Posted by on October 12, 2019 9:32 am
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A major breakthrough in the clinical approach to type 2 diabetes holds out hope that newly diagnosed individuals can avoid many of the disease’s worst effects for far longer, according to Sir Michael Hirst and Dr. Päivi Maria Paldánius writing in CapX. Based on a landmark five-year study of 2,001 patients around the world published in the Lancet, they argue that an aggressive treatment regimen with a combination of medicines could yield big gains for patients and relieve some of the burden on overtaxed health systems.



  • The standard treatment regimen for type 2 diabetes calls for newly diagnosed individuals to receive one medicine, metformin, followed by another oral medicine if the first fails as measured by blood glucose levels.



  • However, as the authors point out this standard of care was formulated based on studies that were mostly limited to male patients in Europe and North America. Thus they didn’t take into account the disease’s characteristics and progression in low- and middle-income countries (LMICs), where weak healthcare systems and various other factors often lead to devastating outcomes like irreversible organ damage and death. The new study is the first to include large numbers of patients from LMICs.



  • The study found that taking both medicines simultaneously (rather than sequentially) delayed the progression of the disease, reducing the likelihood of treatment failure in a given period by 49%. That reflects a much longer period without irreversible organ damage, meaning additional years of good health and productivity. 



  • In a nutshell: “Early diagnosis and treatment with two medicines in combination would cut medical costs by postponing complications and reducing hospital visits with a median cost of $290 per inpatient, while raising the quality of life and lengthening the productive lifespans of diabetes patients, boosting economic growth. This is especially important in high-incidence low- and middle-income countries such as Mexico (with an estimated prevalence of 12.6%) and Egypt (prevalence 16.8%), where type 2 diabetes is a tremendous and growing drag on economic growth and prosperity.”



  • The new findings strongly suggest that the medical community should consider updating the standard of care for type 2 diabetes. The authors suggest that drug companies should also work on developing a cost-effective treatment that combines the two medicines into a single dose regimen.



  • Sir Michael is co-chair of Parliamentary Diabetes Global Network and was President of the International Diabetes Federation (2013-2015). Dr. Paldánius is Worldwide Medical Director, Diabetes at Novartis, and the medical lead of the study.



  • The Lancet study can be read here.