Diabetes is one of the few non-communicable diseases that is increasing in prevalence. An estimated 300 million people worldwide will be affected by diabetes by 2025, largely due to the double impact of an ageing population and a rise in obesity.

This report provides a complete overview of the antidiabetic drugs market, with particular focus on innovations in the sector. It analyses the strengths and weakness of the market and gives a comprehensive update on research trends.

PUBLICATION: JANUARY 2000
REF: BS1042E
PAGES: 150
PRICE: £495/$1,040/¥119,000

CONTENTS
LIST OF TABLES
LIST OF FIGURES
EXECUTIVE SUMMARY
ABBREVIATIONS AND GLOSSARY
CLINICAL TRIAL ACRONYMS

CHAPTER 1 INTRODUCTION TO DIABETES MELLITUS
1.1 Definition of diabetes
1.1.1 The role of insulin
1.1.2 Classification of diabetes
1.1.2.1 Type 1 diabetes mellitus
1.1.2.2 Type 2 diabetes mellitus
1.1.2.3 Gestational diabetes
1.1.2.4 Secondary diabetes
1.1.2.5 Impaired glucose regulation
1.2 Diagnosis of diabetes
1.2.1 ADA and WHO diagnostic criteria for diabetes
1.2.2 Diagnosis of Type 1 diabetes
1.2.3 Diagnosis of Type 2 diabetes
1.3 Pathophysiology of diabetes
1.3.1 Pathophysiology of Type 1 diabetes
1.3.2 Pathophysiology of Type 2 diabetes
1.4 Incidence and prevalence of diabetes
1.5 The economic cost of diabetes
1.6 Risk factors for diabetes
1.6.1 Risk factors for Type 1 diabetes
1.6.1.1 Genetic risk factors
1.6.1.2 Ethnic factors
1.6.1.3 Nutritional risk factors
1.6.1.4 Viruses
1.6.1.5 Vaccinations
1.6.2 Risk factors for Type 2 diabetes
1.6.2.1 Obesity
1.6.2.2 Syndrome X
1.6.2.3 Age
1.6.2.4 Genetic risk factors
1.6.2.5 Physical inactivity
1.7 Complications associated with diabetes
1.7.1 Cardiovascular disease
1.7.2 Vision disorders
1.7.3 Kidney disease
1.7.4 Disorders of the nervous system
1.7.5 Lower extremity disorders
1.7.6 Acute metabolic disorders
1.7.7 Infections
1.8 The management of diabetes and its associated complications
1.8.1 Non-pharmacological management
1.8.2 Pharmacological management
1.8.2.1 Pharmacological management of Type 1 diabetes
1.8.2.2 Pharmacological management of Type 2 diabetes
1.8.2.3 Pharmacological management of diabetic complications
1.9 Conclusion

CHAPTER 2 MARKETED DRUGS FOR THE MANAGEMENT OF DIABETES AND ITS COMPLICATIONS
2.1 Introduction
2.2 Insulin
2.2.1 Human insulin versus animal insulins
2.2.2 Short-acting insulins
2.2.2.1 Biohulin
2.2.2.2 Humulin S
2.2.2.3 Insulin aspart
2.2.2.4 Insulin lispro
2.2.2.5 Insuman rapid
2.2.2.6 Novolin
2.2.2.7 Orgasuline regular
2.2.2.8 Velosulin
2.2.2.9 Animal insulins
2.2.3 Basal insulins
2.2.4 Biphasic insulins
2.2.4.1 Humalog Mix25
2.3 Oral antidiabetic drugs
2.3.1 Sulphonylureas
2.3.1.1 Glibenclamide/glyburide
2.3.1.2 Gliclazide
2.3.1.3 Glimepiride
2.3.1.4 Glipizide
2.3.1.5 Gliquidone
2.3.2 Biguanides
2.3.2.1 Metformin
2.3.3 Alpha-glucosidase inhibitors
2.3.3.1 Acarbose
2.3.3.2 Miglitol
2.3.3.3 Voglibose
2.3.4 Thiazolidinediones (glitazones)
2.3.4.1 Pioglitazone
2.3.4.2 Rosiglitazone
2.3.4.3 Troglitazone
2.3.5 Prandial glucose regulators
2.3.5.1 Nateglinide
2.3.5.2 Repaglinide
2.3.6 Novel insulin sensitisers - DIAB II
2.3.6.1 DIAB II
2.4 Drugs for the treatment of diabetic complications
2.4.1 Drugs for the prevention of cardiovascular disease
2.4.1.1 ACE inhibitors
2.4.1.2 Aspirin
2.4.1.3 Lipid-lowering drugs
2.4.2 Drugs for the treatment of diabetic foot ulcers
2.4.2.1 Becaplermin
2.4.3 Drugs for the treatment of acute metabolic disorders
2.4.3.1 Glucagon (GlucaGen)
2.4.3.2 Glucagon
2.5 Conclusion

