Question 24080 — diseases

Summary

Mr. Brahim Hammouche draws the attention of the Minister of Solidarity and Health to the care and treatment of diabetes, a chronic and progressive disease which is a major public health issue. Its frequency has increased significantly over the past two decades with the disease expected to affect 592 million adults worldwide by 2035. Some medications are well known, effective and inexpensive. Metformin improves the sensitivity of cells to insulin but can cause digestive problems in certain patients. Its use is not recommended when the kidney is functioning poorly and must be discontinued in acute situations such as a vascular accident, infection or surgery. Sulfonamides and glinides, two classes of drugs with a very similar mode of action, stimulate the production insulin through the pancreas. But they can cause hypoglycemia, which means that the patient's blood sugar level must be checked very often. In addition, sulfonamides are contraindicated in cases of renal insufficiency. Acarbose, which slows down the intestinal absorption of glucose and helps avoid blood sugar peaks after meals, can cause digestive problems. Therapeutic treatments with newer drugs, such as DPP4 inhibitors and GLP-1 analogues, provide solutions to patients suffering from diabetes but remain very expensive and their duration of action is very short (particularly with regard to GLP-1 because it is destroyed by the DPP-4 enzyme). The advantage of these new treatments is based on the fact that they have benefited from cardiovascular safety studies as part of their development. Some of them also have a protective effect on the cardiovascular level, which is an additional argument for their use. A new therapeutic class, gliflozins, promote the elimination of sugar in the urine thus leading to weight loss, improve blood pressure and also have a protective effect on the heart. All these advantages mean that their availability in France is eagerly awaited. While some patients can already obtain them in European countries such as Luxembourg for example, he asks when their marketing and reimbursement for ALD and medical benefits rendered will be effective in France. He also questions him about the progress of possible other therapies that would be considered effective in the treatment of diabetes.

Machine translation from French. The official text remains authoritative.

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