Wishing all of you a Happy & Healthy Holiday Season & New Year
Well, it is that time of year again when we look back and think about what we achieved and what our hopes will be for 2023. Should we make resolutions? If we do, how do we plan to live up to our expectations? I suggest if you are going to make a change, review my blog on Change is a Process. It is important to never think you failed at achieving your goal. Many surprising and unexpected events can lead to barriers and even if you got half way to the point of achievement you still did something good for yourself. This happens to all of us whether we like it or not. Rather, think about your successes and keep those in the back of your mind as you move forward.
Was there one moment in 2022 that you considered this year's highlight? If so, why did it make such a difference to you at this time in your life? Did you do something to make it happen such as measuring your blood glucose more frequently , watching what you eat more closely or did you develop a more positive attitude to your diabetes management? As minor as these things sound, they are important in maintaining diabetes control.
What was new in diabetes management in 2022? Some of the events may be considered such as :
Discussion on the Bionic pancreas considered as next generation technology but remains investigational. This was discussed at the American Diabetes Associations 82nd scientific sessions this year. It falls under the name iLet Bionic Pancreas. It is an automated insulin delivery system which requires very little math by the user. Insulin dose is based on weight and then the device adapts continuously to the patient needs. You can set the glucose target. However, there is no need for carbohydrate (CHO) counting but you do have to announce when you are ready to eat. You only have to ballpark your CHO count and the machine does the rest. Oh how wonderful this would be but no doubt it is still a few years away. Such a device could make managing blood glucose easier and improve the quality of life for type 1 diabetes people.
A new drug (Finerenone) has been approved by Health Canada for use in adults with type 2 diabetes and chronic kidney disease (CKD). It is indicated to reduce the risk of a serious decline in kidney function as well as reduce the risk of heart attack, hospital admission for heart failure as well as dying caused by heart disease.
A class of drugs used previously for lowering blood glucose values, known as the SGLT2 inhibitors, are now being recommended for their ability to slow the progression of kidney disease, reducing heart failure and lowering the risk of kidney failure and death in people with kidney disease and type 2 diabetes. These SGLT2 inhibitors will also help to protect the kidneys of people without diabetes. (eg. dapagliflozin, empagliflozin, etc)
Should remission of diabetes be a goal for type 2 patients has been a question brought to the forefront this year at many diabetes conferences. In fact, the new Canadian guidelines will have a whole chapter dedicated to diabetes remission.
Obesity Canada in 2022 published new Pharmacotherapy guidelines for obesity management. This has been long overdue and it is great to see people have a choice, when indicated, of four medications approved for the Canadian market.
New diabetes terminology and some new names for old terminology were introduced over the past year. Discussion on the importance of A1C versus Time in Range (TIR) has been talked about recently. Keep in mind that TIR is for those using continuous glucose monitoring.
New blood glucose measuring devices and continuous glucose monitoring devices were introduced with the goal of being more precise and convenient to use.
In November the Food and Drug Act (FDA- USA) approved the first drug ever intended to delay the onset of type 1 diabetes in adults and children ages 8 and older. The name of the drug is Teplizumab. These individuals must be considered a high risk based on having a close relative with type 1 diabetes and testing positive for at least two type 1 diabetes autoantibodies (see below) and their blood glucose levels have started to become abnormal (stage 2). In stage 2 of type 1 diabetics, people have a substantial amount of insulin production in their pancreas and they often have no symptoms. Stage 3 is when they have little insulin production, if any at all, leading to the symptoms of diabetes such as fatigue, excess thirst and frequent urination. The drug is an injection and works by blocking part of the immune system, stopping its attack on the insulin-producing beta cells of the pancreas.
I can't thank enough the efforts of Diabetes Canada and The American Diabetes Association along with many European Diabetes Associations who are providing great educational opportunities for patients as well as their caregivers. Diabetes is around every one of us and I have a little story to tell you that happened in the last two weeks. Today I was playing pickeball and a man came up to me asking about my pump, and said his sister-in-law had diabetes, has a pump, but also many complications from the diabetes. He as well was type 2. There are at least six people I have met playing that have diabetes or their spouse has diabetes, a mixture of type 1 & 2. Another case was when I was at an apple (fruit) store buying apples and all 4 customers that were in the store had type 2 diabetes except myself.
According to a google search, over 3 million people living in Canada, or 8.9% of the population have been diagnosed with diabetes and after having adjusted for the aging population, the prevalence is increasing an an average rate of 3.3% per year. (released in Oct 2022). This is compared to another 2019 statistic which was 7.8% aged 12 years and older.
Diabetes is a serious disease and both the health-care providers and their patients must work together to prevent the long term complications of diabetes. But even more important is that we respect each others concerns and recommendations. The goal should be the same for both team players. I believe we all know it isn't easy,
In closing, I want to wish all of you a Happy Holiday Season. May you stay well, enjoy your family and friends. This will be the first time in a couple of years where families might be getting together, so that is in itself a wonderful gift.
Autoantibodies- is an antibody (a type of protein) that is produced by our own immune system that is directed against one or more of the person's own protein. This is why Diabetes is referred to as an autoimmune disease.In Diabetes Canada's newsletter this month, there was an article on a well known blues guitarist /singer-songwriter who was born in New Brunswick. Please check on this link.
Looking forward to seeing you all in 2023.