Therapeutical and technological advances have transformed the management of diabetes over the past few decades. Newer medications not only address glycaemic control but also complications caused by diabetes while technological innovations have introduced new methods of monitoring blood sugar levels and drug delivery.
Even though a wide array of anti-diabetic drugs have been available for years, the latest medications go beyond controlling blood glucose levels, explains Dr Kingini Bhadran, Specialist Endocrinology at Aster Clinic, Qusais. “They provide added benefits such as cardiovascular protection, renal protection, retinal protection, and weight loss.”
The availability of newer drugs with supplementary benefits such as weight loss and improvement of fatty liver have helped doctors in the UAE provide tailor-made treatments to patients, says Dr Mahir Khalil Ibrahim Jallo, Clinical Professor and Senior Consultant of Internal Medicine – Diabetes and Endocrinology at Thumbay University Hospital. “Over the past decade, treatment of diabetes has evolved to become more patient-centric. Drugs prescribed to patients are selected not only to mend glucose control but also to avert cardiovascular and renal complications.”
A significant development over the past few years for Dr Sara E. Ghandour, Consultant Endocrinologist at Mediclinic Parkview Hospital, has been the emergence of drugs that improve one of the major comorbidities of diabetes, obesity. “New medications assist and promote weight loss, which is a very significant contributor in diabetes management. In fact, 5-10 per cent weight reduction alone can improve a lot of metabolic parameters such as diabetes.”
She refers to a new class of drugs, GLP 1 agonist and the more recent GLP1-GIP agonist, widely used in the UAE, which has been developed to offer many options such as a daily injectable, weekly injectable and even oral tablets.
“Although varying among the medications, all these agents promote weight loss, which can reach up to 20 per cent weight reduction with the newest additions.
“They are prescribed to patients whenever diabetes control cannot be reached with oral medications alone or as a first-line treatment on top of metformin in patients who are obese or has cardiovascular disease.”
It’s not just the drugs that have seen massive improvement in terms of efficacy. Fine-tuning of technological innovations have also led to increased adoption in recent years.
Dr Darvin V. Das, Specialist Endocrinology and Diabetology at Aster Hospital, Mankhool, cites continuous glucose monitoring devices and continuous subcutaneous insulin infusion, or insulin pump therapy, as examples of latest technologies.
“Continuous glucose monitoring services with mobile technology have been widely used among type 1 diabetes and uncontrolled type 2 diabetes patients,” he says. “These services improve the time to reach the target glucose range.
“Continuous subcutaneous insulin infusions, also called insulin pumps, with sensor integration are used among type 1 and type 2 with frequent multiple daily injections growing in popularity.”
The reason for their widespread acceptance is the control these systems give both patients and healthcare providers as well as the insights they get from the data.
“These devices have been demonstrated to be clinically valuable, improving glycaemic control and reducing risks of hypoglycaemia (low blood sugar) in ambulatory patients with type 1 diabetes and type 2 diabetes,” explains Dr Ghandour. “They assist the healthcare provider to take a closer look on day-to-day glucose levels and micromanage the condition, which provide better diabetes control.
“It is an eye opener for the patient too, as it provides an interactive approach for them to be more in control of their dietary choices and observe their direct impact on blood glucose.”
Dr Jallo echoes the sentiment. “A wide range of innovative glucose monitoring devices, improved sensors and extensive usage of insulin delivery devices like pumps have helped in the management of diabetes and fitted into patients’ lifestyles.
“They have, in many ways, revolutionised how patients manage their diabetes and things are changing quickly in the diabetes care front. There is so much out there, perhaps, making it difficult to navigate. But it’s a positive change.”
And he’s optimistic about the future too. “Pancreas transplant may also gain prominence in the coming years, consequently, helping us find a cure for type 1 diabetes.”
