Letter from the Editor #713:

Now that we have a second SGLT-2 inhibitor on the market we are seeing other companies trying to be the newest "me too’s" on the block. Prescriber acceptance of this class is growing and so it only makes sense that more companies will try to cash in. The newest candidate is ipragliflozin (see Items #2, Ipragliflozin and HbA1C Levels, and #3, Treatment with Ipragliflozin + Metformin). Although this class is only going to grow, it will be the insurance companies that decide the ultimate success as formulary choice, copay and cost will be more important than what these drugs can do.

Maybe instead of trying to get authorizations for these newer meds and asking our patients to pay high copays, we should try other therapies. This week’s Item #5 points out the value of using a combination of 10 Chinese herbs to lower glucose and Item #7 looks at the idea of using soluble fiber to lower glucose and the risk of diabetes. This study gives you the real reason why fiber works and how it may also be brain protective for diabetes patients.

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Dave Joffe, Editor-in-chief