1. New Diabetes Drug Invokana Has MajorTreatment - And Market - PotentialA new treatment option will soon be available to people with type 2 diabetes with the FDA’sapproval on Friday of Invokana, a first-in-class medication to lower blood sugar.Johnson & Johnson’s Invokana (generic name canagliflozin) attacks blood sugar right from theget go, reducing the amount of sugar absorbed from food into the bloodstream. The body thenflushes the excess sugar out in the urine.The medical profession – and analysts – have been paying close attention to Invokana because itlowers blood sugar by a different mechanism than the other diabetes drugs on the market.(Metformin, which I wrote about last week for its anti-cancer and anti-aging benefits, is one ofthe other popular diabetes medications available.)Controlling blood sugar is the key to preventing the many side effects caused by diabetes, suchas vision loss, nerve damage, kidney damage, and increased risk of heart attack and stroke.Johnson & Johnson’s application for Invokana cited nine clinical trials involving more than10,000 patients. The main side effects found were urinary tract infections (UTIs) and yeastinfections caused by large amounts of sugar in the urine. (Women prone to UTIs are familiarwith this problem.) Forbes’ Matthew Herper reports that this problem could limit Invokana’ssales, according to some analysts’ predictions. People taking Invokana were also found to havethe potential to become dizzy or faint when standing up suddenly, giving the drug the potential tocause falls, which can be particularly dangerous to the elderly.Invokana’s action takes place in the kidneys – it blocks an enzyme, sodium-glucose co-transporter 2, from putting sugar removed by the kidneys back in the bloodstream. Thereforesome members of the FDA’s advisory panel expressed concern that Invokana should not betaken by people with moderate to severe kidney disease.Invokana was found in trials to raise cholesterol, both LDL or bad cholesterol and HDL, or“good” cholesterol. An elevated risk of stroke and heart attack was found in the first 30 daysafter starting the medication, but after 30 days Invokana reduced these risks.Some diabetes drugs, in particular the former “blockbuster” Avandia, have run into troublebecause of increased heart attack risk. Avandia is now restricted to patients who’ve tried andfailed to respond to other medications, and is banned in Europe. The FDA required Johnson &Johnson to conduct five additional long-term studies of Invokana’s effects on cardiac health,liver problems, cancer, and pancreatic disease.Any diabetes drug that works well – and has limited side effects – has major market potentialsimply because there are so many people with diabetes.