New drug therapies must be part of the conversation around diabetes, says Netcare doctor Alberlito

Very often, the conversation around type 2 diabetes centers on the impact of lifestyle choices.

While the importance of this factor cannot be underestimated, specialists stress the need to be aware of the many advances in drugs, which can dramatically improve outcomes for diabetic patients.

Speaking on World Diabetes Day on November 14, Dr Tanya van der Made, endocrinologist and medical specialist at Netcare Alberlito Hospital in Ballito, said South Africa had one of the highest obesity rates in the world.

“Obesity can increase the risk of developing type 2 diabetes by a factor of 90. We therefore cannot ignore the health crisis we are currently facing, which is directly linked to lifestyle issues, including poor diet and lack of physical fitness.

“The point is, we have a large population of people with type 2 diabetes who are beyond prevention but who would still be able to lead more productive and fulfilling lives if their disease was optimally managed. This not only involves maintaining a healthy lifestyle, but also having regular reviews of the effectiveness of the medications they are taking. Many older treatments can maintain the status quo, but more advanced treatments could be so much more effective. “

Dr Van der Made points out that diabetes medicines have crossed many new frontiers in recent years, which means there is considerable hope for an even better quality of life for patients. “The opportunity to achieve better patient outcomes is now within reach with a change of medication. It is therefore in the best interest of patients that treating physicians consider the potential benefits of a new drug before renewing an existing script, ”she notes.

“For example, a patient may be on a particular treatment that does the basic job of keeping their diabetes under control, but it is still important to assess the possible benefits of a new treatment approach. I compare him to an astronaut who has the option of wearing a 1980s spacesuit or a newly developed 2021 space suit. Certainly the old one has its place in history and can still do the job, but why would it? -she ? Is the astronaut considering the new suit if it can improve his travel experience? “

According to Dr. Van der Made, the benefits of new diabetes drugs for patients often extend beyond the diabetes itself, to include improvements in cardiovascular and kidney health, to name a few – a few.

She says that if a patient is out of step with their progress, healthcare providers should consider an individualized approach with drug substitution or simplification, in consultation with other experienced practitioners as necessary.

Likewise, she says patients don’t need to worry when their doctor suggests a different treatment and recommends that they ask their treating doctor about new medications at their next check-up.

“The pandemic has highlighted a number of serious health issues, including the continuing association between type 2 diabetes and obesity. Again, as with diabetes, the management of obesity is not often discussed beyond diet and lifestyle, but some newer drugs go so far as to help with weight loss as well, thus benefiting patients who have not been able to progress without medical assistance. she notes.

“GLP1 RA (glucagon-like peptide 1 receptor analogs), for example, was initially used to modify and improve certain body functions in diabetics. However, they can also help control appetite directly via the appetite centers in the brain, thereby reducing the intense hunger described by many type 2 diabetics.

In addition, Dr Van der Made explains that extensive research on these drugs has shown that they offer additional pharmacological benefits, such as reduced cardiovascular risk in high-risk type 2 diabetic patients, as has been shown. in cardiovascular outcome trials.

“These drugs are given under the skin and options exist for daily or weekly doses. As is the case with so many new developments in healthcare around the world, cost can be a determining factor that patients and their physicians will need to discuss.

“Another class of drugs, SGLT2 (sodium glucose-bound transporter 2) inhibitors, indicated for type 2 diabetes, help people with diabetes pass more glucose through their urine and generally reduce the risk of hypoglycemia, according to other medicines the patient may take. to take. This drug also causes weight loss and has the added benefit of lowering blood pressure, demonstrating a significant reduction in the risk of heart failure for patients.

“These drugs are just a few examples of the latest developments in the management of diabetes, and I am excited about the potential to improve the quality of life for patients with this disease. We have the science, research and technology to go safely and boldly where we couldn’t go before.

“Despite the difficult times we live in, it is very encouraging to see the medical evolution in the management of diseases such as diabetes, and to know that when these are supported by responsible lifestyle choices, there is has more options available to people with diabetes, giving them a better chance than ever to achieve the best possible health, ”concludes Dr Van der Made.

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