We are at a point with oral medications for diabetes where there are new drug approvals in recently approved classes, new drug classes where the first in class is approved, as well as late trial research moving quickly for drugs in yet unapproved classes. First it was the DPP-4 inhibitors with Januvia, Onglyza, Tradjenta and Nesina. Next was Cycloset and the new SGLT2-inhibitor, Invokana, recently approved as first in class. Now there is a class called GPR40-agonists of which fasiglifam, from Takeda, is the first to get far enough along in phase 3 trials to garner some interest.
GPR40 receptors appear to be closely involved in the pathology of various metabolic disorders including obesity, dyslipidemia, and type 2 diabetes, and could offer yet another drug class in the diabetes arsenal.
However with all these new classes and drugs one has to wonder if any of them will reach the blockbuster status that Januvia reached. According to Dr. Valentina Gburcik, Cardiovascular & Metabolic Disorders Analyst for the research and consulting firm, GlobalData, "While Takeda's new drug shows promise, the lack of treatments tackling the condition's root cause may result in the underwhelming market performance of individual drugs." She goes on to say, "We are entering an era in the diabetes market where the first-in-class drugs start in many ways to resemble 'me-too' drugs, despite their novel mechanisms of action. With some of the diabetes drugs going off patent, the prospect for future diabetes blockbusters becomes even bleaker due to eventual generic competition to the former blockbusters, and consequently, even more pronounced cost-effectiveness issues."
Speaking of root causes, research on a common gut bacteria could lead to new ways to improve metabolic processes to control obesity and type 2 diabetes.
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AdhereTech has created patented cloud-connected pill bottles that improve medication adherence. These bottles measure the exact number of pills or liquid in the bottle in real-time, wirelessly send this HIPAA-compliant data into the cloud, and remind patients to take their medication via phone call or text. The devices solicit feedback in order to combat all drivers of non-adherence. A study is starting at the Walter Reed Army Medical Center to test for adherence with type 2 diabetes patients. The product should be available in 2014 and the goal is to make it available at no cost to the patient. 
higi was one of the hottest new companies to debut at the annual SXSW conference this year, and it's much more than just an app. The company has begun placing sleek health monitor systems in pharmacies and in other retail locations -- so far about 1,000 have been installed, mostly in the northeast U.S. While picking up their prescriptions, patients can get their "higi" number for free. The higi number is generated using an algorithm that turns stats on weight, BMI, blood pressure, pulse, and other factors such as social well-being, into one single number out of 999. The closer to 999, the better. Patients can download the app to track their scores from the higi machines, view check-in results, and compete with friends and family. The app also includes the unique higi Shots (in beta). The user snaps a picture of their meals and activities throughout the day. Then the program will identify what they're eating/doing to help them make healthier lifestyle choices.
