Value through Innovation02 August 2014

Type 2 Diabetes is a serious pandemic… with serious complications

Type 2 Diabetes is the most common form of diabetes, accounting for 90–95% of all diabetes cases in the world.1 It now affects 382 million people worldwide and is imposing an enormous burden on healthcare systems globally.2 Already a serious global pandemic, it has the potential to get worse. The number of those with diabetes is projected to increase to 592 million people by 2035, or 9.9% of adults.2

More than one person dies every 10 seconds from diabetes-related complications 2

Type 2 Diabetes is a chronic, progressive condition that can severely damage the human body. Each year, 4.8 million deaths are linked directly to diabetes-related causes.2 Despite the availability of multiple classes of oral glucose-lowering medication, insulin, and other injectables, such as GLP-1 mimetics and analogues, many patients often fail to achieve or maintain control of their diabetes over time, raising their risk of serious complications.3

Long-term complications of diabetes include:1 

  • An increased incidence of stroke and heart attack
  • Diabetic kidney disease leading to renal failure with potential risk for dialysis
  • Retinopathy with potential loss of vision
  • Peripheral neuropathy with the risk of foot ulcers, and foot and leg amputations
  • Autonomic neuropathy causing gastrointestinal, genitourinary and cardiovascular symptoms and sexual dysfunction

The management of Type 2 Diabetes

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 complications. 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.

A new era in diabetes

DPP4 inhibitors are used to treat Type 2 Diabetes to effectively reduce blood sugar levels, both before and after eating food.5–8 However, some of the currently available DPP4 inhibitors may have to be prescribed with dose adjustments in case of renal impairment, or with caution in case of hepatic impairment.5–8

At Boehringer Ingelheim, we understand the ongoing need to research and develop newer, innovative 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 current treatments.



Trajenta®, Tradjenta®, Trayenta®, Trazenta® (linagliptin)
Linagliptin is an inhibitor of the enzyme DPP4 (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 once-daily tablet that is used along with diet and exercise to improve glycaemic control in adults with Type 2 Diabetes. Linagliptin should not be used in patients with Type 1 Diabetes or for the treatment of diabetic ketoacidosis (increased ketones in the blood or urine).9,10

Jentadueto®, TrajentaDuo®, Trayenta Duo®, Trajentamet® (linagliptin/metformin HCl)
Linagliptin/metformin HCl is a single-pill combination of linagliptin and metformin that is used along with diet and exercise to improve glycaemic control in adults with Type 2 Diabetes. Linagliptin/metformin HCl is not intended to be used in patients with Type 1 Diabetes or for the treatment of diabetic ketoacidosis (increased ketones in the blood or urine).11,12


1. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2013;36(Suppl 1):S67–74.
2. Diabetes Atlas 6th edition 2013, International Diabetes Federation. (accessed April 2014).
3. Cohen A, Horton ES. Progress in the treatment of Type 2 Diabetes: new pharmacologic approaches to improve glycemic control. Curr Med Res Opin 2007;23(4):905–17.
4. National Kidney Foundation. Diabetes and chronic kidney disease. Report 11-10-0209. (accessed April 2011).
5. EMA. Galvus® (vildagliptin) tablets. EMA Summary of Product Characteristics. 2013.
6. EMA. Januvia® (sitagliptin) tablets. EMA Summary of Product Characteristics. 2014.
7. EMA. Onglyza ® (saxagliptin) tablets. EMA Summary of Product Characteristics.2013.
8. EMA. Vipidia® (alogliptin) tablets. EMA Summary of Product Characteristics. 2013.
9. Tradjenta™ (linagliptin) tablets. Highlights of Prescribing Information. Initial US Approval: 2011.
10. EMA. Trajenta® (linagliptin) tablets. EMA Summary of Product Characteristics. 2012.
11. Jentadueto® (linagliptin/metformin HCI) tablets. EMA Summary of Product Characteristics. 2012
12. Jentadueto™ (linagliptin/metformin HCI) tablets. Highlights of Prescribing Information. Initial US Approval: 2012


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IntroDia™ will explore how physicians and patients perceive early type 2 diabetes conversations