More Treatment Options for Diabetes Means Few Excuses for High Blood Sugar

A generation ago, there was just one kind of pill that could help people with diabetes keep their blood sugar levels down. But today, so many new options are available that it’s almost dizzying. Advertisements for the new medicines seem to be everywhere, and more new medicines are on the way.

These are exciting times for people with diabetes, says a University of Michigan expert who has devoted his career to studying the best ways to prevent and treat the disease. He points to the broad array of new, and tried-and-true, diabetes treatments that can be swallowed, inhaled and injected - plus the powerful tools of healthy eating and regular exercise that are crucial to every diabetes patient’s treatment.

Virtually anyone with diabetes can now find an option that will work for them, and keep their blood sugar low enough to prevent or delay long-term problems like heart attacks, blindness, amputation and kidney failure, says William H. Herman, M.D., MPH, the director of U-M’s Michigan Diabetes Research and Training Center.

The big challenge now is making sure that doctors and patients work together to take advantage of all the options that are available, and making sure that insurance plans keep up, he says. Even with treatment, two-thirds of people with diabetes still have blood-sugar levels that are too high, which puts their future health at risk.

“Nearly 20 million Americans have diabetes, and it’s an enormous and growing problem,” says Herman. “It’s been a long process, but I think we’re really beginning to understand much better what causes diabetes, and many of the new treatments are based on that improved understanding.” Some people with diabetes will need one or two of these options to lower their blood sugar, while others will need several.

Today more than half of adults with diabetes take pills or other oral medicines to treat their disease, according to national statistics. Another 12 percent take pills and also inject insulin. Sixteen percent take insulin alone. And 15 percent don’t use any medications at all – either because diet and exercise work well for them, or perhaps because they don’t have access to good diabetes care and medication.

As the newer treatments become more available, they should help people reduce their average blood-sugar levels, known as A1C levels. Most people should aim for an A1C level of 7, but even if levels are higher, they should try to reduce it as much as they can. Even bringing it down by one point can mean a 40 percent reduction in long-term risk of other diseases.

“It’s now well-proven from scientific studies that diabetes control matters, and that better glucose control over years and decades is associated with a reduced risk of complications affecting the eyes, the kidneys, the nerves and the heart and blood vessels,” says Herman, a member of the Michigan Comprehensive Diabetes Center. “People with diabetes should speak to their physicians about whether they would be candidates for these new treatments, and how they might fit into their diabetes-management programs.”