Doctor checking blood sugar level with glucometer

There is no cure for diabetes, but “game changing” technology and breakthrough medications are altering the treatment of this disease that affects nearly one-third of all older adults.

Every year, 1.5 million Americans are diagnosed with diabetes. Overall, it affects 9 percent of the population and is the seventh-leading cause of death in the United States.

Now, new treatments are eliminating discomforts and making it easier to manage the disease, says Dr. Jessica Castle, an associate professor of medicine who divides her time between treating patients at the Harold Schnitzer Diabetes Health Center and conducting research at OHSU.

A new treatment for Type 1 diabetes allows the user to wear a glucose sensor that inserts a very thin wire into the abdomen tissue that automates insulin delivery.

The wire sends a signal to the insulin pump every five minutes and calculates the required amount of insulin into the body, just as a healthy pancreas would do.

Castle says the sensor is the first of its kind, is available without a prescription and is continually being refined.

For those with Type 2 diabetes, there is a new medication that needs to be taken only once a week, and Castle foresees new medications on the horizon that would only need to be taken once a month.

She says the treatments for Type 2 diabetes have evolved over the years, and multiple breakthroughs have led to better medications. An oral medication, for example, helps control blood sugar and blood pressure, and aids in weight loss. It reduces the risk of dying from heart problems.

“We can help you not only reduce the risk of getting diabetes, but we can reduce the risk of dying from a heart attack,” Castle says. “That is a huge change in diabetes management. Heart attacks and/or stroke are very common causes of death in people with diabetes.”

Diabetes is a chronic condition that affects the way our bodies regulate blood sugar, or glucose. Type 1 diabetes means a person doesn’t produce insulin. Type 2 diabetes means the body doesn’t respond to insulin as well as it should and as the disease progresses, the body often won’t make enough insulin on its own.

Both types can lead to chronically high blood sugar levels, thus increasing the risk of complications that can be serious and life threatening.

Personal management

While diabetes cannot be cured, it can be managed without medications through weight control and healthy lifestyles, combining exercise with good nutrition. However, it requires strong motivation and self-discipline to change long-held habits.

Castle believes up to 56 percent of Americans have pre-diabetes and could avoid Type 2 diabetes by changing their eating habits.

“There is no vacation from chronic conditions,” Castle says. “As a health care provider, we work closely with diabetes educators and behavioral health specialists. People know what they should do but find it hard to change. It’s true for anybody and particularly for chronic conditions. I recommend making a concrete plan for what you want to change. Be very specific, like what, when and where you will make the changes.”

She notes the absence of public service announcements that could influence Americans to change their unhealthy lifestyles. More money should be spent on imaginative ads, like what to buy in the grocery store, instead of the prevalence of drug ads. “Like ‘Sesame Street’ that made it fun to learn your ABCs,” she says.

She’s also concerned about dollar stores moving into non-urban cities. These stores often provide only processed items as food choices.

To combat these external forces, Castle says it’s important to have a strong support system when you’re creating a healthy habits plan.

“We all need support and accountability,” she says. “Checking in with friends, family or a health care team helps when you tell others about your specific goals.”

Castle is encouraged when she sees her patients making healthier choices, like cutting out fast food or drinks.

“One had been drinking a lot of Tropicana orange juice, and stopped with favorable results.,” she says. “My job is to be there for my patients. They are not there for me. I need to align with my patient’s goals, not my goals. We work together.”

She strongly advocates for more physical activity.

“Physical inactivity is another big one,” she says. “People sit and watch TV in the evening but even a small amount of activity could have positive results. Thirty minutes a day can be broken up, so you can do it in two bits. I walk up seven flights every day. I track my activity on my Apple watch. It adds up over time. Parking farther away is another choice.”

Don’t be too hard on yourself if you slip up, she says. “We all stop sometimes, so think about all the times you didn’t stop, not when you did stop. For me, I have to get to the seventh floor where I work, so it was a small choice. I can’t get to the gym during the day, but I have an exercise bike at home. Figure out what’s doable.”

But lifestyle management remains the strongest factor in reversing symptoms

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