Confused Britons Believe Injections are Main Option for Managing Type 2 Diabetes

New Tablet for Type 2 Diabetes Launched Today

LONDON, June 8, 2010 - When Britons think about type 2 diabetes, one of their greatest concerns
is potentially needing to inject themselves,1 as estimated by a new survey
released today. Despite tablets being available to help manage the condition,
nearly half (46 percent) of those surveyed still wrongly perceive injections
as the main treatment for type 2 diabetes*.(1) This misperception amongst the
public, and potentially those yet to be diagnosed, is critical, as four out
of 10 respondents claim they would be most concerned about having to inject
themselves if diagnosed with type 2 diabetes tomorrow.(1)

Furthermore, nine out of 10 said that given the choice they would prefer
to take a tablet over an injection,(1) highlighting the need for additional
oral medicines, such as 'Janumet', a new tablet launched in the UK today for
the treatment of type 2 diabetes.(2) 'Janumet' is a combination tablet that
brings together two leading treatment options into one tablet,(2) reducing
the need for multiple treatments and making life simpler for patients,
especially those who have injection concerns.

Whilst there are 2.6 million Britons currently diagnosed with type 2
diabetes,(3) it is estimated that there are a further 500,000 individuals
unaware they are living with the condition.(3) "It is particularly important
that these undiagnosed patients are not deterred from coming forward by
misunderstandings around type 2 diabetes," commented Dr Dawn Harper, GP in
Gloucestershire, and leading TV medic. "If fears exist around injections,
people need to know that many type 2 diabetics don't need injections to
manage their condition."

The findings highlight a lack of knowledge that tablets do exist to treat
type 2 diabetes,(1) which may help patients control their blood glucose
levels and may in turn delay the need for injections. The survey also found
that as a nation we underestimate the impact of type 2 diabetes on our
health. Over two-thirds of Britons surveyed did not know that heart problems
are a serious complication associated with the condition,(1) despite heart
attacks being the most common cause of death in people with diabetes.(4) Less
than 20 percent of those surveyed were aware of the link of type 2 diabetes
to stroke,(1) and nearly half (43 percent) did not know of the link with
deterioration in vision or, in extreme cases, blindness.(1) Only 25 percent
realised that the condition, and some of the older medications, can lead to
an increase in weight in these patients.(1)

"Whilst the complications associated with type 2 diabetes may result in
long-term health problems, it is important to remember that with careful
treatment management and lifestyle changes, these can be reduced," added Dr
Dawn Harper.

Some of the older tablets may increase the risk of weight gain in type 2
diabetics.(5,6) The good news is that newer medicines, such as twice daily
pill 'Janumet', have a low risk of weight gain,(5) as well as a low risk of
'hypo'5 (hypoglycaemia, or extreme blood sugar lows). 'Janumet', one pill
taken twice daily, contains metformin, a widely used diabetes medicine, and
'Januvia' (sitagliptin)(2) a new generation of medicine in the class of
DPP-4 inhibitors.

* Oral anti-hyperglycaemic agents control the condition and delay
progression of the disease, however most patients over time, will eventually
progress to insulin injections.

About the survey(1)

The survey was conducted amongst 3,000 members of the general
public in the UK by OnePoll. The survey was conducted online in April 2010.
The respondents were over 18 years in age, with 5 percent of respondents
claiming to be type 1 or type 2 patients, 15 percent claiming to be a family
member or carer of someone with diabetes, 4 percent in a medical profession,
and 77 percent claiming to be none of the above.

About diabetes

Type 2 diabetes normally develops later in life and is
characterised by three defects:(7)

    - The cells in the pancreas that produce insulin become 'worn
      out' and can't produce enough insulin.

    - The body's cells become unresponsive to insulin in the
      blood, which prevents the glucose getting in to them.

    - The liver may be producing too much glucose which the body
      doesn't need.

