According to the CDC, 30.3 million Americans live with diabetes, with global rates nearly quadrupling since 1980. These numbers are staggering. Research continues to unveil new information about the disease as well as finding new solutions to help combat the many different ways people are affected by diabetes.
Comorbid depression and diabetes
A 2017 study revealed that patients with diabetes and depression are at an increased risk for nonadherence to their diabetes treatment if there is a prior history of not following through with diabetes therapies prior to a depression diagnosis or if they experience a change in their treatment plan during follow-up.
Researchers discovered that baseline nonadherence to diabetes treatment was “strongly associated with nonadherence to treatment after a depression diagnosis.” Other factors influencing whether or not a patient maintained treatment included receiving a diabetes prescription from a provider who was not an endocrinologist or internist and the addition of insulin to the patient’s treatment regimen.This new research helps spotlight triggers that may be affecting a patient’s ability to maintain their treatment successfully.
“The factors associated with nonadherence that we identified in this study may help clinicians to detect and pay special attention to patients at higher risk for nonadherence,” said study author Carlotta Lunghi, MSc, PhD, a postdoctoral fellow with the faculty of medicine and health sciences at the Université de Sherbrooke in Quebec. “For instance, patients with previous nonadherence behaviors could benefit from closer follow-up by the clinician so that he/she can quickly notice symptoms of depression and a lack of adherence to antidiabetic treatment.”
New treatment shows benefits for patients with diabetes and breast cancer
Patients with diabetes and breast cancer have been found to have poorer health outcomes than patients with breast cancer who do not have diabetes. However, the latest research shows new hope, finding that people living with diabetes and breast cancer could live longer after treatment with metformin, a drug commonly prescribed for type 2 diabetes. The drug could also improve the outcomes for patients with diabetes and breast cancer who are treated with insulin.
Metformin’s benefits appear to be wide reaching. According to a Diabetes.co.uk story, the drug “has been shown in previous studies to improve health outcomes in people with cancers, and may even block the growth of cancer.”
The study looked at 260 people with diabetes and the human epidermal growth factor receptor 2 (HER2)-positive primary breast cancer who were treated with metformin and 186 who were not, measuring study participants for disease-free survival and overall survival compared to breast cancer patients who did not have diabetes.
The findings are promising, indicating that patients who were treated with metformin received a better prognosis related to their cancer and that the drug may also improve the outcomes for patients with breast cancer and diabetes who are treated with insulin. According to the researchers, “Whereas insulin treatment was associated with a detrimental effect, metformin had a salutary effect in patients with diabetes who had HER2-positive and hormone receptor–positive breast cancer.”
“Stepping Up” model of care enhances insulin initiation in primary care
Compounding evidence of how increased patient support improves diabetes health outcomes, new research published in the BMJ (formerly the British Medical Journal) revealed increased insulin initiation rates in primary care and improved HbA1c, without worsening emotional wellbeing, in patients with type 2 diabetes when implementing the “Stepping Up” model of care.
The “Stepping Up” model enhances and reconfigures the role of primary care practice nurses “in leading insulin initiation and mentoring by a registered nurse with diabetes educator credentials,” reported Clinical Advisor. Results showed that “with appropriate support and redesign of the practice system, insulin initiation can become part of routine diabetes management in primary care,” while eliminating the need to refer to specialist services, which would come “with geographical, cost, and accessibility barriers.”
Advancing diabetes understanding and care
While diabetes remains a complex and multi-faceted disease, especially in the face of comorbidities, continuing research like the examples cited above is vital for improving the lives of those managing diabetes. Furthering our understanding of diabetes and experimenting with new medicines and methods of delivering better care will help us accelerate improved health outcomes for millions of lives.