To eradicate diabetes we need to think outside the box.

Written by Patana Teng-umnuay MD PhD

The prevalence of diabetes is increasing worldwide.

Most experts would blame it to be a lifestyle disease and the result of a "western diet". Truth has it that the risk of developing diabetes is much higher for people who live in urban areas however, its occurrence among the rural population is on the rise now too!

One major cause may be the Over-consumption of fructose, partly responsible for the pathogenesis of the metabolic syndrome and subsequently diabetes.

Another possible cause is the lack of beneficial gut microbiota since several studies reveal a difference in the profile of gut microbiome in obese and type 2 diabetes as compared to normal, non-obese people suggesting the role of gut microbiota and systemic inflammation leading to insulin resistance.

To support this statement, a recent study has shown that a frequent application of antibiotics and antacids in children can lead to obesity and metabolic syndrome in adulthood.

With increasing numbers of diabetes cases globally, we will inevitably see more patients who develop chronic complications related to diabetes. Diabetic care does not only strive to keep a patient's blood sugar levels in check but also to prevent diabetes-related complications.

Some of the complications could be caused by the preventive medication itself.

For example, Sulfonylureas, which falls in the group of glucose-lowering agents, is a commonly used preventive medication that is linked to increased incidences of kidney failure, heart failure, beta cell apoptosis and sudden death.

To avoid such complications, I have advised all of my patients to stop taking Sulfonylurea.

Moreover, high dose statins have been routinely prescribed to diabetes patients disregarding individual cardiovascular risks that can lead to statin-related complications.

If we want to see an improvement in diabetic care, we need to think outside the box and wonder whether the application of certain medication adds to the list of causes that lead to the development of diabetes and diabetes-related complications.