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Mark T. Marino, MD, is an internist and a clinical pharmacologist. He did his internal medicine training in the Army at Eisenhower Army Medical Center and his pharmacology training at the Walter Reed Army Institute of Research (WRAIR). He became the Chief of the Pharmacology Research Section at WRAIR and Assistant Professor of Medicine at the Uniformed Services University of the Health Sciences in Bethesda, Maryland, before joining the pharmaceutical industry. He has worked in early clinical drug development at several companies, including Novartis, Eisai, and Roche, prior to joining MannKind Biopharmaceuticals as head of Early Clinical Development. MannKind is currently developing medicines to treat diabetes and cancer.
This class of drugs, also known as the nonsulfonylurea secretagogues, is relatively new compared to the sulfonylureas (chlorpropamide [brand name Diabinese], glyburide [DiaBeta, Glynase, Micronase], glipizide [Glucotrol], glipizide extended-release [Glucotrol XL], and glimepiride [Amaryl]), with the first meglitinide being approved by the U.S. Food and Drug Administration in 1997… [Glucotrol XL], and glimepiride [Amaryl]), with the first meglitinide being approved by the U.S. Food and Drug Administration in 1997. Meglitinides act in a similar manner to the sulfonylureas but with a few major differences…
DPP-4 inhibitors, a relatively new class of drugs for Type 2 diabetes, were introduced in 2006. Sitagliptin (brand name Januvia), the first medicine in this class, was approved for the treatment of Type 2 diabetes in October 2006; in July 2009, a second DPP-4 inhibitor, saxagliptin (Onglyza), was approved…
Sulfonylureas among were the first oral medicines available for the treatment of Type 2 diabetes. They were discovered by accident in France by a researcher who was working on drugs for typhoid fever. Animals that were given sulfounylureas displayed unusual behaviors and were found to have hypoglycemia (low blood glucose). It was quickly recognized that these drugs could be used for the treatment of diabetes…
A curious fact that has been known almost since the discovery of insulin is that glucose taken by mouth stimulates insulin secretion to a greater degree than glucose that is injected straight into the bloodstream. Researchers theorized that a hormone might be released by the gastrointestinal tract in response to glucose that was able to stimulate insulin secretion above and beyond that stimulated by glucose alone. This then-undiscovered hormone was called “incretin,” since it seemed to stimulate insulin production…
Alpha-glucosidase inhibitors, a class of drugs also known as “starch blockers,” function by slowing the absorption of certain carbohydrates in the gastrointestinal tract. Two drugs in this class — acarbose (brand name Precose) and miglitol (Glyset) — are approved in the United States, while two others — voglibose (Volix and others) and emiglitate — are available only outside of the United States…
This class of drugs was introduced into practice over a decade ago, but the first thiazolidinedione turned out to be associated with severe side effects. The drug, named troglitazone (brand name Rezulin), was introduced into the United States in 1997 and removed from clinical use 3 years later due to concerns about liver damage…
Metformin (brand names Glucophage, Glucophage XR, Riomet, Fortamet, Glumetza) is a member of a class of medicines known as biguanides. This type of medicine was first introduced into clinical practice in the 1950’s with a drug called phenformin. Unfortunately, phenformin was found to be associated with lactic acidosis, a serious and often fatal condition, and was removed from the U.S. market in 1977…
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