Diabetes Still Isn't Easy
Diabetes Still Isn't Easy

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Notes from the American Diabetes Association's Scientific Sessions

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The American Diabetes Association's Scientific Session is an enormous meeting, with close to 20,000 attendees from all over the world. The best and the brightest are there to present papers, debate issues, and express well thought out opinions. Everything is covered, but I have selected a few topics to look at which will bear on diabetes treatment in the future.

First is the use of a group of drugs called SGLT_2 Inhibitors. It is normal to excrete sugar in the urine, but the kidney reabsorbs all of it up to a point. This group of drugs blocks that reabsorption so that a controlled amount of glucose leaves the body in the urine. This helps lower blood glucose, and the loss of calories aids in weight loss. The major side effects of this type of drug are local skin infections around the urinary area and/or urinary tract infections. However, this risk can be minimized by a little extra hygiene.

Second was the extended use of drugs call GLP_1 Agonists. This type of drug is delivered by injection, either daily or once a week, and is very effective for weight loss and glucose control. It is often used early in treatment of Type 2 diabetes. An interesting debate was about whether these drugs or insulin were more effective in treating diabetes when first line of pills fail. No resolution came out of that debate, but I would favor insulin.

Third, and of interest to me, was the issue of health care delivery to people with diabetes. When you come down to real numbers (including children and people with prediabetes), nearly half the country—around 140 million people—are affected by this disease. Delivering quality care from the beginning, such as diabetes education and a multitude of preventive measures, is a daunting task. Unfortunately, the workforce to do this is severely deficient, and presents a major public health challenge. If we don’t solve this problem, the number of people with complications in their heart, eyes, kidneys, etc., will be overwhelming.

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About the Author


MD, FACP

Dr. Bernstein is director of the diabetes management program at the Friedman Diabetes Institute.

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