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Why Is Management of Diabetes Important? A person is said to have diabetes when his or her body produces too little or ineffectively uses insulin, resulting in high levels of glucose in the blood. Management of diabetes is crucial as diabetics are at a higher risk of getting kidney failure, heart disease, stroke, blindness, lower-limb amputations and even ending with deaths. It is almost certain that doctors will prescribe medications to their diabetes patients in order to bring their blood sugar down to the acceptable levels. High blood sugar can damage nerves and blood vessels in the lower extremities. If the damage is severe, the patients might require toe, foot or even leg amputation. Around the world, an amputation due to diabetes occurs every 30 seconds. This indeed imposes a huge burden not only on the victims and their families, but also on the healthcare systems. A recent study, conducted by researchers from the National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Australia, found that the anti-cholesterol drug fenofibrate seems to reduce risks of amputation for diabetics by as much as 36 percent. Fenofibrate, produced by Belgian drugs maker Solvay, is a drug used to treat high cholesterol and high triglyceride levels. In the 5-year trial involving 9,795 diabetic patients, 4,895 of them were given fenofibrate while the rest were given a placebo. At the end of the trial, it was found that 115 patients had had lower-limb amputations. The risk of first time amputation was 36 percent lower for patients who were given fenofibrate compared with those who were given placebo. The researches hope that these findings could lead to a change in the standard treatment for prevention of diabetes-related lower-limb amputations.
Findings of the study were published in a special edition on diabetes by The Lancet, which also included another study on how rigorous monitoring and control of blood sugar reduces heart attack. Researchers from Britain's University of Cambridge analyzed 5 previous studies and showed that intensive glucose control in diabetes could actually lead to fewer heart attacks. However, it does not have any significant effect on stroke or death from all other causes. So far, none of the individual studies of glucose control showed consistent benefits and in fact, some of them even suggested negative effect of glucose control. The 5 studies, involving 33,000 patients, provided information on 1,497 heart attacks, 2,318 coronary heart disease, 1,127 strokes, and 2,892 deaths. Patients who were given more drugs to control their blood sugar had a 15 percent reduction in heart attacks. Nevertheless, such intense treatment did not have effect on stroke rates or other causes of death. Besides Type-1and Type-2 diabetes, gestational diabetes (GD) is also considered as one of the most common form of diabetes. GD, affecting nearly 135,000 women in the United States each year, develops only in pregnant women with no prior history of diabetes. Normally, GD will just disappear after women have delivered their babies. A study, conducted by researchers from the University College London and London School of Hygiene and Tropical Medicine, found that women with GD have a higher risk of developing permanent diabetes after giving birth. The researchers analyzed 20 studies involving a total of 675,000 women, of whom 10,859 developed diabetes. They found that women with GD were 7.5 times more likely to develop diabetes after pregnancy, as compared to those with normal sugar control during pregnancy. It is recommended that all pregnant women should be tested for GD between their 24th and 28th weeks of pregnancy.
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