糖尿病 (Diabete Mellitus) is no longer a good term in describing the disease

I gave a talk about diabetes mellitus in the Taiwanese Bible Study last week, pointing out糖尿病 (the disease of having sugar in the urine) is no longer a good term.  We no longer test sugar in the urine to diagnose the disease or monitor the treatment.  Besides, a new drug under development aims to lower blood sugar (glucose) level by causing sugar loss in the urine, thus having lots of sugar in the urine is the goal of the treatment, not pathogenic of the disease.

AstraZeneca and Bristol-Myers Squibb have spent hundreds of millions in developing dapaglifozin, which is a sodium-glucose transporter-2 inhibitor.  Normally the majority of glucose filtered through the glomerulus (the basic unit of the kidney) are reabsorbed back by way of the sodium-glucose transporter, inhibition of which will prevent its reabsorption, causing the loss of glucose in the urine.

FDA rejects it on February 11 citing the concern of higher rate of breast and bladder cancer in the treatment arm.  This is not a surprise, given the FDA expert panel also didn’t recommend it in July 2011.  Like many newer agents, dapaglifozin is not a potent diabetic drug, it only lowers HbA1c by 0.5%; nevertheless, it is a novel approach; a newer class (we have 10 classes of diabetic drugs so far).  I believe this is just a temporary setback.

“Mellitus” means sweet or honey in Latin/Greek, thus Diabetes Mellitus is a better term than 糖尿病.