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Risks from type 2 diabetes treatments can 'outweigh benefits'

Treatments to reduce blood sugar levels could actually be going more harm than good in many type 2 diabetes patients, research suggests.

Older people over 75 are particularly at risk, according to the new findings published online in the journal JAMA Internal Medicine.

“In many cases, insulin treatment may not do anything to add to the person’s quality life expectancy”

John Yudkin

The study authors are from University College London (UCL), the University of Michigan and the Ann Arbor Veterans Affairs Hospital.

They suggest that for a large number of people the benefits of taking diabetes medications are so small that they are outweighed by the minor harms and risks associated with the treatment.

A total of 3.2 million people in the UK have been diagnosed with type 2 diabetes. More than 250,000 of these inject insulin each year while approximately 850,000 receive the oral diabetes medication metformin.

“In many cases, insulin treatment may not do anything to add to the person’s quality life expectancy,” said study author John Yudkin, emeritus professor of medicine at UCL.

UCL

John Yudkin

“If people feel that insulin therapy reduces their quality of life by anything more than around 3%-4%, this will outweigh any potential benefits gained by treatment in almost anyone with type 2 diabetes over around 50 years old,” he said.

The authors claim that whether patients will benefit from a diabetes treatment or not depends less on their blood sugar level than their age and the hassles and side-effects of the ongoing treatment itself.

They modelled the net gains or losses to quality-of-life associated with treatments to lower blood sugar, using a 20-year analysis of type 2 diabetes treatments involving 5,102 people in the UK as a base source.

“This study highlights the importance of looking at the individual needs of the person with type 2 diabetes, rather than adopting a blanket approach”

Simon O’Neill

Simon O’Neill, Diabetes UK’s director of health intelligence, said: “Sometimes there is a balance to be struck where certain medications might help give someone a longer life but also cause side effects that might negatively impact on quality-of-life.

“This study highlights the importance of looking at the individual needs of the person with type 2 diabetes, rather than adopting a blanket approach,” he said.

It also underlines how vital it is that healthcare professionals and people with diabetes work closely together to jointly decide what the best treatment options are for that person and weighing up the potential benefits and side-effects, which will vary from person-to-person, needs to be at the centre of that discussion,” he added.

Readers' comments (4)

  • Yudkin, author of the famous 'pure, white and deadly' is a person, whos voice should be taken seriously. This guy was a prophet in his studies about glucose and frucyose in the 70ties

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  • Patient centred care and shared decision making. This should not be new. We need it throughout healthcare, to help patients avoid unnecessary side effects or consequences of treatments they do not understand.
    Start with the patient, not the pathway.

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  • RE: Anonymous | 2-Jul-2014 6:28 pm
    The John S. Yudkin, MD who co-authored the article cited is not the same John Yudkin (8 August 1910 – 12 July 1995) who wrote "Pure, White and Deadly"

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  • Daverk

    We should be always tailor made the treatment, and look out for zebras, not horses ie not the obvious

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