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    New Diabetes Drug Expected This Week

    How Invokana Works continued...

    The new drug is known as a selective sodium glucose co-transporter inhibitor, or SGLT2. Other drug companies are also working on this type of drug.

    Other diabetes drugs work in differently. Some lower the amount of glucose made by the liver, while others stimulate the pancreas to release more insulin. And still many others work in different ways.

    While Invokana isn't expected to replace other diabetes drugs, ''it's certainly promising," says Aaron Cypess, MD, PhD, of the Joslin Diabetes Center and an assistant professor of medicine at Harvard Medical School. "It's a mechanism we understand and that makes sense."

    But, he says, he does not predict it will be the first drug doctors turn to when medication is needed to treat type 2 diabetes.

    If lifestyle changes like diet, exercise, and weight loss don't control blood sugar enough, metformin is recommended first, says Richard Siegel, MD. That was spelled out in the 2012 American College of Physician treatment guidelines. Siegel is co-director of the Outpatient Diabetes Center at Tufts Medical Center and is an associate professor of medicine at the university's school of medicine in Boston.

    Controlling blood sugar can lower the risk of complications such as heart disease, eye disease, and kidney and nerve problems.

    What Studies Found: Invokana

    In one of the Invokana studies, patients took the drug by itself. Other studies looked at results of the drug when used with other drugs, such as metformin.

    A similar number of patients got their levels of A1c -- a test that measures blood sugar control -- down to the target of less than 7% whether they used Invokana alone or with metformin (45% and 46%, respectively, over a 26-week period). The same was true for how much weight they lost. People taking Invokana alone lost 8.5 pounds over 26 weeks, while those taking both drugs lost a little more than 9 pounds in the same time period.

    Invokana worked better, the company says, in lowering weight and levels of A1c than the drugs sitagliptin (Januvia) or glimepiride (Amaryl).

    Other side effects of Invokana include kidney problems, too much potassium in the blood, low blood sugar, and fainting.

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