A colleague of mine, whom I respect very much, for his humanitarian approach to Diabetes Care among Native American Indians, forwarded this to me:
See attached original article from Diabetes Care, January 2010 issue.
More than 96% of individuals with both IFG and IGT are likely to meet ADA consensus criteria for consideration of metformin.
Because >28% of all those with IFG met the criteria, providers should perform oral glucose tolerance tests to find concomitant IGT in all patients with IFG.
To the extent that our findings are representative of the U.S. population, ~1 in 12 adults has a combination of pre-diabetes and risk factors that may justify consideration of metformin treatment for diabetes prevention.
I wrote to him without delay.
my reaction to this article is pure NAUSEA.. let us keep my reaction to ourselves.. if someone asks about this article we have to have an intelligent discourse . i have embarked on a peer to peer education programme in the Indian country, would send you more details, in which already people who have had diabetes for more than 15 years have come off therapy. Based on articles published, we are too eager to put patients on therapy instead of talking to them and the providers keep on adding medications, such that within a couple of years, a patient with Diabetes in America, ends up with up to five different medications.
As you can see so much bad press about sulfonylureas and there are no drug companies to defend the poor drug, but Actos or Byetta you would see them mounting a multimillion dollar challenge to the published findings.
if we are to follow the published findings
sulfonylurea causes CHF
lantus breast cancer
we are left with Metformin, old fashioned Regular and NPH insulin..
I was happy to receive his reply by return email.
So strange how you read my thoughts – I am obliged to pass along noteworthy findings that come from the medical establishment (such as this one),
but in my heart I feel that we cannot “cure” unhealthy lifestyle, poor personal choices, or the malnutrition of poverty WITH A PILL. The answer is not a drug. Natives in America will never accept this as a solution.
The real answers lie in personal change – education, motivation, and dedication between the patient/client and the health team of the clinic and community.
How we accomplish this paradigm shift in our culture, I do not really know.
Perhaps there will be a cardiovascular crisis in our children and youth – I do not wish to witness such a thing!
Is it true that the King of Tonga once decreed a national initiative for his entire kingdom; all of his people to live healthy, lose weight and eat right?
Maybe one day the leaders of the world can really lead, such as this.
Keep the faith, my friend.
It is nice to know that people like my friend are on the side of the Native Americans.. So many hundreds of providers, without analyzing the situation would begin to prescribe medications to a problem which is strictly SOCIAL..
News about King of Tonga:
King of Tonga
Earlier this year, King George V decided to use his patronage for a major initiative to tackle diabetes in Tonga and other Pacific nations where it has become a serious and debilitating problem.
"Tonga and the Pacific have one of the highest rates of diabetes per capita and my vision is to have a centre of excellence in research and treatment of this totally preventable disease." - His Majesty King George V.
Suffering from Type II diabetes himself, His Majesty is somewhat of an expert on the disease. To mark his recent coronation, he has formed a charity, the Royal Endocrinology Society, to help treat and research diabetes. His Majesty said of the disease, “If not properly managed, it can completely and painfully break the health, and lead to the death of its victims. It hurts their families, already puts a strain on overstretched medical services, and has a negative economic effect.”