The Federal Drug Administration recently announced that it will significantly restrict the use of the diabetes drug Avandia (rosigliatzone) to patients with Type 2 diabetes who cannot control their diabetes on other medications.  This follows years of debate on whether or not the drug was associated with an increased risk of heart attacks.  This much publicized decision gives us an opportunity to discuss this important disease, which is characterized by an elevated blood sugar, and the resultant damage this causes to your blood vessels, heart, eyes, kidneys, nerves, and other organs.

Type 2 diabetes mellitus (DM2) has reached epidemic proportions in our community.  Related to both genetic and environmental factors, the incidence is skyrocketing in relation to obesity, poor diet and lack of regular exercise.  Once minimized as "a touch of diabetes" or "mild diabetes", DM2 is now recognized as a serious, but manageable disease, with life threatening consequences if not approaced aggressively. Unlike its cousin, Type 1 diabetes mellitus, DM2 is often managed with lifestyle modifications before the institution of medication.

Although some patients may present with the classic "diabetes triad" of increased thirst, increase urination and weight loss, most patients remain asymptomatic for months, or even years, before they are diagnosed.  Therefore many professional organizations have developed recommendations on who should be screened through the use of a blood test.  The American Diabetes Association calls for the screening of all overweight or obese patients at the age of 45, or if they have additional risk factors such as high blood pressure, high cholesterol or a family history of diabetes. You should discuss with your primary care physician if you should be screened.

Diet is the cornerstone of management for all patients with diabetes, regardless of whether they take medications or not.  Eating a consistent amount of food, maximizing the intake of fresh vegetables and fish, and keeping weight under control will help lower blood sugar.  Regular exercise is essential.  For those patients unable to lose weight through diet and exercise, surgical treatment of obesity has become a new and effective option if certain criteria are met.

There are multiple medication options to manage the elevated blood sugar seen in DM2.  Metformin, sulfonylureas, and thiazolidinediones are oral medications; insulin and other newer agents are injectable.  Each individual must work with their physician to determine the right approach for them—the bottom line is the need to get blood sugar levels as close to normal as possible. If you are diagnosed with DM2, it can be managed and you can live an active, and a healthy, life.

If you would like to schedule an appointment or would like information on one of our NuHealth centers of care, please call 516-486-NUMC.