The first measure to reduce the risk of developing this disease is to follow healthy lifestyles. Professor Garattini’s advice
Using medications correctly, taking them only when necessary and at the dose indicated by your doctor, is essential to preserving your health. When non-pharmacological prevention of type 2 diabetes (that typical of adults) is not enough, you can rely on medicines that help lower the chances of this disease developing. On the other hand, however, it is also important to know that there are drugs that, on the contrary, can favor it.
World Diabetes Day: causes and risk factors
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Diabetes, whose World Day is celebrated today, is characterized byhyperglycemia, i.e. excessive concentration of glucose in the blood. The basis of hyperglycemia in type 2 diabetes is a reduced production of insulin (the hormone that regulates blood glucose levels) by the pancreas and/or resistance to the action of this hormone, particularly in the liver, adipose tissue and muscles. Currently, there are many people with this disease who follow drug therapy. In reality, that would be enough simple changes in habits to avoid its development. The risk factors for type 2 diabetes are in fact the overweightthe sedentary lifestylethe poor physical activity and some socioeconomic aspects (poor education, which often also determines income, family education, life in the suburbs).
“These factors intersect, as low-income individuals are those who are more likely to follow unhealthy lifestyles and, in particular, to consume very high-calorie foods, to be reluctant to exercise and to pay little attention to health” observes the Professor Silvio Garattiniresearcher, pharmacologist, founder and president of the Mario Negri Institute in Milan and author, in collaboration with Lidia Staszewsky, of Type 2 Diabetes – An Avoidable Disease (Lswr Editions). Since these risk factors are modifiable, as demonstrated by various scientific studies, type 2 diabetes can be prevented by changing lifestyles.
Drugs to prevent diabetes
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When changing habits does not give the desired results or if it is not possible to change lifestyles, as in high-risk individuals, you can try to prevent type 2 diabetes with pharmacological treatment. Indeed, numerous scientific research published over the last twenty years shows that using some hypoglycemic drugs it is possible to lower the risk of developing this disease. In particular, theacarbose and the metformin they increase peripheral sensitivity to insulin, thus decreasing the amount of glucose present in the blood. Specifically, acarbose acts on glucose coming from the gastrointestinal tract and metformin on glucose coming from the liver. Furthermore, the nateglinide stimulates the production of insulin by beta-cells, one of the first deficits in the natural history of diabetes, while i thiazolidinediones reduce the impact of excess fat on insulin sensitivity. Finally, the three most recent classes of antidiabetics are DPP4-i (dipeptidyl peptidase IV inhibitors), GLP-1a (GLP-1 agonists), and SGLT-2i (glyphozines). “The effects of pharmacological approaches on the prevention of type 2 diabetes appear limited in time and not continue after discontinuation of therapy. On the contrary, changes in lifestyle lead to more long-lasting positive effects” underlines Professor Garattini.
What are the drugs that promote Type 2 diabetes?
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However, there are also some drugs that can cause or worsen hyperglycemia. Recently, the World Health Organization and the American Diabetology Association coined the expression “drug-induced diabetes” to indicate this condition. These also include some that are widely used, such as cortisone, often used for their anti-inflammatory action. It also appears that i estrogen-based oral contraceptives promote insulin resistance and reduced glucose tolerance, while hormone replacement therapy with estrogen for menopausal women does not appear to show these effects. In the end tacrolimus And sirolimus, immunosuppressive drugs used after a kidney transplant, favor type 2 diabetes or alterations in blood sugar levels. “The management of hyperglycemia and drug-induced diabetes after transplantation must include, if the risk of diabetes is high, an individualized selection of the immunosuppressant based on the immunological risk and the early blood glucose surveillance and, if necessary, the start of a standard anti-diabetic treatment” specifies Professor Garattini. Ultimately, especially drugs that promote type 2 diabetes should be used only if strictly necessary.
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