How could the effective use of treatments help to combat this growing epidemic?

Professor John Wilding of the University of Liverpool explains how more effective use of treatments and increased support for health professionals can make a difference in the fight against type 2 diabetes

In the United Kingdom, more than 3.5 million people are living with type 2 diabetes. Of these, almost 7,000 are children and young people under 25, a figure almost ten times higher than expected . In addition, there are currently 6 million people at risk for type 2 diabetes in the UK. The National Diabetes Prevention Program, a recent initiative, provides support to 100,000 people with diabetes or at risk of contracting the disease to help reduce their blood sugar through intensive lifestyle changes. However, with another 5,900,000 people at risk, the health service is facing enormous challenges in effectively addressing this growing epidemic.

This increasing prevalence and this early age of onset means that healthcare professionals also have to deal with an increasing number of people with a new diagnosis of diabetes. This can create problems because it can be difficult to determine whether a young man has type 1 diabetes (which requires insulin treatment) or type 2 diabetes. With a limited number of specialists and Due to time constraints, there is a need for further education in primary care, where most people with diabetes are seen.

Type 2 diabetes is progressive and often leads to complications such as heart disease, kidney damage and blindness. It is therefore vital to prescribe the right medication, along with a lifestyle (diet that promotes weight loss and increased physical activity). Most patients will need more drugs as they are and will need to use new drugs effectively. This is something we need to improve in the UK. Evidence has shown that when glucose levels exceed individual target levels, as recommended by current guidelines, the necessary transformation into a second or third drug may take up to two and a half years. The escalation of patients beyond, such as insulin treatment, can take between five and six years. These delays result in a much higher risk of serious complications.

Lack of access to diabetes specialists is one factor that could explain this gradual increase. People have different levels of access to expert care depending on where they live in the country. But the reality is that the current number of diabetes specialists has only the ability to see 5 to 10% of people with type 2 diabetes. Some local programs help to improve diabetes education in people with diabetes. health professionals and people with diabetes. The Liverpool Diabetes Partnership (LDP), for example, provides access to teams of specialists in primary care settings. These teams are able to support the provision of quality education, care and support to people with newly diagnosed or established diabetes. At the same time, they also help improve diabetes management in primary care, leading to fewer complications and costly hospitalizations. Such initiatives, combined with effective treatment, are essential to cope with the burden of type 2 diabetes.

Effective treatments for type 2 diabetes

In recent years, highly effective treatments have become available that not only lower blood glucose levels, but can also reduce the risk of complications of type 2 diabetes. One of these classes of drugs, co-inhibitors, 2 transporter of sodium and glucose (SGLT2is), prevents the kidneys from reabsorbing glucose into the blood. This has been shown to lead to weight loss and further research has shown additional benefits, such as a reduced risk of heart failure and kidney failure. Another class of antidiabetic drugs, called glucagon-like peptide 1 receptor agonists (GLP1RA), has also demonstrated cardiovascular benefits in patients with type 2 diabetes.

These effective treatments may be more expensive than other drugs for type 2 diabetes. However, when used according to the recommendations – especially in patients at high risk of complications – patients who use these drugs are less likely to develop complications, which can result in cost savings over time. While many clinicians are waiting for NICE's recommendations to familiarize them with the many recent evidences demonstrating the benefits of these drugs, diabetes specialists can provide tips to make sure they're used there. where they are most likely to be effective, ultimately leading to improved patient quality of life and long-term cost-effectiveness of the health system.

Type 2 diabetes is a highly manageable and preventable disease. To reduce the burden of type 2 diabetes in the UK, education and support for health professionals and people with diabetes will be essential. This, coupled with effective prevention and treatment strategies, will prevent the number of people living with complications associated with type 2 diabetes from continuing to increase at an alarming rate.

Cello Health Communications, through Napp Pharmaceuticals Limited, helped Professor John Wilding of the University of Liverpool develop this article as Chair of the Diabetes Enhancement Steering Committee. Professor John Wilding wrote this article only with the support of Cello Health for writing medical texts. Napp was not involved in the content of the publication other than to verify its factual accuracy.

Professor John Wilding (DM, FRCP)

Professor of Medicine

Honorary Consultant in Diabetes and Endocrinology

University of Liverpool

University Hospital Aintree, Liverpool, United Kingdom

www.liverpool.ac.uk