Trends in Diabetes Care, Research Raising Questions
USA Today this week published a four-day series titled "The Fight Against Diabetes." Summaries of each day's articles appear below.
- "Diabetes 'Revolution' Is Cutting Both Ways": The article examines how not "everyone is reaping the benefits" from improvements in treatment of the condition, although complications from diabetes have decreased. In addition, the article examines how diabetes "is increasing worldwide at such an alarming rate that the number of new cases is outpacing the number of those benefiting from gains made in treatment," in large part because of obesity. According to experts, the increased rate of diabetes "threatens to overwhelm health systems and undermine economies," USA Today reports (Manning , USA Today, 11/12).
- "Get Off the Road to Diabetes: 'Pre-Diabetes' Diagnosis Can Jump-Start a Change of Habits To Lower Risk": The article examines how individuals at increased risk for diabetes because of age, genetic profile or other factors can change their lifestyle to help reduce their risk for the condition. Indiana University diabetes researcher David Marrero said, "Diabetes is reaching epidemic proportions. The number of people who have early stages -- pre-diabetes -- is three to four times the people with frank diagnoses of diabetes." In reference to the diagnosis of diabetes, he said that "it's better to catch the horse before it gets out of the barn" (Manning , USA Today, 11/12).
The "nationwide trend toward more high-fat food and less high-activity play" that has "run smack into a genetic predisposition for diabetes" has prompted an increase in cases of type 2 diabetes in children, USA Today reports. The trend "threatens to offset the benefits of improved diabetes treatment that have led to reductions in many of the disease's deadly or disabling complications," according to USA Today.
Treatment of type 2 diabetes in children is "uncharted ground," USA Today reports. FDA has approved insulin and metformin as treatments for type 2 diabetes in children.
However, insulin as a first-line treatment for type 2 diabetes can cause weight gain in overweight children, and metformin alone often is inadequate, according to Jane Lynch of the Texas Diabetes Institute.
In addition, although diet and exercise can help manage type 2 diabetes in children, health insurers often do not cover the cost of nutritionists or diabetes education, and "it takes intensive education and reinforcement" to prompt behavioral changes, Lynch said (Manning, USA Today, 11/13).
- "Islets Could Be a Key to Diabetes Cure": Researchers at the University of Minnesota and six other institutions in the U.S., Canada and Sweden plan to conduct a large study on how to improve islet transplants in type 1 diabetes patients who have had kidney transplants and take immunosuppressants, USA Today reports. According to a previous study, transplants of islets -- small organs in the pancreas that contain several types of cells, such as those that produce insulin -- can reduce or eliminate the need for insulin injections in diabetes patients and restore the ability of patients to sense low blood sugar levels in 95% of cases. In the event that islet transplants prove effective, "it is fair to assume that within a few years from now, this will be an approved treatment for type 1 diabetes," Bernhard Hering, director of the Islet Transplant Program at the Diabetes Institute for Immunology and Transplantation at the University of Minnesota, said (Manning, USA Today, 11/14).
- "Think Tasty, but Healthful: People With Diabetes Should Tailor Their Diets, Watch Carbs": Experts say that "[h]ealthful eating and regular physical activity are crucial" for diabetes patients because of the need to control blood sugar levels to prevent complications such as heart disease and kidney failure but that "there's no one single diet that works for everyone," USA Today reports. Most diabetes patients must limit their consumption of carbohydrates, which have the largest effects on blood sugar levels, as well as their consumption of saturated and trans fats, according to Ann Albright, head of the diabetes division at CDC and president of Healthcare and Education at the American Diabetes Association. Albright said, "The more people learn about their choices, the more flexibility and enjoyment they will have" (Hellmich, USA Today, 11/14).
USA Today profiled Sheri Colberg, an associate professor of exercise science at Old Dominion University and author of "50 Secrets of the World's Longest Living People With Diabetes."
The book, scheduled for publication next month and co-written by endocrinologist Steven Edelman, includes profiles and the stories of more than 50 individuals who have lived for decades with diabetes, some more than 80 years.
Colberg, who has type 1 diabetes, said that individuals who have the disease should "live life first and be diabetic second." According to Colberg, the individuals profiled in the book have moved to the "point of embracing diabetes."
Colberg said, "If you don't heed that wake-up call, diabetes can be very devastating. It has the ability to shorten life by about 12 years, and you can have (complications) that reduce the quality of life for the last 20" (Manning, USA Today, 11/15).
In conjunction with the USA Today series, ABC's "World News" on Monday reported on an ongoing study examining the use of oral insulin in young children who are predisposed to developing type 1 diabetes.
The segment includes comments from William Russell, director of pediatric endocrinology at Vanderbilt University, and family members of a child enrolled in the study (Hayes, "World News," ABC, 11/12). Video of the segment and expanded ABC News coverage are available online.