New recommendations for the treatment of Diabetes

Posted by bilal on August 17th, 2019

The strategy aims to control without excess blood sugar level. This spells out the new recommendations on the "drug strategy of glycemic control of type 2 Diabetes ", a disease characterized by an increase in blood sugar, which disrupts the therapeutic strategy.

The type 2 diabetes, noninsulin-dependent (unlike Type 1 diabetes ) and characterized by a value of sugar in the blood above 1.26 g / l after fasting for 8 hours, most often occurs after 50 years.

It is a question of treating the patients well but without excess. Studies have shown that treatments that are too strict can be counterproductive and ultimately harm the patient. This does not detract from the necessary rigor of care.

Diabetes is a common disease that affects nearly 2.7 million people, or nearly 4.6% of the population. This is responsible for a 1.5-fold increase in mortality if poorly monitored and treated poorly.

Indeed, for many patients, it is possible to reduce the average glucose level to more reasonable levels, which reduces the harmful effects of sugar on the walls of the vessels. By changes in diet, a little physical activity and, (if that is not successful), by oral treatment with an anti-diabetic drug. In other cases, especially if blood glucose levels remain high despite at least two oral anti-diabetic medications, insulin may help to better balance diabetes.

Less severe goals

The goal is crucial because, after years of poorly controlled chronic hyperglycemia eye damage (retinopathy), kidney (nephropathies), nerves (neuropathies) and also cardiovascular complications (arthritis, myocardial infarction, accident cerebrovascular, etc.) can all be prevalent.

A real earthquake shook the world of diabetologists a while ago. This was a study named Accord (Action to Control Cardiovascular Risk in Diabetes). The trial was undertaken to demonstrate that it was possible to further reduce the complications of diabetes by targeting the lowest possible average blood glucose levels. These were measured by a marker, HbA1c, used to judge the effectiveness of management.

Against all the odds, the study showed twice as many deaths when resulted when lowering this marker (the HbA1c) of a Diabetic below 6% by an intensive treatment instead of being satisfied a rate between 6 and 7%!

Three times as many severe hypoglycaemias were observed requiring medical assistance. Taking into account this major change, healthcare programs for combating Diabetes, therefore, choose to set the target of HbA1c at "less than 7%" for most patients. In the elderly, if they are in poor health and dependent, the HAS is even more cautious:

Diet and physical activity: essential

The goal remains strict (less than 6.5% HbA1c) for a newly diagnosed person with no history of cardiovascular disease and whose life expectancy is still long. Of course, rigorous checks are still needed for regular Diabetes surveillance, including HbA1c measurement, renal function control, lipid status, and regular fundus. It is also essential for the fight against other potential risk factors (tobacco, hypertension, excess cholesterol, obesity) because diabetes increases cardiovascular risks.

To achieve these new goals, there are many drugs in the therapeutic arsenal. The goal is to offer medicines to improve the health of patients. Doctors now have this joint HAS-ANSM recommendation, a hierarchy of drug use that positions in particular new antidiabetics in the second or third line.

In addition to these new management strategies, diet and physical activity remain essential. "Diabetologists do not you ask to play sports. A simple physical activity is enough. For example, make a 30- to 45-minute walking itinerary every day near your home.