GlobalData analysed the number of type 2 diabetes clinical trials with a start date between January 1, 2018 and December 31, 2018.

Type 2 diabetes is typified by an increase in peripheral resistance to the action of insulin, impairment of insulin secretion, and an increased output of hepatic glucose. The disorder is multifaceted, as the aetiology of type 2 diabetes stem from genetic and environmental risk factors.

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The majority of trials are early-stage, with 35.6% of trials in Phase II of development and 29.6% in Phase I.

Focusing on later-stage trials, Phase IV trials (21.5%) outnumber the number of Phase III studies (13.3%).

China, India, the US, and Japan lead in the number of diagnosed cases of type 2 diabetes in 2017; therefore it is unsurprising that these countries also dominate the research space, considering the high patient population and need to deliver interventions that either prevent the disease or prove beneficial in the prevention and delay of progression and complications.

As shown in Figure 1, China accounts for the highest number of trials (27.1%) initiated in 2018, followed by the US with 14.0%, and Japan and India accounting for 11.1% and 8.2% of trials, respectively.

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Displayed by Figure 2, big pharma dominates the research space in regards to the top sponsors, with Novo Nordisk AS sponsoring the highest number of trials alongside Sanofi (3.45% each), followed by Eli Lilly and Co (2.00%), and MedImmune LLC, Poxel SA, and Tabriz University of Medical Sciences (1.09% each). Excluding Poxel SA and Tabriz University of Medical Sciences, the top sponsors all have glucagon-like peptide-1(GLP-1) receptor agonists indicated for type 2 diabetes within their product pipelines, with all companies researching drugs with this mechanism of action in their clinical trials.

GLP-1 stimulates the production of insulin through the pancreatic islets, but the secretion of GLP-1 is decreased in type 2 diabetes. As a result, modulating GLP-1 production via receptor agonists has become a key focus in type 2 diabetes studies; this is evident through the significant research geared towards it by the top sponsors.