Thursday, October 16, 2008

Change in mindset key to diabetes treatment

Change in mindset key to diabetes treatment
By Nina Muslim, Staff Reporter GULF NEWS
Published: October 15, 2008

Dubai: Doctors and diabetics in the UAE need to introduce insulin early on in the treatment and also need to change their mindset to ensure an effective solution to the problem, a specialist said.

Conventional treatment of diabetes involves changing lifestyle first, such as more exercising and adopting a healthy diet, before taking oral medicine, such as metformin. Insulin is prescribed when other options have not been able to lower blood sugar levels enough.

Professor Julio Rosenstock, director of the Dallas Diabetes and Endocrine Centre, told the press that insulin should be considered early on.

"Doctors use insulin as a threat - 'If you don't exercise, I'll put you on insulin' - as the last resort. But they get put on insulin after 10 years, after all the complications and that is the wrong approach," he said. "They should be considering insulin as the first line of treatment," he added.

Previous studies on diabetes treatment, which have included insulin along with other forms of medicine, have found that early aggressive treatment after diagnosis were better at lowering blood sugar levels, to the American Diabetes Association-recommended ideal of seven per cent A1C. A1C is the average blood sugar level for the past three months.

A study of 12,000 subjects is currently on to determine whether introducing insulin soon after diagnosis and changing dosage according to daily blood glucose levels would control their diabetes better, compared to the standard protocol.

The findings are expected to be released next year.

After the press conference, Rosenstock told Gulf News that patient education was also an important part of the mindset change so they could monitor their condition and administer insulin themselves.

The UAE has the highest rate of diabetes in the world after the South-Pacific Island of Nauru. Diabetes, mostly Type 2 diabetes, affects approximately one in five people, according to the International Diabetes Federation.

The Emirates Diabetes Foundation estimates the diabetes prevalence among Emiratis can be as high as one in five, according to 1998 statistics.

World Health Organisation warns diabetes could affect 70 per cent of UAE residents.

The event also saw the launch of Solo Star, a disposable insulin pen by Sanofi-Aventis, that promises to administer insulin with minimal discomfort.

Abu Dhabi is preparing to mark this year's World Diabetes Day on November 14 with the staging of the second Diabetes walkathon.

More than 10,000 people are expected to join the annual event, dubbed WALK UAE 2008 and held in partnership with the Emirates Foundation, according to organisers at the Imperial College London Diabetes Centre (ICLDC). ICLDC's Medical & Research Director and Consultant Endocrinologist, Dr Maha Taysir Barakat said walking has proved effective in the management and the prevention of diabetes.

"Thirty minutes of moderate physical activity daily helps the body improve the use of its own insulin and wards off Diabetes," she said.

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