Insulin resistance needs to be addressed in diabetes

Medical experts have identified insulin resistance as a key factor which contributes to the development of complications in diabetes.

Diabetes is a chronic, progressive disease associated with high levels of glucose in the bloodstream (hyperglycemia). Diabetes mellitus, the most common type of diabetes, is characterized by beta-cell dysfunction where the pancreas is unable to produce adequate insulin. Insulin resistance also develops, which is a condition wherein the body fails to respond to the circulating insulin effectively.

To compensate for insulin resistance, the pancreas produces more insulin in order to keep blood sugar levels under control.

Eventually, the pancreatic beta-cells tire out and can no longer function properly. This will now cause long-term complications such as damage to the blood vessels and nerve cells, blindness, kidney failure and heart disease.

For some people with type 2 diabetes, diet, exercise and weight reduction alone may work initially, but eventually this regimen does not help control high blood sugar levels.

In these cases, oral medication may be prescribed. Most anti-diabetic agents target only one of the several underlying causes of diabetes.

The complementary actions of the anti-diabetic agents’ metformin and rosiglitazone may maintain optimal blood sugar level control and alleviate insulin resistance in patients with type 2 diabetes. Therefore, their combined use may be indicated for patients whose diabetes is poorly controlled by metformin alone.

According to the United Kingdom Prospective Diabetes Study (UKPDS) published in Lancet, approximately half of patients on monotherapy with metformin or sulphonylurea will require multiple drugs to control the disease within three years.

In another trial which studied 348 patients who had inadequate glucose control on metformin monotherapy for six months, results showed that 28 percent of patients receiving a combination of rosiglitazone and metformin reached the target level compared to eight percent of patients on the near maximum dose of metformin alone.

"There is now mounting evidence confirming that to reach blood sugar levels recommended by experts, many people with type 2 diabetes will need to take combination of therapies with distinct mechanisms of action to attack the disease in different ways," said Dr. Stefano del Prato, professor of endocrinology and metabolism at the School of Medicine, University of Pisa, Italy.

He added that the combination of rosiglitazone maleate and metformin provides two different yet complimentary mechanisms of action. Rosiglitazone maleate targets insulin resistance, while metformin reduces the amount of blood sugar produced by the liver.

The combination of rosiglitazone and metformin in one convenient pill is now available in the Philippines as a product licensed by GlaxoSmithKline, one of the world’s largest research-based pharmaceutical companies.

Patients with type 2 diabetes should consult their doctors to learn more about these new treatments.