With the continuous advancement of medical technology, the reversal of diabetes has begun to dawn. Starting from the pathophysiology of type 2 diabetes, the research and development of hypoglycemic drugs will go further. The pathophysiological mechanism of type 2 diabetes mellitus is complex, involving dysfunction of multiple organs and tissues throughout the body and defects in hormone secretion. Despite the advent of new hypoglycemic drugs targeting different targets, addressing the imbalance of blood glucose homeostasis is still an unmet need for type 2 diabetes.
Professor Peng Yongde, chief physician of the Department of Endocrinology of the First People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, introduced that blood glucose homeostasis is essentially a mechanism for the human body to maintain glucose within the physiological range, which is of great significance to ensure that the brain, red blood cells and other cells that rely on glucose for energy play normal physiological functions. Glucokinase is an important glucose sensor in the human body and plays a central role in maintaining blood glucose homeostasis. Professor Peng Yongde further explained that glucokinase can be imagined as a "** air conditioner", when the air conditioner cannot sense the temperature, the temperature will go out of control. Patients with type 2 diabetes generally have decreased glucokinase activity and are unable to perceive changes in glucose levels, resulting in glucose regulation not being carried out in an orderly manner.
Dolagliatin is an ectopic allosteric glucokinase total activator, targeting glucokinase targets, acting on glucose storage and output organs such as pancreatic islets, intestines, and livers to improve the imbalance of blood glucose homeostasis in patients with type 2 diabetes. The approval and listing of innovative drugs and their inclusion in the new version of the National Medical Insurance Catalogue have provided patients with drug selection and convenience for better disease control, and also greatly reduced the burden of medical expenses on patients.
Professor Peng Yongde said that as China's first in-class drug, the clinical study of dolagliatin was conducted in China based on the data of the Chinese population, which fully demonstrated the improvement of China's drug research and development and innovation capabilities in the field of diabetes. While reducing hyperglycemia, the incidence of hypoglycemia (less than 3mmol L) was less than 1%, and no serious hypoglycemic events occurred. The drug is not metabolized by the kidneys, which provides a new solution for most patients with type 2 diabetes mellitus and renal insufficiency.
The "Expert Guidance on the Clinical Application of Dolagliatin" issued in 2023 pointed out that the following people with type 2 diabetes can use dolagliatin, including: those who do not meet the blood glucose target after 3 months of lifestyle intervention can start the drug as a monotherapy**;Patients who fail to meet the glycemic control standard with metformin** can be used in combination with metformin**;;Newly diagnosed, initial Hba1c 75% and < 9In 0%, the initial combination of the drug and metformin may be considered**.
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