Wednesday, September 24, 2008

Lifestyle Changes Or Drugs?

You've been told by your doctor that your blood sugars are high, not high enough to be diagnosed with diabetes but they're going in that direction.

What should be your primary course of action? Lifestyle changes or drugs?

The conclusion from what HeartWire called "a lively debate" at this month's annual meeting of the European Association for the Study of Diabetes is ... lifestyle changes. 1

Defense for lifestyle changes:
  • Drugs may have no proven benefits as preventative medications.
  • Drugs can have undesirable side-effects.
  • Lifestyle changes, even if stopped, have long-lasting effects.
  • Lifestyle changes are more cost-effective.
  • Lifestyle changes get at the root of type 2 diabetes. ("Not only are they effective at reducing diabetes risk, but they also have "halo effects," including anthropometric, physiological, metabolic, psychological, behavioral, and quality-of-life benefits," claimed Dr. Nick Wareham.)
  • Drugs may discourage people from making lifestyle changes.
Defense for early drug intervention:
  • Effective lifestyle changes are difficult to enact and challenging to upkeep. ("Environmental, cultural, economic, and sociopolitical forces work against lifestyle changes in developed countries," claimed Dr. Paul Zimmet.)
  • Lifestyle changes alone may not be effective for high-risk individuals.
  • There is a lack of evidence from long-term studies on the benefits of specific lifestyle interventions.

1 Lifestyle, Not Drugs, For Preventing Type 2 Diabetes: "Gladiatorial" Debate Concludes, HeartWire, September 11, 2008