What do you think about all of the ads on TV for medicines that treat diabetes? The ads can be mind-boggling, but they do help us realize that we have an increasing number of medications to fight the explosion of diabetes in the United States.There are 29 million people with diabetes (mostly Type 2), with 1.7 million new cases per year. This rate means that three new people are diagnosed with diabetes every minute! Even more concerning is that 86 million Americans older than 20 years have pre-diabetes and have a high risk of developing diabetes. So, what’s so bad about diabetes? Diabetes not only causes blindness, amputations of feet and legs, and kidney failure, but also almost doubles the likelihood of heart attack and stroke.
Now, there is good reason to be optimistic about the ability to prevent and treat diabetes and avoid the bad outcomes that it can cause.The main reason for this optimism is that most (but not all) of the people with Type 2 diabetes have lifestyle factors that contribute to their overweight or obesity. Research shows that those with diabetes who adopt a healthy diet, plus exercise and weight loss, can reduce or even eliminate the need for medication to control the disease.And maintaining a healthy weight may put the disease in remission. Studies show a weight loss of 7 percent to 10 percent of body weight — 14 to 20 pounds for a 200-pound person — cuts the risk for diabetes in half. Even in long-term diabetic patients, losing weight makes it easier to manage the disease.
Newer studies show that intensive diets with rapid weight loss can stop diabetes in its tracks. A recent study from doctors in Newcastle University found that a medically supervised, 600-calorie-a-day diet for six weeks reversed diabetes in seven out of 11 patients who had been diagnosed with the chronic disease in the previous four years. Study participants consumed liquid diet drinks and non-starchy vegetables for two months. After one week, researchers found their pre-breakfast blood sugar levels had returned to normal. Within three months, fat levels were reduced in the pancreas and liver, returning insulin production to normal. Twelve weeks after the diet ended, seven patients still had normal blood sugar levels.The 11 patients averaged a 33-pound weight loss, but they regained an average of 6 pounds over three months. Likewise, about 30 percent of diabetics undergoing bariatric surgery will achieve a remission from it.
Nevertheless, most people with diabetes will need medications to control the disease. This is where it can really be complicated because, other than insulin, there are nine different categories of medications to treat diabetes. People with diabetes can have widely different responses to each of the medications. Also, over time, the need for medications often changes as the pancreas often continues to lose its ability to make insulin. Many patients with Type 2 diabetes will require insulin to control the blood sugars. Treatment must be tailored to each person with diabetes. Figuring out the best medications for any one person with diabetes requires careful attention by skilled and experienced doctors. Endocrinologists are the specialists that have the training and experience to guide people with diabetes to achieve the best control that is possible. In addition, dieticians and diabetes educators play important roles in helping people with diabetes navigate the many options for managing diabetes.
So, the next time that you hear a commercial ad for one of the new medications to treat diabetes, ask your health care provider to help decide what is your best treatment option.
For more information, contact Dr. Ned Weiss at Princeton Endocrinology Associates, LLC, 10 Forrestal Road south, suite 106, Princeton, by calling 609-921-1511, or visit www.princetonendocrinologyassociates.com.