Diabetics may Need More Than Diet

People with type 2 diabetes who try to control the condition with diet alone may not be receiving all the health services they need.

That’s the key finding from a new study out of England that compared health services provided to diabetics on medication with those provided to diabetics not on medication. The study involved nearly 7,700 diabetic patients being treated in various locations throughout the country. About a third attempted to manage the condition with diet alone.

Researchers found people trying to manage their diabetes through diet alone were more likely to have high blood pressure, but less likely to be on medication for high blood pressure. They were also more likely to have high cholesterol, but less likely to be on cholesterol-lowering drugs. While the diet-alone patients had fewer complications from their diabetes than those on medication (68 percent vs. 80 percent), they still experienced more complications than people in the general public.

Also interesting, say the authors, was the wide variation found among different practice locations in the study. In some health practices, as few as 15 percent of patients were on diet alone, while in others as many as 75 percent were trying to control their diabetes without medication.

Study author Julia Hippisley-Cox, M.D., notes while some people with type 2 diabetes are able to manage the condition with diet alone, these results suggest many are going without necessary care. She writes, “Although some individuals with type 2 diabetes might be effectively managed by diet only, there is a case for better routine surveillance … and for greater consistency of clinical practice concerning the decision to start medication.

SOURCE: The Lancet, 2004;364:423-428