“Diabetes is one of the largest global health emergencies of the 21st century. Each year more and more people live with this condition, which can result in life-changing complications. In addition to the 415 million adults who are estimated to currently have diabetes, there are 318 million adults with impaired glucose tolerance, which puts them at high risk of developing the disease in the future.”
IDF Diabetes Atlas, Seventh edition, 2015
Managing diabetes is key to survival
For most of us, losing weight is hard and near on impossible for some. If you are diagnosed with diabetes, the pressure to lose weight, combined with the treatment of the disease, can be overwhelming. Dr Ricky Arenson, Consultant Endocrinologist and Geriatrician, says patients often struggle with managing their diabetes so it is necessary for both patients and doctors to work together to find solutions. “Diabetes is a horrible genetic disorder, and non-diabetics are lucky that they do not have to prick their fingers before every meal and watch everything they eat for the rest of their lives,” Dr Arenson says. “This is not realistically within the reach of all patients.”
“Rather than being disappointed with patients for failing to lose weight and complying with their treatment, I think it’s vital for medical practitioners to engage positively with patients.”
“We need to stop using the ‘doctor versus patient’ model that is quite prevalent in medicine.”
“We should sympathise with our patients, rather than judge them.”
How is diabetes treated?
Contributing to the incidence of diabetes, the world’s fastest growing chronic disease, is the obesity epidemic. “Poor diet contributes significantly to the incidence of type 2 diabetes in Australia and globally,” Dr Arenson says. “Previously we were worried about our fat intake, but recent studies have focussed more on the dangers of refined sugar.”
“Avoiding excessive sugar and carbohydrates will certainly help.” Diabetic patients are encouraged to diet, exercise and lose weight, sometimes with the help of dieticians and diabetes educators. Medical practitioners also stress the significant long-term health benefits complying with treatment has for patients. “We have the opportunity to treat the disease far more aggressively from early on, and thereby create a better future and better outcomes for our diabetic patients,”Dr Arenson says.
Dr Arenson concedes that reality is often different. Lifestyle measures are seldom effective and despite the best efforts of both patient and medical practitioner, most patients do not lose weight. “For complex reasons, I believe the obesity epidemic will continue to worsen in the western world for the foreseeable future, and the incidence and prevalence of diabetes will continue to climb.” For those who cannot manage to lose weight, weight loss surgery has been a progressive step and there are a multitude of treatments available to diabetics, ranging from tablets to injectable options.
“We are living in exciting times, with so many new treatments available to our patients,” Dr Arenson says. “The first line treatment is metformin. After that, there is a wide range of different treatments, depending on the profile and needs of the patient.”
Extensive research into the complex nature of diabetes will also lead to more advances in treatment. “Type 2 diabetes is a far more sophisticated and multi-factorial disease than previously thought, with multi-organ involvement,” Dr Arenson says. “We now understand that it affects many organs in the body, including the brain, kidneys, gut, liver and musculoskeletal system.”
“This more recent research will present a great opportunity to explore new, exciting treatments in the future.”