Patients with type-1 diabetes who are unaware that they are hypoglycemic may have a five-fold increased risk of severely reduced glucose concentrations. Yet hypoglycemia awareness can be restored if patients can switch to and stick with a different insulin regimen. In general, however, these patients are less adherent to agreed-on changes in insulin therapy, even with more clinic visits, compared with patients who are hypoglycemia-aware.

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Bristol-Myers Squibb and AstraZeneca have announced the FDA’s approval of saxagliptin (Onglyza), a dipeptidyl peptidase-4 (DPP-4) inhibitor, as an adjunct to diet and exercise to improve glycemic control in adults with type-2 diabetes mellitus. DPP-4 inhibitors stimulate the pancreas to make more insulin after meals. Merck’s Januvia is the only other DPP-4 inhibitor on the market.

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