Dec. 1, 1999 (Atlanta) -- For people with type 2 diabetes, ignorance is not bliss. According to a study on behalf of the American Association of Diabetes Educators (AADE) in Chicago, two-thirds of diabetes patients don't understand or never heard of one of the illnesses' main causes, and those who don't know have worse control over their disease than those who do know.
There are between 13 million and 14 million people in the U.S. with diabetes. Of those, at least 90% have non-insulin-dependent, or type 2, diabetes. Type 2 diabetes begins in adults over age 40 and is most common after age 55. Nearly half of people with diabetes don't know it because the symptoms, such as fatigue, often develop gradually and are hard to identify at first. But even when they do know, they may not understand what is causing it -- a key factor in treatment.
"I'm not surprised by these results," George Bakris, MD, tells WebMD. "One of the problems we have is an awareness issue. With insulin resistance, it's not as simple as 'know your cholesterol' or 'know your blood sugar.' Insulin resistance is a concept that takes some explanation. One of the messages that comes out of this is that there has to be better education and more time spent with the patient to help them understand what's going on to help them become participants in their care." Bakris is director of Hypertension/Clinical Research Center at Rush Medical College in Chicago.
In people with non-insulin-dependent diabetes, even though the body is releasing insulin, it doesn't lower blood sugar like it's supposed to. This is referred to as insulin resistance and is a major cause of diabetes. In the study, prepared by Yankelovich and Partners, nearly 700 of the more than 1,000 type 2 diabetic patients interviewed by phone had never heard of "insulin resistance." These same people had poorer blood glucose levels than people who did know the term. In people with diabetes, the pancreas either produces little or no insulin -- the hormone that helps glucose get into the body's cells for growth and energy -- or the body's cells do not respond to the insulin that is produced. As a result, glucose builds up in the blood, overflows into the urine, and passes out of the body, causing the body to lose fuel.
"These findings are alarming and demonstrate the critical need for greater education about insulin resistance to help patients keep their diabetes in check," said Christine Tobin, president of AADE, in a prepared statement. "If we can help patients understand the need to directly treat insulin resistance and take appropriate medications early in the disease, we will likely improve their overall diabetes management." The AADE study was funded by SmithKline Beecham Pharmaceuticals, maker of Avandia (rosiglitazone), a drug designed to treat insulin resistance.
Among the medications for treating insulin resistance is a new class of drugs called thiazolidinediones (TZD), or "insulin sensitizers." Instead of trying to make the body produce more insulin, TZDs help make the body more sensitive and responsive to the insulin already available. The AADE study noted that only 13% of patients taking oral medications were using TZDs. Those surveyed who understood insulin resistance were also more likely to be taking these new drugs.
Bakris says type 2 diabetes should not think taking medication alone will solve their illness. He says since most patients are overweight, it's also important to exercise and control their diet. "Patients need to work closely with their doctors to develop an overall strategy," Bakris tells WebMD. "And the doctors need to better educate their patients about overall treatment strategies."
- A study found nearly 70% of patients with type 2 diabetes had never heard of insulin resistance, which is a major cause of the disease.
- A new class of drugs, called thiazolidinediones, helps the body become more sensitive and responsive to insulin that is available, leading to tighter glucose control.
- Those who have never heard of insulin resistance were less likely to have good control of their diabetes or be on the newer medications that could benefit them.