The best diabetes medication is the one a person chooses.
That’s the conclusion of a new study published today in the journal Nature Medicine.
It’s the first research of its kind to examine what happens when people with type 2 diabetes choose their own medication.
The study, led by researchers at the University of Exeter in England, involved 448 people with type 2 diabetes who tried three common diabetes medications, taking each medication for a 16-week period.
The study was double-blinded, meaning that neither the study participants nor the researchers knew which medications were being taken at a given time until the end of the study.
The medications were sitagliptin (Januvia), canagliflozin (Invokana), and pioglitazone (Actos).
Researchers looked at the drugs’ effectiveness on blood glucose levels (blood sugar) and weight as well as their side effects
After the participants had tried all three medications, they were given the option to decide which medication they preferred.
“Interestingly, we found that the treatment people chose was usually the one which gave them best blood sugar control – even before they knew those results,” said Beverley Shields, Ph.D., the lead study author and a senior lecturer in medical statistics at Exeter, in a press release.
Dr. Ishita Prakash Patel, an endocrinologist at Texas Diabetes and Endocrinology told Healthline she appreciates the fact that this study was likely envisioned due to the increasing difficulty to access medical care, but she added the conclusions could have serious implications in the real world.
“A medical plan such as the one outlined in the study could be very dangerous to patients and their health outcomes,” she said.
“The medications mentioned… and most medications, in general, are prescribed by a licensed physician or mid-level after considering many different factors regarding a patient’s medical history. It’s not only how the patient is feeling subjectively,” Patel said.
Colette Heimowitz, MSc, the vice president of nutrition and education at Atkins, sees it differently.
Heimowitz told Healthline she thinks the study’s suggestions are a great approach, especially when you empower a person to be an active participant in their own health outcomes.
“One size does not fit all and this protocol allows for individual adjustments for a more personalized approach,” said Heimowitz.
“Making this a lasting lifestyle change can seem like a daunting challenge, without the proper level of support and guidance,” she added. “The medical practices here in the U.S. are challenged with busy schedules and most doctors do not always have the time for much back-and-forth since private practice must support itself financially.”
“It could work if the follow-ups are with physician assistants or nurses,” Heimowitz said.
Patel says a setup like the one suggested by researchers would be irresponsible in practice and potentially lead to adverse outcomes.
She adds that it’s of utmost importance that a physician is monitoring a trial of any medication.
Patel notes that how you feel while taking a medication is not the only factor to consider.
“Some medications can cause side effects, which may affect the heart, kidneys, and other organ systems, and these symptoms may not be apparent to the patient from the way they are feeling,” she explained.
“There are also many medications that make patients ‘feel better’ but are not the right option, whether due to interactions they may have with other medications or other factors,” she added.
Patel says we need to create better ways for people to access their physicians with questions or concerns.
“And we certainly need physicians and medical professionals, who have decades of training and expertise, to be the ones guiding care,” she stressed.
Heimowitz suggests that people incorporate nutrition into their diabetes treatment plans. They can use recommendations from the American Diabetes Association (ADA) as a guide.
“Although chronic diseases are multi-factorial, we know diet is a major and modifiable risk factor associated with many chronic diseases like diabetes,” she said.
Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.
Current Version
Dec 7, 2022
Written By
Michelle Pugle
Edited By
David Mills
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