A new research published in the journal JAMA Internal Medicine recommends that for older sufferers with type 2 diabetes, medications to decrease blood sugar levels may “do more damage than good.” Around 25.9 million individuals in the US suffering from diabetes, with type 2 diabetes count for more than 90% of all cases.
Type 2 diabetes is characterized by insulin resistance – the failure of the body to generate sufficient insulin or use the hormone efficiently, which leads to high blood sugar levels. Eventually, higher blood sugar levels can cause kidney, eye or heart problems, nerve destruction or heart stroke.
Diagnosis of type 2 diabetes is generally identified via a blood test that measures hemoglobin A1c levels in the blood. This examines shows the average level of glucose the individual has had in their blood over the past 3 months.
In the US, type 2 diabetes is clinically diagnosed when hemoglobin A1c levels arrive at 6.5% or higher. The greater A1c levels are, the higher the risk of other health issues.
Sometimes the situation can be handled via changes in diet, but other sufferers with type 2 diabetes may require medication – like as insulin or metformin – to assist lower their blood sugar levels, and eventually, reduce the risk of diabetes problems.
But the scientists of this recent study, state that the advantages of such therapy – specifically for patients above the age of 50 – may not generally outweigh the negatives.
“In many situations, insulin therapy may not do anything to add to the individual’s quality life expectations,” states this new study co-author John, “If people suffering from diabetes feel that insulin treatment decreases their quality of life by anything more than around 3-4%, this will outweigh any possible benefits obtained by treatment in nearly anyone with type 2 diabetes over around 50 years old.”
Advantages ‘Dependent on Age at Treatment Started and Side Effects’
For their research, lead by Sandeep Vijan, the team examined 5,102 sufferers in the UK with type 2 diabetes who handled their diabetes through the use of insulin pills or injection therapy.
More than a 20-year follow-up, the scientists viewed at how the therapies impacted patients’ entire quality of life and whether they were effective in decreasing their danger of diabetes complications.
They then compared the decreased risk of such issues with the burden of using diabetes drugs and the side effects related with them.
With respect to the scientists, they identified that the advantages of insulin therapy for sufferers with type 2 diabetes are quite much dependent on their age at therapy started and the possible side effects, instead of their blood sugar levels.
For instance, they calculate that a individual with type 2 diabetes who starts insulin treatment at age 45 and lowers their hemoglobin A1c levels by 1% may experience an additional 10 months of healthy life.
But for a sufferer who begins therapy for type 2 diabetes at age 75, they approximate the treatment may only obtain them an extra 3 weeks of healthy life. The scientists say this prompts the query – is 10-15 years of tablets or injection therapy with possible side effects worth it?
Prof. John comments:
“Finally, the goal of a therapy is not to reduce blood sugar for its own sake but to avoid debilitating or dangerous problems. If the possibility of these complications is appropriately low and the burden of treatment correspondingly high, therapy will do more damage than good. The stability among the two can never be recognized by a simple figure such as blood sugar level.”
The group claims that their outcomes apply to type 2 diabetes patients with hemoglobin A1c levels beneath 8.5%. But they observe that individuals with levels above 8.5% may be probably to see greater advantages from insulin treatment, as they are at higher risk of diabetes problems.
However, the group indicates that using a sufferer’s hemoglobin A1c levels alone to assess if they will advantage from insulin therapy is a “fundamentally flawed strategy.”
“Instead,” they add, “each glycemic therapy decision should be individualized, generally on the foundation of the patients’ views of the burdens of treatment, with age and preliminary level of glycemic control important secondary considerations.”
“Presently, we are failing our patients by not knowing that their choices and views of treatment problem are the most essential aspects in assisting them make glycemic treatment choices that are best for them.”