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they can be delayed with improved care, especially care early in diabetes progression,

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which brings me to my third reason why new treatments are needed. Compliance or

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adherence to taking medicine is really too low. While not many payers will say so

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publicly, they indicate privately that adherence to diabetes medications is about 50% and

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that’s on a really good day. This suggests that the armamentarium of diabetes

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medications could possibly benefit from the addition of better, more tolerable therapies.

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Notably, today there are no disease modifying alternatives for diabetes available.

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Perhaps these can be developed one day. That’s truly a patient dream. For that to

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happen, industry and investors must believe in a reasonable regulatory environment. If

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they don’t we all will lose.

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that same time period, the cost of diabetes complications doubled from under 20

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billion to more than 40 billion. This is in five years. The expectations are that spending

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on complications will increase to 53 billion in 2012 and 75 billion in 2020 if current

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obesity trends continue. That’s new data from The Lewin Group who made all of the

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data for the ADA publications on the cost of diabetes in America. Those came out earlier

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this month.

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answer is undoubtedly a combination of factors, but we believe from many surveys with

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patients and doctors that it could largely be because current diabetes medications are not

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broadly tolerable. The most widely used diabetes medication today, for example,

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Metformin caused GI problems in 40% of patients who took it the international multi-

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center randomized double-blinded placebo-controlled 44,000 patient DREAM trial. That

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was reported in 2006.

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As everyone here knows, many of these complications are preventable or

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Why are A1cs so low? Why is diabetes management so challenging? The

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