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A multi-pronged approach to diabetes management

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International diabetes experts lay emphasis on having holistic approach toward diabetes management

Raelene KambliMunich

Diabetes is often understated by patients and healthcare providers, therefore it is one of the leading metabolic diseases worldover. According to the International Diabetes Federation, by 2040 there will be one in every ten individuals suffering from diabetes. The World Health Organisation has warned in a report on World Health Day early this year on the increasing numbers of diabetics worldwide. The report says that the number of adults worldwide affected by diabetes has quadrupled since 1980. Nearly one in 11 people are now affected by the disease, with obesity and unhealthy eating included in the factors driving the rise as per this report. As per IDF Diabetes Atlas 2015, it now affects 415 million people globally and without effective prevention and management the number of cases is predicted to rise to 642 million people by 2040. Type II diabetes is the most common form of diabetes and in developed countries it accounts for up to 95 per cent of all cases.

In keeping with the increasing number of people diabetes worldwide, the European Association for the Study of Diabetes organises an annual conference that focuses on research in diabetes management. This year the conference was organised in Munich and saw representatives and diabetes research experts from across the world presenting their studies. Some of the research papers presented during the annual meeting included: Management of hyperglycaemia in type II diabetes, 2015: a patient-centred approach, New WHO criteria on use of Glycated Haemoglobin (HbA1c) in the Diagnosis of Diabetes Mellitus, cardiovascular disease and diabetes in people with severe mental illness position, prevention of amputation by diabetic education, etc.

One among the many scientific programmes at the EASD was conducted by Boehringer Ingelheim in partnership with Eli Lilly on Insulin: A historical Perspective. On the sidelines of this event, Boehringer Ingelheim also organised  panel discussions on ‘A new conversation in type ÍI diabetes’ and ‘Diabetes-where science and art meet? The panelist for these discussion comprises Jilly Cater, Healthcare journalist from UK who also moderated the discussion, Georg van Husen, Therapuetic Area Head, Cardiometabolism, Boehringer Ingelheim, International, Germany, Professor Robert Chilton, Associate Professor of Medicine, Cadiology Division, University of Texas, USA, Professor Merlin Thomas, Diabetologist, Head of  Biochemistry of Diabetic Complications Laboratory at the baker IDI Heart and Diabetes Institute, Austria and Su Down, Diabetes Nurse Consultant, Somerset Partnership NHS Foundation Trust, UK.

The panel began with presenting global statistics on diabetes. The panel also discussed various aspects of diabetes management and research happening in this field. Speaking about the growing prevalence of diabetes, Husen said, “Every 6 seconds a person  dies due to complications caused by diabetes. Globally, there are around 400 million people living with diabetes and this number is going to increase by 50 per cent in the next few years.” He further pointed out that diabetes reduces the life expectancy of a person by six years. Going forward, he recommended that combination of different treatment option is the need of the hour to manage diabetes.

Professor Chilton stated that drugs cannot solve the problem of diabetes. There is a need to correct eating habits of people. He further went on to accentuate the growing numbers of CVDs across the global due diabetes. He also spoke about the overuse of stents in CVD patients. “You don’t live longer with stents. People forget to take medicine while they have stents. Therefore a holistic approach to managing diabetes is a must. There is a need to balance the glucose, salt and sugar among diabetes for better management. Moreover, we need better drugs that can maintain this balance in patients.” Talking about the importance of Empaglifozin drug in managing diabetes, he said that this drug has proved to reduce death risk in many patients.

Additionally, Professor Thomas drew attention towards the increasing kidney-related disorders caused by diabetes. He also spoke of his book Understanding type II diabetes and explained the relevance of research in the field of diabetes management. The discussion further moved on to breaking various myths about insulin intake and the effectiveness of insulin in diabetes management. Journalists from various countries present at the event asked questions related to diabetes management  relevant to their  countries.

When asked about the Indian scenario, Dr Thomas who has closely worked with various experts in India said that India is undergoing a diabetes pandemic. It is a must that the Indian government takes responsibility in combating diabestes. “There are many poor patients in India who are deprived of medicine as they cannot afford it. The Indian government should provide subsidy on diabetes drugs and services related to diabetes management in order to curb the menace,” he summed up.

IDF Diabetes Atlas 2015’s report indicates that India has 69.2 million diabetics. It is the largest contributor to regional mortality with 1.1 million deaths attributable to diabetes in 2013 (IDF 6th Edition). IDF’s reports also mentions that Indians are prone to diabetes because of the ‘Asian Indian phenotype’ – these are certain unique clinical and biochemical abnormalities in Indians which include increased insulin resistance, greater abdominal adiposity i.e. higher waist circumference despite lower body mass index, lower adiponectin and higher high sensitive C-reactive protein levels. This phenotype makes Asian Indians more prone to diabetes and premature coronary artery disease. Moreover, the awareness of diabetes and its complications is less in India.

When asked about the awareness of diabetes in India, Dr Thomas went on to say that people in India do not take diabetes very seriously and so there is a need that healthcare providers go that extra mile to create more awareness among patients especially in term of medicines, nutrition and lifestyle changes.

The key learning from this discussion was that diabetes affects different organs of a human body; therefore, there is a need for a multi-pronged strategy to combat diabetes.

(The author attended EASD 2016 as a BI invitee)

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