Seeing your loved ones suffer day in and day out due to a chronic condition and not being able to do much about it is one of the most difficult emotions to process in life. It becomes even more challenging when they are very old or very young—basically, people who need care and support. Diabetes spares no age group; it affects young and old alike. While type 1 diabetes (earlier called juvenile diabetes) mainly affects children, teens, and young adults, people develop type 2 diabetes later in life. Imagine a family where both kinds of diabetics live under the same roof, and then imagine diabetes medications failing because of various reasons, the ensuing emotions of patients, and the pressure on the caregivers. Despite the advances in medical science, diabetes medicines have been known to fail to effectively manage the disease.
Data on Diabetes
According to the International Diabetes Federation, in 2021, the world had 537 million adults (20–79 years old) suffering from diabetes. This is nearly 10% of the world’s population. The numbers are predicted to reach 643 million people by 2030. Every 3 in 4 adults with diabetes live in low- and middle-income countries. This means that the failure of diabetes medications is a serious cause for concern for a major part of the world. Diabetes caused 6.7 million deaths in 2021—that means 1 death every 5 seconds due to diabetes.
Failure Factors
There are many different types of diabetes medications available, but not all of them are effective for every individual. In some cases, a medication that works well for one person may not work at all for another. Let’s go over the top reasons why diabetes medications fail.
Poor Adherence to the Medication Regimen
The most common reason diabetes medications fail is poor adherence or non-adherence to the medication regimen. People with diabetes must take their medications as prescribed in order to effectively control their blood sugar levels, but some may forget to take them or skip doses because of busy schedules. This can lead to poor control of their blood sugar levels and increase the risk of complications.
In some cases, the prescribed dose of diabetes medication may not be enough to adequately control the sudden increase in a person's blood sugar levels.
Changes in Diet
The individual may be following an unhealthy diet or might not be aware that some foods and medicines can interact. These meals may affect how well the body absorbs the medication and controls your condition.
Changes in Lifestyle
Certain lifestyle choices one makes might contribute to their diabetes or worsen it. Numerous medicines might not be able to repair the body if a person is overweight because of being physically inactive or continues to indulge in smoking and drinking.
Complexity of Diabetes
Another reason that diabetes medications may fail is due to the complexity of the disease itself. Diabetes involves many different factors, including genetics, lifestyle, and other health conditions. This may make it difficult for doctors or healthcare providers to pinpoint the best course of treatment for an individual. Patients in such cases may be prescribed medicines that do not take into consideration the unique underlying causes of their condition.
Increase in Resistance
Like in the case of antibiotics, some medications like insulin may be rendered ineffective over time because our bodies get used to them, which means they become resistant to the medicines. In such cases, higher dosages of the medicines might be required, which would lead to a marked increase in side effects, which again might require different medications to treat. Moreover, as people grow older, their bodies are unable to withstand the effects of higher doses of medicines or a large number of medicines. This makes it difficult to control rising blood sugar levels.
The Vicious Cycle of Other Health Issues
A rise in blood sugar levels leads not only to diabetes but to other severe health conditions as well. Too much glucose in the bloodstream can damage blood vessels that supply blood to vital organs, which may ultimately lead to multiple organ damage. The heart, kidneys, and eyes might be affected. Plus, the nerves might also be affected. Thus, diabetes patients might need medicines to cope with these other health conditions, which might lead to increased blood sugar levels all over again. This never-ending loop makes it difficult to control diabetes.
Very High Cost of Medicines
The cost of diabetes is a significant barrier, as most people cannot afford it. Former Chief Justice of India, NV Ramana, who himself is a diabetic, said in a symposium in November 2021 that more government support and subsidies are needed for diabetes medicines. The cost of getting treated for this life-long disease is beyond the reach of most patients. This can make it difficult for patients to afford the medications they need to effectively control their blood glucose levels, leading to poor adherence and an increased risk of complications.
What can be Done?
It’s not all doom and gloom out there. Even though most diabetes medicines fail, certain steps can be taken to rectify the situation.
A Holistic Health Outlook is Required
India is both the most populated country and the diabetes capital of the world. This means Indian healthcare providers have a huge task on their hands if they want to tackle the disease. India’s COVID management experience has shown that large-scale health crises can be effectively managed. Healthcare providers need to take a more patient-centered approach when it comes to diabetes and see their condition in totality, including their medical history, lifestyle, and other existing health conditions. Moreover, doctors should develop a treatment plan that is uncomplicated and easy to follow and that also takes the patient’s financial abilities into account.
Focus on Alternative Approaches
While medicines are crucial to improving health in certain health conditions, alternative approaches should also be looked into. After all, prevention is better than cure. Incorporating supplements like magnesium and alpha-lipoic acid may help improve insulin sensitivity and blood glucose control. Lifestyle changes such as exercise, healthy eating, and weight management can all have a positive impact on blood glucose levels and overall health.
Mental Health Support
Diabetes is a lifelong condition and becomes psychologically burdensome in the long run. This is because there is a constant need to control and regulate the different factors that might make blood sugar levels shoot up. People with diabetes have been found to be more prone to depression than people without diabetes. Thus, a system for providing mental health support to diabetes patients and their caregivers needs to be developed on a large scale, especially in India.
Conclusion
There are several reasons why diabetes medications may fail, but a holistic treatment approach can help increase the efficacy of these medicines in most cases; in fact, diabetes reversal may also be possible in certain cases. Both the patient and the doctor need to work in tandem and communicate well, while government agencies need to be heavily involved too. The whole world needs to come together to fight diabetes.
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