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DOES DIABETES TREATMENT WORK?

DIABETES UK has responded to new research from UCL, the University of Michigan and the Ann Arbor Veterans Affairs Hospital that suggests that some diabetes medications might be doing some people more harm than good.

The study, published in JAMA Internal Medicine, found that whether patients with Type 2 diabetes, particularly older people, benefit from diabetes treatment depends less on their blood sugar level than their age and the side-effects of the treatment.

SIMON O’Neill, Director of Health Intelligence for Diabetes UK, said the study highlighted the need to avoid a blanket approach to treatment.

He said: “Clearly, everyone with Type 1 diabetes needs to have insulin to stay alive. But for the treatment of Type 2 diabetes, sometimes there is a balance to be struck where certain medications might help give someone a longer life but also cause side effects that might negatively impact on quality of life.

“This study highlights the importance of looking at the individual needs of the person with Type 2 diabetes, rather than adopting a blanket approach. It also underlines how vital it is that healthcare professionals and people with diabetes work closely together to jointly decide what the best treatment options are for that person and weighing up the potential benefits and side-effects, which will vary from person to person, needs to be at the centre of that discussion.

“This is why having a care plan jointly agreed by the person and the healthcare professional is part of the 15 Healthcare Essentials that everyone with the condition should get. We would strongly advise people not to stop taking medication without talking to their GP first.”

IAIN Bain, chairman of Diabetes UK Furness Area Group, who has Type 2 diabetes, said sufferers should take responsibility for their condition working in partnership with their GP and diabetes nurse specialist.

He said: “The first thing that came to mind on reading this report was that this, to me, is a new slant on looking at the overall picture in terms of life expectancy and the slightly changed perspective of now considering the effects of medication in relation to life expectancy. I think there are generally more potential difficulties in terms of using insulin compared with tablets. The main thing I pick up on is that diabetes sufferers have to accept responsibility for managing their condition in partnership with their diabetes nurse specialist.

“One thing Diabetes UK is pushing is for is the 15 essential health checks diabetes sufferers should be receiving from their GP; things like regular foot checks, regular eye screening, that blood pressure is checked etc.

“As time goes on, new treatments are coming to the forefront of the market so it’s a case of working in partnership with your GP, finding what works for you, but the main thing is people who suffer from diabetes have to take responsibility of their own health, and that goes for me too. The starting point should be diet and exercise, but of course, for some, particularly the more elderly diabetes population, it’s not always possible for them to exercise so this is a further difficulty. At the moment I’m on medication and endeavouring to eat healthily and to get more exercise into my life than I do. For patients it’s a case of learning about the situation and being aware of what’s needed and knowing there is support around, either from Diabetes UK and its careline, or if they want to chat to fellow sufferers there’s the Furness Area Support Group which meets at The Forum every second Wednesday of the month.”

DR Cathy Hay, clinical director of Cumbria Diabetes, said diabetes medication should be tailored to the individual.

She said: “We do recognise the need to tailor diabetes treatment on an individual basis. As with all medications there are potential side effects which need to be considered alongside the risks from poor diabetes control. The balance between risk and benefit from drug treatment for an individual will depend upon a number of factors including age. We would always aim to discuss the risks and benefits with patients prior to reaching agreement on treatment.

The study results in the JAMA paper support this individualised approach.”

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