Are type 2 diabetics being overtreated?

For some type 2 diabetics, taking frequent insulin shots or medication may be more trouble than it's worth, according to findings published in the Journal of the American Medical Association Internal Medicine.

In contrast to what current guidelines suggest about diabetes treatment – that it should be intensified until blood sugar goals are reached – the new study proposes that medication protocol should focus more on the safety and potential side effects that may occur when treating type 2 diabetics.

"For people with type 2 diabetes, the goal of managing blood sugar levels is to prevent associated diabetes complications, such as kidney, eye and heart disease, but it is essential to balance complication risks and treatment burdens when deciding how aggressively to treat blood sugars," said lead author Sandeep Vijan M.D., M.S., professor of Internal Medicine at the U-M Medical School and research scientist at the Center for Clinical Management Research at the VA Ann Arbor Healthcare System.

Quality of life in question

Vijan explained that treatment costs, risks and burdens can increase significantly once glucose control is achieved. So prescribing medication, he argues, is not just about reducing health complications but also about improving the patient's quality of life.

"If you're a patient with fairly low complication risks, but are experiencing symptoms from low blood sugar, gaining weight or find frequent insulin shots to be disruptive to your daily life, then the drugs are doing more harm than good."

The study found that treatment benefits tend to decline with age – and by age 75, risks tend to outweigh the benefits.

The findings don't apply to about 15 to 20 percent of type 2 diabetics that have extremely high blood sugar levels, however.

Senior author Dr. Rodney Hayward concluded that it's all about individualized treatment.

"Drugs that lower blood sugar levels are extremely beneficial in some patients but offer almost no benefit for others," Hayward said. "These results have major implications for the millions of people who are currently being told that they need to increase medication in order to achieve their 'glucose goal.'"

Source: Science Daily

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