I am searching for information on how patients with Type 2 diabetes
manage their illness. Traditionally patients mmanage diabetes by the
following ways:
Diet/exercise:
Oral medications only:
Insulin only:
Combination (oral and insulin together):
I am trying to figure out what percentage of Type 2 patients are in
each "bucket" - can you help me with this?
I think this information might be available through NHANES data. I
haven't found it there however. I'm just looking for estimates.
Hello again Alabama9,
My search returned the following results on information on how
patients with Type 2 diabetes manage their illness.
Special Supplement to Managed Care
TREATMENT AND MANAGEMENT OF TYPE 2 DIABETES
Volume 9, No. 8
August 2000
Present level of diabetes care
“Among 10.2 million patients with diagnosed diabetes, a minority are
on diet and exercise alone, and the majority are on pharmacologic
treatment, which is growing substantially.”
Monotherapy 3.6 Million
Non-insulin combination therapy 1.7 Million
Insulin combination therapy, 0.5 Million
Insulin alone 1.0 Million
“Monotherapy is used by about 3.6 million patients; non-insulin
combination therapy, 1.7 million; insulin combination therapy, 0.5
million; and insulinalone, 1 million. Despite this use of
pharmacotherapy, the present level of care is suboptimal, if not
inadequate, for many patients.”
Source:
This MANAGED CARE special supplement, “Treatment and Management
of Type 2 Diabetes,” is based on information presented at “Management
of Type 2 Diabetes in a Managed Care Environment,” a meeting held in
New York on May 13, 2000. This meeting was moderated by Lawrence
Blonde, M.D., vice chairman of the Department of Medicine at Ochsner
Clinic, New Orleans, and who served as faculty editor of this
publication.
http://www.managedcaremag.com/supplements/0008_typetwo_suppl/0008.typetwo.pdf
===================================================
According to the National Diabetes Information Clearinghouse:
Type 1 diabetes may account for 5 percent to 10 percent of all
diagnosed cases of diabetes.
Type 2 diabetes may account for about 90 to 95 percent of all
diagnosed cases of diabetes.
http://diabetes.niddk.nih.gov/dm/pubs/statistics/index.htm#1
===================================================
Diabetes Prevention Program study (DPP)
"Currently only 15 percent of people with type 2 diabetes are
controlled with diet and exercise alone. The main reason for this is
that they are too far advanced in their natural history and multiple
drugs/insulin are needed to control the diabetes, which is also not
easy."
Source: ABC News
http://abcnews.go.com/sections/living/DailyNews/OnCall_diabetesq&a020206.html
===================================================
“For persons with Type II diabetes, the basics of treatment are diet
control, weight reduction, and exercise. Weight reduction appears to
partially reverse the body's inability to use insulin. A person whose
blood sugar level remains high may also require insulin injections. An
oral sugar-lowering agent may be prescribed for persons who do not
require insulin to control diabetes as well as for people who have
trouble injecting themselves or whose diabetes is not controlled by
insulin.”
- 40 percent of individuals with Type II diabetes require insulin
- 49 percent take oral agents
- 10 percent use diet and exercise alone
“Moderate exercise, even ten minutes a day, helps people with Type II
diabetes maintain a constant level of glucose in the blood and lose
weight. This in turn may decrease the amount of medication required.”
Contributed By: Frank Vinicor, B.A., M.D., M.P.H.
Director, Diabetes Translation, National Center for Chronic Disease
Prevention and Health Promotion, Centers for Disease Control and
Prevention. Director, Collaborating Center on Diabetes Mellitus, World
Health Organization (WHO). Clinical Associate Professor of Medicine,
School of Medicine, Emory University.
http://westernskiesdialysis.com/education/diabetes.html
===================================================
Veteran's Health Administration Survey, 1994
Diabetes Mellitus, Type 2
11.8% (139,646) of VA "Unique Patients" Diabetic
52% treated with oral agents alone
39% treated with insulin alone
8% treated with both insulin and oral agents
Source: UPCMD
http://www.upcmd.com/dot/examples/00005/disease_data.html
===================================================
A Review of Current Treatment Options for Type 2 Diabetes Mellitus
By Ariane An, PharmD, and Edward Deng,
“For more than 90% of the type 2 diabetic population, diet and
exercise alone cannot provide adequate control of serum glucose
levels.”
