Coalition urges action now to manage diabetes
to drastically improve the management of diabetes to prevent a
potentially devastating and costly global burden.
The warning is in response to the growing number diabetes cases that threatens to engulf the healthcare systems of industrialised nations already creaking under the weight of a $286bn (€226bn) bill for diabetes-related complications each year.
Diabetes has reached unprecedented, epidemic levels - there are approximately 230m people with diabetes worldwide and without further action this figure is predicted to rise to 350m by 2025.
Previous trials have proved that poor blood sugar management leads to diabetes-related complications such as blindness, amputations, kidney failure, heart attack and nerve damage. Diabetes is the fourth leading cause of disease-related death worldwide.
The consensus report is the result of a coalition, which consists of 25 diabetes experts from 16 different countries who met in February 2005, to look at ways to address this worrying global burden after learning about the results of a major international survey.
The survey: "Optimising Control in Diabetes (OPTIMIZE) Survey" in which almost 1,500 people with type 2 diabetes from seven countries were questioned about their attitudes to diabetes management.
"Diabetes is a progressive disease and almost all patients with type 2 diabetes who are currently controlling their condition through diet, exercise and oral therapy will ultimately require insulin, the gold standard treatment for the successful management of diabetes," said Professor Cefalu, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA.
"However, a treatment is only successful if patients are willing to use it. Recent clinical research shows that half of patients for whom oral diabetes medicines are not sufficient for them to reach blood sugar targets are delaying for at least four to six years before commencing insulin treatment."
He added that even patients who are suffering from the complications of uncontrolled diabetes, such as neuropathy and retinopathy, which can lead to blindness, are still delaying insulin treatment
While insulin is the most effective blood sugar lowing treatment available, the fear is it is not being used effectively.
The survey revealed that people with type 2 diabetes feared insulin rather than seeing it as an effective treatment to maintain optimal blood sugar control.
This fear has been perpetuated by some doctors who use insulin therapy as a threat to promote compliance during the early stages of diabetes but in fact insulin is the most effective and natural way of controlling blood sugar.
The OPTIMIZE report also highlighted the reluctance to use or intensify insulin treatment due to injection-related factors.
"We must dispel these fears and improve the management of diabetes, which includes increasing acceptance of insulin by communicating its use as a viable optimal treatment, if we are to reduce the ever-increasing burden of this disease," said Professor Mathieu, University of Leuven, Belgium.
"Patient self management is crucial to attaining a successful treatment outcome. If a patient is unhappy with their treatment they are unlikely to administer it as accurately as prescribed. All insulin regimens should be adapted to suit the needs of each patient and through offering the appropriate range of treatment choices patient preference can be taken into account and may help to encourage more successful treatment outcomes."