CHAPTER 3 DRUGS IN DEVELOPMENT FOR THE MANAGEMENT OF DIABETES AND ITS COMPLICATIONS
3.1 Introduction
3.2 Insulin products in development
3.2.1 Long-acting insulin products
3.2.1.1 Basulin
3.2.1.2 Insulin glargine
3.2.1.3 NN-304
3.2.2 Oral insulin products
3.2.2.1 Macrulin
3.2.2.2 Oralin
3.2.2.3 Oral insulin, Emisphere
3.2.2.4 Oral insulin, Protein Delivery
3.2.3 Inhaleable insulin products
3.2.3.1 Inhaled insulin, Alkermes
3.2.3.2 Inhaled insulin, Dura
3.2.3.3 Inhaled insulin, Inhale Therapeutic
3.2.3.4 Inhaled insulin, Quadrant
3.2.3.5 NN1998
3.2.4 Transdermal insulin products
3.2.4.1 Transfersulin
3.3 Oral antidiabetic products in development - insulin sensitisers
3.3.1 PPAR-gamma agonists in development
3.3.1.1 Thiazolidinediones (glitazones) PPAR-gamma agonists
3.3.2 Other oral insulin-sensitising products in development
3.3.2.1 AJ-9677
3.3.2.2 Bromocriptine
3.3.2.3 CLX-0901
3.3.2.4 CRE-16336
3.3.2.5 Dexlipotam
3.3.2.6 DRF-2593
3.3.2.7 INS-1
3.4 Injectable insulin sensitisers in development
3.4.1.1 Pramlintide
3.4.1.2 SomatoKine
3.5 Insulin stimulators in development
3.5.1 Glucagon-like peptide-1 agonists
3.5.1.1 Exendin-4
3.5.1.2 GLP-1, Amylin
3.5.1.3 GLP-1, Watson
3.5.1.4 NN-2211
3.5.1.5 AZM-134
3.5.1.6 GLP-1, Suntory
3.5.2 Other insulin stimulators in development
3.5.2.1 BTS-67582
3.5.2.2 Mitiglinide
3.5.2.3 S-15261
3.6 Other antidiabetic agents in development
3.6.1 AZM-145
3.6.2 Diabetes vaccine
3.6.3 Diamyd
3.6.4 DPP-728A
3.6.5 Glucocorticoid antagonists
3.6.6 Glucose lowering agents
3.6.7 GLUT4 modulators
3.6.8 MXC-3255
3.6.9 NBI-6024
3.7 Products in development for the treatment and prevention of diabetic complications
3.7.1 Aldose reductase inhibitors
3.7.1.1 AS-3201
3.7.1.2 Fidarestat
3.7.1.3 Minalrestat
3.7.1.4 Zenarestat
3.7.1.5 Zopolrestat
3.7.2 Advanced glycation end-product inhibitors
3.7.2.1 ALT-711
3.7.2.2 ALT-946
3.7.2.3 BST-4001
3.7.2.4 EXO-226
3.7.2.5 Pimagedine
3.7.2.6 RAGE
3.7.3 Agents in development for diabetic foot ulcers
3.7.3.1 Apligraf
3.7.3.2 Dermagraft
3.7.3.3 TGF-beta-2
3.7.4 Other agents in development for diabetic complications
3.7.4.1 Antioxidant molecules
3.7.4.2 Ly-333531
3.7.4.3 Memantine
3.7.4.4 NN-1869
3.7.4.5 Pregabalin
3.8 Conclusion