(..)
“In the United Kingdom Prospective Diabetes Study, about 95% of new
diabetic cases failed to control FPG and HbA1c with 3 months of
dietary management.”
(..)
“When a typical 3- to 6-month trial of diet and exercise is
ineffective, pharmacologic therapy must be initiated to assist
glycemic goals.”
Source: Pharmacy Times
http://secure.pharmacytimes.com/lessons/html/Diabetes_CE.htm
===================================================
Goldman Sachs – Twenty Fourth Annual Global Healthcare Conference
June 2003
On Page 8 of this presentation there is a graph illustrating Type 2
diabetes treatment slope.
Diet and Exercise Alone
Oral Therapy 66%
Oral/Insulin 7%
Insulin Therapy 27%
http://www.novonordisk.com/images/investors/investor_presentations/2003/LRS_Goldman%2011-06-2003_.ppt
===================================================
From the study: "Meeting ADA guidelines in endocrinologist practice."
Diabetes Care 23, pp. 444-448.Miller, C.D., Phillips, L.S., Tate,
M.K., and others. (2000, April).
“Only 38 percent used oral medications alone, and 54 percent of these
used two or more medications. 31% percent used oral medications and
insulin, and 26 percent used insulin alone;”
Source: The Agency for Healthcare Research
http://www.ahcpr.gov/research/may00/0500RA5.htm
===================================================
As many as 25 percent of people with Type 2 diabetes say that they
would refuse to take insulin injections even if their doctor
prescribed them, new study findings suggest.
According to Dr. William Polonsky:
"More than one quarter of patients with Type 2 diabetes not on insulin
said there would be no way they would be willing to take insulin if
their doctor prescribed it."
Source: Lifescan News
http://www.lifescan.com/care/news/dn061603-5.html
===================================================
“Many type 2 diabetics can control their condition with diet and
exercise alone for years.”
“If they cannot, then medication is introduced. Most often a single
oral agent that stimulates or preserves any residual insulin is the
first choice.
Some patients may be able to control their glucose levels with a
single drug.
One study reported, however, that after three years, half of the
patients needed more than one agent, and at nine years, only 25% could
remain on a single drug. In fact, according to a 1999 survey, 90% of
diabetes specialists reported that they prescribed three or more
medications for their patients.”
(..)
“For some people who cannot control their diabetes with diet or oral
medicine, combinations of insulin and other oral medicine are proving
to be very effective. Insulin may also be a temporary option, such as
during pregnancy. Eventually, however, the disease deteriorates in
many people with type 2 diabetes and full insulin replacement is
required.”
Source: Health and Age
http://www.healthandage.com/html/well_connected/pdf/doc60.pdf
============================================
Additional Information That May Interest You
============================================
Statistics from Ireland
Many people with type 2 diabetes are not following diet and exercise
recommendations to manage their illness, according to a new national
survey.
Instead, the research shows that people with type 2 diabetes are
relying heavily on oral medication in treating the illness.
Of those surveyed 70 percent do not incorporate exercise into the
management of their condition and 39 percent report that they do not
follow specific dietary recommendations.
Source: Irish Health Headlines
http://www.vhihealthe.com/news/n280401a.html
Search Criteria:
Diabetes "diet and exercise alone" "Insulin alone” million
Type 2 diabetes patients manage illness percent OR %
Diabetes type 2 treatments
I hope the above information helps you in your research. If anything
is unclear or if a link does not function, please let me know and I’ll
be glad to offer further assistance.
Best Regards,
Bobbie7-ga Effexor and neuropathy::
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Diabetes management - Type 2 patients