Tag Archives: Pharmaceutical drug

A New Class of Diabetes Medication Arrives in Singapore

ID-10074199

Despite current treatment including insulin, only 40% of patients in Indonesia35% of patients in Singapore and 22% of patients in Malaysia have good diabetes control.

A new class of medication called the SGLT2 inhibitor has been approved in Singapore, the first one being Invokana (canagliflozin). It has a unique mode of action for the treatment of type 2 diabetes mellitus.

In the kidneys when blood is pushed through a glomerulus (the smallest operating unit in the kidney), glomerular filtrate (earliest urine) is formed. It contains glucose (sugar), different ions, water and waste products. The good stuff is retained through reabsorption. Glucose is reabsorbed through the SGLT2 channels.

SGLT2 inhibitors block the action of the SGLT2 channels, so glucose is lost in urine. Thus the blood glucose drops and diabetes control improves. Patients also lose weight as they are losing energy in the urine. The glucose in the urine also drags water with it and thus patients’ blood pressure drops.

The most important benefit is that it is not dependent on insulin secretion, so the risk of a dangerously low blood sugar (hypoglycemia) is prevented. With this extra class of oral medication, patients may be able to delay their use of insulin.

There are side effects though. First, the sugar in the urine increases the risk of a urine tract infection and fungal infection around the urethra. Second, patients can get dehydrated unless they replenish their fluids with an extra glass of water.

I am very glad that we now have another weapon in the treatment of diabetes.

Advertisements

Counterfeit Drugs a problem in Indonesia

fake drugsPhoto courtesy:  Victor Habbick,

I am sometimes asked about the huge price difference of drugs between Indonesia and Singapore. Rent, labor, the strong Singapore dollar, and differential pricing are all factors. However, there is one very important factor – fake or counterfeit drugs. Counterfeit drugs have become a huge problem in Indonesia. The pharmacies used to buy drugs from “independent medication sellers”, but are now buying them simply online.

I had come across instances when I simply switched medication from overseas to Singapore ones, and saw huge differences in the effect of lowering blood pressure and blood sugar. I can only surmise that the “strengths” of the medications are different.

Part of the problem reported was that the pharmacies find it difficult to differentiate between genuine and fake medication. I totally agree. There is no way for even pharmacists and doctors like us to differentiate between the fake and real thing, since boxes, logoes can all be faked. The only way to ensure that the drugs are genuine is to buy direct from the Big Pharmaceutical Companies themselves.

Pharmacists and doctors must realize that fake drugs may not contain any active ingredients, and can also contain harmful ingredients. They must make a stand to sell the real thing to their patients. Patients must also buy medication from registered pharmacies and not from dodgy ones.

Fake Drugs in Bangladesh

Pills

Image courtesy of Baitong333 / FreeDigitalPhotos.net

A lot of Bangladeshi patients come to Singapore for medical treatment. Recently, I have noticed more patients asking to buy medication from Singapore as well. A check on the news show that selling medication that is counterfeit and expired is common in Bangladesh, and the government is finally doing something about it.

The pharmacists are fighting back. They are staging a strike, closing down all the pharmacies in Dhaka. The poor patients are the ones who suffer.

Eventually they will have to open again. Pharmacists have great responsibilities and they should uphold the highest standards in dispensing medication. Counterfeit medication is extremely dangerous and can cause patients to suffer side effects or even lose their lives.

I applaud the Bangladeshi government to take this first step to protect the patients. I am also glad that in Singapore, we can buy medication from any doctor’s office or pharmacy and be sure that the medication is genuine.