CHAPTER 4 DIABETES MARKET INFORMATION AND EPIDEMIOLOGY
4.1 Introduction
4.2 Market value
4.2.1 World pharmaceutical sales
4.2.2 The antidiabetic market
4.3 Market structure
4.3.1 The market for insulin products
4.3.2 The market for oral antidiabetic drugs
4.4 Market growth
4.4.1 Market growth for insulin products
4.4.2 Market growth for oral antidiabetic drugs
4.4.2.1 Market growth for sulphonylureas
4.4.2.2 Market growth for metformin
4.4.2.3 Market growth for thiazolidinediones (glitazones)
4.4.2.4 Market growth for alpha-glucosidase inhibitors
4.4.2.5 Market growth for prandial glucose regulators
4.5 Market influences
4.6 Epidemiology
4.6.1 Global prevalence of diabetes
4.6.1.1 North America
4.6.1.2 Europe
4.6.1.3 Asia
4.6.1.4 South and Central America
4.6.1.5 Oceania
4.6.1.6 Africa
4.7 Conclusion

CHAPTER 5 PROFILES OF SELECTED COMPANIES
5.1 Amylin
5.1.1 Agreements re antidiabetic therapy
5.1.2 Financial highlights
5.1.3 Antidiabetic drugs marketed and in development
5.2 Aradigm Corporation
5.2.1 Agreements re antidiabetic therapy
5.2.2 Financial highlights
5.2.3 Antidiabetic drugs marketed and in development
5.3 Bayer
5.3.1 Agreements re antidiabetic therapy
5.3.2 Financial highlights
5.3.3 Antidiabetic drugs marketed and in development
5.4 Biotech Holdings Ltd
5.4.1 Agreements re antidiabetic therapy
5.4.2 Financial highlights
5.4.3 Antidiabetic drugs marketed and in development
5.5 Boehringer Ingelheim
5.5.1 Agreements re antidiabetic therapy
5.5.2 Financial highlights
5.5.3 Antidiabetic drugs marketed and in development
5.6 Bristol-Myers Squibb
5.6.1 Agreements re antidiabetic therapy
5.6.2 Financial highlights
5.6.3 Antidiabetic drugs marketed and in development
5.7 Glaxo Wellcome
5.7.1 Agreements re antidiabetic therapy
5.7.2 Financial highlights
5.7.3 Antidiabetic drugs marketed and in development
5.8 Hoechst Marion Roussel
5.8.1 Agreements re antidiabetic therapy
5.8.2 Financial highlights
5.8.3 Antidiabetic drugs marketed and in development
5.9 Inhale Therapeutics
5.9.1 Agreements re antidiabetic therapy
5.9.2 Financial highlights
5.9.3 Antidiabetic drugs marketed and in development
5.10 Eli Lilly
5.10.1 Agreements re antidiabetic therapy
5.10.2 Financial highlights
5.10.3 Antidiabetic drugs marketed and in development
5.11 Merck KGaA
5.11.1 Agreements re antidiabetic therapy
5.11.2 Financial highlights
5.11.3 Antidiabetic drugs marketed and in development
5.12 Novartis
5.12.1 Agreements re antidiabetic therapy
5.12.2 Financial highlights
5.12.3 Antidiabetic drugs marketed and in development
5.13 Novo Nordisk
5.13.1 Agreements re antidiabetic therapy
5.13.2 Financial highlights
5.13.3 Antidiabetic drugs marketed and in development
5.14 Pfizer
5.14.1 Agreements re antidiabetic therapy
5.14.2 Financial highlights
5.14.3 Antidiabetic drugs marketed and in development
5.15 Pharmacia & Upjohn
5.15.1 Agreements re antidiabetic therapy
5.15.2 Financial highlights
5.15.3 Antidiabetic drugs marketed and in development
5.16 Sankyo
5.16.1 Agreements re antidiabetic therapy
5.16.2 Financial highlights
5.16.3 Antidiabetic drugs marketed and in development
5.17 Sanofi-Synth�labo
5.17.1 Agreements re antidiabetic therapy
5.17.2 Financial highlights
5.17.3 Antidiabetic drugs marketed and in development
5.18 SmithKline Beecham
5.18.1 Agreements re antidiabetic therapy
5.18.2 Financial highlights
5.18.3 Antidiabetic drugs marketed and in development
5.19 Takeda
5.19.1 Agreements re antidiabetic therapy
5.19.2 Financial highlights
5.19.3 Antidiabetic drugs marketed and in development
5.20 Warner-Lambert
5.20.1 Agreements re antidiabetic therapy
5.20.2 Financial highlights
5.20.3 Antidiabetic drugs marketed and in development

CHAPTER 6 DIRECTORY
REFERENCES
APPENDIX 1

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