Whilst lifestyle changes are the cornerstone of diabetes treatment, pharmacological therapies are usually required, not just for glycaemic control but also for cardiovascular risk management. Although therapies are launched following evidence that they show benefit to a particular facet of diabetes management (often marginal), their use in the real world often throws up major issues. These have included the impact of thiazolidendiones on CV risk, bladder malignancy and fractures, the impact of drugs acting on the GLP-1 pathway and pancreatitis and the potential link between insulin glargine and cancer (eventually dispelled). These post marketing complications only serve to cause concern to both patients and clinicians.
Archives for June 2013
Despite advances in insulin technology and the development of different regimens including multiple daily injections (MDI), there still remain a group of patients with Type 1 diabetes who pose significant management problems. Problems include erratic blood glucose readings, unpredictable and debilitating hypoglycaemia and issues with injection sites. For this group of patients, an insulin pump is an option.