America Losing the Fight With Type 2 Diabetes

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By Dennis Thompson
HealthDay Reporter
Tuesday, December 30, 2008; 12:00 AM

TUESDAY, Dec. 30 (HealthDay News) -- The type 2 diabetes epidemic that continues to sweep across the United States has left an estimated 24 million Americans struggling with the disease, up more than 3 million people since 2005.

And, of course, with the epidemic comes the wave of illnesses and disabilities brought on by diabetes -- heart disease and stroke, blindness, amputations, kidney disease and nervous system damage.

Doctors are trying to reverse the tide in two ways.

First, they're continuing to press the public to adopt healthy lifestyle changes that can head off type 2 diabetes, or, at the very least, help control it if it's already present. And researchers are pushing to develop new drugs to help people manage their diabetes more effectively.

"You have to look at the management of diabetes as a package, really," said Ann Albright, director of the U.S. Centers for Disease Control and Prevention's Division of Diabetes Translation. "You really need to be taking advantage of all the tools in the toolbox."

Unfortunately, much of America continues to be slow in picking up those tools, particularly needed lifestyle changes, despite mounting evidence that they're very effective.

In type 2 diabetes, either the body doesn't produce enough of the hormone insulin or the cells "ignore" the insulin, which is needed for the body to use blood sugar, or glucose, for energy. Lack of exercise and being overweight are key contributors to type 2 diabetes.

Some type 2 diabetes medications have come under scrutiny recently after research found that a leading drug, Avandia, seemed to increase the risk of heart attack.

"That created a fair amount of uproar about drug safety in diabetes," said Dr. John Buse, director of the Diabetes Care Center at the University of North Carolina School of Medicine, and president of medicine and science for the American Diabetes Association.

Advisors to the U.S. Food and Drug Administration have recommended that drugs designed to control type 2 diabetes be subjected to more thorough safety reviews. The FDA has left Avandia on the market, however, concluding that the risk of heart attack isn't higher than that associated with similar drugs.

The concern now is that worries over heart attack have led many people to leave their diabetes untreated, abandoning their medication without picking up other drugs or other means of controlling the disease, Buse said.

"A lot of people stopped their diabetes drugs and didn't start others," he said. "There's a lot of concern that those people have lost control of their diabetes."

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