New Delhi: Are we on the cusp of a diabetes epidemic in India? The answer could be an emphatic yes. If we are not able to manage the sugar problem in youngsters, experts feel India is going to become the hub for diabetes and that day is not too far away. Given that the prevalence of Type 2 diabetes is getting younger; it’s no longer in the 40s but is nowadays prevalent in the 20s and 30s is becoming a serious problem for us. About 25 per cent of those with diabetes onset under 25 have Type 2 diabetes. A majority of India’s population is within this 25 and 35 years age group (around 50% and 60% respectively). If this is not worrisome already, women have also been found to be more susceptible to early-onset Type 2 diabetes. This trend threatens to seriously hamper the country’s economic development, let’s not forget the burden on the medical expense.
Diabetes is not a modern day illness, it has been around for ages. Problems arising out of this health condition is also not something very ‘out of the blue’. The reason why we are still struggling to keep the disease under control is because it is getting younger, thanks to lifestyle choices and the pollution hazard. Also because there has been no noticeable upgrade in treatment for diabetes.
We haven’t graduated from Metformin for T2DM
It’s a first-choice medication to lower blood glucose (sugar) among people with diabetes, and it’s very commonly prescribed. Metformin can also help people lose weight, among other effects. With this type of diabetes, insulin produced by the pancreas is not able to get sugar into the cells of the body where it can work properly. This is where Metformin comes to the rescue. Most doctors still prefer to prescribe this drug for managing T2DM. This is considered as the first-line treatment.
If you are interested in the history of metformin, it goes back hundreds of years. In Europe, the medicinal herb Galega officinalis was popular for digestive health and to treat UTI issues. However, in 1918 a scientist discovered that its ingredients, especially guanidine, could also help lower blood sugar. Since then medicines containing guanidine, such as metformin and phenformin, were developed to treat diabetes. They have existed since then.
But the metformin has been laced with problems of late. Some experts have even commented on how the medicine has a negative impact on Vitamin B levels in the body. The anti-diabetes drug also has serious implications for those who cannot take strong dosage of the medicine. It is due to the side effects and also the advent of insulin that has hampered the growth trajectory of this drug in the market.
However, the changing times call for more efficient ways of managing gestational and T2DM. And Metformin is not the answer to that. But we still find people consuming this drug to manage diabetes. “It is because there is a very skewed disease management system in our country. Our hospital records are all over the place. We don’t have any checks on drugs being sold over the counter… ” says Dr Ambrish Mittal, a popular endocrinologist in India.
FDCs for diabetes – a probable solution or a menace?
So are other drugs better than the age-old Metformin? According to Dr Mittal, Insulin remains the most effective therapy to lower glucose, particularly in comparison to most oral medicines for type 2 (including metformin). Researchers working on drug therapy for T2DM say there are good results shown by other medication such as Rybelsus and even Ozempic, which is being used widely in the west.
“In India, we have a very traditional but safe way to treat diabetes. There are two options to keep your blood sugar in control, via insulin or pills. Most people opt for pills as the first line of treatment and it has worked for us till now. With the advent of new tech, we may look at other options for managing diabetes too,” he reiterated.
There is also talk of drugs which will help to tackle both hypertension and diabetes in the same pill. While trials have come out positive, doctors here have a wait and watch approach. Only question is can we afford to wait any longer to improvise (and better) or line of defence against t2dm?
Experts feel it is the right thing to do and that with a condition like diabetes, the pill is the right way!
Metformin has been the first line of treatment for both gestational as well as T2DM in India. Although the medicine has been around for ages and its side effects are better monitored than other FDCs in the market, some scientists working on diabetes drugs feel the time is right for India to invest in other category of drugs. Maybe it’s time for a prescription overhaul. Health Health News: Latest News from Health Care, Mental Health, Weight Loss, Disease, Nutrition, Healthcare