Risk factors for type 2 diabetes include being overweight,
high blood pressure, family history, ethnicity (Afro-Caribbean and Asian
groups), and ageing (most common in those aged over 40 years old, and younger
in 'at-risk' ethnic groups).(8)

Without effective management, type 2 diabetes can lead to
heart disease, stroke, limb amputation, kidney failure and blindness. It is
also associated with impotence and mental health issues.(9)

About hypoglycaemia

Hypoglycaemia occurs when the level of glucose in the blood
falls too low, usually under 4 mmol/l. People with diabetes who take insulin
and/or certain diabetes tablets are at risk of having hypoglycaemia. It may
occur if someone has taken too much diabetes medication, delayed or missed a
meal or snack, not eaten enough carbohydrate, taken part in unplanned or more
strenuous exercise than usual, and has been drinking alcohol without food.
Sometimes there is no obvious cause. When hypoglycaemia happens the person
often experiences 'warning signs', which occur as the body tries to raise the
blood glucose level. These 'warning signs' vary from person to person but
often include feeling shaky, sweating, tingling in the lips, going pale,
heart pounding, confusion and irritability. (10)

Treatment is usually very simple and requires taking some fast
acting carbohydrate, such as a sugary drink or some glucose tablets, and
following this up with some longer acting carbohydrate, such as a cereal bar.
If left untreated the person might, eventually, become unconscious and would
need to be treated with an injection of glucagon (a hormone that raises blood
glucose levels). But in the vast majority of cases the body will release its
own stores of glucose and raise the blood glucose level to normal, though
this may take several hours.(10)

About MSD

Today's MSD is working to help the world be well. Through our
medicines, vaccines, biologic therapies, and consumer and animal products, we
work with customers and operate in more than 140 countries to deliver
innovative health solutions. We also demonstrate our commitment to increasing
access to healthcare through far-reaching programs that donate and deliver
our products to the people who need them. MSD. Be Well. For more information,
visit www.msd-uk.co.uk

'Januvia'(R) is a Registered Trademark of Merck Sharp & Dohme
Corp., a subsidiary of Merck & Co., Inc., Whitehouse Station, New Jersey,
USA.

References:

1. Consumer survey results, led by OnePoll, on behalf of MSD. Data on
file.

2. Janumet SPC. Dated March 2010.

3. Diabetes UK website. Guide to diabetes fact sheet. Reviewed 03.06.10
www.diabetes.org.uk/Guide-to-diabetes/Introduction-to-diabetes/What_is_diabetes/

4. British Heart Foundation Statistics. Mortality from diabetes.
www.heartstats.org/datapage.asp?id=1113

5. Nauck MA, Meininger G, Sheng D, Terranella L, Stein PP, Tesone P, et
al. Efficacy and safety of the dipeptidyl peptidase-4 inhibitor, sitagliptin,
compared with the sulfonylurea, glIpizide, in patients with type 2 diabetes
inadequately controlled on metformin alone: A randomized, double-blind,
non-inferiority trial. Diabetes, Obesity and Metabolism 2007;9(2):194-205

6. Hermansen, Kjeld; Morensen, Lene S. Bodyweight changes associated with
antihyperlycaemic agents in type 2 diabetes mellitus. Drug Safety: 2007 -
Vol. 30, Issue 12, pp 1127-1142

7. Chavez B. Type 2 Diabetes: Insulin Resistance, Beta Cell. Dysfunction
and Other Metabolic Hormonal Abnormalities. Chapter 3; Page 24

8. Diabetes UK website. Guide to diabetes fact sheet. Causes & risk
factors. Reviewed 03.06.10
www.diabetes.org.uk/Guide-to-diabetes/Introduction-to-diabetes/Causes_and_Risk_Factors/

9. Diabetes UK website. Guide to diabetes fact sheet. Complications.
Reviewed 03.06.10 www.diabetes.org.uk/Guide-to-diabetes/Complications/

10. Diabetes UK website. Guide to diabetes fact sheet. Hypoglycaemia.
Reviewed 03.06.10
www.diabetes.org.uk/Guide-to-diabetes/Complications/Hypoglycaemia/

(Due to the length of these URLs, it may be necessary to copy and paste
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For further information, please contact: Louise Barr, Merck Sharp & Dohme Limited, Office: +44(0)1992-452126 / 467272, louise_barr at merck.com; Georgie Griffith / Nicki Graham, Cohn & Wolfe, Office: +44(0)20-7331-5369 / 5365, georgie.griffith at cohnwolfe.com