Diabetes Viewpoints

Changes in Diabetes Care

By Melissa Conrad Stöppler, M.D.

It’s not only the patients who are having trouble keeping up with the new research, news, and advances in diabetes care.

Recently, I was at a meeting with a group of other physicians, and the talk turned to a discussion of the available medications for the treatment of diabetes. Even MDs with specialty training in internal medicine reported that it’s hard to keep up with the latest recommendations for diabetes care. Some doctors admit that they first learned of recent changes in the recommendations for diabetes care via the news media. And if the rate of evolution of the diabetes field and the advent of new recommendations for care is surprising to doctors, it’s bound to be overwhelming for those living with the condition.

Two recent significant developments in diabetes care that were widely reported by the news media in 2007 serve as examples of the ever-changing arena of diabetes management:

• The announcement in October 2007 that Pfizer planned to take its inhaled insulin (Exubera) off the market for commercial reasons; namely, its “failure to make a market impact” since its launch in 2006. The advent of the inhaled insulin was touted by many as a major breakthrough in diabetes care just a year earlier. Even though the product didn’t receive the broad reception hoped for, many people did begin using the new drug. Their doctors have now been advised to start switching their patients off of Exubera to other medicines to control high blood sugar.

• The May 2007 release of a report in The New England Journal of Medicine suggesting that Avandia (generic name rosiglitazone), a drug widely prescribed to treat type 2 diabetes, increases the already-elevated risk of heart attack in a person with diabetes by 43%. People taking Avandia have been advised to discuss their treatment plans with their doctor to determine whether a change in medications is warranted.

Looking at the positive side, all the new developments and changes in diabetes management couldn’t be occurring at such a rapid rate without intensive and ongoing research directed at improving the lives of people with diabetes. Without awareness, advocacy, and research funding, the field could never progress this rapidly.

But the changes are sometimes still hard to decipher. While it may be difficult to stay on top of all the developments in the field of diabetes research, all my medical colleagues agree that an informed patient who is an active part of his or her health care team has the best chances of a successful outcome and improved quality of life. I’d encourage everyone with diabetes to read and educate yourself as much as possible about diabetes. Become your own advocate. If you see an interesting report in the media about diabetes management or diabetes research, take notes, and ask your doctor to help you make sense of the findings and how they may affect your care.

Read more of Melissa's columns here.