. EMA Summary of Product Characteristics. Approval 25 September 2011. www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/002110/WC500115745.pdf}

^{2 Tradjenta™ (linagliptin) tablets. Highlights of Prescribing Information. Initial U.S. Approval: 2011.}