Latest trends in diabetes treatment and care

Doctor testing patient patient's glucose

It is known as the “silent” disease because symptoms often develop slowly and might not be noticeable at first. Type 2 diabetes and its growing prevalence has become a topic of concern and health professionals are doubling down on their efforts to educate the public to its dangers and underscore the importance of its prevention.

According to Adriana Kuker, MD, an endocrinologist at NewYork-Presbyterian, “Diabetes is an endocrine disorder that causes blood glucose (sugar) levels to rise higher than normal. The most common form is type 2 diabetes, where the body either resists the effects of insulin — a hormone that regulates the movement of sugar into your cells — or doesn't produce enough insulin to maintain a normal glucose level. Initial warning signs people should watch for include increased thirst, increased urination, fatigue, and slow healing of sores.”

Although research has yet to fully understand why some people develop diabetes, there are some known risk factors and topping the list is excess weight. Says Katie Campbell, a registered dietitian and certified diabetes educator at NewYork-Presbyterian Lawrence Hospital, “The more fatty tissue you have, the more resistant your cells become to insulin.” But there are other factors that come into play, such as leading a sedentary lifestyle, a family history of the disease, and age. “Type 2 diabetes usually develops as a person gets older, especially after age 45. But these days, we’re seeing a dramatic increase in children and usually for the same reasons – unhealthy diet and inactivity.”

Uncontrolled diabetes can lead to serious and even life-threatening complications. “Rapid and extreme rises in blood sugar can lead to dehydration, a buildup of acid in the blood, organ damage, coma, and even death, if not treated promptly,” explains Dr. Kuker, who also notes that diabetes is a leading cause of preventable blindness, non-traumatic leg amputations, kidney damage, as well as heart attack and stroke.

Diabetes management: collaborative care is key

There are many types of medications for diabetes management, ranging from pills to injections to personal infusion pumps, all of which are approved by the Food and Drug Administration. “It is important that patients take medications as prescribed and monitor their blood sugar levels regularly in order to avoid dangerous fluctuations,” advises Dr. Kuker. “Beyond that, diabetes care is now evolving to include medical teams to better address specific goals, barriers and challenges that are unique to each patient. We’re finding that the best approach is a collaborative one that includes not only the patient and physician, but specialists such as endocrinologists, pharmacists, nurse practitioners, dietitians, certified diabetes educators, and social workers.”

Educating patients on topics such as nutrition, exercise, and the importance of regular glucose monitoring helps empower them to be decision makers in their own care; much of diabetes care depends more on patient behavior than clinical interventions. “For example, if you are overweight or obese, a weight loss of 5-10 percent of your body weight can improve your heart health, lower blood pressure and cholesterol, and improve your blood sugar,” notes Ms. Campbell. “Choose a variety of plant-based sources such as beans, fruits, vegetables, and whole grains.  Always practice mindful eating behaviors such as portion control and reading nutrition labels. It’s also important to increase exercise by walking an extra 30 minutes a day, which can help shed pounds and lower blood sugar levels.”

While the condition may be considered a “silent” one, the statistics are loud and clear: more than 29 million people in the United States have diabetes, up from the previous estimate of 26 million in 2010, according to a report by the Centers for Disease Control and Prevention. Says Dr. Kuker, “With greater patient education and involvement, the diabetes can be better managed, and many may avoid developing it altogether.”