Posted by Sandy Donchess on June 03, 1999 at 10:57:05:
Variety of therapies needed for diabetes
NEW YORK, Jun 02 (Reuters Health) -- Most people with adult onset, or type 2 diabetes, need a variety of treatments to keep their blood sugar under control in the long run, according to researchers.
In a study of more than 4,000 patients treated with diet alone or drugs such as insulin, sulfonylurea, or metformin, only about 50% of patients could keep their diabetes in check with a single agent after 3 years.
After 9 years, blood sugar was still effectively controlled with diet alone in only 8% of people, with insulin alone in 42% of people, and sulfonylurea alone in 24% of people.
``The majority of patients need multiple therapies to attain... target (blood sugar) levels in the longer term,'' researchers report in the June 2nd issue of The Journal of the American Medical Association.
Several factors increased the probability of requiring multiple therapies for diabetes treatment, according to study authors Dr. Robert C. Turner and colleagues from the Radcliffe Infirmary in Oxford, England, and researchers from the UK Prospective Diabetes Study Group.
The team reports that the severity of diabetes at the time of diagnosis is a major factor in determining the likelihood of the patient achieving target blood sugar levels. Diabetics who were obese, diagnosed with diabetes at a relatively young age, or who had higher blood sugar levels or triglycerides at time of diagnosis were more likely to need several treatments to keep their diabetes under control.
Those who were initially treated with intensive insulin therapy were less likely to require additional treatments. The research team attributes the increasing failure of a single therapy to achieve tight control of blood sugar to a decline in the function of beta cells, cells in the pancreas that produce insulin.
SOURCE: The Journal of the American Medical Association 1999;281:2005-2012.