Diet and exercise is better than drugs for preventing and reversing Type 2 diabetes, says an organization of B.C. physicians.
The Therapeutics Initiative, an organization that was established more than two decades ago by the Department of Pharmacology and Therapeutics in cooperation with the Department of Family Practice at The University of British Columbia, issued a report Wednesday that says controlling blood glucose with multiple “may be misguided” and that diet and exercise produce a better outcome for diabetics.
One of the group’s members says that for a condition as common as it is, a lot of things are still uncertain about Type 2 diabetes.
“It’s kind of frightening because we don’t really have the right evidence for treating the Type 2 epidemic. What we’ve been doing is not very scientific,” said Dr. Tom Perry, a Vancouver pharmacologist with the Therapeutics Initiative. “There are lots of patients we may be under-treating too. The problem is we don’t know how low the glucose levels should go in order to reduce the risk of bad things happening to patients,” he continued.
Diabetes is a condition that causes the body to produce too much glucose and not enough (or any) insulin to help break down the sugar in our body. Risks can include kidney failure, heart disease, blindness, and in extreme cases, amputation of certain body parts (usually the feet). In 2013, according to the BC Ministry of Health British Columbians alone spent over $52 million on blood glucose strips alone. Also according to Diabetes Canada (formerly known as the Canadian Diabetes Association) the prevalence of diabetes in Canada is expected to rise by 44 per cent over the next ten years.
Type 2 diabetes is typically brought on by poor lifestyle choices. It is possible to detect the condition before you become a diabetic so you can make changes to your lifestyle and not have to deal with the possibly deadly disease, but many patients wait until it is too late. It is not to be confused with Type 1 diabetes, also previously known as juvenile diabetes, which the patient is born with or develops earlier on in their life and cannot be cured.
The proper blood glucose level for those living with type 2 diabetes is unknown, and drugs such as insulin which aid in lowering blood glucose levels are actually being overused by doctors, says the report.
Not everyone agrees with the conclusion of Therapeutics Initiative. Lawrence Leiter, a professor of medicine and nutritional sciences at the University of Toronto says the Therapeutics Initiative is cherry-picking data.
“In the past two years, we have evidence from large, well-conducted, randomized controlled trials that three different medications for the management of diabetes — empagliflozin (Jardiance), liraglutide (Victoza) and semaglutide (not yet approved) — significantly reduced the risk of cardiovascular events in patients with a history of diabetes and cardiovascular disease, and that empagliflozin also reduced the risk of kidney problems,” he told the Vancouver Sun. “Canadian Diabetes Association clinical practice guidelines have for many years emphasized that we must not just lower blood glucose levels but also improve all risk factors, including blood pressure and cholesterol (and) the most recent update to our guidelines, published in November 2016, now recommend the use of empagliflozin and liraglutide to reduce the risk of complications in appropriate patients.”
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