In August 1922, 13-year-old Elizabeth Evans Hughes, extremely weak at only 45 pounds, was one of the first patients treated with insulin. It saved her life. She went on to graduate from college, get married and have three children. She died when she was 73.
Before insulin, diabetes led to death. The best treatment was a starvation diet, which allowed patients to live a few extra years—if they didn’t die of starvation first. When insulin was discovered in 1921, it forever changed what it meant to have type 1 diabetes. Today, people with the disease have an almost normal life expectancy and insulin is regarded as one of the greatest medical discoveries in history.
But the pharmaceutical industry didn’t stop there. It has continued to advance diabetes treatment. Today, medications for type 2 diabetes that support cardiovascular health and weight loss, in addition to blood sugar control, are once again promising to change what it means to be diagnosed with diabetes.
Good glycemic control is the hallmark of diabetes therapies, however according to Dr. Ronnie Aronson, we are now looking to effects beyond glucose-lowering when selecting medication.
“There have been substantial changes in the last decade,” says Aronson, a general endocrinologist and founder and chief medical officer of LMC Healthcare, which has 11 diabetes and endocrinology clinics across Canada. “A movement arose for treatments that go beyond lowering blood sugar levels to ones that benefit overall health and help patients avoid early death.”
Dr. Aronson says innovative new medicines currently being researched have been shown to both help with weight loss (often recommended for patients with type 2) and lower blood pressure, while another new class of drugs lowers blood sugar, leads to weight loss, and may even reduce the rate of heart attacks, stroke and hospitalization for heart failure.
These studies are especially noteworthy as people with diabetes are three times more likely to be hospitalized with cardiovascular disease, according to Diabetes Canada.
“The old question for a physician was, ‘How do I lower my patient’s sugar?’ Now, the question is, ‘What drugs should my patient be on to lower their sugar and optimize their survival?’” Dr. Aronson says.
“Patients used to be on 11 pills. We can now reduce that to five or six and have better control and weight loss. This is because of the pharmaceutical industry—and it makes getting healthy easier.”
Research is also changing how people with diabetes monitor their blood sugar. Traditionally, they’d prick their fingers several times a day, but today, a tiny sensor underneath the skin can transmit a reading every five minutes to a smartphone, showing how the body responds to insulin, food or exercise. This constant awareness can help patients avoid high or low blood sugar or allow for intervention before a situation becomes severe.
However, lack of public funding and differences in private coverage means access to this technology is out of reach for many. This is the case for many diabetes medications, supplies and devices, where government coverage varies across jurisdictions
“Access is often limited to paying out of pocket or to people with employee benefits that cover it,” says Dr. Aronson. “These drugs may be more expensive, but they save lives, improve productivity and reduce health care costs. Governments should factor these benefits into their relative cost planning.”
Diabetes Canada estimates that diabetes costs the health care system $3.4 billion a year, a number that’s expected to rise to $5 billion by 2026.
“The older, more affordable drugs carry the risks of weight gain and unwanted low blood sugar (hypoglycemia), which both translate to high costs in hospital emergency rooms,” says Dr. Aronson. “Those high costs could be reduced significantly with a movement to new types of therapy.”
This story was created by Content Works, Postmedia’s commercial content division and Patient Diaries, on behalf of Innovative Medicines Canada (IMC) and an IMC member company