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European Pharmaceutical Contractor
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Type 2 diabetes is occurring in epidemic proportions all around the world, and this growing trend will translate into a very large increase in excess morbidity and mortality, especially from cardiovascular disease. It is now estimated that there are more than 175 million diabetics throughout the world (1). In this country the prevalence of diagnosed diabetes among adults has increased by 40 per cent in 10 years, from 4.9 per cent in 1990 to 6.9 per cent in 1999 (3, 4). Furthermore, the problem is expected to increase cumulatively by 165 per cent between 2000 and 2050 (5). For those born in the US in 2000, the lifetime risk will be roughly one in three for men and two in five for women (2). To gain control over this rising pandemic, public health issues such as obesity and sedentary lifestyle will need to be addressed, and much more widespread pharmacological intervention instituted.
In the past decade we have witnessed the introduction of a multitude of new medications, including a-glucosidase inhibitors, a biguanide, the thiazolidinediones, insulin analogues, meglitinides and D-phenyalanine derivatives. These new agents have dramatically increased the number of options available to health care providers and patients. Notwithstanding the availability of this wide and ever-increasing array of agents, the goal of attaining sustained normoglycaemia in most patients remains elusive. Recently we have seen a surge of interest in alternate routes for insulin administration, including pulmonary, nasal, buccal and oral routes. The latter, oral insulin, will be the focus of this review, together with a discussion of its potential benefits.
Type 2 diabetes is a complex metabolic disorder involving defects in insulin resistance and secretion that combine to reduce glucose uptake in insulin-sensitive tissues, as well as to impair the suppression of hepatic glucose production (see Figure 1). Increasing insulin resistance characterises the prediabetic state. As long as the beta cells (ß-cells) mass is preserved and the cells function properly, insulin resistance results in compensatory hyperinsulinemia, which maintains relatively normal glucose control. While this compensated, insulin-resistant state persists, individuals may exhibit either normal or impaired glucose tolerance (IGT), but not outright diabetes.
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Industry Events |
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4th Annual Patient Recruitment and Retention in Clinical Trials
13-15 October 2008, Amsterdam
Patient recruitment
is now consuming thirty percent of clinical trial time - more time than any
other clinical trial activity - and almost half of all trial delays result from
patient recruitment problems.
As the
recruiting culture becomes more sophisticated and the forces affecting patient
enrollment grow more numerous and complex, pharmaceutical companies are
striving to discover new strategies to facilitate enrollment in clinical
trials.
With
increasing industry pressure to develop, test and market greater numbers of new
drugs faster, pharmaceutical companies need to perform clinical trials as
quickly as possible. Inefficient patient recruitment processes is a formidable
barrier to pharmaceutical companies' success in launching new products.
Improving the patient recruitment process is imperative to avoid wasted
investments and eliminate costly delays in bringing new drugs to market --
today and even more so in the not-so-distant future. Improved patient
recruitment presents one of the largest opportunities for pharmaceutical
companies to eliminate delays in clinical trials, thereby making it possible to
reduce time to market. With patent time limits and large overheads
meaning that any delays in the development timeline can be disastrous, a good
understanding of how to successfully recruit patients for trials is vital for
any company looking to succeed.
More info >> |
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News and Press Releases |
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New PFA SonicLine® ultrasonic flowmeters
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